Chapter 4 Blood Donor Medical Assessment, Collection, and Complications Gary Bachowski MD, PhD, Gary Bachowski MD, PhDSearch for more papers by this author Gary Bachowski MD, PhD, Gary Bachowski MD, PhDSearch for more papers by this author Book Editor(s):Jeffrey McCullough, Jeffrey McCullough University of Minnesota, Minneapolis, MN, USASearch for more papers by this author First published: 02 March 2021 https://doi.org/10.1002/9781119599586.ch4 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Summary Whole blood is collected by venipuncture from healthy adults into plastic bags containing a liquid anticoagulant preservative solution. This chapter provides the concepts and rationale for blood donor assessment and blood collection but does not refer to every specific US Food and Drug Administration requirement. It is important that the blood collection staff provide a warm, friendly, professional, and efficient environment in which the medical assessment and blood donation can take place. The medical history is an extremely important part of the selection of donors because it can reveal reasons why donation might not be wise for the donor or reasons why the donor's blood might pose increased risk for the patient. The chapter focuses on the postdonation care and adverse reactions to blood donation. The selection of donors for plateletpheresis, leukapheresis, and plasmapheresis uses the same general criteria used for whole blood donors. Transfusion Medicine, Fifth Edition RelatedInformation

Objective: This case report investigates an unusual hCG result in a woman who is not pregnant. Patient and methods: A 43-year-old woman was admitted for recurrence of thrombotic thrombocytopenic purpura (TTP) and therapeutic plasma exchange (TPE) was initiated. Prior to transitioning the patient from TPE to immunosuppressive therapy, a serum qualitative hCG test was performed and was positive. Several etiologies for elevated hCG were considered and investigated, including heterophile antibody interference, endogenous hCG from pituitary or malignancy, and exogenous hCG. Results: Retrospective measurement of hCG levels in remnant samples, including a sample obtained prior to TPE initiation, demonstrated that the hCG elevation occurred with plasma administration for TPE. Further investigation with the American Red Cross confirmed that a plasma donor was unknowingly pregnant and in the latter half of the first trimester at the time of donation, when hCG levels peak. Conclusion: In plasma recipients with unexplained hCG elevation, passive transfer of hCG from plasma should be considered in the differential diagnosis. Retrospective measurement of hCG in remnant samples obtained prior to plasma exchange can assist in confirming the source.

TransfusionVolume 57, Issue 6 p. 1582-1583 LETTERS TO THE EDITOR Cytomegalovirus-safe blood: the unclear effect of sickle hemoglobin Thomas J. Gniadek MD, PhD, Corresponding Author Thomas J. Gniadek MD, PhD thomas.gniadek@gmail.com Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesotae-mail: thomas.gniadek@gmail.comSearch for more papers by this authorGary Bachowski MD, PhD, Gary Bachowski MD, PhD Mid-American Blood Service Division, American Red Cross North-Central Region, St Paul, MinnesotaSearch for more papers by this authorJed Gorlin MD, MBA, Jed Gorlin MD, MBA Innovative Blood Resources, Hennepin County Medical Center and Children's Hospitals and Clinics of Minnesota, Minneapolis, MinnesotaSearch for more papers by this authorJohn D. Roback MD, PhD, John D. Roback MD, PhD Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GeorgiaSearch for more papers by this authorPaul M. Ness MD, Paul M. Ness MD Blood Bank, The Johns Hopkins University School of Medicine, Bethesda, MarylandSearch for more papers by this author Thomas J. Gniadek MD, PhD, Corresponding Author Thomas J. Gniadek MD, PhD thomas.gniadek@gmail.com Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesotae-mail: thomas.gniadek@gmail.comSearch for more papers by this authorGary Bachowski MD, PhD, Gary Bachowski MD, PhD Mid-American Blood Service Division, American Red Cross North-Central Region, St Paul, MinnesotaSearch for more papers by this authorJed Gorlin MD, MBA, Jed Gorlin MD, MBA Innovative Blood Resources, Hennepin County Medical Center and Children's Hospitals and Clinics of Minnesota, Minneapolis, MinnesotaSearch for more papers by this authorJohn D. Roback MD, PhD, John D. Roback MD, PhD Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GeorgiaSearch for more papers by this authorPaul M. Ness MD, Paul M. Ness MD Blood Bank, The Johns Hopkins University School of Medicine, Bethesda, MarylandSearch for more papers by this author First published: 08 June 2017 https://doi.org/10.1111/trf.14138Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume57, Issue6June 2017Pages 1582-1583 RelatedInformation

BACKGROUND:Septic transfusion reactions to apheresis platelets (PLTs) continue to occur despite preventive measures. This study evaluated the effect of two operational changes designed to reduce bacterial risk: 1) introducing inlet-line sample diversion on two-arm procedures and 2) increasing the sample volume cultured from 4 to 8 mL from all donations.STUDY DESIGN AND METHODS:Aerobic culture results and septic transfusion reactions reported between December 1, 2006, and July 31, 2008 (Period 2), were compared to March 1, 2004, to May 31, 2006 (Period 1).RESULTS:During Period 2, a total of 781,936 apheresis PLT collections were cultured, of which 130 donations (1:6015) were confirmed positive and 9 (1:86,882) had negative culture results but were associated with 11 septic reactions. Confirmed-positive cultures from two-arm procedures decreased (27.2 to 14.7 per 10(5) collections; odds ratio [OR], 0.54; 95% confidence interval [CI], 0.41-0.70) in Period 2, owing to a lower rate of skin flora contamination. Detection of contamination of one-arm collections significantly increased by 54% in Period 2 (13.7 vs. 21.1 per 10(5) collections; OR, 1.54; 95% CI, 1.05-2.27). Fewer septic transfusion reactions occurred in Period 2, but the difference did not reach significance (1.7 vs. 1.2 per 10(5) donations; OR, 0.68; 95% CI, 0.30-1.53).CONCLUSION:Inlet-line diversion decreased bacterial contamination during two-arm collections by more than 46%. Concurrently, doubling the sample volume was associated with a 54% relative increase in culture sensitivity. These interventions act cooperatively to decrease bacterial risk.