8 Donor Selection & Screening

• Donor selection and screening encompasses medical history of donor, physical exam and serological screening of donor blood.
• Blood banks must confirm donor identification and link the donor to existing donor records.

  • Blood donation is voluntary based on RA 7719
• Temporary deferral means that the prospective donor is unable to donate blood for a definite period of time

  • e.g., Donor has received a blood transfusion; defer for 12 months from the date of transfusion
• Indefinite deferral means that the prospective donor is unable to donate blood for someone else for an unspecified period of time due to current regulatory requirements
• Permanent deferral means that the prospective donor will never be eligible to donate for someone else

  • may be eligible for autologous blood donation
• Donors should appear to be in good health without obvious signs and symptoms of colds, flu or other illnesses
• If the donor is currently taking an antibiotic or taking any other medications for an infection, the donor should be deferred until completion or if it has cleared up
• Donors who took tetracyclines or other antibiotics are acceptable for donation as it is for severe acne, thus acceptable for donation
• All drugs must be cleared by the blood collection facility or blood bank medical director
• Donors must be provided adequate information not just the benefits but also the risks involved no matter high or small and risks.

  • Donors must be also be informed about high risk behavior related to HIV and must be given opportunity to ask questions regarding any aspects of the collection procedures
• Donors screening officer should inform the donor that if you tested negative in HIV testing, because you still have a chance to transmit HIV because of its window period
• Donors who have taken aspirin or aspirin containing modification, 3 days prior to donation may not be suitable for plateletpheresis because aspirin is an anti-platelet drug
• Female donors should be temporarily deferred for 6 weeks following pregnancy termination as well as in cases of miscarriage
• First or second trimester abortion or miscarriage will not be deferred in donating blood according to AABB
• 12 months deferral if the donor received blood transfusion during her pregnancy.
• Time of interval between allogenic whole blood donation is about 8 weeks (in the Philippines it’s 3 months)

  • Deferral is 48 hours for time interval between apheresis and whole blood donation.
  • For infrequent plasma apheresis it’s 4 weeks
  • For double unit red cell it should be 16 weeks
• 2 weeks deferral if donor received live attenuated or bacterial vaccine [e.g. rubeola, mumps, oral polio, typhoid, or yellow fever]

  • 4 weeks deferral if received live attenuated vaccine for rubella (German measles) or chickenpox
  • 14-21 days deferral for smallpox vaccine or until the scab has fallen off
  • No deferral for toxoids, killed or synthetic viral, bacterial or rickettsial vaccines
• Donor who received live attenuated vaccine is deferred because there is a possibility that your donated blood will be donated to immunocompromised patient and may cause life threatening infection.
• 12 months deferral if donor has had a blood transfusion or a transplant such as organ, tissue or bone marrow or a graft such as bone or skin
• 12 months deferral for percutaneous exposure or needle prick injury because of the risk of Bloodborne pathogens.
• 12 months deferral from the time of sexual contact if donor had sexual contact with anyone who has HIV/AIDs or has had a positive test for HIV/AIDS
• Exposure to high risk individual is 12 month deferral
• 12 months deferral from the time of sexual contact if donor had sex with anyone who has ever used a needle to take drugs or steroids or anything not prescribed by their doctor

  • IV probe users are high risk individuals
• 12 months deferral after sexual contact or discontinuation of close contact or living with a person who has hepatitis C or other hepatitis viruses.
• Female donors who had sexual contact with a male who has ever had sexual contact with another male is deferred for 12 months from the time of sexual contact
• Donors who had been treated for syphilis or gonorrhea (STDs) should be deferred for 12 months after completion of therapy
• Treponema pallidum may live for 1-5 days in cold storage and thrives well at room temperature
• Donors who had been in juvenile detention, lockup or prison for more than 72 hours is deferred for 12 months from the last day of incarceration because of unhygienic and high risk activities of prisoner in the prison.
• 1 year deferral following departure from malaria-endemic area, provided that the donor showed no signs and symptoms of malaria
• 3 years deferral for immigrants, refugees, citizens or person who have resided in an endemic area for at least 5 consecutive years, provided that the donor is symptom free
• Indefinite deferral for donors who have Creutzfeldt Jakob Disease because it can be transmitted via corneal transplants, human dura mater grafts, pituitary derived HGH, neurosurgical instrument
• 12 months deferral for any military personnel deployed in Iraq → risk for Leishmaniasis
• Avodart and Proscar are used for prostate gland enlargement

  • 6 months deferral from last dose
• Propecia is a drug used for baldness

  • 1 month deferral from last dose
• Accutane is a drug used for severe acne

  • 1 month deferral from last dose
• Soriatane is a drug used for severe psoriasis

  • 3 years deferral from last dose
• Tegison is a drug also used for severe psoriasis

  • Permanent deferral
• Teratogenic drugs or substances can cause congenital malformation whcih can be passed from the mother to her baby thru placental, which is detrimental → drugs are deferred for specific months/years
• Growth hormone drug is used for children with impaired growth

  • Permanent deferral
  • RATIONALE: Creutzfeldt-Jakob Disease
• Bovine insulin is a drug used for type 1 DM

  • Indefinite deferral
  • RATIONALE: Mad Cow Disease