DONOR SCREENING AND DEFERRAL

Background

It is important for the Blood Banks to ensure a safe and adequate blood supply for the  people. An important first step in the safety process is ensuring that blood only from healthy donors enters the blood supply. All blood used for transfusion  is drawn from volunteer donors who are not paid for the donation. Before giving blood, donors are questioned about their health and risk factors for disease, and are given an abbreviated medical examination.

The Donation Process

Education

When prospective donors enter a blood bank, they are normally asked to read educational materials on blood donation. These materials contain information on the risks of infectious diseases transmitted by blood transfusion, including the signs and symptoms of AIDS.

Health History

Prospective donor is asked about the detailed health history of the donor. The history is designed to ask questions that protect the health of both the donor and the recipient. To ensure that every donor is asked the same questions, there is a recommended use of a uniform donor history questionnaire. However, blood banks often create their own questionnaires using the same general guidelines. In addition to questions about transfusion transmissible diseases, prospective donors are asked questions to determine whether donating blood might endanger their health. If a prospective donor responds positively to any of these questions, he or she will be “deferred” or asked not to donate blood. The health history is also used to identify prospective donors who have been exposed to, or who may have diseases such as, human immunodeficiency virus (HIV), hepatitis, malaria, babesiosis or Chagas’ disease. These individuals are further evaluated and may be deferred.

Physical Examination

The next step in the donation process is an abbreviated physical examination that includes checking the blood pressure, pulse and temperature. A few drops of blood are taken from a finger or an earlobe to ensure that anemia is not present. Abnormalities found in any part of the physical examination may be a cause for deferral.

The Actual Donation

Prospective donors who pass successfully through these steps proceed to the actual donation process, which takes about 20 minutes. The donor sits in a reclining chair or lies on the bed. The skin covering the inner part of the elbow joint is cleansed. A sterile, previously unused needle connected to plastic tubing and a blood bag is inserted into an arm vein. The donor is asked to repeatedly squeeze his or her hand to help blood flow from the vein into the blood bag. Typically, one unit of blood, roughly equivalent to a pint, is collected. After the blood is collected, it is sent to the laboratory for testing and component preparation. The donor is escorted to an observation area for light refreshments/friut juice and a brief rest period.

Adult males have about 12 pints of blood in their circulation and adult females have about 9 pints. The donor's body replenishes the fluid lost from donation in about 24 hours. The red blood cells that are lost are generally replaced in a few weeks. Whole blood can be donated once every eight weeks.

The Deferral Process

Individuals who are disqualified as blood donors are said to be “deferred.” A prospective donor may be deferred at any point during the collection and testing process. Whether or not a person is deferred temporarily or permanently will depend on the specific reason for disqualification (e.g., a person may be deferred temporarily because of anemia, a condition which is usually reversible). If a person is to be deferred for the protection of the blood recipient, normally his or her name is entered into a list of deferred donors maintained by many blood banks.” If a deferred donor attempts to give blood before the end of the deferral period, the donor would not be accepted for donation.

At the end of a temporary deferral period, the donor may return to the blood bank, and, if the reason for the original deferral no longer exists, can be re-entered into the system.