Cause Of Deferral Research Articles

Blood donor questionnaires and infectious disease screening in Latin American countries.

Blood donor questionnaires are tools used to screen prospective blood donors to determine their eligibility. There are limited data regarding blood donor questionnaires and infectious disease screening of the blood supply in Latin American countries. This study aimed to survey donor centres in Latin American countries to learn more about blood donor screening and infection assessment. An international team of transfusion medicine professionals including medical directors and supervisors who work or collaborate with Latin American donor centres, called 'Comité de Investigación en Medicina Transfusional', designed a survey (16 questions) to characterize blood donor eligibility in Latin America. Eighty-two institutions from 14 Latin American countries responded to the survey. Most donor centres (66%; 54 of 82) had a donor deferral percentage between 5% and 25%, and the most common causes of deferrals were low haemoglobin and high-risk behaviour. Most donors in blood centres were directed family donors compared with voluntary donors. Infection evaluation included mostly serologic assessment (81%; 30 of 37) for human immunodeficiency virus (HIV), Hepatitis B, Hepatitis C, Treponema pallidum and Trypanosoma cruzi rather than nucleic acid tests (5%; 2 of 37). Heterogeneity exists in donor selection and infectious disease screening in Latin American countries. This survey provides valuable information to understand Latin American blood centre practices.

Analysis of Blood Donor Deferral Pattern at a Tertiary Care Hospital in Chennai: A Cross-Sectional Retrospective Study.

Background Blood is essential for saving lives, particularly in emergencies. However, many patients, especially in developing countries face delays in accessing safe blood due to inadequate infrastructure, insufficient blood banks, poorly equipped laboratories, unreliable transportation systems, low donation rates driven by cultural beliefs, fear, and misconceptions, poor blood donor recruitment and retention, economic constraints, and a general lack of awareness and education about blood donation. Ensuring safe transfusions requires advanced technology and promoting healthy, voluntary donations. Donor selection is crucial for safety, preventing adverse reactions through proper criteria and infection screenings. Donor deferrals can discourage donors and hinder recruitment, so identifying and addressing deferral causes is vital. Blood centers must balance quality and quantity by using thorough donor assessments. Efforts should focus on both recruiting new donors and retaining deferred ones to ensure a stable blood supply. Aim The aim of the study is to evaluate and analyze the patterns and causes of blood donor deferrals in a tertiary care hospital. The objectives are to determine the incidence and reasons for blood donor deferrals. Materials and methods A cross-sectional retrospective study was conducted for 36 months fromMay 2021 to May 2024.A simple random sampling method was used to select the blood donors who reported for donation. Data was obtained from records maintained by the blood center. Descriptive statistics were utilized to summarize the demographics of the blood donors, including deferral rates among males and females, and the frequency of temporary and permanent deferrals. A Chi-square test was done to find the association between gender and deferral rates in blood donation. This analysis aimed to explore gender variations and underlying health status differences between male and female donors, as these can influence deferral rates. Results From May 2021 to May 2024, 17,082 people registered to donate blood at the Blood Centre, Department of Transfusion Medicine. Out of these, 1,000 donors, or 5.85%, were deferred. The majority of donors were males 16,638, with only 444 females. Most deferrals (76.4%) were temporary, often due to low hemoglobin levels or recent alcohol intake. Permanent deferrals (23.6%) were usually due to uncontrolled hypertension and diabetes. A significant association was found between gender and type of deferral among participants (p < 0.05). Conclusion This cross-sectional retrospective study on blood donor deferral patterns in a tertiary care hospital highlights key reasons such as low hemoglobin, recent alcohol intake, hypertension, and diabetes. To improve donor eligibility and retention, targeted strategies including enhanced education and community engagement are essential. These efforts will strengthen blood transfusion services and support critical healthcare needs effectively.

Characteristics of first-time blood donors with unsatisfactory hemoglobin level and positive hepatitis B test in Binh Dinh Province

Blood transfusion is essential in the treatment of a various diseases. In order to guarantee a safe and sufficient volume of blood supply, it is crucial to select appropriate donors based on stringent eligibility criteria. The objective of this study was to furnish robust epidemiological information and identify the risk factors linked to hepatitis B virus (HBV) infection and low hemoglobin levels in first-time blood donors in Binh Dinh. Understanding the causes for donor deferrals can assist better plan and establish an efficient recruiting strategies as well as evaluate donor selection criteria. A cross-sectional study was undertaken in Binh Dinh Provincial General Hospital from November 2022 to February 2023 to examine individuals in their first-time blood donation. Data were sourced directly from voluntary blood donation registration forms. HBsAg results were assessed using rapid immunochromatographic tests and chemiluminescent immunoassays. The rate of unsatisfactory hemoglobin levels was 2.56% tested on 1,638 participants. This rate was significantly associated with female sex (18 times greater odds than males), and lower weight. The results revealed that the rate of HBV infection was 3.13% when detected by the rapid test, but increased by 0.58% when measured by chemiluminescent microparticle immunoassay. The positive hepatitis B deferral correlated with sex (p&lt;0.05), age group (p&lt;0.05) and occupation (p&lt;0.05). HBV was found the leading cause of deferral in the study area and associated with males, age groups (25–35 and 36–44), officer, worker-farmer, and self-employed people. The prevalence of low hemoglobin donor deferral obtained was 2.56%. Low hemoglobin deferral is associated with female gender, lower body weight, worker-farmer, and self-employed - others. This finding underscores a significant public health concerns, highlighting the need for strategies to lower the infection rates. Understanding the factors leading to defered donation can contribute to development of proactive strategies for recruiting and retaining donors.

Frequency of Blood Donor Deferrals in Urban Population among Random Voluntary Donors and Evaluation of Gross Differences in Various Study Groups

Introduction: The most important aspect of the blood donor selection criteria is the selection of Healthy donors for donating blood to safeguard the health of the donor as well as the patient. Based on the selection criteria donors are considered either fit or unfit (deferred) to donate blood. Aim: Primary aim of the study is to analyze and evaluate the various causes of donor deferrals in comparison to different regional studies with special emphasis on temporary donor deferrals, in order to retain them as potential future donors. Materials &amp; Methods: A retrospective study was conducted with available data of all donors registered between May 2022 and Dec 2023. Donor deferral data was analyzed for various causes of deferral patterns. Results: A total of 2003 donors registered for voluntary blood donation out of which 244(80.79%) were accepted for donation and 302(15.07 %.) were deferred for various reasons. Total number of temporary deferrals were 244(80.79%) and permanent deferrals were 58(19.20%). Discussion: The overall deferral rate in this study was 15.48%. Low Hemoglobin (36.09%) was the commonest cause for temporary deferral and the commonest age group which had maximum deferrals was 18---25 yrs. Hypertension was the main cause of permanent deferral. Conclusion: The incidence of donor deferral can be reduced by furnishing the appropriate information related to blood donations and educating the general public and blood donors through awareness programs. Follow up of the donors must be encouraged to remove the negative feeling in deferred donors to make them potential future donors.

Profile of Blood Donors and Reasons for Deferral at a District Hospital in North Goa

Introduction: A blood transfusion is a life-sustaining procedure in several medical and surgical conditions. It isvital that an adequate inventory of safe blood is established by implementing stringent donor selection criteria andscreening for transfusion transmitted infections by ultrasensitive methods of detection. Despite a huge population,scarcity of blood lingers nationwide and it is important to analyse the varied reasons of deferrals in order to lessenthe deferrals in the future.The aim of this paper is to scrutinise the demographic profile of blood donors and evaluate the patterns andreasons for donor deferral at North Goa District hospital, India.Materials and Methods: This is a retrospective study carried out at the Blood Centre , North Goa Districthospital,India,. All those who registered for donation between June 2022 till May 2023 were included in the study.The donors were screened by a questionnaire followed by medical examination and were selected or deferredbased on the guidelines laid down by Drugs and Cosmetics Act,1940 and Directorate General of Health Services,MoHFW,Govt of India1.2 .Data was collected using a proforma and analysed by SPSS software wherever indicated.Results: During this time period, 2611 donors registered for blood donation, out of which 425 donors were deferreddue to diverse reasons. Most of the donors were voluntary donors(98.3%) of which majority were males(86.4%).The commonest cause of deferral in males was high BP(24%) and high Hb(11.3%) whereas the commonest cause ofdeferrals in females was low Hb (46.9%). Most of the donors were rejected due to temporary reasons(97.1%). Thecommonest reason of permanent deferrals was a medical history of uncontrolled DM.

Analysis of Blood Donor Deferral Pattern during COVID-19 Pandemic at a Tertiary Care Hospital-based Blood Centre, Jammu and Kashmir, India: A Cross-sectional Study

Introduction: Blood donor deferral is vital for ensuring safe blood transfusion. However, with the unfolding Coronavirus Disease-2019 (COVID-19) pandemic, significant changes were made in donor screening and blood donation criteria, resulting in a shift in the pattern of donor deferrals. Aim: To estimate the blood donor deferral patterns during the COVID-19 pandemic. Materials and Methods: A retrospective cross-sectional study was conducted in the Department of Transfusion Medicine at SMHS Hospital/GMC Srinagar, Jammu and Kashmir, India. The study spanned two years, from March 2020 to February 2022. All blood donors were screened in accordance with the Ministry of Health and Family Welfare (MOHFW), National Acquired Immune Deficiency Syndrome (AIDS) control organisation (National blood transfusion services) 2017 guidelines. The data was analysed in Microsoft Excel, considering factors such as age, gender, type of deferral, and reasons for deferral. Results: Deferred blood donors were most common in the age group of 18-33 years. During the study period, a total of 19,895 blood donors (19493 males and 402 females) were registered for blood donation. Out of these, 3441 donors (17.30%) were deferred, with a male donor deferral rate of 3258/19493 (16.71%) and a female donor deferral rate of 183/402 (45.52%). Temporary blood donor deferrals accounted for 3272 (95.09%) cases, while permanent deferrals were 169 (4.91%). The most common cause of deferral was low haemoglobin, accounting for 991/3441 (28.80%) cases, followed by deferrals due to reasons attributable to the COVID-19 pandemic (786/3441, 22.84%) and hypertension (653/3441, 18.98%). Conclusion: The study observed a substantial increase in the total donor deferral rate, as well as a change in the donor deferral pattern during the COVID-19 pandemic.

Voluntary blood donation camp- A challenge during COVID-19 pandemic

Voluntary blood donors are the mainstay of any blood donation camp, whether in a hospital or in a blood bank. Selection of such donors becomes an important element in any blood donation program. However, the spread of COVID-19 worldwide had a crippling impact on blood donations/ blood safety and had posed a huge challenge. Hence, an insight into conduction of a blood donation camp during the pandemic and analysis of reasons for donor deferral becomes highly important.This is an observational study about a voluntary blood donation camp held for general public during the second wave of COVID-19 in a school at Kottur, Karnataka. Donor details were taken with the help of questionnaires. Procedures and safety protocols put in place during donation was noted and reasons for deferral obtained from donor questionnaires and by examination of donors was analyzed.The blood donation camp was conducted with proper COVID-19 guidelines. A total of 105 individuals came for donation of which 37 were deferred. 6 deferrals were due to COVID-related cause, 31 deferrals were non-COVID related and overall the most common cause of deferral was hypertension. With the help of proper safety measures, blood donation camps can be successfully conducted during pandemic like COVID-19. And the crisis for blood and its products can be met by adopting appropriate guidelines.

Blood Donor Deferral Due to Anemia

Background: The Blood safety is a major issue all over worldwide in transfusion medicine. For this reason, blood donor selection is vital for the safety of donors and recipients as well as for maintaining an adequate blood supply. Detailed evaluation of various causes for the deferral of blood donors may be helpful for medical personnel to limit the barriers that disrupt blood donation. This study aimed to analyze the rate of deferral donors due to anemia and evaluate the various causes of deferral in blood donors to achieve 100% acceptance. Methods: This is an Observational descriptive record-based study over 1 year. Donor selection criteria were followed according to the National guidelines of blood donation. The donors data was collected from the Donor deferral registry concerning age and Gender. The results are demonstrated as frequency and percentage in the form of tables and graphs. Result: A total of 9059 donors presented to the blood bank during the study period, 7713 (85.14%) were accepted, and 1346 (14.86%) were deferred. 268 donors were deferred due to Anemia with low hemoglobin, that is 250 (93.29%) were females and 18 (6.71%) were males. All these anemic deferred donors were categorized as moderate 3.35% and 96.65% were mild anemia. Keywords: Blood donation, Donor deferral, Low Haemoglobin, Anemia.

Plateletpheresis donor deferral patterns at a tertiary care hospital in North India: A need for rethink of haemoglobin cutoff.

The donor deferral criteria for blood or apheresis donations are established for two main reasons: (i) to ensure the safety of the blood donor (non-maleficence); (ii) to obtain safe blood of standard quality that has therapeutic benefit for the patient (beneficence). This study was planned to assess the various causes and patterns of plateletpheresis donor deferral in our hospital and to subsequently assess whether any evidence based changes can be done in the current plateletpheresis donor deferral criteria in India to maximize the platelet donor pool without compromising donor safety. The present study was conducted from May 2021 till June 2022 in the department of transfusion medicine of a tertiary care hospital in North India. The first part of the study was conducted from May 2021 till March 2022 to assess the various causes of donor deferral by analysing the plateletpheresis donor deferral data during the corresponding period. The second part of the study was conducted from April 2022 till June 2022, to assess: (i) average decrease in haemoglobin after plateletpheresis procedure; (ii) red blood cell loss during plateletpheresis procedure; (iii) to determine whether any correlation exists between donor haemoglobin and platelet yield. During the study period, a total of 260 donors were screened for plateletpheresis, out of which 221 (85%) donors were accepted and 39 (15%) donors were deferred for various reasons. Out of the 39 deferred donors, 33 (84.6%) were temporary deferrals, while 6 (15.4%) were permanent deferrals. Low haemoglobin (Hb<12.5g/dl) was a cause of deferral in 12.8% (n=5) of the deferred donors. 192 (73.9%) out of the 260 donors were replacement donors. The calculated mean decrease in haemoglobin as a result of plateletpheresis procedure was 0.4g/dl. No correlation was seen between donor pre-donation haemoglobin and platelet yield (p=0.86, r=0.06, R2=0.003). The calculated mean red cell loss as a result of plateletpheresis procedure was 28ml. Low haemoglobin (<12.5g/dl) is a significant cause of temporary plateletpheresis donor deferral in India. In view of the advancement in plateletpheresis technology, which has resulted in minimal red cell loss with the current generation apheresis devices, haemoglobin cutoff of 12.5g/dl needs to be reconsidered. Perhaps, after performing a multi-centric trial, a consenscus can be reached for revision of haemoglobin cutoff for plateletpheresis donations.

Prevalence and causes of pre-donation deferrals among potential plateletpheresis donors at a blood center in Eastern China.

In China, the platelet donation interval is 14days. The eligibility criterion of plateletpheresis donors (PD) is more stringent than that of whole blood donors, so the deferral causes are very complicated. However, the deferral prevalence and causes among PDs are not well known in China. To analyse the deferral prevalence and influencing factors during pre-donation among PDs in a blood centre in Eastern China. From December 26, 2020 to December 25, 2021, all data of potential PDs during pre-donation were extracted from the register system and collected using Microsoft Excel. The number of deferred visits and the corresponding causes were retrospectively analysed, and the re-donation rate of deferred donors was calculated. A total of 19,762 visits were included in the study. Of these 17,847 (90.3%) donated platelets successfully and 1915 (9.7%) were deferred. The prevalence of deferrals was high among those less than 35years old (p<0.05) and first-time donors (p=0). The leading cause for deferral was elevated alanine transaminase (51.4%) followed by abnormal haematological parameters (37.15%). High white blood cell count was the first deferral factor (26.9%) in abnormal haematological parameters. In more than 2 ineligible items, low haemoglobin and haematocrit simultaneously were dominant (58.3%). The re-donation rate of repeat donors (65.4%) was higher than that of first-time donors (19.3%) (p=0). The deferral prevalence in Chinese plateletpheresis donors was not high. First-time and young donors were more frequently deferred. The repeat donors should be of concern, especially with abnormal haematological parameters.

Impact of Universal Donor History Questionnaire in Pre-Donation Deferrals a Tertiary Care Hospital Experience

Objective: The purpose of this research was to better understand the factors that lead to pre-donation deferral at a tertiary care hospital's Blood bank. Understanding the factors that lead donors to decline can inform more effective selection criteria. Study Design: Cross-sectional/Descriptive study Place and Duration: Diagnostic and research laboratory Liaquat university of Medical and Health Sciences Jamshoro Hyderabad. January 2022-December 2022 Methods: This study comprised of 2200 donors at blood bank of LUMHS. The UDHQ included 25 questions to assess donors' backgrounds in regards to things like injections, medicines, time since last donation, tattoos, general health, dental work, sexual relationships, malaria/T.B., surgery, jaundice, vaccination, positive viral markers, etc. Haemoglobin (Hemacue 50/Diaspect Hb with daily quality control), Heart rate/rhythm, Blood pressure, Body temperature, Weight/Height, and Jaundice were all part of the physical exam. Results: There were majority 1578 (71.7%) males and 622 (28.3%) female donors among all cases. Donors mean age was 26.12±9.88 years and mean weight was 61.3±8.49 kg. 1435 (65.2%) cases were from urban areas. Among all, 1650 (75%) donors were accepted and 550 (25%) donors were deferral. Most common cause of deferral was low hemoglobin followed by anemia, HCV, HBV, inappropriate pulse rate, low BP, jaundice, active infection, malaria, syphilis, allergy, aspirin intake, drugs, last donation, skin/eye colour and sexual relationship. There were 1870 (85%) cases of replacement donors among all cases. Conclusion: The selection of healthy blood and the reduction of donor injury will be made possible by a thorough pre-donation screening interview and physical examination. Our setup has a somewhat higher blood donor deferral rate because to stringent donor sector requirements and extra attention paid to donor selection processes. The increased replacement donor deferral rate is a result of refusals for past injection history and poor hemoglobin levels. Keywords: Donors, Deferrals, Hemoglobin, Infection, HCV

Gender Distribution and Reasons for Donor Deferral in Blood Donors at a Tertiary Healthcare Centre, Kerala, India: A Cross-sectional Study

Introduction: One of the primary responsibilities of the blood bank is to provide safe blood to patients. Blood donors are screened before blood donation and deferred from donating if they have diseases or conditions that may affect blood quality or lead to adverse reactions. Blood donor deferral ensures both donor and patient safety. Understanding deferral reasons can help raise awareness among blood donors. Aim: To determine the percentage of female blood donors and the number of deferrals in male and female donors for various reasons. Materials and Methods: This retrospective cross-sectional study was conducted at Department of Transfusion Medicine, Government Medical college, Kozhikode, Kerala, India. The study period was one year from April 2018 to March 2019. Data on the number of male and female donors, donors accepted for donation, and those deferred for various reasons were collected through questionnaires and blood bank records. Data analysis was performed using Stastistical Packages of Social Sciences (SPSS) version 17.0 software, employing the Chi-square test with a significance level of p&lt;0.05. Results: Out of 36,318 blood donors, only 1,521 (4.2%) were females. During the study period, 30,007 donors were selected for donation, of which 792 (2.64%) were female donors. Among the 6,311 deferred donors, 1,171 (18.55%) were deferred due to fever and respiratory tract infections, the most common reason for deferral. The deferral rate for females was significantly higher than for males. Females had a deferral rate of 47.9% (729 out of 1,521 female donors), while males had a deferral rate of 16.04% (5,582 donors). Fever and respiratory tract infections were the main cause of deferral among males, with 1,055 (18.9%) deferred for this reason. Among females, low haemoglobin (306, 41.98%) was the primary cause of deferral. Conclusion: Females constitute a minority of the blood donor population. Motivational efforts can increase blood donation among females. Raising awareness about nutritional anaemia and implementing preventive measures can reduce deferrals among female blood donors.

Analysis of Variation in Blood Donor Deferral Section Statistics as per Drugs and Cosmetics (Second Amendment) Rules, 2020: An Institutional Experience

Introduction: The safety of donated blood is of utmost importance for the well-being of the recipient, which requires proper adherence to donor acceptance criteria. In March 2020, new amendments were introduced in the Drugs and Cosmetics Act, which included several new criteria. It is important to explore these changes and their impact on the donor pool to ensure adequate maintenance of whole blood/component inventory in our blood centre. Aim: To study the variation in deferral statistics of blood donors after the introduction of new donor criteria as per the Drugs and Cosmetics (Second Amendment) Rules, 2020. Materials and Methods: The present study was conducted from October 1, 2022, to June 30, 2023, in the Department of Immunohaematology and Blood Transfusion (Blood Centre) of a tertiary care hospital in Punjab, India. Retrospective data for three years was collected from blood donor records and deferral records, divided into two groups: group 1 (October 1, 2018, to March 31, 2020) for the old criteria, and group 2 (April 1, 2020, to September 30, 2021) for the new criteria. Reasons for deferral of donors were categorised into four stages: clinical history, medical examination, investigations (hemoglobin levels), and inadequate collection for both male and female donors. The collected data was entered into a Microsoft Excel sheet. Variables in different categories were represented as frequencies and percentages. Chi-square test was used for comparison between the data of the two groups. Results: In group I, 332 out of 6,588 donors (5.04%) were deferred, and in group II, 345 out of 6,143 donors (5.61%) were deferred. The deferral rate was comparatively higher in females in both groups, with 17.98% (41/228) in group I and 21.65% (21/97) in group II. The percentage of deferred donors was higher in the age group of 18-30 years in both groups, with 50.60% (168/332) in group I and 47.25% (163/345) in group II. The maximum number of donors were deferred at stage I (clinical history), with 270/332 (81.33%) in group I and 296/345 (85.8%) in group II, followed by stage III (investigations), with 34/332 (10.24%) in group I and 33/345 (9.56%) in group II. COVID-19 related history was the third most common cause of deferral in group II, accounting for 43 (12.46%) of the total deferred cases, which was not present in group I. Conclusion: The new guidelines, although comprehensive, only minimally increased the deferral rate and did not have a significant impact on the donor pool of our blood centre. Knowledge about the latest deferral guidelines and donor deferral rates is of utmost significance for the maintenance of inventory and to reduce the loss of a significant donor pool.

EVALUATION OF BLOOD DONOR DEFERRAL IN A BLOOD CENTRE OF A TEACHING HOSPITAL, NORTHEAST INDIA

Introduction: One of the important goals of a blood centre is to maintain safe blood supply while maximizing the potential blood donors to donate blood. Donor deferral has a negative impact on donor retention and recruitment. Therefore, due care should be given during donor selection to avoid false deferral. Material &amp; Methods: This cross-sectional study included all the potential blood donors who registered for donation in the Blood Centre of a teaching hospital, Northeast India, between November, 2020 and October, 2022. The prevalence, pattern and leading causes of deferral were evaluated. Results: Out of 20,137 prospective blood donors, 3779 were deferred due to various reasons. The prevalence of deferral was 18.77%. Temporary deferral accounted 87.25% of all deferrals. Physical and physiological conditions were the commonest reason (1768) for deferral followed by medical and surgical conditions (1061). The common causes of deferrals were hypertension (20.83%), medications (19.58%), poor sleep (14.45%), alcoholism (7.75%), TTI risk (6.62%) and anaemia (5.74%). Conclusion: The process of donor deferral should not be an element of discouragement for future donations of temporarily deferred donors. Pre-donation information in various forms can help in reducing deferrals due to factors that are modiable by the prospective donors. More precise donor selection criteria may reduce the subjective variations of donor interviewers.

Effectiveness of Combined Verbal Screening and Uniform Donor Questionnaire in Blood Donor Deferral; Evaluation at a Regional Blood Bank

Introduction: Blood transfusion is a potentially life-saving procedure that replaces the blood lost either during surgery or after injury. It also serves as a mean of replacing blood in the patients who cannot replenish enough blood for their own body. Donors come from all walks of life with established lifestyle. A detailed questionnaire along with verbal screening and general physical examination should be performed in all blood donors before labeling them unsuitable for donation. Objective: To evaluate the effectiveness of verbal screening in addition to uniform donor questionnaire as a routine pre-donation protocol for donor selection and deferral. Material and Methods: This cross-sectional study was conducted at a regional blood bank in Northern Pakistan over a period of six months from January 2021 to June 2021. The blood donors who were deferred after assessment by uniform donor questionnaire (UDQ), verbal screening and general physical examination were critically analyzed. The causes of deferral were noted. The data was analyzed by using SPSS Version 23. Results: A total of 400 blood donors were deferred during the study period. Their ages ranged from 25 to 40 years with a median age of 29 years. Majority of them were males (97.5%). Among these, 332 were deferred on uniform donor questionnaire, 48 on verbal screening and 20 on general physical examination. Conclusion: Assessment of blood donors by verbal interview as an adjunct to donor questionnaire is very effective in donor selection and deferral process and should be made a mandatory part of pre-donation blood donor selection protocol. Keywords: Transfusion, uniform donor questionnaire, verbal screening

Study of donor deferral during blood donation: A single centre teaching hospital study

Background: Safe blood transfusion can be a crucial lifesaving intervention in many clinical situations.For safe blood products donor selection is the first and foremost measure of blood donation. Objective:Aim of the study to determine the incidence and causes for deferral in blood donors. Materials and Methods: This cross-sectional retrospective study was done at Transfusion medicine department in Delta Medical College and Hospital, Bangladesh during 6 months period. In current study data were extracted from the register book and analyzed. Prospective donors were confidentially interviewed and examined and screened for causes of temporary and permanent deferral of blood donation. Data were presented as charts, table and analyzed with Microsoft Excel. Result: A total of 2215 directed donors were studied,of them, 1555 (73.52%) were male and 560 (26.48%) females. Predominantly blood donors belonged to 31–40 years of age group (38.01%). Out of 2115 directed donors, 423 (20%) were deferred. Deferral was significantly more likely in female. The most common cause for deferralwere history of anemia (27.66%). Other causes were antibiotic &amp; medications, high blood pressure, low blood pressure, frequent donation, Positive HBsAg, HCV markers, suspected addiction, and vaccination. Conclusion: Effective measures are required for documenting the deferred donors and appropriate preventive intervention program should be undertaken for prevalent causes of deferrals, like low Hb, Infections with HBV etc. Anemia is the most prevalent reason of temporary deferral for blood donation in this region of Bangladesh. Other reasons were hypertension, hypotension,suspected addiction, vaccination etc. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 645-647

Understanding deferral rate and reason among voluntary blood donors at a tertiary care center

Healthy Donor selection is necessary for procurement of safe blood in addition to the screenings of blood bags for infectious diseases. Deferrals lead to loss of precious blood/components available for transfusion in emergency situation. To avoid such problems, we should be aware about its reasons and frequency. To find the incidence of donors who were deferred from donating blood and to determine the causes for same.The study was conducted in the blood bank of tertiary health care center, from January 2015 to December 2017 to find the incidence of deferral and reason behind it. Criteria for deferral was decided as per guidelines given by national health authority.A total of 10,000 donors were screened of which 99% were voluntary donors (VD). The total 598 donors were deferred among 10000 registered during study period. The total donor deferral rate was 6%. The percentage of deferral amongst males was 5.7% and females 7.4%. A majority (65%) of the deferred donors were between 18 to 30 years. The major causes of deferral were anemia and hypertension.Analysis of the deferrals showed that the proportion of temporary deferral was more common than the permanent deferral. Conducting pre-donation camp awareness session can reduce the deferral rate. Temporarily deferred individuals must be informed and followed up to encourage donation in future.

Blood Donors and Their Deferral Pattern in a University Hospital, Nepal

Background and Objectives: Blood transfusion is a life-saving procedure and the selection of healthy blood donors is essential steps for safe blood transfusion. Proper selection of blood donors is needed for the safety of both blood donors and recipients. The aim of this study was to assess the demographic profile of blood donors and determine the frequency and reason of donor deferral in a university hospital of Nepal. Methods: This hospital-based retrospective study was carried out in the Blood Bank Unit of the tertiary care center of Nepal. Data were collected from the record book maintained in the blood bank from January 2016 to December 2020. Data were analyzed using Microsoft Office Excel 2010 for descriptive analysis. Results: A total of 3697 individuals came for blood donation during the study period; among them, 2802 (75.8%) were male and 895 (24.2%) were female. Total number of voluntary donation were 2175 (58.8%), while 1522 (41.2%) were family/replacement donation. Among all donors, 351 (9.5%) donors were deferred for different reasons. The most common cause of donor deferral was hypertension (15.0%), followed by medication (14.0%), while anemia (32.8%) was the leading cause of deferral in female donors. Out of total deferral cases, 92.6% of donors were temporary deferral, while 7.4% were deferred permanently. Conclusion: Most deferrals were temporarily due to hypertension, medication, and anemia. Awareness about these causes of deferral can increases the donor pool.

Source plasma deferral trends: A 3‐year analysis of 255 centers in the United States

BackgroundPlasma contains many important proteins of therapeutic interest including albumin, clotting factors, and antibodies. Source plasma (SP) is in great demand particularly due to a shortage of immunoglobulin. To better understand how to increase supply, we examined SP donor deferrals for the previous 3 years.Study designThis is a description of donor deferrals at 255 plasma donation centers in the United States for April 1, 2017 to March 31, 2020.ResultsA total of 4 587 923 events were evaluated for the 3‐year period 2017‐2020. There were 873 227 deferrals analyzed for 2017‐2018, 1 765 582 in 2018‐2019, and 1 949 114 for 2019‐2020. The most common deferral each year was for unacceptable blood pressure (BP) or pulse which comprised 27.9%, 28.2%, and 28.3% of deferrals in 2017‐2018, 2018‐2019, and 2019‐2020, respectively. The second most common cause of deferral was for unacceptable hematocrit which comprised 14.1% of deferrals in 2017‐2018, and 16.0% in 2018‐2019 and 2019‐2020. The majority of these deferred donors had low hematocrits and were predominately (~80%) female. Deferral for unacceptable total protein comprised a smaller percentage (~4%) of deferrals.DiscussionMost donor deferrals were due to unacceptable screening results, particularly high BP, elevated pulse, low protein, and low hematocrit. Although rates of deferrals in other categories have been slightly increasing over time, they comprise a small percentage. Donor education regarding healthy lifestyle choices may improve overall donor health, decrease deferrals, and increase SP supply.

PREVALENCE OF BLOOD DONOR DEFERRAL AND ITS DISTRIBUTION BY SEX, TYPE OF DEFERRAL AND CAUSES IN POPULATION OF KARACHI, PAKISTAN

Background: Donor selection is an important step for safe blood transfusion. The objectives of this study were to determine prevalence of blood donor deferral and its distribution by sex, type of deferral and causes in population of Karachi, Pakistan.Materials Methods: This cross-sectional study was conducted at Department of Pathology, Hamdard University, Karachi, Pakistan from July 1, 2019 to June 30, 2020. Hamdard University Hospital, Karachi is assumed to cater 1.5 million population. With 1% donors, population at risk was 15,000. With 10% donor deferral, 1.073% margin of error and 95% confidence interval, sample size was calculated as 2,503. The technique was consecutive non-probability. Sex, age in years, weight, temperature, blood pressure and pulse were noted. Tests for CBC, blood grouping, hepatitis B, Hepatitis C, HIV, malaria and syphilis were done. Donor selection criteria included age range 18-60 years, weight ≥50 kg, pulse rate 60-100/ min, systolic blood pressure 101-150 mmHg, diastolic blood pressure 60-100 mmHg, temperature ≤99◦F, hemoglobin ≥13.0 g/dl for men and ≥12.5g/dl for women. All categorical variables were analyzed by count and percentage with 80%CI.Results: Out of 2,503 donors, 2,493 (99.7%) were men and 10 (0.3%) women. Frequency of deferral was 139 (5.5533%), including 129 (5.1538%) men and 10 (0.3995%) women and 58 (2.3172%) temporary and 81 (3.2361%) permanent. Causes of temporary deferral were; anemia 33 (1.3184%), low weight 8 (0.3196%), acute infection and on medication each 5 (0.1998%), donation of blood in last 8 weeks 4 (0.1598%) and hypotension 3 (0.1198%) cases. Causes of permanent deferral were; HCV 32 (1.2784%), HBV 30 (1.1985%), syphilis 17 (0.6792%), HIV and diabetes mellitus each one (0.04%) case.Conclusion: Prevalence of blood donor deferral was 5.55% in our study, which is almost half of all the cited studies here from global, regional, national and local populations. Prevalence in men was many times higher than women and prevalence of permanent causes was higher than temporary causes. Anemia and HCV were the two major causes of deferral in our study. Proper donor selection is a key of safe blood transfusion. Appropriate measures are needed to prevent causes of deferral.