Discuss the measures that can be used to reduce the risk of transmitting viruses to patients via red cells, platelets and fresh frozen plasma

1. Donor Selection

Motivation – altruistic ie. no financial gain

Rules dictating who can donate blood are complex and are constantly being updated by the NBS - (please correct these if you think they are out of date)

Permanent exclusions

• People who are carriers of infectious diseases such as
• HIV +
• Hep B carrier
• Hep C carrier
• High risk behaviour 
• MSM
• Money or drugs for sex
• IVDU includes body building drugs
• Risk of CJD
• Previous recipient of a blood transfusion
• Human pituatry hormones
• Family history
• People who have diseases of unknown or viral aetiology
• UC, Crohns, malignancy

Temporary exclusions 

• 12 month exclusion if had sex in the last year with
• A partner who has high risk behaviour (as above)
• + anyone who has received clotting factor concentrates or who has been sexually active in areas where HIV is common
• 6 month exclusion if
• Travel to malaria endemic country
• Infectious disease or contact or finished antibiotics within the last 7 days
• Vaccination
• Piercing, tattoo, acupuncture outside the NHS
• Complicated dental work
• Serious illness or major surjery
• Pregnancy or delivered within last 9 months

2. Venepuncture

• Checks of donor identity
• Check for integrity of blood pack
• Labelling of pack and samples
• Arm cleansing / Diversion pouch
• Closed bag technique
• Mixing of packs to prevent clotting

3. Storage / processing

• Storage and transport conditions – cold chain 4 C for red cells
• Microbiology - environmental testing
• Platelet storage 5 days
• Moves to increase to 7 days, with micro testing
• Leukodepletion - will reduce risk of CMV transmission 

4. Microbiology

Mandatory tests

• Syphilis (Ab)
• HBV (Nucleic acid testing (NAT) HBsAg) 
• HIV(NAT and Ab and Ag testing) 
• HCV (Ab and NAT) 
• HTLVI and II (Ab and NAT)

Discretionary tests

• CMV (test 30%)

5. Transfusion

• Mecahnisms in place to withdraw products if necessary
• Appropriate transfusion
• Traceability and ‘look back’ procedures