Blood Transfusion and Donation

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Donating Blood

Blood is usually donated at special collection centers. Some centers use vans (often called bloodmobiles) that travel to different areas to collect blood. Some larger hospitals have their own centers to collect and process donated blood. After blood is tested for safety and processed into components, it’s stored in blood banks until needed.

Keeping the blood supply safe

The US Food and Drug Administration (FDA) closely regulates blood to keep the blood supply safe. The AABB (formerly the American Association of Blood Banks) also publishes guidelines for safe transfusions, which its members must follow.

In the United States, all blood centers follow careful procedures to keep the blood supply safe. Everyone who comes in to donate is asked many questions and has a chance to say whether their blood may be unsafe for any reason. Also, previous donation records and lists of ineligible donors are checked. Lab tests are done to look for blood that might transmit diseases (described in Getting a blood transfusion). People are not allowed to donate blood if their lab tests or questionnaires show that they may be at high risk for certain diseases.

Only sterile equipment is used to collect blood. The needle used to draw blood from your vein has never been used before, and it’s thrown away right after it’s used. Donors cannot get hepatitis, HIV, or any other infections or diseases from giving blood.

Reactions from donating are rare and are almost always minor when they do happen. If you’re healthy, you can donate a unit (about a pint) of blood without harm because one unit is a small part of your total blood volume. Your body will replace the lost fluid within a day, and your bone marrow will replace all of the blood cells, usually within 4 to 6 weeks. You must wait at least 8 weeks between whole blood donations. Some blood components can be donated more often.

Rules that protect blood donors

Aside from protecting those who receive donated blood, rules are also in place to protect people who want to donate. Although guidelines can vary slightly by state and facility, for the most part donors must:

  • Be healthy
  • Be at least 17 years old (or 16 with parental consent)
  • Weigh at least 110 pounds
  • Not have donated blood within the past 8 weeks (this can be shorter for most apheresis donations)

People who are taking “blood thinners” or certain drugs that are used to treat acne, baldness, or an enlarged prostate may not be able to donate unless they’ve stopped the drug for a few days or weeks. People who have taken certain drugs for psoriasis or taken products made from human plasma or tissues may be kept from donating blood even longer. Other health and travel questions are reviewed with each donor in detail. (For a complete listing of eligibility of criteria, check the Red Cross website at www.redcrossblood.org/donating-blood/eligibility-requirements/eligibility-criteria-alphabetical-listing.)

If you’re interested in donating blood, contact AABB for a list of member institutions, or visit their online blood bank locator. You can also contact America’s Blood Centers or the American Red Cross for donation centers near you.

The donation process

Before giving blood, get a good night’s sleep, eat a well-balanced meal, and drink extra fluids that are non-alcoholic and non-caffeinated.. Many donor centers ask that you bring in a list of all the medicines you’re taking and your donor card, driver’s license, or 2 forms of other identification.

FDA guidelines require that before giving blood, you must register; have your blood pressure, temperature, and heart rate checked; answer health questions; and get a blood test (usually by sticking a finger for a few drops of blood). You’ll need to fill out a questionnaire, asking about certain behaviors or travel that might put you at increased risk for some diseases. You must also be told details about what donating blood will be like before you decide to actually give blood.

You’ll sit in a reclining chair or lie on a table. An area on your arm will be cleaned, and a sterile needle put into a vein (usually where your elbow bends). Removing a unit of whole blood usually takes about 10 to 15 minutes. Apheresis donation (described in Blood Transfusions for People with Cancer) may take 2 hours or longer.

Once your blood is taken, you’ll be asked to stay for a short time to make sure you’re feeling well. You’ll be given something to drink (such as fruit juice) and a light snack before leaving.

You can go back to normal activities soon after giving blood, but some centers recommend that you have someone else drive home after you donate. You might feel tired, but this usually only lasts a few hours.

Types of donations

There are several types of blood donation.

Volunteer whole blood donation

Most blood donations come as units of whole blood from volunteers who have no connection to the person who will get the blood. Once donated, the units are usually separated into components.

Apheresis donation

Apheresis (A-fur-REE-sis) allows volunteers to donate just one blood component. Blood is drawn out through a vein in the arm, and a machine separates the needed component (usually platelets, although red blood cells, white blood cells, and plasma can also be collected this way). The rest of the blood is then returned to the donor, usually through a vein in the other arm. This procedure can take up to 2 or more hours depending on which blood component is being collected.

The advantage of this type of donation is that, since most of the blood is returned, a large amount of a needed component can be collected. Patients who need many platelet transfusions, like some cancer patients, are exposed to fewer donors in this way than they would be from platelets pooled from many donors. This cuts down on the risk of both transfusion reactions and infections.

As with whole blood donation, apheresis donors should:

  • Get a good night’s sleep.
  • Eat a well-balanced meal.
  • Drink extra fluids before donating.

Since aspirin makes platelets less useful to a transfusion recipient, donors are usually asked not take aspirin for 36 hours before donation. The same FDA guidelines as those for whole blood donation must be followed. Unlike whole blood donors, those who give platelets or plasma via apheresis usually can give again in a week or so. Different blood centers may have different rules about this.

During the apheresis procedure, donors may feel cold, or they may feel a tingling sensation around the lips and nose, but this goes away once the procedure is completed. (It’s caused by the drug that is used to keep the blood from clotting in the machine.) Other side effects, such as feeling tired, are much like those from whole blood donation.

Autologous blood donation

Donating your own blood for later use is called autologous (aw-TAHL-uh-gus) donation. Autologous donation is most often done in the weeks before you have a scheduled surgery that will likely require blood transfusion. Your own blood can then be used during or after the operation to replace any blood you may have lost.

This is generally thought to be the safest form of blood transfusion because you’re getting your own blood back. Still, it’s not totally without risk. There’s always the very small chance that bacterial contamination or clerical errors can happen.

People who aren’t able to donate blood for others may still be able to donate blood for themselves.

There is a processing fee for collecting, testing, storing, and delivering each unit of autologous blood. Be aware that your health insurance may not fully pay for this. You also need to plan ahead so that you have enough time before surgery to have your blood cell counts go back to normal after your blood has been collected.

Directed donation

Donating blood for a family member, friend, or other specified patient is called directed donation. This can be done at any blood donation center, but you should call ahead to check requirements and schedule the donation. The donor must meet the same requirements as for regular blood donation, and the donor’s blood must match the blood type of the recipient.

Blood from directed donors has not been shown to be safer than blood from volunteer donors and, the same types of testing are done on blood from directed donors. As with autologous donation, there’s a processing fee for collecting, testing, and delivering each unit of directed donor blood. This fee might not be covered by health insurance. If the person the blood was intended for doesn’t need it, some blood banks will use it for someone else. In others, it may be thrown out.

Paid donation

Blood from paid donors cannot be used in the United States for transfusion purposes. Plasma is the only component for which donors are sometimes paid, and it’s taken by the apheresis method. Plasma can be treated for safety in ways that blood cells cannot.

Plasma taken from paid donors is generally treated and processed by pharmaceutical companies into drugs. It cannot be used as cryoprecipitate or fresh frozen plasma in patients.

Blood donation resources

American Red Cross
Toll-free number: 1-800-RED CROSS (1-800-733-2767)
Website: www.redcross.org

    Provides a locator service to find the Red Cross chapter or Blood Services region that serves you. A direct website for information on blood donation is www.redcrossbood.org.

America’s Blood Centers
Toll-free number: 1-888-US-BLOOD (1-888-872-5663)
Website: www.americasblood.org

    Has a listing of local ABC centers for donating blood; the website also offers general information about blood, blood donation, and blood use.

AABB (formerly American Association of Blood Banks)
Telephone: 301-907-6977
Website: www.aabb.org

    Sets standards, inspects, and accredits blood collection and transfusion facilities. The AABB website has a blood bank locator, and general information on blood, blood product donation, and transfusions.

References

AABB, American Red Cross, America’s Blood Centers, and the Armed Services Blood Program. Circular of Information for the Use of Human Blood and Blood Components. November 2013. Accessed at www.aabb.org/tm/coi/Documents/coi1113.pdf on June 20, 2016.

American Red Cross. Donating Blood: Eligibility Guidelines. Accessed at www.redcrossblood.org/donating-blood/eligibility-requirements on June 20, 2016.

Centers for Disease Control and Prevention. Blood Safety. Accessed at www.cdc.gov/bloodsafety/bbp/bacterial-contamination-of-platelets.html on June 20, 2016.

Food and Drug Administration, Center for Biologics Evaluation and Research. Guidance for Industry: An Acceptable Circular of Information for the Use of Human Blood and Blood Components. Updated April 2014. Accessed at www.fda.gov/downloads/biologicsbloodvaccines/guidancecomplianceregulatoryinformation/guidances/blood/ucm364593.pdf on June 20, 2016.

Vassallo R, Benjamin RJ, Dodd R, Eder A, McLaughlin LGS, Stramer S, et al. for the American Red Cross. A Compendium of Transfusion Practice Guidelines. Second Edition 2013. Accessed at www.redcrossblood.org/sites/arc/files/59802_compendium_brochure_v_6_10_9_13.pdf on June 20, 2016.


Last Medical Review: 06/20/2016
Last Revised: 06/20/2016