Frequency and reasons of donor deferral prior to blood donation process: a single centre experience

Characteristics and causes of pre-donation deferrals at a Chinese blood center

OBJECTIVES

The purpose of this retrospective analysis was to understand the causes and characteristics of the pre-donation deferral, so as to enhance blood safety and improve donor satisfaction.

BACKGROUND

Blood transfusion is crucial in managing a variety of different medical and surgical needs. Its benefits are manifold but there are risks for the recipients. Thus some blood donors are deferred from donating when they do not meet certain criteria. An in-depth understanding of the underlying causes of donor deferral will not only improve donor selection but also ensure blood safety and avoid donor complaints.

MATERIALS AND METHODS

This single-center experience was carried out from 26th July 2018 to 25th July 2019 on all whole blood donors in Tianjin, China. Donors' demographics and information were retrieved; comparisons between deferral data were summarized by the Chi-square test using Statistical Product and Service Solutions (SPSS) application version 22. The difference between groups were considered statistically significant when p < 0.05.

RESULTS

A total of 190,846 participants were included; whereby 119,951 (62.85 %) of participants were first-time blood donors. The pre-donation deferral rate was 9.26 %, and deferral was more likely seen in first-time donors, male donors, and donors of age above 35 years (p < 0.05). Overall, raised alanine aminotransferase (ALT) contributed to 48.46 % of all temporary deferrals, followed by lipaemia (20.71 %). For female donors, low hemoglobin was the leading cause of temporary deferral. Positive hepatitis B surface antigen (Hepatitis B) and syphilis were the two common causes of permanent deferrals, with incidence at 11.65 % and 3.93 %, respectively.

CONCLUSION

Pre-donation deferral remains a significant problem in China and accounted for 9.26 % of participants in this study. Raised ALT and lipaemia were common temporary deferrals, especially among first-time donors, males, and older donors. Appropriate interventions should be taken to address the blood quality, improve the donor retention strategies in order to secure an adequate and safe blood supply.

Co-prevalence of human Papillomaviruses (HPV) and Epstein-Barr virus (EBV) in healthy blood donors from diverse nationalities in Qatar

Background

Infections by both human oncoviruses, human Papillomaviruses (HPV) and Epstein–Barr virus (EBV) are very common in the adult human population and are associated with various malignancies. While HPV is generally transmitted sexually or via skin-to-skin contact, EBV is frequently transmitted by oral secretions, blood transfusions and organ transplants. This study aims to determine the prevalence and circulating genotypes of HPV and EBV in healthy blood donors in Qatar.

Methods

We explored the co-prevalence of high-risk HPVs and EBV in 378 males and only 7 females blood donors of different nationalities (mainly from Qatar, Egypt, Syria, Jordan, Pakistan, and India) residing in Qatar, using polymerase chain reaction (PCR). DNA was extracted from the buffy coat and genotyping was performed using PCR and nested-PCR targeting E6 and E7 as well as LMP-1 of HPV and EBV, respectively.

Results

We found that from the total number of 385 cases of healthy blood donors studied, 54.8% and 61% of the samples are HPVs and EBV positive, respectively. Additionally, our data revealed that the co-presence of both high-risk HPVs and EBV is 40.4% of the total samples. More significantly, this study pointed out for the first time that the most frequent high-risk HPV types in Qatar are 59 (54.8%), 31 (53.7%), 52 (49.1%), 51 (48.6%), 58 (47%) and 35 (45.5%), while the most commonly expressed low-risk HPV types are 53 (50.6%), 11 (45.5), 73 (41.7%) and 6 (41.3%), with all the cases showing multiple HPVs infection.

Conclusion

In this study, we demonstrated for the first time that HPV and EBV are commonly co-present in healthy blood donors in Qatar. On the other hand, it is important to highlight that these oncoviruses can also be co-present in several types of human cancers where they can cooperate in the initiation and/or progression of these cancers. Therefore, more studies regarding the co-presence of these oncoviruses and their interaction are necessary to understand their cooperative role in human diseases.

Acute blood transfusion reactions in a tertiary care hospital in Pakistan - an initiative towards haemovigilance

OBJECTIVE

In this study, we report acute blood transfusion reactions at our hospital, compare our analysis with the reported data and identify areas for improvement.

BACKGROUND

Haemovigilance programmes have been implemented in many countries, and adverse events associated with blood transfusion are published in their annual reports. Pakistan has no current established programme.

MATERIAL AND METHODS

A cross-sectional study was conducted, and all adverse reactions reported to the blood bank from January 2014 to March 2016 were included. An adverse response in the patient, related to administration of blood (within 24 h), was considered an immediate transfusion reaction.

RESULTS

During the study period, 20 956 blood components were issued. A total of 32 (0·15%) adverse reactions were documented. Allergic reactions were the most common adverse event observed in 15 (46·8%) of the cases. Febrile non-haemolytic transfusion reaction (FNHTR) was the second most common reaction seen in nine (28%) followed by bacterial contamination in four (12·5%) and acute haemolytic reaction in two (6·2%) of the cases.

CONCLUSION

The low incidence indicates underreporting and the need for a formal haemovigilance system. International benchmarking between different medical systems is helpful to identify areas in the transfusion process that have to be changed to improve transfusion safety.

Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons

Background

To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to define donor pre-donation deferral rates, causes of deferral, and characteristics of deferred donors in Dubai.

Materials and methods

This retrospective study was conducted on all donors who presented for allogeneic blood donation between January 1, 2010, until June 30, 2013, in Dubai Blood Donation Centre, accredited by the American Association of Blood Banks. The donation and deferral data were analyzed to determine the demographic characteristics of accepted and deferred donors, and frequency analyses were also conducted.

Results

Among 142,431 individuals presenting during the study period, 114,827 (80.6%) were accepted for donation, and 27,604 (19.4%) were deferred. The overall proportion of deferrals was higher among individuals less than 21 years old (35%, P<0.000), females (44% were deferred compared to 15% of males, P<0.0001), and first-time donors (22% were deferred vs 14% of repeat donors, P<0.0001). The main causes for a temporary deferral were low hemoglobin and high blood pressure.

Discussion

The deferral rate among blood donors in Dubai is relatively high compared to the internationally reported rates. This rate was higher among first-time donors and females, with low hemoglobin as the major factor leading to a temporary deferral of donors. Strategies to mitigate deferral and improve blood donor retention are urged in Dubai to avoid additional stress on the blood supply.