ABSTRACT
I) BLOOD DONATION Blood for transfusion can be donated either by an unpaid volunteer donor (allo
geneic) or by the same individual who will later receive it (autologous). Directed allogeneic donations may be made for a specific recipient. Marrow transplant re cipients generally receive allogeneic products due to the large number required during the course of their hospitalization. Normal marrow donors, related or un related, should donate autologous blood prior to harvest, to be reinfused as needed during or after the harvest. Donation of a unit of packed red blood cells (PRBC) involves removal of approximately 450 ml of whole blood via the antecubital vein, and 1-2 units of PRBC are usually adequate for an average adult marrow harvest. In a healthy person, this is generally without complications except for an occasional vasovagal episode which is treated by terminating the donation, and placing the donor in the supine or Trendelenberg position. Although rare, other potential complications include seizures related to a severe vasovagal episode and, in older donors or those with unrecognized cardiac conditions, cardiopulmonary decom pensation. After donation, the donor is encouraged to drink fluids to help com pensate for the blood volume lost. Contraindications to donation other than ane mia (females: hemoglobin < 12.5 g/dl, males: hemoglobin < 13.5 g/dl) include among other things, factors which would generally make the person unsuitable as a marrow donor, i.e. pregnancy, a medical history of malignancy, cardiac disease and HIV infection,
Donor red blood cells must be compatible with the recipient’s ABO and Rh type (special considerations regarding allogeneic transplant between ABO or Rh-mismatched donor and recipient pairs will be discussed separately later; see also Tables 3.1.3 and 3.1.4). As a rule of thumb, infusion of 1 unit of PRBC should increase the hematocrit by 3% and the hemoglobin by 1 g/dl. 1) W hole B lood
Except for trauma patients with massive hemorrhage, whole blood is rarely used today. A unit of whole blood consists of -450 ml of blood collected into an anticoagulant solution and has a hematocrit of 3644%.
