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can donate blood are complex and are constantly being updated by the NBS - (please correct these if you think they are out of date)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
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
5. Transfusion
- Mecahnisms in place to withdraw products if necessary
- Appropriate transfusion
- Traceability and ‘look back’ procedures