Directed (designated) blood donation programs
- Arthur J Silvergleid, MD
Arthur J Silvergleid, MD
- Section Editor — Transfusion Medicine
- Affiliate Associate Professor, Department of Pathology and Cell Biology
- University of South Florida, College of Medicine
- Medical Director, OneBlood, Inc.
Prior to 1983, recipient-specific donations were considered medically indicated in a limited number of clinical situations. These included pre-renal transplant sensitization regimens; HLA-matched or family member apheresis-harvested platelet concentrates for refractory, thrombocytopenic patients; and washed maternal platelets for infants with isoimmune neonatal thrombocytopenia.
In direct response to concerns about blood safety raised by the AIDS epidemic, directed donations increased dramatically after 1985, despite official discouragement by all of the major blood banking organizations. Currently, directed donations constitute less than 1 percent of all blood collected, a figure that seems to be stable. While any blood component (red blood cells, plasma, cryoprecipitate, platelets or granulocytes) can be directed towards a particular patient, the vast majority of directed donations are for red blood cells.
This topic covers issues specifically related to directed blood donation. The safety of blood donation for the donor, and the risks and benefits of any blood transfusion are discussed separately.
- Williams AE, Kleinman S, Gilcher RO, et al. The prevalence of infectious disease markers in directed vs homologous blood donations (abstract). Transfusion 1992; 32:45S.
- Strauss RG, Wieland MR, Randels MJ, Koerner TA. Feasibility and success of a single-donor red cell program for pediatric elective surgery patients. Transfusion 1992; 32:747.
- Juji T, Takahashi K, Shibata Y, et al. Post-transfusion graft-versus-host disease in immunocompetent patients after cardiac surgery in Japan. N Engl J Med 1989; 321:56.
- Petz LD, Calhoun L, Yam P, et al. Transfusion-associated graft-versus-host disease in immunocompetent patients: report of a fatal case associated with transfusion of blood from a second-degree relative, and a survey of predisposing factors. Transfusion 1993; 33:742.
- Kanter MH. Transfusion-associated graft-versus-host disease: do transfusions from second-degree relatives pose a greater risk than those from first-degree relatives? Transfusion 1992; 32:323.
- Perkins HA. Should all blood from related donors be irradiated? Transfusion 1992; 32:302.
- Klein HG (Ed). Standards for blood banks and transfusion services, 16th ed, American Association of Blood Banks, Bethesda, 1994.
- SAFETY OF DIRECTED BLOOD
- No difference in infectious disease risk
- Risks with future pregnancy
- TECHNICAL CONSIDERATIONS
- Informed consent
- Frequency of donation
- Dedicated donors
- Timing between donation and transfusion
- Testing of blood for directed donation
- Directed donation that is not used
- BLOOD IRRADIATION WITH RELATED DONORS
- INFORMATION FOR PATIENTS