In the US, storage and transport of blood components by the provisions of the State Food and Drug Administration and the AABB are (formerly American Association of Banks) and regulated in some states through regional health authorities. The Spendervoruntersuchung includes an extensive questionnaire of health history and to, the measurement of the temperature, the heartbeat and blood pressure as well as a determination of hemoglobin. Some potential donors may be temporarily or permanently excluded from donation (see table: Temporary or permanent exclusion criteria for blood donation). Through the selection criteria excluded donors are protected from possible side effects of the donation and the recipient against possible transmission of diseases. Whole blood donations are limited every 56 days on a one-time implementation of use, while apheresis donation erythrocytes (donations is double the usual amount of erythrocytes in a session) all 112 days are limited to a single execution. Apheresis platelet donations may be carried out every 72 hours, with the maximum number of 24 per year. With rare exceptions blood donations be made without payment. (See also the American Red Cross for information on the suitability of donors.) Temporary or permanent exclusion criteria for blood donation criteria result for donation Note AIDS or belonging to a high-risk group, male homosexuals Permanent rejecting high risk activities such as i.v. Drug use and sexual activity with HIV-infected anemia temporarily defer donation after healed anemia allowed use of bovine insulin (due to risk of variant Creutzfeldt-Jacob disease) Remember those who served since 1980 bovine insulin: as donors unsuitable Malignant tumors Permanently individuals with relatively simple treatable forms (eg small carcinomas of the skin.) may be suitable as a donor Congenital coagulation disorder Persistent – drug (selection) Temporarily waiting time depends on the drug from: Finasteride: wait 1 month after the last dose isotretinoin: wait 1 month after the last dose of dutasteride: waiting period 6 months after the last dose acitretin: Waiting period of 3 years after the last dose etretinate: wait indefinitely hepatitis exposure Temporarily waiting 12 months after a possible exposure Hepatitis Permanently As a donor unsuitable if ever viral hepatitis was diagnosed move hypertension Temporarily donation until the blood pressure is malaria or malaria exposure Temporarily waiting period of 3 years after a malaria treatment or by place of residence in an endemic malaria area under control; Wait 12 months after the visit to a malaria endemic area on US bases in Europe stationed military personnel at risk for variant Creutzfeldt-Jacob disease Permanently UK, Germany, Belgium, Netherlands: ? 6 months between 1980 and 1990 Other European countries: ? 6 months 1980-1996 pregnancy temporarily wait 6 weeks after giving birth Severe asthma Persistent – Severe heart disease Remember – stay in the UK or Europe for individuals at risk for variant Creutzfeldt-Jakob disease Permanently UK: Total stay> 3 months from 1980 to 1996 Europe (except France): Total stay ? 5 years since 1980 France: Total stay> 5 years since 1980 Tattoo Out of waiting 12 months transfusion, which increase the risk of variant Creutzfeldt-Jacob disease can temporarily wait 12 months Permanently recipients of blood products in the UK since 1980 vaccines (selection) Temporarily waiting time depends on the dose from toxoid, synthetic or killed viral, bacterial or Rickettsienimpfstoffe * with asymptomatic and afebrile donors: no wait measles, mumps, polio – (Sabin) or (oral) typhoid vaccines : wait 2 weeks rubella, or varicella : waiting time 4 weeks * These vaccines include those (Salk), Rocky Mountain spotted fever, tetanus and typhoid injection against anthrax, cholera, diphtheria, hepatitis A, hepatitis B, influenza, Lyme disease, paratyphoid, whooping cough, plague, pneumococcal polysaccharide polio. those who received other attenuated viral or bacterial vaccines, may be excluded depending on the vaccine for 2 or 4 weeks. UK = United Kingdom. In the standard blood donation about 450 ml whole blood is collected in a plastic bag containing a antikoagulatorsches preservative. Whole blood or packed red blood cells, which were preserved with citrate-phosphate-dextrose-adenine, can be stored for up to 35 days. With the addition of adenine-dextrose-saline solution are storable erythrocyte concentrates up to 42 days. The autologous blood donation, d. H. the removal of the patient’s own blood is used less frequently for transfusion. In the 2-3 weeks before a scheduled surgery up to 3-4 units of whole blood or packed red blood cells are collected. The patient is substituted in parallel with iron. Such elective autologous donations can be considered when suitable blood is hard to come by because the patient antibodies to erythrocyte antigens formed or has a rare blood type. Specific methods enable the collection and autotransfusion of blood after trauma or during surgery. Investigations prior to transfusion to the donor to be carried out tests include the typing of AB0 and Rh0 (D), antibody screening and testing for infectious diseases (see table: testing for infectious diseases). Testing for infectious diseases infectious agent type of test Chagas disease antibody test hepatitis B core antibody test hepatitis B surface antigen test Hepatitis C virus nucleic acid test and antibody test HIV * Nucleic acid test HIV-1 and HIV-2 * antibody test Human T-cell lymphotropic virus type 1 and 2 antibody test Treponema pallidum (syphilis) antigen test West Nile virus nucleic acid test * If the antibody test is positive, is used to confirm a Western blot or a recombinant immunoblot assay durchgeführ t. A compatibility study analyzed the erythrocytes of the recipient to antigens compared to A, B and Rh0 (D). In addition, a screening test is for antibodies to other red cell antigens. This includes the cross-matching to ensure that the plasma of the receiver is compatible with the erythrocyte antigens of the donor. The impact assessment must be carried out prior to transfusion, although it is often performed in cases of emergency, the test only after release of blood products by the blood bank. In addition, the investigations in the diagnosis of transfusion reaction can be helpful. The AB0-typing of donor and recipient blood is carried out to prevent the transfusion of incompatible red blood cells (erythrocytes Compatible types). In general, the transfused blood should have the same AB0 type as the recipient. In emergency situations or if the correct blood type of the patient is doubtful or unknown, packed red blood cells can (not whole blood, acute hemolytic transfusion reaction Transfusion Complications: Acute hemolytic transfusion reactions (AHTR)) of the blood group 0 Rh negative, which still contain neither A-B antigens, regardless are used by the AB0 type. Compatible red cells types By Rh typing is to determine whether the patient’s Rh factor Rh0 (D) has (Rh-positive) or not (Rh-negative). Rh-negative patients should receive Rh-negative blood always, unless in life-threatening emergency situations where no Rh-negative blood is available. Patients with Rh-positive blood type can, however, receive Rh-positive and Rh-negative blood. Occasionally react erythrocytes of Rh-positive patients only weakly on the Rh-standard test (weak D or Du-positive). These patients are nevertheless considered to be Rh-positive. An antibody screening for irregular antibodies is routinely carried out by the recipient and prenatally in pregnant women. Irregular antibodies directed specifically against other erythrocyte antigens A and B, for. B. Rh0 (D), Kell (K), Duffy (Fy). Its early detection is important because such antibodies severe hemolytic transfusion reactions or hemolytic jaundice in the newborn (Perinatal Anemia: hemolysis) can cause. In addition, they hinder the compatibility testing and delay the provision of compatible blood products. The indirect antiglobulin test (indirect Coombs test) for the the detection of irregular red cell antibodies in serum. This test can be positive if irregular antibodies or free (not bound to red blood cells) antibodies are present, eg. Example, in the autoimmune hemolytic anemia (autoimmune hemolytic anemia). The erythrocytes to be tested are incubated with patient plasma or serum is mixed, washed, and added antihuman globulin. Thereafter, the agglutination reaction is observed. Since an antibody was discovered, its specificity must be determined. This allows assessment of its clinical significance selected appropriate blood products and hemolytic jaundice are controlled in newborns. The direct antiglobulin test (direct Coombs test) facing antibody surrounding the red blood cells of the patient in vivo. It is used when the suspected immune-mediated hemolysis is. Here erythrocytes of the patient are mixed directly with antihuman globulin and wait for agglutination. If a positive test result to the clinical findings fits, it must be assumed that an autoimmune hemolytic anemia, drug-induced hemolysis, a transfusion reaction or a hemolytic jaundice of the newborn. An antibody titration is carried out when a clinically significant irregular antibodies in plasma of a pregnant woman is detected, or if in a patient associated with a cold agglutinin autoimmune hemolytic anemia is present (autoimmune hemolytic anemia). The maternal antibody titer correlates relatively well with the severity of hemolytic jaundice in the newborn and in the treatment – often used as a benchmark – in combination with ultrasound and studies of the amniotic fluid. Due to the additional implementation of crossmatch after AB0 typing and the antibody screening only 0.01% will be discovered more incompatibilities. Therefore, many hospitals perform more computerized, electronic crossmatch by as physical cross-matching in patients with negative antibody screening. Is a clinically relevant erythrocyte antibodies against the recipient, so donors syrup shall be selected that are negative for this antigen. In addition, a Antiglobulinkreuzprobe with receiver plasma donor red blood cells and antihuman globulin is performed. No clinically relevant antibodies against the recipient, confirms the AB0 compatibility by an immediate crossmatch that bypasses the Antiglobulinphase. Emergency transfusions are performed when time does not exist sufficient (generally <60 minutes) to perform thorough compatibility testing because the patient is in hemorrhagic shock. If time permits, should the AB0 / Rh type compatible blood is transfused (to determine about 10 minutes required). In more urgent situations, the blood is transfused with unexplained 0 AB0 blood type and Rh unclear type Rh-negative blood for women of childbearing age; in other cases, either Rh-negative or Rh-positive blood can be used. According to the "type and screen", the procedure is when a transfusion is scheduled in a corresponding situation, for. As in elective surgical procedures. Here, first, the determination of the AB0 / Rh type and antibody screening the patient. If no antibodies are present and the patient requires blood, Rh-specific or compatible blood is issued without the Antiglobulinphase the crossmatch AB0 /. In the detection of an irregular antibody carrying out all the tests necessary.