Recruiting refugees and migrants as potential hematopoietic stem cell donors to serve patients of comparable ethnicities with rare human leucocyte antigen patterns - The BluStar.NRW project in North Western Germany

Currently, approximately 19 million people with a migration background live in Germany. The majority of those descend from regions where the population has a genetically different distribution of HLA antigens when compared to the HLA frequencies usually found in North Western Europe. In case of severe haematological disorders of these individuals, allogeneic stem cell transplantation may be the treatment of choice. However, finding appropriate histocompatible hematopoietic stem cell donors continues to be a major challenge. If no matching sibling donors are available, there are only few suitable donors with a similar genetic background available in international blood stem cell donor registries. The "BluStar.NRW" project aimed to recruit new blood and hematopoietic stem cell donors with a migration background and to noticeably increase the number of suitable donors for patients within this group. Since December 2017, a total number of 9100 blood and stem cell donors with a migration background were recruited and typed for this project. HLA typing for HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 was performed by Next Generation Sequencing. We assessed the proportion of rare alleles according to HLA frequency tables, as defined by a frequency of <1:1000. The rare HLA allele frequencies according to HLA frequency tables of the BluStar.NRW cohort were compared with a matched control donor cohort: Rare HLA-A, -B, -C, -DRB1 and -DQB1 alleles occurred three times more frequent than in the control group, but rare HLA-DPB1 alleles occurred more frequently in the control cohort. This difference was highly significant for all HLA alleles (p < 0.0001 for HLA-A, -B, -C, -DRB1, -DPB1; p = 0.0002 for HLA-DQB1). In addition, the distribution of rare alleles differed between the two groups. To date, 29 work-ups were initiated, 12 PBSC, one BM and three DLI were collected so far out of the BluStar.NRW cohort. The apheresis probability is twofold higher (0.18% vs. 0.07%) compared to the control group which clearly shows a serious medical need. However, 13 work-ups were cancelled in the BluStar.NRW donor cohort which represents an almost twice as higher cancellation rate (45% vs. 25%). This single registry analysis with a large sample cohort clearly indicates that hematopoietic stem cell donors with a migration background represent an adequate donor pool to serve patients of comparable ethnicity.

Applying a modified and extended theory of planned behavior to predict blood donation intentions among Chinese university students: An empirical investigation

Background

The blood shortage in China has become a nationwide issue, which poses a threat to critical medical treatments and puts patients at risk. To address this problem, blood donation recruitment and retention campaigns have been launched, with university students being recognized as an important target audience. To recruit this particular population effectively, it is crucial to comprehend their motivations for donating blood.

Methods

This study used a modified and extended Ajzen's Theory of Planned Behavior to explain the determinants of blood donation intention among N = 1165 China's young adults through an online cross-sectional survey, utilizing a snowball sampling technique to recruit participants.

Results

In line with previous TPB-based studies, we found positive associations between attitude (β = 0.071, p < .01), subjective norms (β = 0.264, p < .001), and self-efficacy (β = 0.536, p < .001) with blood donation intention. Attitude and self-efficacy mediated the relationships between anxiety, altruism, and social norm with blood donation intention (β = 0.817, p < .01, 95%CI [0.737, 0.909]; β = 1.31, p < .01, 95%CI [1.203, 1.409]; β = 1.301, p < .01, 95%CI [1.209, 1.403]). Attitude also mediated the relationship between altruism and social norm with blood donation intention (β = .456, p < .01, 95%CI [0.38, 0.53]; β = 0.447, p < .01, 95%CI [0.374, 0.52]).

Conclusion

Our results highlight the significance of utilizing communication strategies, such as promoting altruism and reducing donation anxiety, as well as creating a supportive social environment. These strategies can improve attitudes and intentions toward blood donation, leading to an increase in blood donation rates.

The effect of motivational strategy on voluntary plasma donation, a field trial

BACKGROUND

Plasma protein therapies (PPTs) are a group of medicines extracted from human plasma through fractionation. The manufacture of adequate amounts of PPTs requires a large volume of human plasma. WHO emphasized that whole blood and blood component donations should be voluntary and non-remunerated. So, motivating people to donate plasma is crucial. In this study, we evaluated the impact of social media on motivating blood donors to donate plasma without any compensation and the moderating effects of blood donation history on plasma donation.

METHODS AND MATERIALS

we allocated blood donors (n = 501) to intervention and control groups randomly. Participants in the intervention group got educational and motivational messages through a WhatsApp channel. Then, we followed up all participants for six months and registered the information of the plasma donation during this period.

RESULT

In the intervention group, 6.8% had returned to donate plasma, while this was 2% in the control group (p = 0.016, OR:3.59, 95%CI:1.3-9.89). Among regular blood donors in the intervention group, 17.86% had returned to donate plasma but, no regular donor returned to donate plasma in the control group (p = 0.055). In addition, 10.8% of donors who had academic education in the intervention group returned to donate plasma, although this was 2.54% in the control group (P = 0.0485).

CONCLUSION

Our findings suggest that the educational interventions have more effects on academically educated donors to motivate them to donate plasma.

Source Plasma Donation: The Experience of the Iranian Blood Transfusion Organization

Background: A declining need for red blood cells coupled with strengthening demand for plasma-derived medicines has led to a strong focus on moving whole blood donors to plasmapheresis. The purpose of this study was to evaluate the four-year policies of the Iranian Blood Transfusion Organization (IBTO) in terms of plasmapheresis recruitment of first-time donors and its effect on plasmapheresis outcome.   Materials and Methods: Plasmapheresis data related to 16 centers from 2016 to 2019 was obtained from IBTO software. This information includes; (1) blood donation number, (2) plasmapheresis donation number, (3) number of plasmapheresis donors, (4) plasmapheresis donor demographic data, (5) plasmapheresis donor status, (6) frequency of plasma donation for each donor, (7) volume of plasma and (8) the prevalence of transfusion-transmissible infections (TTIs) in plasmapheresis donors. Results: The result of this study demonstrated that plasmapheresis collection centers have recruited 85,515 (91%) first-time and 8,595(9%) regular and repeated donors from 2016 to 2019 years. Plasmapheresis to blood donation index was increased from 0.2% in 2016 to 4.9% in 2019. The mean donation number was 2 times per year. The trend of the yearly Whole Blood Donation (WBD) Index decreased from 26.69 to 24.11/1000 for the general population. The total volume of collected source plasma was 49,203 liters during this period. However, 46,000 liters of recovered plasma were decreased due to less WBD. Furthermore, the results indicated that the prevalence of HCV was significantly higher in first-time donors compared to repeated and regular donors (P = 0.000). Conclusion: It is concluded that during four years, the net volume of plasma did not increase and plasmapheresis led to reducing WBD in our country. Moreover, first-time plasmapheresis donors can be associated with challenges such as increasing screening costs and compromising the safety of plasma resources. Therefore IBTO decided to stop the project and focus on its main role to prepare safe and sufficient blood components through WB collection and also single donor platelet and concurrent plasma by plateletpheresis.

Donor program for fecal microbiota transplantation: A 3-year experience of a large-volume Italian stool bank

BACKGROUND

Due to the increasing rise of C. difficile infection, stool banks and donor programs have been launched to grant access to fecal microbiota transplantation (FMT). Our aim is to describe characteristics and outcomes of the donor program at our stool bank.

METHODS

Donor candidates underwent a four-step selection process, including a clinical interview, blood and stool testing, a further questionnaire and a direct stool testing the day of each donation. From March 2020, specific changes to this process were introduced to avoid the potential transmission of COVID-19. We evaluated the rate of excluded candidates at each step of the screening, as well as the number of total fecal aliquots provided by qualified donors.

RESULTS

Overall, 114 donor candidates were evaluated. Seventy-five candidates declined to join the program for logistic or personal issues, three were excluded after the questionnaire and seven for positive stool exams. Finally, 29 (25%) subjects qualified as stool donors, and provided 70 stool samples. Fifteen samples were excluded after direct molecular stool testing. A total of 127 aliquots was finally obtained.

CONCLUSIONS

Donor recruitment for FMT is a challenging process, and only a small rate of candidates are eligible as donors.

Plateletpheresis donation through donor awareness, motivation, and recruitment drives: A unique concept and experience from a tertiary care oncology centre in India

OBJECTIVES

The majority of blood donor motivational and awareness activities are directed toward whole blood donation and not much emphasis is given to the plateletpheresis. The study was designed to analyze the effectiveness of the unique concept of platelet drives (PD) to increase voluntary plateletpheresis donations.

MATERIALS AND METHODS

The study was a retrospective study conducted at a tertiary care oncology hospital-based blood transfusion services (BTS).

RESULTS

A total of 13 PDs were conducted from January 2016 to December 2020. A total of 559 potential donors came for the donor registration and 125 donors got deferred on medical history. A total of 434 donors gave their samples for the testing of plateletpheresis. The median age of potential male and female donors was 32 and 30 years respectively. A total of 58 males and two females have donated single donor platelets (14.3% vs. 7.4%, P=0.319). The median age of male and female donors was 36 and 42 years, respectively. In male donors, 48 had donated once, seven donated twice, two donated thrice and one donor donated four times. Out of two female donors, one donor donated twice and the other donor donated four times. The female donors were more committed to repeat donations (P=0.004). Since the start of PDs, the number of voluntary donations has increased considerably over the years.

CONCLUSION

PDs have helped in increasing the number of voluntary plateletpheresis donors. All the BTS must have the standard operating procedures in place for these kinds of awareness and motivational drives.

Emotional labour and cord blood collection: frontline perspectives

PURPOSE

This paper aims to examine emotional labour in the work of frontline staff (FLS) of the Canadian Blood Services' Cord Blood Bank (CBB), contributes to understandings of emotional labour by allied healthcare workers and suggests implications for healthcare managers.

DESIGN/METHODOLOGY/APPROACH

Qualitative interviews with 15 FLS were conducted and analyzed as part of a process evaluation of donor recruitment and cord blood collection in Canada.

FINDINGS

Emotional labour with donors and hospital staff emerged as a vital component of FLS' donor recruitment and cord blood collection work. Emotional labour was performed with donors to contribute to a positive birthing experience, facilitate communication and provide support. Emotional labour was performed with hospital staff to gain acceptance and build relationships, enlist support and navigate hierarchies of authority.

RESEARCH LIMITATIONS/IMPLICATIONS

The results indicate that FLS perform emotional labour with women to provide donor care and with hospital staff to facilitate organizational conditions. The findings are based on FLS' accounts of their work and would be enhanced by research that examines the perspectives of donors and hospital staff.

PRACTICAL IMPLICATIONS

Attention should be paid to organizational conditions that induce the performance of emotional labour and may add to FLS workload. Formal reciprocal arrangements between FLS and hospital staff may reduce the responsibility on FLS and enable them to focus on recruitment and collections.

ORIGINALITY/VALUE

This paper addresses a gap in the healthcare management literature by identifying the emotional labour of allied healthcare workers. It also contributes to the cord blood banking literature by providing empirically grounded analysis of frontline collection staff.

Hospital-Based Donor Recruitment and Predonation Serologic Testing for COVID-19 Convalescent Plasma

Objectives

Serologic testing for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in potential donors of coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) may not be performed until after blood donation. A hospital-based recruitment program for CCP may be an efficient way to identify potential donors prospectively

Methods

Patients who recovered from known or suspected COVID-19 were identified and recruited through medical record searches and public appeals in March and April 2020. Participants were screened with a modified donor history questionnaire and, if eligible, were asked for consent and tested for SARS-CoV-2 antibodies (IgG and IgM). Participants positive for SARS-CoV-2 IgG were referred for CCP collection.

Results

Of 179 patients screened, 128 completed serologic testing and 89 were referred for CCP donation. IgG antibodies to SARS-CoV-2 were detected in 23 of 51 participants with suspected COVID-19 and 66 of 77 participants with self-reported COVID-19 confirmed by polymerase chain reaction (PCR). The anti–SARS-CoV-2 IgG level met the US Food and Drug Administration criteria for “high-titer” CCP in 39% of participants confirmed by PCR, as measured by the Ortho VITROS IgG assay. A wide range of SARS-CoV-2 IgG levels were observed.

Conclusions

A hospital-based CCP donor recruitment program can prospectively identify potential CCP donors. Variability in SARS-CoV-2 IgG levels has implications for the selection of CCP units for transfusion.

How to reverse first time donors to become regular donors? A questionnaire survey in Estonia

BACKGROUND

Donating blood in Estonia is non-remunerated and voluntary. Estonian Blood Service system has four independent regional blood centres that are responsible for blood collection, processing, screening and distribution of blood components to hospitals for clinical use.

STUDY DESIGN

This research was carried out as a questionnaire survey. A questionnaire was developed to study lapsing first time donors' (FTD) blood donation experience, intention and willingness to donate again.

METHODS

A thousand five hundred and forty-six questionnaires were posted to donors who had one successful donation in 2010 and who had not returned to second donation till the year 2012. For data analysis routine statistical methods were used. To evaluate the most appropriate number of classes, based on previous experience and future expectations, latent class analysis was used.

RESULTS

There were 453 respondents (29.3%). For the majority of aspects of blood donation experience the emotions were positive. Results of the study suggested that blood collection agencies should intervene to bolster donors' attitudes, perceived control, and identity as a donor during this crucial post-first donation period.

CONCLUSION

First blood donation seems to have been a positive experience. Reasons leading to stopping blood donation should be studied further. Establishing a donor registry for Estonia would be essential to keep track of donors.

Individual Characteristics Associated with Blood Donation: A Cross-National Comparison of the German and Swiss Population between 1994 and 2010

OBJECTIVE

The aim of this study is to compare individual characteristics associated with blood donation in the German and Swiss population between 1994 and 2010.

METHODS

Population-based survey data from the Eurobarometer 1994 and 2009, the Swiss Health Survey 1997, and the Swiss Blood Donation Survey 2010 were used to compare age-adjusted percentages of German and Swiss adults ever having donated blood (n = 8,746). A multivariate logistic regression was applied to the pooled data to estimate odds ratios (OR).

RESULTS

Donor rates between 1994 and 2010 increased by 8.6% in Germany (p = 0.0045) and remained stable in Switzerland. The likelihood to report donating increased with age. Gender differences (OR = 2.85; p = 0.0000) and differences between education levels were more pronounced in Switzerland as compared to Germany (OR = 2.56; p = 0.0000 and OR = 2.73; p = 0.0010). Furthermore education differences were more marked in men in both countries (OR = 1.99; p = 0.0000 and OR = 1.68; p = 0.0140).

CONCLUSION

The blood establishments should intensify their efforts to motivate women and lower educated people to give blood. Our data suggest that population-based surveys could be a helpful tool to describe donor rates in different countries and to guide future recruitment strategies.