Whole Blood Donations
The most common type of blood donation is whole blood where one unit (roughly one pint) of blood is taken from a donor. The donation is called “whole blood” because the blood is taken in its entirety, for separation into its component parts later in the lab. This donation process takes about one hour from the time the donor comes in, to the time the donor is ready to leave. The donation itself takes only 10 to 15 minutes. Whole blood donations can be performed every 56 days.
Apheresis or Automated Donations
Automated donations are done by a process called “apheresis,” which allows the donor to maximize his or her donation for their blood type and give specific components. The apheresis instrument uses sterile tubing, chambers and needles to ensure a safe donor experience. The selected component or components are saved and the remaining blood is returned to the donor. Most automated donations consist of a combination of platelets, red cells and plasma, usually 2 of the 3 components. Apheresis allows a more generous donation of each of these components than whole blood donation would, but does require a longer time commitment from the donor, up to 2 hours of actual donation time.
The apheresis instrument works by centrifugation (spinning) of the blood that has been drawn from the donor, layering the cells of the blood by weight or density and separating them from the liquid, while maintaining them in a closed circuit to prevent infection. The instrument can then draw out the desired part or parts of the blood into a sterile bag for storage.
Here are some special notes about the following automated donations:
A single platelet donation by apheresis can help one patient (single donation), two patients (double donation) or three patients (triple donation). The donor’s platelet count and the amount of available time the donor has to spend at the donation center will determine whether they can donate a single, double or triple dose. Platelets help the blood clot, and are used primarily in cancer patients, heart surgery, and massive bleeding such as trauma. Because certain medications interfere with platelet function, platelet donors must not be taking aspirin or other medications that affect platelets.
RED BLOOD CELLS
Automated donation can allow one or two units of red blood cells to be collected at one sitting. To qualify for double red cell donation, donors must meet special criteria including higher hemoglobin/hematocrit. Double red cell donation can only be done once every 112 days (16 weeks) or more. Double red cell donation is ideal for donors who want to minimize their trips to the blood center and who are blood type O.
Plasma is the liquid part of the blood. It is transfused to replace clotting factors in trauma patients and other large volume transfusions, liver disease and burn victims. Automated donation allows collection of a larger amount of plasma from one donor at one sitting than whole blood donation. This is particularly good for donors of type AB, which is the universal donor for plasma. Plasma can be donated every 4 weeks or more.
A very specialized type of automated donation is granulocytes, a type of white blood cells. Granulocytes are only collected upon a physician’s request for a specific patient need. The donor and patient blood types must match, and the granulocyte cannot be stored but must be transfused immediately. Therefore, interested donors will be called and scheduled for a granulocyte donation when the need arises. Because granulocyte collections require specific instrument software for the cell separation, they can only be collected at our Preston Valley and Rosedale Donor Centers.
Donors doing a granulocyte donation must be willing to do a longer apheresis procedure, around 3 hours. Donors must also get a red cell settling medication called hydroxyethyl starch, or HES to help the red blood cells separate from the white blood cells. Finally, donors must come in for a pre-donation visit for an eligibility check, infectious disease testing in advance, and administration of white blood cell mobilization medicine. Granulocytes tend to stay stuck on the sides of the vein walls and do not flow freely in the bloodstream, so they are hard to collect normally. The mobilization medicine causes them to let go of the vein walls and flow free in the blood and be collected by our apheresis instrument. The type of medicine used is typically a steroid (or occasionally G-CSF) which must be administered prior to donation.
Granulocytes are life-saving for patients with poor bone marrow function after cancer treatment or transplantation or patients with certain blood disorders that cause poor white blood cell function. A course of daily transfusion for at least 3 to 5 days is generally needed for treatment of bacterial infection in these patients.
A note to prospective granulocyte donors: Persons with allergy to starch or who should not take steroids should not donate granulocytes. Contact our medical team for more info on this issue.
Source plasma is a special type of plasma donation by automated collection which will be made into blood derivatives which are used to treat many diseases. Depending on the size and blood count of the donor, 400 to 800 ml of plasma will be retained, and the blood cells returned to the donor. Donation is limited to once every 4 weeks or longer to protect the protein-making ability of the body. (More frequent plasma donation would require blood tests and periodic physical exam). The donation will take about 20 minutes for screening and about 40 minutes for the actual donation, although times may vary somewhat depending on the individual.
Source plasma is sent to a facility that pools plasma from many donors and then treats it to make sure there is no infection, then separates the different protein types and concentrates them. This process allows the best use of select donor plasma for treatment of many different diseases. The patient with each disease can get a concentrate of the protein he or she is lacking. Because of the magnitude of the process involved in pooling, treating and separating the proteins, the community blood center cannot do this process, and a blood derivative manufacturer must be involved in the preparation of these products. Blood derivative manufacturing facilities are almost exclusively located outside of the United States, mostly in Europe. The blood derivatives used by patients in the United States come back from these companies after processing.
Products made from source plasma include albumin concentrates, clotting factor concentrates, antithrombin, fibrinogen concentrate, and gamma globulin concentrates to name the most common.
Source plasma donors have different eligibility criteria. Source plasma contains no cells, so deferral criteria that affect the red blood cells do not apply. For example, malaria is an infection of red blood cells. Therefore, the malaria deferral rules do not apply to source plasma donors; travel to malarial risk areas will be acceptable. However the Creutzfeldt-Jakob disease (CJD) travel risk questions will still apply. Females with pregnancy history may qualify for source plasma donation in many cases. There are also additional questions for source plasma donors, such as recent surgery, diabetes, recent tattoos, and colonoscopy. These rules apply because the plasma has to be processed outside the United States, in the European Union. Therefore donors must meet not only the United States regulatory rules, but also the rules of the European Union.
A note on tracking of donation totals: Carter BloodCare (and all blood centers) are required by the Food and Drug Administration (FDA) to track red cell and plasma volume loss over a rolling 12 month period. Donors are not allowed to surpass certain volume limits of blood loss in that 12 month period. Depending on whether donors are doing single, double or triple donations, and what combination of products are given, will affect how quickly they meet these limitations. Also, platelet donors are limited to 24 platelet donation procedures in a 12 month period. All of these restrictions are in place to protect the health of our blood donors.
Special donations fall into three categories: autologous, directed and therapeutic. For more information, or to schedule a special donation, call
Donation of your own blood (usually red blood cells) prior to planned (non-emergency) surgery is available with the request of your physician. An extra fee generally applies. Donations must be made within a specific time frame (no less than 5 days and no more than 30 days prior to surgery). Donations must be scheduled in advance at donor center sites.
Directed donation is a friend or family member that is approved to donate for a specific patient. If the blood type is compatible, the unit will be reserved for that patient. Directed donations require the approval of the patient’s physician and the patient must approve the names of the directed donors. Extra fees apply.
Some individuals require withdrawal of blood for treatment of a medical condition. Carter BloodCare provides this service with a doctor’s prescription. There is a fee for standard therapeutic donation. For persons with hereditary hemochromatosis or high blood counts due to testosterone therapy, Carter BloodCare offers a program for enrollment with doctor’s endorsement. If enrolled, the individual can qualify for blood withdrawal at no charge and possible use of the units for patient transfusion, if the donor has no disqualifying health history.