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Standards,RegulationsandGoverningBodies h [X X hp x (#%'0*,.8135@8:<H?X X, X0  1.0%% ThebloodbankingindustryintheUSisveryregulatedandmanyagenciesareinvolvedinsettingthe p standardsandguidelinesforpractice.H%%   2.0  The FoodandDrugAdministration (FDA4 O  5  http://www.fda.gov/6 O   7 ( Ԁ)isthegovernmentalagencyresponsible  forensuringthesafetyofthenationsbloodsupplybymandatingallfacilitiescomplywiththeirstandards. | The2followingagenciesfallunderthe umbrellaoftheFDA.T%%   0  a.0%%The CenterforBiologicsEvaluationandResearch ( _CBER_ 4 O  5  http://www.fda.gov/cber/blood.htm6\Op  7 L%) ,  regulatesthecollectionandmanufactureofbloodandbloodcomponents.#[Xm7X%[&]Z#[&]%X[Xm7 `!%%   0  b.0%% CodeofFederalRegulations(_CFR_Ԅ 4 O  5  http://www.gpoaccess.gov/cfr /6cOw  7 Ԁ) mandatesthatallbloodcollection <" facilitiescomplywith"CurrentGoodManufacturingPractice(cGMPs)forBloodandBlood  # Components". $%%   2.0  AmericanAssociationofBloodBanks(_AABB_Ԅ 4 O  5  http://www.aabb.org #[Xm7X%[&]#[&]%X[Xm76hO|  7 ) istheprofessionalorganizationwhich "H & setsstandardsforpractitionersinthefieldoftransfusionmedicine.|#$!'%% 0    a.0%%Providesminimumstandardsforbloodcentersandtransfusionservices.T$!(%%     b.0  Twopublications,AABBStandardsforBloodBanksandTransfusionServicesandtheTechnicalManual.,%")%%   3.0  The CollegeofAmericanPathology(CAP4 O  5  http://www.cap.org6O  7 Q ) provideslaboratoryinspectionand &$+ accreditationinthehospitalsetting.'`%,%%   4.0  The JointCommissiononAccreditationofHealthcareOrganizations(JCAHO4 O  5  http://www.jcaho.org 6IO]  7 H%)  h)'. inspectsalloperationsofhealthcareorganizationseveryotheryear,includingthelaboratory.D*'/%%   5.0  The NationalCommitteeforClinicalLaboratoryStandards(NCCLS4 QO  5  http://www.nccls.org 6O  7 e#E) isan +)1 organizationthatprovidespublishedstandardsforclinicallaboratoryscienceinallareasofpractice,e.g.,a ,x*2 standardformatforproceduremanuals.EffectiveJanuary2005willbecalledClinicalandLaboratory -P+3 StandardsInstitute..(,4%% e~ e  e  D.  DonorScreening X   1.0   Serves2purposes :%% 0    a.0%%Assesshealthofpotentialdonortoensuredonationwillnotharmthem.%% 0    b.0%%Protectpotentialrecipientbypreventingselectionofdonorswhomayhaveinfectiousdiseases.b%%   2.0  Willhaveoneoffouroutcomes:acceptance,temporarydeferral,indefinitedeferralorpermanentdeferral. j  Indefinitedeferralsareforthoseconditionsforwhichatesttodefinitivelydetermineinfectiousstatusis B notavailable.Forthepurposesofthislectureguide indefiniteand permanentwillbesynonymous. %%   3.0  Threecomponentsofdonorscreening: r %% 0    a.0%%Registration J %% 0    b.0%%MedicalHistoryz " %% 0    c.0%%PhysicalExaminationR %%   4.0  Donorselectionisbasedonalimitedphysicalexamandmedicalhistory. %% 0    a.0%%Performanceshouldbedoneinawaytomaintainprivacy,allayapprehensionandallowtimefor Z discussion.2%% 0    b.0%%Uponsuccessfulcompletionofthescreeningprocessthedonorwillgoontotheactualphlebotomy.b %% E.  RegistrationoftheDonor    1.0  Mustobtaincompleteandaccuratedemographicinformationabouteachdonor.j%%   2.0  Recordsmustbekept5yearsor6monthsaftercomponentexpires.B%%   3.0  Informationtobeobtainedfromdonorr%% 0    a.0%%Dateofcurrentdonation"%% 0  0%%b.0%%Dateofpreviousdonation0W%%W%W%     c.0  Fullnameorpreviousnamesz%%     d.0  AddressR%% 0  0%%e.0%%Phonenumber*%%     f.0  GenderZ %%     g.0  Ageand/ordateofbirth.2!%% [X X  hp x (#%'0*,.8135@8:<H?X X, X0  0%%  1)0 %%Atleast17yearsofage. " % % 0  0%%  2)0 %%Elderlyacceptediftheymeetall_requirements_# % % 0  0%%  3)0 %%Autologousdonation b$ % %     h.0  Reasonforpreviousdeferralsj" &%% 0    i.0%%Writteninformedconsentmustbeobtained.B# '%%   3.0  Additionalusefulinformation:$")%% 0    a.  Additionalidentificationinformationsuchassocialsecurityordriverslicensenumber%r#*%%     b.  Nameofpatientorgrouptobecredited &J$+     c.  Race z'"%,     d.0  UniquecharacteristicsofthedonorR(%-%%   4.0  Informationwhich must beprovidedtotheprospectivedonor.*'/%%   0  a.0%%EducationalmaterialsabouthighriskactivitiesforexposuretoHIV,mustdocument.*(0%%   0  b.0%%Warningsaboutpossibledonorreactionstodonation,firsttimedonorsmayneedmoreextensive +\)1 information.,4*2%%   0  c.0%%Informationonteststhatwillbedoneandnotificationofresults.d- +3%%   0  d.  Postphlebotomycareinstructions.<.+4%% ЇF.0  MedicalHistoryX%%   1.0  Blooddonationshouldnotdonatemorethan 525mlevery8weeks ,for_hemapheresis_Ԁitis48hours.%%   2.0  Havetheybeendeferredasadonorbeforeand,ifyes,whatwasthereason.b%%   3.0  _AABB_Ԁhassimplifiedandstandardizedthisprocessbyprovidinga" UniformMedicalHistory j QuestionnaireforWholeBloodDonors 4toYO  5  http://tinyurl.com/6yo3k60O0.  7toe"1ԀF%%   4.0  Reasonsfordeferralandtimelimitsofdeferralarechangingconstantly,mustkeepproceduresuptodate.  %%   4.0   Permanentdeferral : R %%   0  a.0%%Menandwomenwhohaveengagedinsexfordrugsormoneysince1977. , %% 0  0%%b.0%%Menwhohavehadsexwithanothermale,evenonetime,since1977.\  %% 0    c.0%%PeoplewhohaveusedIVdrugs(evenonce).4 %% 0    d.0%%Takingclottingfactorsforableedingdisordersuchashemophilia.  %% 0    e.0%%PeoplewithclinicalorlaboratoryevidenceofHIVinfection. %%   0  f.0%%Hepatitisafterage11.d%%   0  g.0%%Cancer : Leukemiaandlymphoma,individualswhohadtreatmentandhavebeendiseasefreefor5years < maybeacceptableafterevaluationbyaqualifiedphysician.p%% 0  0%%h.0%%_Cruetzfeldt_ԀJakobdisease(_CJD_):Thefollowingindividualsarepermanentlydeferred:H%% 0  0%%0%%1)0 %%Receivedpituitarygrowthhormoneofhumanorigin  % % 0  0%%0%%2)0 %%Receivedatransplantofbraincovering(duramater)orcornealtransplant. % % 0  0%%0%%3)0 %%Familymemberwith_CJD_.x % %   0  0%%4)0 %%Spentacumulativeof3monthsormorebetween198096intheUK#[Xm7X%[&]#[&]%X[Xm7.P % %   0  0%%5)0 %%TakenBovineInsulinimportedfromcountriesinwhich MadCowDiseasehasbeenfound, ( permanent#[Xm7X%[&][:#[&]%X[Xm7X % % 0  0%%_i_.0%%Individualswhohaveeverhadthefollowingparasiticblooddiseases:ChagasDiseaseor_Babesiosis_.0%% 0    l.0%%Peoplewhohaveeverhadapositivetestforoneormoreofthefollowing:%% 0  0%%  1)0 %%_HBsAg_ % % 0  0%%  2)0 %%HepatitisC` % % 0  0%%  3)0 %%_HTLV_ԀI/II8 % % 0  0%%  4)0 %%HIVh  % % 0    m.0%%Donorwhodonatedonlyunitofbloodgiventoapatientwhothendevelopedposttransfusionhepatitis, " orhasbeeninvolvedin2ormorecasesofposttransfusion_hepatitis.#[Xm7X%[&]z;#[&]%X[Xm7_#%%   5.0   Deferfor12months !H%%%     a.0  Recipientofblood,bloodcomponentsorhadtissueororgantransplant.R# '%% 0  0%%b.0%%Highriskbehaviors:%")%% 0  0%%0%%1)0 %%Womenwhohavehadsexwithmenwhohavehadsexwithanotherman,evenonetime,since %#* 1977.&Z$+ % % 0      2)0 %%Hashadsexwithsomeonewhowasgivendrugsormoneyforsex.'2%, % % 0  0%%0%%3)0 %%HashadsexwithanypersonwhoisapastorpresentIVdruguser.b( &- % % 0  0%%  4)0 %%Historyofsyphilisorgonorrhea.:)&. % % 0  0%%0%%5)0 %%Hadsexwithsomeonewhohastakenclottingfactorsonregularbasis.*'/ % %   0  0%%6)0 %%SexualpartnerofsomeonewhoisHIVpositive.*(0 % % 0  0%%c.0%%Receivedaninjectionofhepatitisimmuneglobulin(_HBIG_).,B*2%%  0  0%%d.0%%Acupuncture,tattooing,orearpiercingdoneunderquestionablecircumstances.r-+3%% 0  0%%e.0%%Accidentalneedleexposureornonsterileskinpenetrationwithinstrumentscontaminatedwithbloodor X  bodyfluids.0%% 0  0%%f.0%%Rabiesvaccinegivenfollowingthebiteofarabidanimal.%% 0  0%%g.0%%Recentinmateofaprison,juveniledetentionormentalinstitutionformorethan72consecutivehours.%% 0  0%%h.0%%ClosecontactwithAIDSorhepatitispatientwhichisdefinedasdonorswhosharelivingquartersorare ` asexualpartnerofapersonwithviralhepatitisorAIDS.8%% 0    _i_.0%%Traveledtoamalarialendemicarea,componentsfreeof_RBCs_Ԁareexempt.h%%   0  j.0%%Intranasaluseofcocaine@%% 0  6.0%%Temporarydeferral  %% 0  0%%a.0%%Immunizations H %%   0  0%%1)0 %%Measles(rubeola),mumps,yellowfever,oralpolio,typhoid2weeksx  % %   0  0%%2)0 %%Germanmeasles(rubella),Varicellazoster(chickenpox)4weeksP  % % 0  0%%0%%3)0 %%Smallpox2months(  % %   0  0%%4)0 %%Rabies,_HBIG_Ԁ1year  % % 0  0%%0%%5)0 %% NOTE: Thereisnodeferralfor_toxoids_Ԁorkilledvaccines(includingHepatitisBvaccine).  % %   0  b.0%%Medications4%% 0  0%%  1)0 %%Aspirin,_piroxicam_Ԁ(_Feldene_)deferplateletdonorsfor3days.d  % % 0      2)0 %%Isotretinoin(Accutane)or1month< % % 0  0%%0%%3)0 %%Finasteride(Proscar)(Propecia)1month % %   0  0%%4)0 %%_Acitretin_Ԁ(_Soriatane_)3years % % 0      5)0 %%Etretinate(Tegison)permanentl % %   0  0%%6)0 %%_Dutasteride_Ԁ(_Avodart_)6months.D % % 0  0%%c.0%%Existingpregnancyorpregnancyinlast6weeksiscausefordeferralexceptunderextremelyunusual L circumstances.$%%   0  d.0%%Livedinmalarialendemicareaorhadmalarialinfection3years%%   0  e.0%%WestNilevirusdeferredfor28daysfromonsetofsymptomsoruntilpatientissymptomfreefor28 | days. NOTE :Recentarticlerecommending56daydeferral.T%% 0  7.0%%Otherillnessesormedicationsareevaluatedonanindividualbasis.` %% G.  PhysicalExamination "   1.  Generalappearance  h$   2.0  Weight110lbs.!@%%%   3.0  Temperature37.5Cor99.5Fp" &%%   4.0  Pulse50100beatsperminuteandregularH# '%%   5.0  Bloodpressure $!(%% 0    a.0%%Systoliclessthanorequalto180mmHg$")%%   0  b.0%%Diastoliclessthanorequalto100mmHg%x#*%%   6.  Determinationofhemoglobinlevel &P$+     a.0  allogeneic(regular)donors12.5g/dL'(%,%%   0  b.0%%autologousdonors11.0g/dLX(&-%%     c.0  Hemoglobindeterminationbycoppersulfatewithaspecificgravityof1.053forallogeneic,1.049for 0)&. autologousisaqualitativescreeningtest.*'/%%   7.0  Hematocritmaybeperformedinsteadof,orinadditionto,thehemoglobin.*(0%% 0    a.0%%allogeneic(regular)donor38%+`)1%%   0  b.0%%autologousdonor33%,8*2%%   8.0  Skinatvenipuncturesitemustbefreeoflesionsandneedlemarks.@.+4%% Ї_H.  ConfidentialUnitExclusion(CUE) X   1.0  Donorsmustbegiventheconfidentialopportunitytoinformbloodcollectionfacilitynottousetheirblood  fortransfusion.%%   2.0  Selfexclusionopportunityisgiventodonoruponcompletionofhistoryandphysical,andpriortogoinginto 8 thedonorroom.h%%   3.0  Ballotsystem,usesbarcodelabels. %%   4.0  Encouragedonortocallbloodcenteriftheychangetheirmindaboutacceptability. p %%   5.0  Donorshouldbeinformedthattheirbloodwillbetestedandtheywillbenotifiedofabnormalresults.x %% I.  Donorcategories (  0  1.0%%Theterms" _allogeneic_ "," homologous "and" randomdonor "areusedtodescribeblooddonatedbyan   individualtobegiventoanyone.\%%   2.0  Therapeuticbleeding(phlebotomy )isthetermusedwhenbloodiscollectedfroma patient formedical d  reasons.@%%   3.0  Autologousdonation isthetermusedforpatientswhodonatetheirownbloodpriortoanelectiveprocedure  forusebythepatientifexcessivebleedingoccurs.t%% 0  0%%a.0%%Verypopularfororthopedic,vascular,urologicandcardiacprocedures.L%% 0  0%%b.0%%Requiresdoctorsorderfornumberofunits.Cancollectupto5to6units.|$%%   0  c.0%%Autologousunitsarenotallowedto" crossedover ".T%% 0  0%%d.0%%Ifdonorhaspositiveserologymustbelabeled_biohazard_Ԁandstoredseparately.0%%   4. Recipientspecificdesignateddonations   0  0%%a.0%%Raredonorsd%% 0  0%%b.0%%Motherandbabies<%% 0  0%%c.0%%Singledonorforcomponentsl %%   5.0  Directeddonor isadonorpopulationcreatedduetothepublicsfearofAIDS,thepatientselectshisown " donors.#%%   6.0  _Hemapheresis_Ԁisremovalof1ormorebloodcomponentssuchasplasma,platelets,or_WBCs_Ԁfromadonor, !P% theunusedportionisreturnedtothedonor."( &%% 0  7.0%%Bonemarrowprocessingandprogenitorcellcollectionisthenewesttypeoftissueharvesting.0$!(%%   0  a.0%%Bonemarrow(usuallyautologous)isprocessedwhilepatientisinremissionandfrozen.%#*%%   0  b.0%%Stemcellnewesttherapywhichisreplacingbonemarrowtransplants.&`$+%%   0  0%%1)0 %%Stemcellsharvestedfromperipheralbloodbyapheresis.h(&- % % 0  0%%0%%2)0 %%Patientirradiatedandstemcells_reinfused_.@)&. % % 0  0%%0%%3)0 %%Infusedstemcellswillengraftandproduce"normal"cells.*'/ % % J.0  CollectionofBlood+p)1%%  0  1.0%%Phlebotomyperformedbywelltrainedpersonnel.x- +3%% _  2.0  Materialsandinstrumentsaresterile,singleuseanddisposable,bloodcontainersmustbepyrogenfree,sterile X  andFDAapproved.0%%   3.0  Identificationofdonorvery,verycritical.%%     a.  Identifydonorrecordwiththedonor      b.  Attachmentofnumberedlabels `     c.  Labelingprocessingtubes 8     d.  Finalrecheck h 0  4.PreparingVenipunctureSite %%     a.0  Selectlargefirmveininareafreeoflesions.  %%     b.0  Preparationofvenipuncturesiteiscritical,preparetoastateofsurgicalcleanlinessusingiodinesolution. p %%   5.0  Collectingtheunitx %%   0  a.0%%Glovesshouldbeavailableanddonothavetobewornexcept:( %% 0  0%%0%%1)0 %%bypersonnelintraining  % % 0  0%%0%%2)0 %%duringcollectionofautologousunits  % % 0  0%%0%%3)0 %%ifphlebotomisthascuts,scratchesorbreaksintheskiX % % 0  0%%b.0%%Collectedfromasinglevenipunctureusinga16or17gaugeneedle.`%% 0  0%%c.0%%Duringcollectionmixbloodwithanticoagulantfrequently.8%% 0  0%%d.0%%Monitoramountcollectedcarefullybyweighingorvisualinspection,maximumvolumeis450+/45  mls.%% 0  0%%e.0%%Collectionshouldbecompletedwithin15minutesifplateletswillbeprepared.h%% K.0  Adversedonorreactionsp%% 0  1.  Syncopeisageneraltermusedforfainting. %%     a.0  Signs/symptomsmayinclude:weakness,sweating,dizziness,pallor,lossofconsciousness,convulsions x and/orinvoluntarypassageofurineorfeces,skinfeelscold,bloodpressurefallsandpulserateoften P slowssignificantly.(%%     b.0  Removetourniquetandwithdrawneedle X %%     c.0  Movedonortoareaofprivacyfortreatment2!%%     d.0  Callphysicianiftreatmentdoesnotleadtorapidrecovery "%% 0  2.0%%Hyperventilationcausedbyexcessiverespiration,havedonorrebreatheintoapaperbag. b$%%   3.0  Nauseaandvomitingj" &%%   4.0  Twitchingormuscularspasmsoccursmostcommonlywithlossofconsciousnessandoccursinonehalfof $!( donorswholoseconsciousness.$")%%   50  Hematoma&J$+%%   6.Trueconvulsionsarerare R(%-   0  a.0%%Callsomeonetohelpyouimmediately*)&.%%     b.  Makesuredonorhasadequateairway *'/     c.0  Notifybloodbankphysician*(0%%   7.0  Seriouscardiacdifficultiesareexceedinglyrarebutiftheydooccurcallformedicalaidand/oranemergency ,2*2 careunitimmediately(ambulance).IfdonorisincardiacarrestbeginCPRimmediatelyandcontinueuntil b- +3 emergencypersonnel_arrive.:.+4%% Ї  8.Recordanydonorreactions. X L.  CareoftheDonorAfterPhlebotomy    1.0  Checkarmandapplybandage.`%%   2.0  Havedonorremainreclinedindonorchairforafewminutes.8%%   3.0  Allowdonortositupwhenhis/herconditionappearssatisfactory,checkphlebotomysitetomakesure h bleedinghasstopped,andhavepatientremainseatedfor1015minutes.@%%   4.0  Donorinstructionsforpostphlebotomycare.  %%     a.0  Eatanddrinkbeforeleaving. p %%     b.0  Donotleaveuntilreleasedbystaff. H %%     c.0  Drinkmorefluidsinnext4hours.x %%     d.0  Noalcoholuntilyouhaveeaten.P %%     e.0  Donotsmokeforonehalfhour.( %%     f.0  Ifbleedingcontinuesraisearmandapplypressure. %%     g.0  Iffaintordizzyliedownorsitdownwithheadbetweenyourlegs. %%   0  h.0%%Ifsymptomspersistreturntobloodbankorseeyourdoctor.X%%     _i_.0  Cautionsaboutreturningtowork.0%%     j.0  Removebandage.`%%     k.0  Restorationofnormalbloodvolumeoccursinapproximately3days.8%%   5.0  Thankdonorandofferrefreshments,watchforsignsofdonorreaction.%%   6.Notereactions(ifany)orifdonorleaveswithoutpermission. @ M.  Processingdonorblood H   1.0  AllreagentsusedfortestingmustmeetorexceedappropriateFDAregulations.%%   2.0  Records Cannotrelyonpreviousrecords P%%     a.0  Alltestresultsandinterpretationsmustberecordedimmediatelyuponcompletionoftesting.*%%     b.0  Recordsystemmustbesuchthatanyunitcanbetracedfromitssourcetofinaldisposition.Z %%     c.0  Alllabrecordspertainingtoanindividualunitmustberetrievable,includinginvestigationofadverse 2! affects. "%%     d.0  Recordsshouldberetainedfor5yearsor6monthsafterexpirationdate.#%% 0  3.0%%Generalconsiderationsindonorprocessing!:%%%     a.0  Numbersonbloodbag,processingtubesanddonorrecordsshouldberecheckedpriortoprocessing.j" &%%     b.0  ABOgroupandDtype,includingweakD,mustbedeterminedusingappropriatetestingprocedures. B# '  CANNOTRELYONPREVIOUSRECORDS. $!(%%     c.0  Donorwithhistoryoftransfusionorpregnancyshouldbetestedforunexpectedantibodies.$")%%   4.Testingfordiseasesw_hich_Ԁmaybetransmittedbytransfusion: &J$+     a.0  HepatitisBSurfaceAntigen(_HBsAg_)z'"%,%%     b.0  HepatitisBcoreantibody(_HBc_)R(%-%%     c.0  HepatitisCanti_HCV_*)&.%%     d.0  HIVantiHIV1,antiHIV2andHIV(p24)antigen*'/%%     e.0  HumanTcell_lymphotrophic_Ԁvirus_HTLV_ԄI/II*(0%%     f.0  Syphilis_RPR_+Z)1%%   b- +3   0  g.0%%NucleicAcidAmplificationTestNATteststhatdetectviralnucleicacidsaremoresensitivethan X  currentscreeningtestsisexpectedtoreducethepreantibody_sero_Ԅconversionwindowperiod.0%%   0  0%%1)0 %%ForHIVfromcurrent22daystoabout12days. % %   0  0%%2)0 %%For_HCV_Ԁfrom70daysto10to14days. % %   0  0%%3)0 %%WestNileVirus(_WNV_)` % % S8  5.0  Fortransfusionunitsmustbenonreactive,negativeorwithinnormalrange,ifunitmustbetransfusedprior  totestingitmustbeconspicuouslylabeledanddoctormustsignreleaseform.c%%   6.0  Additionaloptionaltestswhichmaybeperformedinclude_CMV_Ԁtesting,specialantigentypingandtestfor k  sicklecelltrait.C  %%   7.0  Labelingdonorunits %%  _(93\  0  a.0%%Propernameofcomponent. s %% 0  0%%b.0%%Uniquedonornumber. K %% 0  0%%c.0%%ABOgroup,Dtype(notrequiredforplasmacomponents).{# %%   0  d.0%%Interpretationofantibodytestsandresultsofunusualtests,_ie_,_CMV_.S %% 0  0%%e.0%%Typeandvolumeofanticoagulantandthevolumeoftheunit(notrequiredfor_CRYO_).+ %% 0    f.0%%Requiredstoragetemperature%% 0  0%%g.0%%Expirationdate.%% 0  0%%h.0%%Nameandaddressofthecollectingfacilityand/orfacilitythatpreparedthecomponent.[%% 0  0%%_i_.0%%ReferencetotheCircularofInformation.3%% 0  0%%j.0%%Appropriatedonorclassificationc %% 0  0%%k.0%%Resultsoftestsforinfectiousdiseases.0%%;%% 0  0%%l.0%%Essentialinstructionsorprecautionswhich must include:%% 0  0%%0%%1)0 %%"thisproductmaytransmitinfectiousagents" % % 0  0%%0%%2)0 %%"properlyidentifyintendedrecipient"m % % 0  0%%0%%3)0 %%"federallawrequiresaprescription"E % % 0  0%%l.0%%Additives,sedimentingagentsand_cryoprotective_Ԁagentsadded.M%% 0  0%%m.0%%Pooledcomponentsmustincludethenameofthecomponent,auniqueidentificationnumber,numberof % unitsinthepool,ABOandDtypeofallunitsandthefinalvolume.%% 0  8.0%%TheonlyrepeattestingrequiredbythetransfusionserviceisconfirmationoftheABOandDtype_of_Ԁredcell U  bloodproducts.-!%%     a.0  Discrepanciesmustbereportedtothecollectingfacilityandmustberesolvedpriortoissue.5 #%%     b.0  Repetitionofothertestsondonorunitsisnotrequiredorrecommended. !$%%   9.0  Donorsamplesmustbestoredinthetransfusionserviceat16C foratleast7daysafter%  transfusion .#[Xm7X%[&]K@#