Blood Donor Selection

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Blood Donor Selection

• Daniel K. Noland
• September 13, 2005

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Case A

• 62 y.o. male, regular donor at same center
• reported feeling well but tired after chasing
  his grandchildren all weekend
• PE-temp380C, pulse 98, BP172/85, hematocrit
  39.5, and wt 175 lbs
• Received temporary deferral until afebrile and
  asymptomatic

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Temporary Deferrals

• Physical Exam includes wt(gt110 lbs),
  Temp(lt37.5 C), HR 50-100, BP(lt180/100),
  crit(gt38) or hmgb(gt12.5 g/dL) and skin exam (no
  needle tracks, Kaposis, etc.)
• Can recheck if physiologic cause is suspected
  (recent hot liquids, exercise, etc.)
• Remains high-defer until resolution or MD
  evaluation (though HR lt50 okay athletes)

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Temporary Deferrals 2

• Live attenuated vaccines require 2 weeks
  (Rubeola, mumps, oral polio, oral typhoid, and
  yellow fever) or 4 (rubella, VZV)
• Meds Aspirin-36 hours platelets only
• Proscar or Accutane-1 month deferral
• Soriatane-3 years
• Pregnancy-gt6 weeks after conclusion

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Case B

• Healthy-appearing 22 yo male at college blood
  drive
• Physical exam all acceptable
• No prescription medications, ginkgo biloba and
  St. Johns Wort OTC
• One of his house-mates had been ill recently
  and he thought diagnosed with hepatitis

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Case B/Temp Deferral 3

• The physical exam deferrals are for donor safety,
  in general
• Medication and infectious disease exposures are
  for blood supply safety
• Most ID exposures (travel to malaria endemic
  area, tattoo, blood exposure, household or sexual
  hepatitis, high risk sex, jail gt72 h, GC/
  syphilis/tx thereof) require 12 months deferral

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Case C

• 30 y.o. female, local center, PE-no deferrals
• Most recent foreign travel Lived in Greece with
  father on military base 1994-1996
• Permanent CJD deferral criteria gt3 mo in UK, gt5
  years in Europe, or gt 6 mo Europe military base
  (1980-1996), insulin from UK, human tissue
  derived treatments
• will lose of 5 of donors, but decrease donor
  person-days of exposure 90

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Permanent Deferrals

• Major organ dz, Heme malignancy, recurrent solid
  tumor, family hx of CJD, pos HBSag, repeat Hep B
  core Ag, CJD risk
• Clinical or lab evidence of HIV, HCV or HTLV
  (includes only donor of unit that resulted in
  disease)
• Evidence of IV drug use
• Hx of Chagas disease or babesiosis

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Case C 2

• Same woman comes in w/o history of foreign travel
  but Hgb is 12.0 g/dL
• While this is WNL for lab testing, it is
  insufficient to donate
• Most common deferral especially in women
• May be as much as 40 to 60 of deferrals

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