Impact of Elevated Hemoglobin and Serum Protein on Vasovagal Reaction from Blood Donation.

Takeshi Odajima,Hiroki Sugimori,Minoko Takanashi,Kazunori Nakajima,Masaya Munakata,Taiko Tanba,Mutsuhiko Minami,Toshiko Motoji,Kentaro Yoshinaga,M Consuelo Del Cañizo

doi:10.1371/journal.pone.0148854

Takeshi Odajima, Hiroki Sugimori + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0148854

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Abstract

We conducted a cross-sectional study to elucidate factors contributing to vasovagal reaction (VVR), the most frequent side effect following whole blood and apheresis donations. Complications recorded at the collection sites after voluntary donations by the Japanese Red Cross Tokyo Blood Center (JRC), in the 2006 and 2007 fiscal years, were analyzed by both univariate analysis and the multivariate conditional logistic regression model. Of 1,119,716 blood donations over the full two years, complications were recorded for 13,320 donations (1.18%), among which 67% were VVR. There were 4,303 VVR cases which had sufficient information and could be used for this study. For each VVR case, two sex- and age-matched controls (n = 8,606) were randomly selected from the donors without complications. Age, sex, body mass index (BMI), predonation blood pressure, pulse and blood test results, including total protein, albumin, and hemoglobin, were compared between the VVR group and the control group. In univariate analysis, the VVR group was significantly younger, with a lower BMI, higher blood pressure and higher blood protein and hemoglobin levels than the control group (p<0.001). Furthermore, blood protein and hemoglobin levels showed dose-dependent relationships with VVR incidences by the Cochran-Armitage trend test (p<0.01). For both sexes, after adjusting for confounders with the multivariate conditional logistic regression model, the higher than median groups for total protein (male: OR 1.97; 95%CI 1.76,-2.21; female: OR 2.29; 95%CI 2.05–2.56), albumin (male: 1.75; 1.55–1.96; female: 1.76; 1.57–1.97) and hemoglobin (male: 1.98; 1.76–2.22; female: 1.62; 1.45–1.81) had statistically significant higher risk of VVR compared to the lower than median groups. These elevated serum protein and hemoglobin levels might offer new indicators to help understand VVR occurrence.

Highlights

The volunteer spirit of healthy donors is the foundation of blood donation
We have reported that the vasovagal reaction (VVR) risk is associated with a young age, low body mass index (BMI), high blood pressure before blood collection, fast pulse rate, first-time donation, small circulating blood volume (CBV) and short sleep time [10]
Age, sex, height, weight, BMI, CBV, predonation systolic blood pressure (SBP), predonation diastolic blood pressure (DBP), predonation pulse rate, donation status, donation type, total protein (TP), Alb and Hb were analyzed as subgroups for evaluating the baseline characteristics of blood donors

Summary

Introduction

The volunteer spirit of healthy donors is the foundation of blood donation. In Japan, blood is collected from approximately 5 million people annually. There have been reports on the risk from blood donation for first-time donors, youth, females, donors who have a small blood volume, a high pulse rate before blood collection, etc. The relationships between VVR and blood chemical values such as total protein (TP), albumin (Alb) and hemoglobin (Hb) have not been studied sufficiently far. We analyzed how these values influence and are related to the occurrence of VVR using the data of blood donors over a 2 year period at the JRC Tokyo Blood Center

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