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Encyclopedia of Health and Medicine

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128 The Blood <strong>and</strong> Lymph<br />

blood products used for transfusions. According to<br />

the American Association <strong>of</strong> Blood Banks, 8 million<br />

Americans donate 15 million units <strong>of</strong> blood<br />

each year. Because blood banks separate the<br />

majority <strong>of</strong> donated blood into component blood<br />

products, one unit <strong>of</strong> donated whole blood can<br />

meet multiple needs.<br />

The body replaces lost fluid volume (PLASMA)<br />

within 24 hours <strong>of</strong> donation, <strong>and</strong> erythrocytes<br />

(red blood cells) <strong>and</strong> other blood cells in six to<br />

eight weeks. A healthy adult may donate one unit<br />

<strong>of</strong> whole blood every eight weeks. There is no cost<br />

for donating blood, <strong>and</strong> there is very minimal risk.<br />

A person cannot contract HEPATITIS, HIV/AIDS, or<br />

other infectious diseases through the process <strong>of</strong><br />

donating blood.<br />

Donor Requirements<br />

In the United States, individual states <strong>and</strong> blood<br />

banks establish regulations <strong>and</strong> procedures to<br />

determine donor eligibility. In general, a prospective<br />

donor must<br />

• be 17 years <strong>of</strong> age or older<br />

• pass a preliminary health screening that identifies<br />

potential health risks for the donor or for<br />

recipients <strong>of</strong> the donor’s blood<br />

• weigh 100 pounds or more<br />

<strong>Health</strong> screening questions aim to reveal<br />

behaviors or practices that carry a risk for INFEC-<br />

TION with diseases such as hepatitis <strong>and</strong> HIV/AIDS.<br />

Such behaviors include intravenous DRUG use <strong>and</strong><br />

sex with multiple partners. In 1998, US blood<br />

banks also began screening prospective donors for<br />

possible exposure to variant Creutzfeldt-Jakob disease<br />

(VCJD), the human illness resulting from<br />

bovine spongiform encephalopathy (“mad cow”<br />

disease). Numerous health conditions may preclude<br />

an individual from donating blood; blood<br />

banks refer to these exclusions as deferrals.<br />

The Blood Donation Procedure<br />

The total blood donation process takes about 45<br />

minutes to an hour, about 20 minutes <strong>of</strong> which is<br />

the actual blood withdrawal (called PHLEBOTOMY).<br />

Once the prospective donor clears the health<br />

screening, he or she sits in a reclining chair to be<br />

comfortable for the donation process. The technician<br />

cleanses the inner arm at the elbow with an<br />

antiseptic <strong>and</strong> puts a tourniquet briefly around the<br />

upper arm to cause the veins to engorge. The<br />

technician then inserts a sterile needle, connected<br />

to collection tubing <strong>and</strong> bag, into one <strong>of</strong> the veins<br />

<strong>and</strong> releases the tourniquet.<br />

The technician may ask the person to periodically<br />

squeeze an object to help move blood<br />

through the VEIN during collection. After blood fills<br />

the collection bag (one unit), the technician withdraws<br />

the needle <strong>and</strong> places pressure over the<br />

puncture site for several minutes to suppress any<br />

bleeding, then applies a b<strong>and</strong>age that should stay<br />

in place for two to four hours. The person moves<br />

to a resting area, usually to have a drink <strong>of</strong> juice<br />

or water <strong>and</strong> a snack, then may leave when he or<br />

she feels comfortable. The risks associated with<br />

donating blood are very minor <strong>and</strong> may include<br />

bleeding, bruising, or discomfort at the needle<br />

insertion site.<br />

Donor Blood Distribution <strong>and</strong> Use<br />

Most donated blood goes to centralized blood<br />

banks for distribution to hospitals, which administer<br />

it to anyone who needs it. Two exceptions are<br />

• autologous donation (BLOOD AUTODONATION), in<br />

which an individual donates blood for his or<br />

her own transfusion such as for a planned<br />

major surgery<br />

• directed donation, in which an individual asks<br />

that others donate blood on his or her behalf<br />

<strong>and</strong> specified use, such as following a major<br />

trauma or unanticipated major surgery<br />

Blood banks generally cannot use blood not<br />

used for self-transfusion (autologous donation) or<br />

not administered to the intended recipient<br />

(directed donation) for general transfusions <strong>and</strong><br />

must instead throw it away. Some blood banks<br />

screen <strong>and</strong> process autologous donations differently<br />

from general donations, making autologous<br />

donations unacceptable for general use. Other<br />

blood banks h<strong>and</strong>le autologous <strong>and</strong> general donations<br />

the same <strong>and</strong> have procedures for donors to<br />

authorize, at the time <strong>of</strong> donation, other use <strong>of</strong><br />

their blood under such circumstances to avoid<br />

unnecessary waste <strong>of</strong> such a valuable resource.<br />

Though blood banks screen <strong>and</strong> process directed

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