Blood Collection Centers Research Articles

Donor reactions and injuries from whole blood donation.

In this review of common and uncommon donor reactions and injuries, donation-associated deaths were found to be extremely rare and generally thought to be coincidental; the rate of coincidental deaths was less than what would be expected based on life insurance tables. Vasovagal reactions, hematomas/bruises, and history of irritation or allergic reaction to adhesive tape or skin preparations are observed daily in a busy blood collection center. Syncopal vasovagal reactions sometimes resemble shock, but unlike shock, they reverse themselves and do not cause death. Through good management, a blood donor organization can minimize the incidence of syncope. Accidental arterial venipuncture is very uncommon (1 in 100,000), and donors with arterial punctures do well if pressure is applied for an extended period of time. Rarely, a pseudoaneurysm results, and this requires surgery. AV fistulas and compartment syndromes can also occur, but these are extremely rare; most experienced blood center physicians have never observed a case. Neurologic needle injuries occur approximately once in every 6,300 donations. Although neurologic needle injury complaints are usually received within 10 days of blood donation, 10% of the injured donors may complain weeks to months later. Most donors with needle injuries recover within a month and many within a day or two, but approximately 30% will have a recovery period of greater than 1 month and an occasional case may exceed 6 months. Donors with neurologic needle injuries generally have a full recovery, even when the recovery period may be extended. Thrombophlebitis has a low incidence (1 in 50,000 to 1 in 100,000), and infection at the phlebotomy site is rare. Both are easily treated and have little impact on the donor's health.

Hepatitis B surface antigenemia in blood donors following vaccination

Detection of hepatitis B surface antigen (HBsAg) in recently vaccinated adults has not previously been reported. Transient detectable HBsAg has been observed in newborn infants immunized with a recombinant hepatitis B vaccine. Over a 1-year period, eight HBsAg-positive blood donors mentioned during donor notification that they had been vaccinated for hepatitis B virus 1 to 3 days before donation. Follow-up tests for HBsAg, antibodies to HBsAg, and antibodies to hepatitis B core antigen were performed 3 to 37 weeks after immunization. Four months later, a group of 19 donors who were coworkers received hepatitis B vaccination and then donated blood the next day. The coworkers were observed for duration of antigenemia. A total of nine cases of transient, confirmed (neutralizable) antigenemia occurred in healthy individuals who donated blood 1 to 3 days following vaccination with a recombinant hepatitis B vaccine. Follow-up testing showed no evidence of infection by hepatitis B virus. One (5.3%) of 19 blood donors vaccinated as a group had antigenemia at Day 1 but not on Days 2 and 3 following immunization. Individuals recently vaccinated for hepatitis B may test positive for HBsAg and become permanently disqualified as blood donors. Therefore, blood collection centers should consider temporary deferral of potential donors who recently received hepatitis B vaccine.

Blood center perspective: defining the ideal platelet concentrate.

During the past two decades, an increased demand for platelets has challenged blood collection centers to produce a safe and readily available supply. Defining the ideal platelet for transfusion is a process that cannot be decided by a single entity. Collection centers are only one member of a partnership which involves the donor, transfusion service, hospital administration, clinicians, and patients. Regulatory definitions exist to help guide collection centers to the minimum acceptable criteria for the production of platelets, but in reality, the standard by which clinicians judge the efficacy of the product is most important.

Effects of new brochures on blood donor recruitment and retention

Currently, donors may arrive at blood collection sites without prior knowledge of eligibility and deferral criteria. The effects of distributing newly developed recruitment brochures 2 weeks in advance of blood drives and the provision of brochures on temporary deferral at the taking of health history were examined in four southeastern regional blood collection centers. Twenty-four similar pairs of worksites, with employee-only recruitment, were randomly assigned to a control (C) or experimental (E) group. Information about sponsor recruitment strategies, worksite factors, and first-time, repeat, and temporarily deferred donors was obtained at three collection drives per site over a 1-year period. Drive 1 was used as a baseline. Two weeks before Drives 2 and 3, the recruitment brochures were distributed to all Group E employees, with temporary deferral brochures provided as needed when the health history was taken. No significant differences between groups or drives were found in the total percentage of employees recruited or returning as a result of recruitment or deferral brochure distribution (Wilcoxon's signed rank test and t test). Substantiating previous observations by donor recruiters, the study results showed decreased donations during vacation periods and busier times at the workplace. Loudspeaker announcements led to decreased donations; increased donations followed special appeals in relation to a specific patient, an accident, or a natural disaster. The brochures may have encouraged previous donors to return, but their use did not significantly increase the recruitment of new donors or the return of temporarily deferred donors.

Evaluation of two commercially available photometers for blood donor haemoglobin measurement

Two commercially available portable haemoglobin measuring devices (Delphi Haemoglobin Meter and HemoCue) were evaluated both within the laboratory and under routine operating conditions in blood donation collection centres. Both meters demonstrated satisfactory accuracy when compared to the reference cyanmethaemoglobin (HiCN) method. Within-run and between-run precision of both meters was satisfactory. There was no significant difference evident between capillary and venous haemoglobin results using either meter. In the main blood collection centre, using Delphi meters, 63.1% of results returned from an external proficiency testing program were acceptable (± 2SD of Quality Control Laboratory result). In satellite centres using Delphi meters 36.5% were acceptable while 60.0% of HemoCue results from satellite centres were acceptable. Assay time was almost twice as long using the HemoCue. The study confirmed the necessity to evaluate equipment and operators under both controlled and routine operating conditions. External proficiency testing programs are recommended to monitor operator performance on a regular basis.

Results of nationwide screening of blood and plasma for antibodies to human T-cell lymphotrophic III virus, type III.

From April 22 to July 28, and from October 7 to November 3, 1985 the American Red Cross, the Council of Community Blood Centers, the American Association of Blood Banks, and the American Blood Resources Association provided the Food and Drug Administration with data at 2-week intervals on human T-lymphotropic virus type III (HTLV-III) test kit results at blood and plasma collection centers. Reports were received from over 150 blood collection centers that screened 2,502,829 units of blood for antibody to HTLV-III by enzyme-linked immunosorbent assay (ELISA) during nine 2-week surveillance intervals. Of these, 25,324 or 1.01 percent were initially reactive and 8443 or 0.34 percent were repeatedly reactive. The repeatedly reactive rate for women was 0.33 percent and for men 0.30 percent. Data for source plasma was collected at 275 locations and tested at eight central laboratories showed that for 2,603,652 units screened (which may represent multiple collections from the same donor) 3978 or 0.15 percent were repeatedly reactive. Screening results from both blood and plasma collection centers varied over time and among kits.

Leads from the MMWR. Results of human T-lymphotropic virus type III test kits reported from blood collection centers--United States, April 22 to May 19, 1985

Leads from the MMWR. Results of human T-lymphotropic virus type III test kits reported from blood collection centers--United States, April 22 to May 19, 1985

Single donor platelet transfusion.

Cytopheresis equipment from a number of manufacturers now permits the rapid, safe, and eflicient procurement of functionally normal platelets from Single donors. There has been an extensive proliferation of these blood cell separators and virtually all large blood collection centers and most large hospitals have at least one blood cell Separator in Operation. Transfusions from Single donors selected by HLA typing are a wellaccepted feature of the management of alloimmunized patients [1, 2]. In addition, occasional centers located at a distance from regional blood transfusion centers utilize nonmatched transfusions from Single donors as a major part of their “regular” platelet supply. Because most Single donor transfusions are not obtained from “closed systems” however, these collections cannot be stored for more than 24 h, making it more difficult to utilize such produets rationally as a form of long-term platelet inventory. Furthermore, the availability of newer plastic bags now allows storage of platelet concentrates at ambient temperatures with preservation of normal posttransfusion recovery after 7 days of storage [3]. Thus, there should be few such “geographic peculiarities” which necessitate the widespread use of Single donor platelets as “random donor platelets” in the future.

Alanine aminotransferase levels among volunteer blood donors: geographic variation and risk factors.

The incidence of elevated levels of alanine aminotransferase (ALT) in the serum of volunteer blood donors from different geographic areas of the United States was evaluated. Five regional blood collection centers participated by collecting samples randomly from volunteer blood donors. Serum samples were centrally tested for elevated ALT levels, and a sociodemographic questionnaire was sent to donors with elevated ALT levels and to a randomly selected group with normal levels. Significant regional variation was found in the incidence of elevated ALT levels. Age, sex, and the use of alcohol were all significantly associated with elevated ALT levels. These preliminary data are important in the consideration of a program to screen blood donors for elevated ALT levels in serum.