Directed blood donations

A donation that is given specifically for transfusion to a named

patient. Directed donors are friends or relatives who wish to give
blood for a specific patient. In 2006, approximately 70,000 units of
blood were donated as directed donor units. This represented 0.4% of
the total available blood supply, which was a huge decrease from
1989. The appeal of directed donor blood is that the patient hopes
those donors will be safer than the regular blood supply. However,
this blood might be less safe than the general community supply
because the donors would be under considerable pressure to donate
and might not be candid about their medical and riskbehavior
history. In general, the data do not indicate that directed donors are
either more or less safe than regular donors.
The use of directed donations has decreased over the last 10
years, but the ongoing demand from patients for transfusions from
specific donors during scheduled surgeries likely still reflects the
skewed perception among the general public of the risk for HIV
associated with blood transfusion. Despite this, directed donor blood
has considerable appeal to many patients. Some blood banks decline
directed donations and some accept these donors as a service to the
patients. Each hospital must also decide whether to sequester the
blood and use it only for the intended patient or to allow the directed
donor blood to become part of the communitys general blood supply
if it is not used for the originally intended patient. If directed donor
units are to be crossed over into the general supply, the donors
must meet all the usual FDA requirements for routine blood donation.
In either situation, directed donor blood requires additional attention
and record systems for the blood center and hospital, thus increasing
the cost and creating the possibility for errors to occur and the blood
to be unavailable when desired for the particular patient.

Directed donations have higher viral marker rates than volunteer

donations, mostly but not entirely reflecting the higher prevalence of
first-time donors among the former group. There is no evidence that
directed donations are safer to use than donations from volunteer
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community donors. On the contrary, some concerns persist that
directed donors may feel unduly pressured to give blood, which could
compromise blood safety.

Directed donors must meet the same criteria as voluntary

donors, and their blood can be used for other patients if not needed
by the individual for whom the donations were initially intended. If
collection of whole blood is required from a directed donor more than
once in an 8-week period, the Code of federal regulations (CFR)
requires that the donor be examined and certified to be in good
health by a physician on the day of donation

The donor center should clearly communicate its directed-donation

procedures so that the expectations regarding the availability of
directed donor units are known to the ordering physician and patient.
The communication required includes defining the mandated interval
between collection of the blood and its availability to the patient,
mentioning the possibility that the patient will identify donors who are
not ABO compatible or not otherwise acceptable blood donors and
defining the policy for release of donor-directed units for transfusion
to other patients.
Additional information on the container can be conveyed using a
tie tag. Tie tags are especially useful for autologous and directed
donations. Tie tags include the patients identifying information,
the name of the hospital where the patient will be admitted for
surgery, date of surgery, and other information that may be
helpful to the hospital transfusion service.
Irradiation of blood components from directed donations
especially from family members or other related donors
PTP can be prevented by using antigen matched donors.
Autologous donations and directed donations from antigen
matched donors and family members may be appropriate

N.B: Patientspecific donation

* There are a few situations in which appropriate transfusion therapy
involves collecting blood from a particular donor for a particular
patient. Examples are donorspecific transfusions prior to kidney
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transplantation, maternal platelets for a fetus projected to have
neonatal thrombocytopenia or family members of a patient with a
rare blood type.
* In these situations, the donors must meet all the usual FDA
requirements, except that they may donate as often as every 3 days
so long as their hemoglobin remains above the normal donor
hemoglobin requirements.
* The units donated must undergo all routine laboratory testing.