Donor Registration Policy

Number:  5.1

Policy:

  1. All policies, processes, and procedures must comply with Qatari, HMC, and applicable accreditation standards (i.e. AABB, CAP, ISO, and JCI).
  2. All prospective donors must show an approved identity document with picture (e.g., Qatari ID, other GCC ID, passport) that confirms their identity with a unique alphanumeric identifier.
  3. All positively identified candidates will be assigned a Hematos donor ID if they do not already have one.
  4. All donors with the previous old donor ID will be assigned a Hematos donor ID.  All future donations will be done using the Hematos ID.
  5. All positively identified candidates must be checked in the donor deferral database.
    1. Only those without contraindications may be accepted for further processing.

References:

  1. HMC 1001 Setting Specification, Version 1.5, Hematos IIG, Medinfo
  2. Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, Maryland, USA

Donor Recruitment and Campaigns Process

5.0.1 PROCESS:  Donor Recruitment and Campaigns

Process:

  1. Company or organization contacts Coordinator, Donor Recruitment to schedule donation OR:
  2. Coordinator, Donor Recruitment contacts companies or organizations to schedule donations.
  3. The Coordinator, Donor Affairs, is responsible for all recruitment activities:
    1. Serves as initial contact point for organizations and companies desiring to have a donor campaign.
    2. Schedules donor campaigns in advance, arranges for emergency collections as needed.
    3. Assigns donor recruitment staff to visit and inspect prospective donation sites.
    4. Arranges logistics of resources for donor campaigns (personnel, equipment, vehicles, supplies)
    5. Coordinates with HMC Public Relations and the media
    6. Prepares news media to encourage donation
  4. All contacts and schedules are entered into Hematos IIG.
  5. Donor recruitment materials are left at donation site to encourage donation and provide means for donors to schedule their donations during the campaign.
  6. Donor recruitment staff prepare the donation site at time of donation.
  7. Donation processes are conducted in accordance to policies, processes, and procedures for registration, donor questionnaire, physical examination, and collection.
  8. Hematos IIG is accessed by either wireless connection (VPN) or off-line data dump to check donor against donor deferral database.
  9. Blood is stored at suitable temperatures at collection site and in transit back to Donor Center.
  10. Campaign blood components and specimens are received in Donor Center and transferred for further processing and testing.

References:

  1. HMC 1001 Setting Specification, Version 1.5, Hematos IIG, Medinfo
  2. Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, Maryland, USA

Donor Recruitment and Campaigns Policy

5.0 Donor Recruitment and Campaigns Policy

Policy:

  1. All policies, processes, and procedures must comply with local, national, and applicable international accreditation standards (i.e. AABB, CAP, ISO, and JCI).
  2. All recruitment information must be entered into Hematos IIG.
  3. The Coordinator, Donor Affairs, is responsible for all recruitment activities.
  4. Donor recruitment staff will visit scheduled donation sites in advance and assess their suitability and prepare them for use before the start of each campaign.
  5. Donor recruitment materials and announcements will be left at each location during the inspection visit.
  6. Collected blood will be stored at room temperature during the collection on-site and transported back to the Donor Center in suitable validated containers to maintain storage at desirable temperature.
  7. The processes and procedures for normal donation, e.g. registration, donor questionnaire, physical examination, and collection apply.

References:

  1. HMC 1001 Setting Specification, Version 1.5, Hematos IIG, Medinfo
  2. Standards for Blood Banks and Transfusion Services, Current Edition, AABB, Bethesda, Maryland, USA

Daratumumab (Anti-CD38) Interference with Compatibility Testing

This is a revised version of a previous post.

Principle:

Daratumumab is a monoclonal antibody that binds to CD38 antigen, which is expressed weakly on the surface of all RBCs.  It may thus cause a positive direct antiglobulin test DAT and so interfere with compatibility testing if an antiglobulin phase is required.

This effect may persist up to 6 months after discontinuing the drug.  The monoclonal antibody does not interfere with routine ABO/D typing.

Special techniques (neutralization of CD38 antibodies by CD38 anti-idiotypic antibodies, or soluble CD38 antigen) may remove the panreactivity but may not be generally available.  DTT, a sulfhydryl reagent may denature the native CD38 antigen on RBCs but it should be used under a biologic hood.

Kell antigens will be denatured so Kell antibodies cannot be detected after treatment so Kell-negative RBCs should be used.  In the Gulf Area, this is about 72% of RBCs.

Policy:

  1. The clinical services must inform Transfusion Medicine of patients who will be receiving daratumumab therapy BEFORE treatment is started.
  2. Transfusion Medicine staff will enter a general comment (i.e. not associated with a particular result) in the patients Medinfo HIIG record:  PATIENT ON DARATUMUMAB.
  3. If not already done, Transfusion Medicine staff will perform an extended antigen typing:  at least C, c, E, e, K, k, Kpa, Jka, Jkb, Fya, Fyb ,M, N, S, s, Lea, Leb, P1—even if no antibodies are currently identified.
  4. Transfusion Medicine staff will send each such patient’s record to a Transfusion Medicine Physician to determine the blood type including extended antigens to match for future transfusions.
  5. When compatibility testing is requested, perform it as per our SOPs.
  6. If available, prepare DTT-treated cells for testing but realize that this will denature Kell antigens.  Use K-nell RBCs.
  7. Release least “incompatible” RBCs must be approved by the Transfusion Medicine Physician.
  8. When the DAT becomes negative (i.e. up to SIX months after cessation of Daratumumab therapy), routine compatibility testing and RBC selection will apply.

References:

Trick or Treatment, Anti-CD38 Reactivity and How to Treat It, AABB Satellite Symposium transcript, U. Cincinnati and RedMedEd, October, 2015 (attachment)

Service Level Agreement Example

At HMC Doha, I used service level agreements SLA to specifically define responsibilities in a contract for service between various entities including:

  • Transfusion Medicine and outside clients (blood components and transfusion testing)
  • Transfusion Medicine and HMC departments outside blood bank (e.g. operating theatres, liver transplant, trauma, etc.)
  • Blood Donor Center and HMC hospital blood banks

The following is a sample of a previous SLA between the Transfusion Medicine Division and one of HMC’s hospital’s operating theatres.