Skip to Main Content

Blood procurement is a vital national priority that is met in the United States by volunteer donors and a pluralistic blood collection program that includes the American Red Cross, independent community blood centers, and hospitals. More than 13 million units of whole blood are collected from approximately 10 million donors annually. Recruitment of donors is preceded by a medical history and limited physical examination. The donated blood is subjected to as many as 15 tests, which include determination of blood type, examination for red cell antibodies, and a series of studies for infectious agents that may be transmitted by blood transfusion. The process usually starts with donations from random, unrelated donors but may include autologous, patient-specific, or patient-directed donors in special circumstances. In some cases, collection of red cells, platelets, leukocytes, or plasma is achieved by hemapheresis. Plasma for the subsequent manufacture of derivatives such as albumin and intravenous immunoglobulin is obtained from paid donors by for-profit organizations different from those that collect whole blood and prepare blood components. The meticulous attention to donor risk characteristics and the use of sensitive assays to detect infectious agents that may be transmitted by blood have greatly improved the safety of blood as a therapeutic product in countries that apply these practices. Nevertheless, a risk of viral and bacterial infection, albeit small, remains. The introduction of nucleic acid amplification and bacterial detection techniques to detect microbial contaminants are the latest steps to further decrease the risk of acquiring an infection through transfusion.

Acronyms and Abbreviations

Acronyms and abbreviations that appear in this chapter include: AABB, American Association of Blood Banks; CPD, citrate, phosphate, dextrose; G-CSF, granulocyte colony-stimulating factor; U, units.

System in the United States

The United States has a pluralistic rather than the single national system of blood collection that exists in other developed countries.1,2 In the United States during 2005, approximately 15,019,000 units of blood were available for use (Table 139–1). Approximately 94 percent of the blood was collected in regional blood centers and hospitals collected 6 percent.3 Approximately 2 percent of the units donated in the United States were autologous donations and another 0.9 percent were directed donations—that is, blood given by family or friends for a specific patient. Both autologous and directed donations decreased from 2001.3 Of red cells collected, 97.7 percent of allogeneic, 59 percent of autologous, and 100 percent of directed donor red cells were transfused.3 Approximately 5,300,000 patients received a red cell transfusion for an average of 2.7 units per patient.3 A single organization, the American Red Cross, collects approximately 45 percent of the blood through its network of 36 regional blood centers. Community blood centers and hospitals collect the remainder. Community blood centers are individual, locally operated, nonprofit organizations, whereas the American Red Cross is a single national corporation with a single FDA license and set of operating procedures ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.