Blood Donation Screening Tests: Complete Panel and Rationale

Standard Blood Donor Screening in the US (FDA/AABB)

Every unit undergoes mandatory testing before release.

Donor Eligibility Screening (Pre-Donation)

• Health history questionnaire (risk behaviors, travel, medications).
• Physical: Hb/Hct (fingerstick), BP, pulse, temperature.
• Weight ≥110 lb (50 kg).

Laboratory Testing on Each Donation

Additional Tests (Not Universal)

• Hemoglobin electrophoresis (sickle cell trait – donor info).
• CBC (WBC, RBC, platelets, indices) – donor health, not recipient safety.
• ALT (liver health surrogate).
• CMV status (for immunocompromised recipients).
• Hemoglobin S (sickle) – donor notification.

Pathogen Reduction Technologies

• INTERCEPT (platelets/plasma), Mirasol (platelets/plasma/whole blood) – reduce residual risk.

Deferral & Notification

• Reactive → confirmatory testing → donor notification, counseling, deferral registry.
• Lookback/recall if recent donation from positive donor.

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Test	Method	Purpose
ABO/Rh typing	Automated agglutination	Compatibility for transfusion
Antibody screen (unexpected)	Indirect antiglobulin	Detect alloantibodies (Kell, Duffy, Kidd, etc.)
HIV-1/2 Ag/Ab	Chemiluminescence (4th gen)	Window ~18 days
HBV: HBsAg, anti-HBc, HBV DNA	NAT + serology	Window ~21 days (DNA)
HCV: Ab + HCV RNA	NAT + serology	Window ~7 days (RNA)
Syphilis (Treponema pallidum)	Treponemal (EIA/CIA) + nontreponemal (RPR)	Detect active/past
HTLV-I/II Ab	EIA	Endemic areas, transfusion-associated
West Nile Virus RNA	NAT (seasonal/universal)	Emerging threat
Zika Virus RNA	NAT (as needed)	Outbreak-responsive
Babesia (endemic areas)	Ab + PCR	Transfusion-transmitted
Chagas (T. cruzi) Ab	EIA	Risk-based / universal