Criteria for selection of blood donors

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Criteria for Selection of Blood Donors

Blood donor selection aims to protect both the donor (from harm during phlebotomy) and the recipient (from transfusion-transmitted infections). The evaluation must take place on the day of donation, before blood collection.

1. Registration & Identification

Donors must provide a valid form of identification
Demographic details: full name, home address, date of birth/age

2. Age

Minimum age: 17 years (without parental permission) in most states
16-year-olds may donate with parental consent in some states
No upper age limit is universally mandated (assessed individually)

3. Physical Examination Requirements

Parameter	Acceptable Range
General appearance	Must appear in good health
Temperature (oral)	≤37.5°C (99.5°F)
Pulse	50-100 bpm, regular
Blood pressure	Systolic ≤180 mmHg; Diastolic ≤100 mmHg
Minimum weight	≥50 kg (110 lbs)
Hemoglobin (female)	≥12.5 g/dL (or Hct ≥38%)
Hemoglobin (male)	≥13.0 g/dL (or Hct ≥39%)
Venipuncture sites	Both arms free of lesions; no evidence of repeated IV drug injection

Note: Hemoglobin/hematocrit cannot be measured by earlobe puncture. Athletes with HR <50 may be accepted if otherwise healthy.

4. Medical History

Donors must be free of:

Major systemic disease (cardiac, hepatic, pulmonary)
Active cancer
Abnormal bleeding tendency
Any condition as listed below (unless cleared by medical director)

5. Donation Intervals (Frequency)

Type of Donation	Minimum Interval
Single unit whole blood	≥8 weeks (56 days)
2-unit red cell apheresis	≥16 weeks
Plateletpheresis	≤2/week, ≥2 days apart, ≤4 times per 12 months

6. Donor Deferrals

Indefinite (Permanent) Deferral

HIV/HCV: repeatedly reactive antibody or NAT
On antiretroviral therapy (HIV medications)
Evidence of HTLV or Trypanosoma cruzi infection
HBV surface antigen positive, or repeatedly reactive core antibody/NAT
Family history of Creutzfeldt-Jakob disease (CJD)
Received allogeneic dura mater or human pituitary-derived growth hormone
Received live cells, tissues, or organs from a non-human animal source
Lived >5 years in a malaria-endemic area (after departure, 3 years if symptom-free)

2-Year Deferral

Positive (reactive) NAT for Babesia
Injectable long-acting pre/post-exposure prophylaxis (PrEP/PEP) medications for HIV prevention

12-Month Deferral

Residing with, or sexual contact with, a person with viral hepatitis
Incarceration >72 consecutive hours

3-Month Deferral

Exchanged sex for money, drugs, or other payment; or sex with someone who did
History or treatment of syphilis or gonorrhea (or positive syphilis screening test after therapy)
Receipt of blood products, human tissue, or plasma-derived clotting factors
Mucous membrane exposure to blood, or needle-stick from another person
Non-prescription (illicit) injection drug use
Skin penetrations: tattoos, acupuncture, or piercings (in non-regulated settings)

7. Information Given to Donors (Pre-Donation)

Before donating, donors are informed of:

Risks associated with phlebotomy
Infections transmissible through transfusion
Signs and symptoms of HIV/AIDS
The importance of providing accurate history
The importance of not donating if they have increased infection risk
Notification requirements if results are significantly abnormal

Donors must provide written informed consent.

8. Autologous Donation (Self-Donation for Own Surgery)

Requires a physician's order
Hemoglobin ≥11.0 g/dL or Hct ≥33%
No condition predisposing to bacteremia
Blood must be collected >72 hours before anticipated surgery
Units reserved exclusively for autologous use

Summary

The selection process is governed by FDA regulations and AABB Standards and balances donor health protection against recipient safety. The key elements are: age, physical exam (weight, Hb, BP, pulse, temperature), medical/social history, and structured deferral periods based on infection risk behaviors or exposures.

Quick Compendium of Clinical Pathology, 5th edition, sections 2.1.1-2.1.2 (Tables t2.1, t2.2)
Henry's Clinical Diagnosis and Management by Laboratory Methods, section on Apheresis Donor Selection

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