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McElfresh DC, Bennett J, Enriquez K, Pham TD. Measuring the effectiveness of online search ads on blood donor recruitment and donation. Transfusion 2024; 64:1016-1024. [PMID: 38693096 DOI: 10.1111/trf.17850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Acutely highlighted during the COVID-19 pandemic, the tenuousness of the blood supply continues to be a lynchpin of the most important medical procedures. Online advertisements have become a mainstay in donor recruitment. We set out to determine the effectiveness of online search ads and variations thereof on blood donations with an emphasis on first-time donors. STUDY DESIGN AND METHODS From September 01, 2022 through March 31, 2023, we performed a campaign comparison experiment through a major search-ads platform with two distinct messages: one altruistic ("Altruistic") and one with a prospect of rewards ("Promotion"). We developed a method to track donation outcomes and associated them with impressions, click-throughs, and conversions. We compared the performance of the Altruistic and Promotion arms to a control group that was not associated with any search-ads ("Baseline"). RESULTS Analyzing 34,157 donations during the study period, the Promotion group, and not Altruistic, had a significant difference of first-time donors over Baseline (24% vs. 12%, p = 7e-6). We analyzed 49,305 appointments and discovered that appointments made from the Altruistic arm resulted in a significantly higher percentage of donations when compared to Baseline (57% vs. 53%, p = .009); however, the Promotion group had a higher percentage of donations from first-time donors when compared to Baseline (12% vs. 8%, p = .006). CONCLUSION We developed a method for determining the effectiveness of online search ads on donation outcomes. Rewards/promotions messaging was most effective at recruiting first-time donors. Our methodology is generalizable to different blood centers to explore messaging effectiveness among their unique communities.
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Affiliation(s)
- Duncan C McElfresh
- Department of Health Policy, Center for Innovation to Implementation, Veterans Affairs Health Care, Palo Alto, California, USA
| | - Jenn Bennett
- Stanford Blood Center, Stanford Health Care, Stanford, California, USA
| | - Kay Enriquez
- Stanford Blood Center, Stanford Health Care, Stanford, California, USA
| | - Tho D Pham
- Stanford Blood Center, Stanford Health Care, Stanford, California, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
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2
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Miller YM, Bakhtary S, Chou ST, Hailu B, Reik RA, Richard RH, Spencer BR, Witherspoon R, Delaney M. Involvement of Diverse Populations in Transfusion Medicine Research. Transfus Med Rev 2023; 37:150766. [PMID: 37993382 PMCID: PMC11032214 DOI: 10.1016/j.tmrv.2023.150766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 11/24/2023]
Abstract
Communities of color and diverse communities (eg, race, socioeconomic status, language, sexual orientation etc.) have not been recruited and enrolled equitably to participate in research studies in transfusion medicine. The exclusion of diverse communities in transfusion research can lead to health disparities lack of access to approved therapeutics and unequal allocation of interventions, resulting in missed opportunities to optimize health for individuals and communities. Involvement of diverse populations in research goes beyond inclusion as research subjects. Strategies should include specific studies on health conditions of importance to diverse communities with stable funding sources and specific funding announcements to develop projects led by diverse researchers, mentorship of diverse researchers, and openness to various ways of communicating research plans. Qualitative approaches and interdisciplinary collaboration should be supported to enhance inclusivity.
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Affiliation(s)
| | - Sara Bakhtary
- Transfusion Medicine, Department of Laboratory Medicine, University of California San Francisco, USA
| | - Stella T Chou
- Division of Transfusion Medicine, The Children's Hospital of Philadelphia University of Pennsylvania School of Medicine, USA
| | | | | | - Raven Hardy Richard
- National Institutes of Health (NIH) National Human Genome Research Institute (NHGRI), USA
| | | | | | - Meghan Delaney
- Division of Pathology & Laboratory Medicine Children's National Hospital, The George Washington University, USA
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3
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Examining participant representation by sex, race, ethnicity and age in United States blood donation and blood transfusion clinical trials. Transfus Apher Sci 2023:103653. [PMID: 36781328 DOI: 10.1016/j.transci.2023.103653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Significant inequities based on sex, race, ethnicity, and age exist among participants in clinical trials dedicated to investigating medical disease states. While general demographic data regarding blood donors and blood transfusion recipients have been studied extensively, the demographics of participants involved in blood donation and blood transfusion clinical trials are unknown. We performed a cross-sectional analysis of United States (U.S.) -based interventional blood donation and blood transfusion clinical trials registered with Clinicaltrials.gov to ascertain the composition of participants' sex, race, ethnicity, and age, as well as diagnostic conditions and geographic trial locations.Eligible trials were undertaken between July 2003 and August 2020. Thirty-eight of the one hundred and fifty-two blood donation and blood transfusion clinical trials met inclusion criteria (seven blood donation and thirty-one blood transfusion trials). While the participant dataset from trial reports were incomplete, 100 % of blood donation trials reported sex and age, 71.4 % reported race, and 42.3 % reported ethnicity. 96.8 % of blood transfusion trials reported sex, 51.6 % reported race, 38.7 % reported ethnicity, and 100 % reported age. Among 2720 participants enrolled in the seven blood donation trials, females were underrepresented (28.5 %) compared to U.S. Census data. Conversely, female (50.8 %) and male participants (49.2 %) were equally represented in blood transfusion trials (9255 participants). White participants were overrepresented in blood donation trials (73.4 %), while Hispanic or Latinos were underrepresented in both blood donation (7.7 %) and blood transfusion (8.2 %) trials compared to 2019 U.S.Census data. Only 8.3 % of blood transfusion clinical trials open to adults reported including older adults (i.e., ≥ 65yo). Despite mandatory reporting requirements and an already established framework, researchers frequently failed to report complete demographics of blood donation and blood transfusion clinical trial participants. Furthermore, various demographic groups were underrepresented in blood donation and/or blood transfusion clinical trials, including females, Hispanic or Latino individuals, and older adults. These findings demonstrate the need for implementation of strategies to ensure equitable representation of individuals in blood donation and transfusion clinical trials.
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Abidoye O, Johnson A, Cho YM, Ogbuagu H, Choudhury H, Takegawa R, Hayashida K, Shinozaki K, Aoki T, Okuma Y, Zanos S, Zafeiropoulos S, Giannis D, Pipolo DO, Becker LB, Miyara SJ, Guevara S, Molmenti EP. Upper-Extremity Deep Venous Thrombosis after Whole Blood Donation—A Case Report. Int J Angiol 2022. [DOI: 10.1055/s-0042-1756216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
AbstractUpper-extremity deep venous thrombosis (UEDVT) after whole blood donation is rarely reported. Blood donation has a low rate of complications and is typically safe. A small percentage of blood donors experience donation-related events such as UEDVT, which are extremely rare. We are reporting a rare case of a UEDVT following blood donation. This is an extremely rare event; only five cases were reported to our knowledge. A 22-year-old Caucasian woman with a past medical history of provoked pulmonary embolism completed 6 months of apixaban and negative thrombophilia workup presented to the hospital with complaints of progressive pain and swelling in her right arm. The patient reports donating blood using her right arm in January 2021. Phlebotomy duration for blood donation was approximately 10minutes. She reported pain and swelling several days after blood donation. Subsequently, a duplex ultrasound showed a thrombus in the right brachial vein. The patient was started on apixaban for 6 months. Although most whole blood donors do not experience complications, DVT is a rare complication from whole blood donation with severe consequences. It should be considered in a donor with worsening pain and swelling.
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Affiliation(s)
- Oluseyi Abidoye
- Internal Medicine Department, Northeast Georgia Medical Center, Gainesville, Georgia
| | | | - Young Min Cho
- Internal Medicine Department, Northeast Georgia Medical Center, Gainesville, Georgia
| | - Henry Ogbuagu
- Internal Medicine Department, Northeast Georgia Medical Center, Gainesville, Georgia
| | - Hasan Choudhury
- Internal Medicine Department, Northeast Georgia Medical Center, Gainesville, Georgia
| | - Ryosuke Takegawa
- Feinstein Institutes for Medical Research, Manhasset, New York
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York
| | - Kei Hayashida
- Feinstein Institutes for Medical Research, Manhasset, New York
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York
| | - Koichiro Shinozaki
- Feinstein Institutes for Medical Research, Manhasset, New York
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York
| | - Tomoaki Aoki
- Feinstein Institutes for Medical Research, Manhasset, New York
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York
| | - Yu Okuma
- Feinstein Institutes for Medical Research, Manhasset, New York
- Department of Neurological Surgery, Sonoda Daiichi Hospital, Tokyo, Japan
| | - Stavros Zanos
- Feinstein Institutes for Medical Research, Manhasset, New York
- Elmezzi Graduate School of Molecular Medicine, Manhasset, New York
| | - Stefanos Zafeiropoulos
- Feinstein Institutes for Medical Research, Manhasset, New York
- Elmezzi Graduate School of Molecular Medicine, Manhasset, New York
| | - Dimitrios Giannis
- Department of Surgery, North Shore University Hospital, Manhasset, New York
| | - Derek O. Pipolo
- Department of Surgery, North Shore University Hospital, Manhasset, New York
| | - Lance B. Becker
- Feinstein Institutes for Medical Research, Manhasset, New York
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Santiago J. Miyara
- Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sara Guevara
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
- Department of Family Medicine, Glen Cove Hospital, Glen Cove, New York
| | - Ernesto P. Molmenti
- Department of Surgery, North Shore University Hospital, Manhasset, New York
- Department of Family Medicine, Glen Cove Hospital, Glen Cove, New York
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5
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Sheykhsoltan M, Wu W, Mei Z, Ward DC, Ziman A. Who donates? Patterns of blood donation and donor characteristics at a university-affiliated hospital-based donor center. Transfusion 2021; 62:346-354. [PMID: 34859437 DOI: 10.1111/trf.16754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/13/2021] [Accepted: 11/14/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Blood donors are a crucial element of the blood supply chain. Optimal recruitment strategies built upon the robust understanding of local donor behavior and demographics-specifically, the donor characteristics of our university-affiliated hospital-based donor center-improve outreach and retention of donors. STUDY DESIGN AND METHODS This retrospective study analyzed blood donors' genders, ethnicities, and donation frequencies at a university-affiliated hospital-based donor center from 2014-2019, stratified into seven age cohorts. Donor ethnicity demographics were compared to the reported student, employee, and LA County population. RESULTS Female donors outnumbered male donors in all age cohorts. The majority of donors self-identified (SI) as White (36.7%), Hispanic/Latino (21.6%), or Asian (19.1%). Older donors (age > 25) donated more frequently (4.1 vs. 2.3 donations per donor) than younger donors (age ≤ 25). Repeat donors who donated in multiple years during the study period were more likely to donate multiple times each year than those donors who only donated during 1 year. DISCUSSION Our donor demographics more closely reflect the university student and employee demographics than LA County demographics, demonstrating the broad local efforts of recruitment by student groups and donor center recruitment staff. However, non-White populations continue to be underrepresented. The majority of donors only donated once during the study period. Recruitment strategies to increase donor engagement among underrepresented populations and increase the proportion of repeat donors are likely to prove most beneficial.
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Affiliation(s)
| | - Wesley Wu
- University of California Los Angeles, Los Angeles, California, USA
| | - Zhen Mei
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Dawn C Ward
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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6
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Mowla SJ, Sapiano MRP, Jones JM, Berger JJ, Basavaraju SV. Supplemental findings of the 2019 National Blood Collection and Utilization Survey. Transfusion 2021; 61 Suppl 2:S11-S35. [PMID: 34337759 DOI: 10.1111/trf.16606] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Supplemental data from the 2019 National Blood Collection and Utilization Survey (NBCUS) are presented and include findings on donor characteristics, autologous and directed donations and transfusions, platelets (PLTs), plasma and granulocyte transfusions, pediatric transfusions, transfusion-associated adverse events, cost of blood units, hospital policies and practices, and implementation of blood safety measures, including pathogen reduction technology (PRT). METHODS National estimates were produced using weighting and imputation methods for a number of donors, donations, donor deferrals, autologous and directed donations and transfusions, PLT and plasma collections and transfusions, a number of crossmatch procedures, a number of units irradiated and leukoreduced, pediatric transfusions, and transfusion-associated adverse events. RESULTS Between 2017 and 2019, there was a slight decrease in successful donations by 1.1%. Donations by persons aged 16-18 decreased by 10.1% while donations among donors >65 years increased by 10.5%. From 2017 to 2019, the median price paid for blood components by hospitals for leukoreduced red blood cell units, leukoreduced apheresis PLT units, and for fresh frozen plasma units continued to decrease. The rate of life-threatening transfusion-related adverse reactions continued to decrease. Most whole blood/red blood cell units (97%) and PLT units (97%) were leukoreduced. CONCLUSION Blood donations decreased between 2017 and 2019. Donations from younger donors continued to decline while donations among older donors have steadily increased. Prices paid for blood products by hospitals decreased. Implementation of PRT among blood centers and hospitals is slowly expanding.
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Affiliation(s)
- Sanjida J Mowla
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education (ORISE), Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mathew R P Sapiano
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jefferson M Jones
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James J Berger
- U.S. Department of Health and Human Services, Office of HIV/AIDS and infectious Disease Policy, Office of the Assistant Secretary for Health, Washington, District of Columbia, USA
| | - Sridhar V Basavaraju
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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7
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Comparative Performance of Latest-Generation and FDA-Cleared Serology Tests for the Diagnosis of Chagas Disease. J Clin Microbiol 2021; 59:JCM.00158-21. [PMID: 33762363 DOI: 10.1128/jcm.00158-21] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/20/2021] [Indexed: 11/20/2022] Open
Abstract
Confirmed diagnosis of chronic Chagas disease (CD) requires positive results by two different IgG serology tests. Variable sensitivity has been reported among tests and in different geographic regions. Inadequate specificity presents a particular challenge in low-prevalence settings such as the United States. This study provides a direct comparison of the latest-generation IgG serology assays with four previously assessed FDA-cleared tests. Seven hundred ten blood donor plasma specimens were evaluated by Wiener Lisado and Wiener v.4.0 enzyme-linked immunosorbent assays (ELISAs) and Abbott PRISM Chagas chemiluminescent assay (ChLIA). Sensitivity and specificity were assessed relative to infection status as determined by the original blood donation testing algorithm. All three latest-generation assays demonstrated 100% specificity (95% confidence interval [CI], 98.6 to 100.0). Wiener Lisado, Wiener v.4.0, and Abbott PRISM had sensitivities of 97.1% (95% CI, 95.1 to 98.4), 98.9% (95% CI, 97.4 to 99.6), and 95.5% (95% CI, 93.2 to 97.3), respectively. As with previously evaluated FDA-cleared tests, all three assays had the highest reactivity and sensitivity in samples from donors born in South America and lowest reactivity and sensitivity in specimens from those born in Mexico, with intermediate results in specimens from Central American donors. Wiener v.4.0 had the highest diagnostic sensitivity in all comparisons. Our findings suggest that the latest-generation CD serology tests could improve diagnostic sensitivity without affecting specificity.
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8
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Lasky B, Goodhue Meyer E, Steele WR, Crowder LA, Young PP. COVID-19 convalescent plasma donor characteristics, product disposition, and comparison with standard apheresis donors. Transfusion 2021; 61:1471-1478. [PMID: 33458811 PMCID: PMC8013318 DOI: 10.1111/trf.16286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 12/15/2022]
Abstract
Background With coronavirus disease 2019 (COVID‐19) convalescent plasma (CCP) offering an early treatment option for COVID‐19, blood collectors needed to quickly overcome obstacles to recruiting and qualifying eligible donors. We provide attributes of CCP donors and products and compare to standard donors and products. Study Design and Methods Information on CCP donors was gathered from the American Red Cross qualification website through product collection. Data from 2019 for standard plasma/platelet apheresis (SA) and whole blood (WB) donor demographics and SA donations including product disposition and reactions were used for comparison. Results Of almost 59 000 donors registering on the website, 75% reported an existing COVID‐19 diagnostic polymerase chain reaction or an antibody test. The majority (56.2%) of 10 231 CCP donors were first‐time donors in contrast to SA or WB donor populations, which were only 3.0% and 30.6%, respectively, first‐time donors. The number of female donors was 12% higher than SA donors. Older (≥ 65 years) and younger (16‐19 years) were comparatively underrepresented in CCP donors. Deferral (10.2%) and Quantity Not Sufficient rates (6.4%) for presenting CCP donations were higher than SA (8.2% and 1.1%, respectively). Human leukocyte antigen antibody reactivity was the highest cause of product loss for CCP donations vs SA donations (9.6% vs 1.3%). Acute adverse events also occurred at a higher rate among both first‐time and repeat CCP donations compared to SA. Conclusions CCP donors were more likely to be first‐time and female donors than WB or SA donors. CCP donations had a higher rate of donor adverse reactions, deferrals, and product loss than SA donations. See editorial on page 1345–1349, in this issue
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Affiliation(s)
- Baia Lasky
- American Red Cross, Biomedical Services Headquarters, Washington, DC, USA
| | - Erin Goodhue Meyer
- American Red Cross, Biomedical Services Headquarters, Washington, DC, USA.,Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Whitney R Steele
- American Red Cross, Biomedical Services Headquarters, Washington, DC, USA
| | - Lauren A Crowder
- American Red Cross, Biomedical Services Headquarters, Washington, DC, USA
| | - Pampee P Young
- American Red Cross, Biomedical Services Headquarters, Washington, DC, USA.,Department of Pathology, Vanderbilt University Medical Center, Microbiology and Immunology, Nashville, Tennessee, USA
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Priyono A, Masser BM, Dyda A, Davison TE, Irving DO, Karki S. Long-term return and donation pattern of those who begin donating at different ages: A retrospective cohort analysis of blood donors in Australia. Transfusion 2020; 61:799-810. [PMID: 33179790 DOI: 10.1111/trf.16187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND This study compared the likelihood of return to donate and donation rate ratio by age of donors at their first donation when followed up to 12 years. STUDY DESIGN AND METHODS Donation history of two cohorts of first-time donors (those donating in 2007 and 2013) was extracted until March 2019 from Australian Red Cross Lifeblood's national database. Poisson regression analyses compared donor return and negative-binomial regression estimated the rate ratio of donations. RESULTS A total of 120 469 and 95 381 donors were included in the 2007 and 2013 cohorts, respectively. Compared to donors aged 20-24 years, the likelihood of return in both cohorts increased consistently as age at first donation increased from 30-years and above. Average number of whole-blood and plasmapheresis donations increased as the age at first donation increased from 30-years onward. The whole-blood donation rate was highest for donors ≥60 years, while plasmapheresis donation rate was highest for donors aged 50-59 years. These patterns were largely consistent when stratified by sex. CONCLUSIONS To continuously ensure the short- to mid-term sufficiency of blood supply in Australia, targeted recruitment of donors aged 30-years and above may be considered, however its feasibility and impact should be explored further given relatively smaller proportion of new donors are middle-aged and older under current policies. Future studies with a longer follow-up period are needed to examine whether the frequency of donation among those who start donating at a younger age increases later in their life when they are 30-years or over.
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Affiliation(s)
- Agus Priyono
- Department of Health Systems and Populations, Macquarie University, Sydney, New South Wales, Australia.,Clinical Services and Research, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Barbara M Masser
- Clinical Services and Research, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
| | - Amalie Dyda
- Department of Health Systems and Populations, Macquarie University, Sydney, New South Wales, Australia
| | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - David O Irving
- Clinical Services and Research, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Surendra Karki
- Clinical Services and Research, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Blood donation for all: inclusivity is important to the blood supply. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 19:1-2. [PMID: 33085597 DOI: 10.2450/2020.0303-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Whitman JD, Townsend RL, Bern C, Stramer SL. Evaluation of matrix effects and prolonged storage on Trypanosoma cruzi serology in blood donor specimens. Transfusion 2020; 60:1149-1153. [PMID: 32163175 DOI: 10.1111/trf.15736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Blood products appropriately stored for research protocols provide an invaluable resource for amassing large numbers of specimens for clinical research, especially for low-prevalence diseases, such as Chagas disease. STUDY DESIGN AND METHODS We evaluated serologic results of 500 blood donation plasma component (PC) specimens confirmed as Trypanosoma cruzi seropositive by Food and Drug Administration-recommended algorithms. Subsets were retested using the T. cruzi enzyme-linked immunosorbent assay (ELISA; Ortho Clinical Diagnostics) and PRISM Chagas assay (Abbott Laboratories). Initial results for vacutainer-derived venous serum (VS) and PC specimens with matching results were also compared. RESULTS On initial testing, matrix effects between VS and PC were observed with ELISA demonstrating a mean change in the PC of -0.39 signal/cutoff ratio (S/CO) (p < 0.0001) and PRISM of +0.35 S/CO (p = 0.008). In matched PC specimens between current (retest) versus initial test results, both ELISA and PRISM had a decrease in mean S/COs of -0.76 (p < 0.0001) and - 0.90 (p < 0.0001), respectively. When the change in S/CO for matched PC specimens was analyzed as a function of time, PRISM showed no significant S/CO decrease (Y = -0.002941*X - 0.6250; p = 0.20; R2 = 0.005), whereas the ELISA showed a significant S/CO decrease in more recently collected specimens (Y = 0.007183*X-1.516; p < 0.0001; R2 = 0.06). CONCLUSION While T. cruzi serology results showed minor but significant differences in matrix effects between initial VS and PC testing values, and minor changes in PC test values over time, our data validate the use of PC specimens for head-to-head test performance comparison studies with the caveat that these limitations are assessed for appropriate study design.
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Affiliation(s)
- Jeffrey D Whitman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California
| | | | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Susan L Stramer
- American Red Cross, Scientific Affairs, Gaithersburg, Maryland
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12
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Shaz BH, Domen RE, France CR. Remunerating donors to ensure a safe and available blood supply. Transfusion 2019; 60 Suppl 3:S134-S137. [DOI: 10.1111/trf.15647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | - Ronald E. Domen
- Penn State College of Medicine and Hershey Medical Center Hershey Pennsylvania
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13
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Chagas Disease Serological Test Performance in U.S. Blood Donor Specimens. J Clin Microbiol 2019; 57:JCM.01217-19. [PMID: 31511333 PMCID: PMC6879282 DOI: 10.1128/jcm.01217-19] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/04/2019] [Indexed: 12/19/2022] Open
Abstract
Chagas disease affects an estimated 300,000 individuals in the United States. Diagnosis in the chronic phase requires positive results from two different IgG serological tests. Three enzyme-linked immunosorbent assays (ELISAs) (Hemagen, Ortho, and Wiener) and one rapid test (InBios) are FDA cleared, but comparative data in U.S. populations are sparse. We evaluated 500 seropositive and 300 seronegative blood donor plasma samples. Country of birth was known for 255 seropositive specimens, which were grouped into regions as follows: Mexico (n = 94), Central America (n = 88), and South America (n = 73). Specimens were tested by the four FDA-cleared IgG serological assays. Test performance was evaluated by two comparators and latent class analysis. InBios had the highest sensitivity (97.4% to 99.3%) but the lowest specificity (87.5% to 92.3%). Hemagen had the lowest sensitivity (88.0% to 92.0%) but high specificity (99.0% to 100.0%). The level of sensitivity was intermediate for Ortho (92.4% to 96.5%) and Wiener (94.0% to 97.1%); both had high specificity (98.8% to 100.0% and 96.7% to 99.3%, respectively). The levels of antibody reactivity and clinical sensitivity were lowest in donors from Mexico, intermediate in those from Central America, and highest in those from South America. Our findings provide an initial evidence base to improve laboratory diagnosis of Chagas disease in the United States. The best current testing algorithm would employ a high-sensitivity screening test followed by a high-specificity confirmatory test.
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The global need and availability of blood products: a modelling study. LANCET HAEMATOLOGY 2019; 6:e606-e615. [PMID: 31631023 DOI: 10.1016/s2352-3026(19)30200-5] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Blood transfusions are an important resource of every health-care system, with often limited supply in low-income and middle-income countries; however, the degree of unmet need for blood transfusions is often unknown. We therefore aimed to estimate the blood transfusion need and supply at national level to determine gaps in transfusion services globally. METHODS We did a modelling study involving 195 countries and territories. We used blood component preparation data from 2011-13 to estimate blood availability for 180 (92%) of 195 countries from the WHO Global Status Report on Blood Safety and Availability. We calculated disease-specific transfusion needs per prevalent case for 20 causes in the USA using the National (Nationwide) Inpatient Sample dataset between the years 2000 and 2014, and the State Inpatient Databases between 2003 and 2007 from the Healthcare Cost and Utilization Project. Using prevalence estimates for the USA from the Global Burden of Disease (GBD) 2017 study, we estimated the ideal disease specific-transfusion rate as the lowest rate from the years 2000 to 2014. We applied this rate to GBD prevalence results for 195 countries to estimate transfusion needs. Unmet need was the difference between the estimated supply and need. FINDINGS In 2017, the global blood need was 304 711 244 (95% uncertainty interval [UI] 293 064 637-314 049 479) and the global blood supply was 272 270 243 (268 002 639-276 698 494) blood product units, with a need-to-supply ratio of 1·12 (95% UI 1·07-1·16). Of the 195 countries, 119 (61%) did not have sufficient blood supply to meet their need. Across these 119 countries, the unmet need totalled 102 359 632 (95% UI 93 381 710-111 360 725) blood product units, equal to 1849 (1687-2011) units per 100 000 population globally. Every country in central, eastern, and western sub-Saharan Africa, Oceania, and south Asia had insufficient blood to meet their needs. INTERPRETATION Our data suggest that the gap between need and supply is large in many low-income and middle-income countries, and reinforce that the WHO target of 10-20 donations per 1000 population is an underestimate for many countries. A continuous expansion and optimisation of national transfusion services and implementation of evidence-based strategies for blood availability is needed globally, as is more government support, financially, structurally, and through establishment of a regulatory oversight to ensure supply, quality, and safety in low-income and middle-income countries. FUNDING National Institutes of Health.
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15
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Patel EU, Bloch EM, Grabowski MK, Goel R, Lokhandwala PM, Brunker PAR, White JL, Shaz B, Ness PM, Tobian AAR. Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population-based study. Transfusion 2019; 59:2899-2907. [PMID: 31222779 DOI: 10.1111/trf.15415] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Contemporary population-based data on characteristics associated with blood donation in the United States (U.S.) are limited. STUDY DESIGN AND METHODS A cross-sectional analysis was performed among 28,739 persons aged 18 years and older who participated in the 2016 National Health Interview Survey, a household survey of the noninstitutionalized U.S. civilian population. Analyses were weighted and accounted for the complex survey design. Adjusted prevalence ratios (aPR) were estimated by multivariable log-binomial regression. RESULTS The percentage of individuals reporting a past-year history of blood donation was 5.7% (95% confidence interval [CI], 5.3%-6.1%) and was highest in the youngest age group (18-24 years, 8.4%). A past-year history of blood donation was more common in males compared to females (6.3% vs. 5.1%; aPR, 1.12 [95% CI, 0.99-1.27]) and those born in the U.S. compared to individuals born outside the U.S. (6.4% vs. 2.4%; aPR, 1.92 [95% CI, 1.49-2.47]). The percentage of individuals with a past-year history of blood donation was significantly lower in blacks (3.9%; aPR, 0.60 [95% CI, 0.47-0.75]) and Hispanics (3.0%; aPR, 0.63 [95% CI, 0.48-0.83]) in comparison to whites (6.9%). Being a college graduate, being employed, being physically active, and never being a cigarette smoker were factors positively associated with blood donation. The percentage of individuals with a past-year history of blood donation varied by geographic census region, with prevalence being higher in the Midwest (7.3%) and South (6.0%) compared to the Northeast (4.7%) and West (4.4%). CONCLUSION Continued differences in the blood donor population with reference to the U.S. population underscore the need to understand barriers or deterrents to blood donation. Evidence-based donor recruitment and related policies remain imperative to ensure that there is a sustainable blood supply.
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Affiliation(s)
- Eshan U Patel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan M Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary K Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
| | - Parvez M Lokhandwala
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia A R Brunker
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
| | - Jodie L White
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Beth Shaz
- New York Blood Center, New York, New York
| | - Paul M Ness
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaron A R Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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16
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Kanias T, Stone M, Page GP, Guo Y, Endres-Dighe SM, Lanteri MC, Spencer BR, Cable RG, Triulzi DJ, Kiss JE, Murphy EL, Kleinman S, Gladwin MT, Busch MP, Mast AE. Frequent blood donations alter susceptibility of red blood cells to storage- and stress-induced hemolysis. Transfusion 2018; 59:67-78. [PMID: 30474858 DOI: 10.1111/trf.14998] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 05/14/2018] [Accepted: 05/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Frequent whole blood donations increase the prevalence of iron depletion in blood donors, which may subsequently interfere with normal erythropoiesis. The purpose of this study was to evaluate the associations between donation frequency and red blood cell (RBC) storage stability in a racially/ethnically diverse population of blood donors. STUDY DESIGN Leukoreduced RBC concentrate-derived samples from 13,403 donors were stored for 39 to 42 days (1-6°C) and then evaluated for storage, osmotic, and oxidative hemolysis. Iron status was evaluated by plasma ferritin measurement and self-reported intake of iron supplements. Donation history in the prior 2 years was obtained for each subject. RESULTS Frequent blood donors enrolled in this study were likely to be white, male, and of older age (56.1 ± 5.0 years). Prior donation intensity was negatively associated with oxidative hemolysis (p < 0.0001) in multivariate analyses correcting for age, sex, and race/ethnicity. Increased plasma ferritin concentration was associated with increased RBC susceptibility to each of the three measures of hemolysis (p < 0.0001 for all), whereas self-reported iron intake was associated with reduced susceptibility to osmotic and oxidative hemolysis (p < 0.0001 for both). CONCLUSIONS Frequent blood donations may alter the quality of blood components by modulating RBC predisposition to hemolysis. RBCs collected from frequent donors with low ferritin have altered susceptibility to hemolysis. Thus, frequent donation and associated iron loss may alter the quality of stored RBC components collected from iron-deficient donors. Further investigation is necessary to assess posttransfusion safety and efficacy in patients receiving these RBC products.
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Affiliation(s)
- Tamir Kanias
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mars Stone
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | | | - Yuelong Guo
- RTI International, Research Triangle Park, North Carolina
| | | | - Marion C Lanteri
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | | | | | - Darrell J Triulzi
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.,The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - Joseph E Kiss
- The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - Edward L Murphy
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | - Steve Kleinman
- University of British Columbia, Victoria, British Columbia, Canada
| | - Mark T Gladwin
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael P Busch
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | - Alan E Mast
- Blood Research Institute, Blood Center of Wisconsin, and Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee
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RH genotype matching for transfusion support in sickle cell disease. Blood 2018; 132:1198-1207. [DOI: 10.1182/blood-2018-05-851360] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/05/2018] [Indexed: 11/20/2022] Open
Abstract
Key PointsRH genotyping of red cells may improve matching of patients and donors and reduce Rh alloimmunization. RH genotype matching may improve use of an African American blood donor inventory.
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18
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Khan J, Delaney M. Transfusion Support of Minority Patients: Extended Antigen Donor Typing and Recruitment of Minority Blood Donors. Transfus Med Hemother 2018; 45:271-276. [PMID: 30283277 DOI: 10.1159/000491883] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/06/2018] [Indexed: 01/16/2023] Open
Abstract
One of the most important and persistent complications of blood transfusion is red blood cell (RBC) alloimmunization. When a patient is exposed to RBC antigens that differ from their own they can form alloantibodies to these foreign antigens. Blood group antigens are highly conserved and follow ancestral patterns of inheritance that may demonstrate population restriction. Minority populations who require chronic transfusion are at particularly high risk of alloimmunization when the blood donor population does not share the same ancestral background, resulting in exposure to non-self RBC antigens. It is incumbent on blood collectors to support patients with risk factors for alloimmunization as well as patients who have already formed alloantibodies. Increasing utilization of RBC genotyping may represent an opportunity to improve access to RBC units from donors that match the extended RBC phenotype of all possible patients.
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Affiliation(s)
- Jenna Khan
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Meghan Delaney
- Pathology & Laboratory Medicine Division, Children's National Health System, Washington, DC, USA.,Department of Pathology & Pediatrics, The George Washington University, Washington, DC, USA
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19
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Rossmann SN. Donors and data-increasing deficits. Transfusion 2017; 57:1635-1638. [PMID: 28675528 DOI: 10.1111/trf.14180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Susan N Rossmann
- Medical Services, Gulf Coast Regional Blood Center, Houston, Texas
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