Donor selection
Allogeneic Donor Selection
• Two goals of screening
– Protect the health of the potential donor.
– Protect the health of the potential recipient.
• Therefore, two major questions should be answered in the
process of donor selection:
1. Will a donation of approximately 450ml of whole blood at this
time be harmful to the donor?
2. Could blood drawn from this donor at this time potentially
transmit a disease to the recipient?
• The following information should be Known for each donor:
– Consent to donate (Blood Donor Educational Materials, MAKING
YOUR BLOOD DONATION SAFE).
– Donor’s name (full name).
– Donor’s address and phone number.
– Gender ( if female ask about pregnancy).
– Date of birth and age (at least 17 years of age), no upper age limit
for blood donors. Any individual who is in a good health and meet
all the requirements may donate.
– Donor occupation (police, pilots, fire fighter ,heavy machinery
operator) need to be informed and cautioned concerning safe
return to full range of job activities.
– Time of last meal: it is better a donor not be fasting at the time of
donation (not more than 4hrs).
– Date of last donation.
Medical History
• Medical History based on a standardized questionnaire obtains
critical information about the donor’s health and risk factors which
may make it unsafe for donation.
• Are you feeling healthy and well today? Donors should appear to be
in good health without obvious signs or symptoms of colds, flu, or
other illness.
• Any donor returning to risky occupations such as police officers,
firefighters, pilots, bus, or train drivers, heavy machine operator,
mining, etc... needs to be informed and cautioned concerning safe
return to their full range of job activities.
1. Cardiovascular disease, including hypertension.
Active pulmonary tuberculosis.
3. Gastrointestinal disorders with impaired absorption.
4. Chronic renal disease.
• are permanently deferred.
(defer indefinitely)
I. History of viral hepatitis.
II. A confirmed positive test result for Hepatitis B surface antigen
(HBsAg) (Currently has or previously exposed).
III. More than one reactive test result for hepatitis B core antibody
(anti-HBc).
IV. Presents with an elevated alanine aminotransferase (ALT) level,
more than twice the highest acceptable level on any one occasion
or above the acceptable high level on two occasions.
V. Has present or past evidence (either clinical or laboratory) of
hepatitis C infection.
6. Defer 12 months for:
• Hepatitis B or C virus in family or close contact.
• Persons who have received Hepatitis B immunoglobulin (HBIG)
must wait for 12 months to be sure they were not infected.
• Accidental needle stick injury.
Donor deferral/exclusion
• Donors had a positive test for AIDS (HIV) or AIDS antibody or antigen,
should be permanently deferred (Indefinite deferral).
• Those at risk of HIV through lifestyle (sexual practices, tattooing, abuse of
self-injected drugs) should not donate blood permanently deferred.
• Donors’ arms should be checked for evidence of scars or punctures
indicating addiction to self-injected drugs or for presence of any skin
lesions in the venipuncture site should be indefinitely deferred.
• Defer 12 months if health care worker exposed to blood of patients with
HIV infection by a needle stick or open wound.
Donor deferral/exclusion
• Donors who have had malaria deferred for 3 years after last symptom.
• Visitors, immigrants or refugees from endemic area of malaria deferred
for 3 years.
• Travelers to areas considers to be endemic for malaria should be
deferred for 1 year following departure.
• Leishmaniasis: Deferral period is 12 months after departure from Iraq.
Other infectious diseases:
9. Donor with history of Syphilis and Gonorrhea: Best to reject such
donors, defer for 12 months after completion of therapy. The agent
that causes syphilis is Treponema pallidum, may live for 1 to 5 days
in cold storage so that only a fresh unit of RBCs may transmit
infection. Therefore, the blood should not be issued before at least 6
days of storage in refrigerator. The spirochetes do not survive
refrigeration.
• The reason for deferral is not as a fear of transmission of these
diseases, as they are sexually transmitted diseases, the donor has
higher risk of exposure to HIV and hepatitis infection.
Donor deferral/exclusion
• If received a blood transfusion : Eligible 12 months after transfusion.
• If no blood transfusion : deferred until healing is completed, feeling
well, and has returned to full activity.
11. Donors who during the preceding 12 months have received a
transfusion of blood or its components or other human tissues
(organ, tissue, bone marrow transplant, or bone or skin graft) should
be deferred for 12 months from the time of receiving the blood
product or graft.
• The time interval between whole blood donations is 8 weeks
Donor deferral/exclusion
– A history of cancer, leukemia, or lymphoma deferred indefinitely.
– Persons with a history of aplastic anemia, granulocytopenia, sickle cell
anemia, thalassemia, polycythemia, persons with a history of hemophilia
A or B and severe thrombocytopenia because there is a high risk of
bleeding following venipuncture. Are permanently deferred.
Donor deferral/exclusion
• Accept diabetics on oral medication.
• Insulin dependent diabetics are eligible for whole blood donation
only if blood sugar is well controlled and have NEVER taken Bovine
insulin (Mad cow disease can be transmitted by blood transfusion).
15. A donor with a history of epilepsy with frequent convulsions,
seizures and other CNS disorders are usually permanently deferred.
Donor deferral/exclusion
• Defer for 4 weeks for donors taking acne therapy (teratogenic drugs)
that can remain in the blood several weeks. Tetratogens in donor unit
could be harmful to a fetus of a pregnant recipient.
• Defer for 2 days from last dose of antibiotics, antifungal or antiviral,
donors must have completed his treatment and free from illness.
• Aspirin: Acceptable for whole blood donations. Platelet donors must
wait three days after last dose. Because aspirin causes a significant
decrease in platelets function.
17. Defer indefinitely for Pituitary-Derived Human Growth Hormone.
Donor deferral/exclusion
• Defer 4 weeks for German Measles (rubella) and Chicken Pox
attenuated virus vaccines.
• Defer 2 weeks for Measles, Mumps, oral Polio, typhoid, Yellow Fever live
attenuated virus and bacterial vaccine.
• Defer 14 to 21 days for smallpox vaccination.
• Hepatitis B vaccination- donor is not deferred.
• Defer 12 months for donors who have received rabies vaccine.
• Accept hepatitis A vaccine and most other immunizations/ vaccinations
by killed viruses or toxoids, e.g., flu, tetanus, if the donor is providing
symptom-free and fever-free.
Donor deferral/exclusion
• Deferred during pregnancy.
• Deferred for 6 weeks after uncomplicated third trimester or term
delivery.
• A first or second trimester abortion or miscarriage need not be a
cause for deferral.
• If delivery or abortion required a blood transfusion the donor must
be deferred for 12 months.
• General appearance: If the donor looks ill, or is excessively nervous,
it is best to defer the donation.
• Age: ≥ 17 years
• Weight : above 50 kg (100 pounds) a maximum of 10.5 mL of
blood/kg of donor weight for whole blood collection.
• Temperature: Not >37.5oC
• Pulse: 50-100 beats per minute; if more than 100 defer the donor ,
less than 50 is accepted in athletes.
• Blood pressure: Normal blood pressure 120/80
• Hemoglobin (Hb):
– ≥ 12.5 g/dL or 38% PCV for women.
– ≥ 13.5 g/dL or 41% PCV for men.
– In general, ≥ 12.5 g/dL or 38% PCV are acceptable for both.
• Skin lesions, arm check: if there is evidence of self injected drug
the donor must be indefinitely deferred. Because there is
extremely high risk of hepatitis and HIV infection in drug abusers.
