Dr. Milagros M.

Viacrucis
Honorary Consultant
Davao Blood Center
 Core topics
Purpose of blood donor screening
Categories of blood donors
Qualifications for a suitable donor
 DHQ
 Brief PE
 Hemoglobin determination
Dedicated Donor
Apheresis Donor

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 Purpose of BDonor Selection
Determine whether the potential donor is
in good health
 ensures that the donor is protected against
damage to his/her own health
 the recipient is protected against the transmission
of disease, or the administration of blood products
that could be detrimental to the recipient
only persons in normal health with a good
medical history should be accepted as donors of
whole blood or a component of blood for
therapeutic use
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 Risk of Being Infected
Sexual Intercourse
 Male to Male = 1:100
 Male to Female = 1:300
 Female to Male = 1:500
Vertical
 Before/during labor = 1:4
 Breastfeeding = 1:10

Direct
 Needle stick injury = 1:300 (0.3%)
 Needle sharing = 1:100
 Blood transfusion = 1:1 (100%)
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 Window Period
EIA Testing System
HBV : 59 days
HCV : 82 days
HIV-1 : 21 days

Immune reaction

Serological positive

Infection Time
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 Window Period
EIA + NAT Test Sys HBV : 34 days HBV : 59 days
HCV : 23 days HCV : 82 days
HIV-1 : 11 days HIV-1 : 21 days

NAT positive

Immune reaction

Serological positive

Virus
Infection Time
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 Categories of donors
Donations are considered within the following
categories:
 Whole blood donation
 Donation by apheresis
 Directed donations
There is no evidence that directed donations lead
to improved patient care nor that they reduce the
risk of acquiring transfusion-transmitted
infections.

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 Informed consent to donate
legal and ethical requirement
protects a person’s freedom of choice and respects
the person’s autonomy
implies one’s willingness to donate blood
 given by a mentally competent person
 who has received the necessary information
 who has adequately understood the information
 who, after considering the information, has arrived at a
decision without having been subjected to coercion,
undue influence, or intimidation

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 Informed consent to donate
The donor should have an opportunity to ask
questions
The donor has the option to withdraw from giving
blood without being exposed to undue
embarrassment

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 Privacy and Confidentiality
Handling of all donor and donation records should
be in accordance with the principle of respect for
person
Interview in a place where there is audio privacy
All personal information including the results of
tests must be kept confidential
 DHQ, record of results of test and all other donor’s
record including electronic data bank must be kept
confidential

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 Confidentiality
If the donor consents, significantly abnormal findings
during physical examination and blood testing will be
communicated to the company physician or
city/municipal health officer
The blood centers are using screening tests and
NOT confirmatory/definitive tests
 there are false positive and false negative results
 purpose of testing: blood safety not diagnosis

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 Responsibility of BSF to gift of life
BSF assumes stewardship of the donated gift and
undertakes to manage the gift in a responsible
manner and to protect the gift status at all times.
 Optimize the use of the gift
 Component preparation – more than 1 patient can
make use of the gift
 Prevent wastage due to outdating
 In the BSF
 In the hospitals

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 Frequency of Donation
Frequency of Donation
It is the Philippine National Blood Services’ policy
that donors of whole blood may normally donate
every twelve weeks.
Medical officer on an individual basis may modify the
frequency of donation.
 Females (15-44yrs old) – not more than 2x in
one year
Careful consideration of weight, dietary habits

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 Blood Donor’s – Body Weight (1)

More than 50 kilos

No more than 10.5ml/kg body weight should be
taken as whole blood during one blood donation
Standard donation: 430 ml + 10% (387 ml to 473 ml)
exclusive of anticoagulants. [450 ml to 536 including
anticoagulant]
Ideal ratio of anticoagulant: blood = 1:7
Underfilled - Whole blood units less than 450 ml shall
not be processed (more anticoagulant vs blood)
Overfilled Whole blood units greater than 536/540 shall
not be processed (lesser anticoagulant vs blood)
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 Blood Donor’s – Body Weight (2)

Volume of Donation
If volume of blood unit is:
 Underfilled/Incomplete: <450 ml including anti-
coagulant, DISCARD
 Overfilled = >536 or 540 ml including anticoagulant,
DISCARD [deficient in anticoagulant]

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 Blood Donor’s - Age
16 – 17 years old with written parental consent
18 - 65 years old
New donors between the ages of 16 – 60 years
(before 61st birthday)
Repeat donors: between the ages 16 – 65 years

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 Blood Donor’s - Occupation
At least 12-24 hours interval between donation
and returning to the occupation or hobby.
 - piloting an aircraft
 - bus or train driving
 - operating crane and similar heavy equipment
 - climbing of ladders or scaffolding or coconut
tree
 - gliding
 - climbing
 - diving

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 Female Blood Donor
Pregnant women should not be accepted
Deferral period is 12 months from date of delivery
Female blood donor who breastfed is deferred for
a minimum of three months after weaning.

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 Donor Medical History (1)

Donor Medical History

 evaluated using the DHQ
 donor accepted, by a qualified medical officer
 should have the final decision

DHQ and donor declaration must be completed and

signed by the donor on the same day as donation
Interviewer signs the box to certify that the donor has
read the Blood Safety Information Kit and that
relevant questions have been asked on same day
Medical Evaluation Officer signs on same day

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 Donor Medical History (2)

A-Z Guide to Assessment of Blood Donors –

provides guidance concerning criteria for acceptance
or deferral
 Deferral list for conditions
 Medication deferral list
 Vaccination deferral list
When in doubt about the suitability of the donor,
DEFER
When in doubt about the quality of the blood unit,
DISCARD

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 Donor Medical History (3)

The DHQ defines the audit trail of donation clearly

linking the donor to the donation
DHQ shall include an option for confidential unit
exclusion (CUE)
DHQs should be kept for at least 10 years
 ideally for the lifetime of the donor
 should include donation # and donor ID #

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 Confidential Unit Exclusion (CUE)

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 Brief Physical Examination
Donor Appearance
Donor appears healthy
 Conjunctivae and skin not pale
 Conjunctivae and skin not yellowish
Skin at the potential venepuncture sites should be
free of lesions.
Inspect arms for needle marks
BP and Pulse Rate
BP = 60/90 – 160/100
Pulse rate = 60 – 100 per minute, regular
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 Brief Physical Examination
Heart and Lungs
Heart
 Heart rate = 60 – 100 beats per minute, regular in
rhythm
 No murmurs
Lungs - normal
 Conjunctivae and skin not pale
 Conjunctivae and skin not yellowish

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 Hemoglobin
Maximum values:
➢ Female donors: 175g/l
➢ Male donors: 185g/l
Minimum values:
➢ Female donors: 125g/l
➢ Male donors: 135g/l

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 Dedicated Donors
Persons who require repeated transfusions (like
patients with thalassemia) are encouraged to
have a pool of dedicated donors.
Dedicated donors minimize antigen exposure and
antibody reactions, delay refractoriness, and
prolong efficacy of blood products.
discretion of a Transfusion Medicine Specialist

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 Apheresis Donors
To be an apheresis donor, one has to be a whole
blood donor first
Apheresis is a procedure used to collect:
 Plasma (plasmapheresis) or
 Cellular components (cytopheresis) which include:
▪ Red cells
▪ Platelets (plateletpheresis)
▪ Granulocytes (granulocytopheresis)
▪ Hemopoeitic progenitor cells derived from peripheral
blood

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 Key points
Suitable donor – VNRBD who is healthy and has no
risky behavior associated with transfusion
transmissible infections and qualifies with
requirements for weight and hemoglobin
Respect for person requires informed consent
Informed consent is both a legal and ethical
requirement
Pre-donation information, education and counseling is
necessary to enable the blood donor to provide an
informed consent
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