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Allogeneic and Autologous Blood Donor Selection 䊱 Anne F. Eder, MD, PhD
H E P R O C E S S O F selecting blood donors aims to determine—to the extent possible—that the donor is free of diseases that can be transmitted to patients by blood transfusion and is able to tolerate the collection procedure without experiencing significant complications. Overlapping safeguards to protect both donor and recipient safety are used in the selection process, which involves donor education, health history assessment and focused physical examination, additional instructions after the donation, and maintenance of records about ineligible (ie, deferred) donors. Infectious disease testing of donations is also a critical part of the process. (See Chapter 8.) Before blood is collected, individuals are provided with educational material that describes the donation process and are instructed not to donate if they are at increased risk of infection with blood-borne pathogens. Potential donors are then given a focused physical examination and are questioned directly about specific risk behaviors as well as about medications, travel, and other factors that potentially affect recipient or donor safety.
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Donors are asked about risks related to infectious diseases for which sensitive tests are currently in place, for which tests are not universally used, and for which licensed screening tests are not yet available. (See Table 5-1.) To prevent future donation by ineligible donors, blood collection facilities maintain a confidential list of deferred donors to exclude individuals either for reactive test results, health history, or medical reasons. Deferrals may be for a defined interval of time, indefinite, or permanent. The selection criteria used for autologous donation are often less stringent than those for allogeneic donation, but the focus remains on providing the safest possible blood for transfusion to the donorpatient and on evaluating the risk that the collection procedure poses to his or her health. Blood components for transfusion are collected from volunteer, nonremunerated donors in the United States. Otherwise they must be labeled as being from paid donors.1 The blood center must determine donor eligibility on the day of collection, in accordance with federal and state regulations2 and volun-
Anne F. Eder, MD, PhD, Executive Medical Officer, Biomedical Services, National Headquarters, American Red Cross, Washington, District of Columbia The author has disclosed no conflicts of interest.
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