Donor Deferral Research Articles

Analysis of donor deferrals causes in blood donation center-tertiary care hospital study

Background: Blood donor selection is important in providing safety to the recipients and also preventing transfusion related complications. Temporary causes for deferral should be counseled while permanent causes deferred for a life time. In this study, analysis was done to know the causes donor deferrals. Methods: A one year cross- sectional study was conducted in our hospital from the period March 2022 to March 2023.All the donors who were unfit for blood donation were included in the study. All the reasons for the deferrals are listed and analyzed the data. Results: Among 7147 total donations, voluntary are 3775, replacement are 3372.Out of which 150 donors are deferred, most were males 129 (86%) and the rest were females 21 (14%). The rejection rate in our study was 2.09%. The most common reason for the permanent rejection is Hepatitis-B and low hemoglobin level for temporary rejection. Conclusions: A vast majority of donors were rejected permanently 103 (68.6%), while the rest of them were rejected temporarily 47 (31.4%).

International review of blood donation screening for anti-HBc and occult hepatitis B virus infection.

Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.

Platelet Pathogen Reduction Technology-Should We Stay or Should We Go…?

The recent COVID-19 pandemic has significantly challenged blood transfusion services (BTS) for providing blood products and for keeping blood supplies available. The possibility that a similar pandemic event may occur again has induced researchers and transfusionists to investigate the adoption of new tools to prevent and reduce these risks. Similarly, increased donor travelling and globalization, with consequent donor deferral and donor pool reduction, have contributed to raising awareness on this topic. Although recent studies have validated the use of pathogen reduction technology (PRT) for the control of transfusion-transmitted infections (TTI) this method is not a standard of care despite increasing adoption. We present a critical commentary on the role of PRT for platelets and on associated problems for blood transfusion services (BTS). The balance of the cost effectiveness of adopting PRT is also discussed.

A Retrospective Study on Analysis of Donor Deferral Characteristics of Plateletpheresis at a Tertiary Care Hospital in North India

A Retrospective Study on Analysis of Donor Deferral Characteristics of Plateletpheresis at a Tertiary Care Hospital in North India

Optimal malarial screening strategy in Australian blood donors: A cost-effectiveness analysis.

The risk of transfusion-transmitted malaria (TTM) infections is extremely low in Australia, and the cost-effectiveness of the current screening strategy has not been assessed. This study aims to conduct a cost-effectiveness analysis of different malaria screening strategies in blood donors as part of the risk-based decision-making framework. A decision tree model was developed to assess the cost-effectiveness of five alternative malaria screening strategies from a healthcare sector perspective. Screening strategies combining total or partial removal of malaria testing with different deferral periods were considered. The probabilities of developing severe and uncomplicated TTM were based on a literature review of cases in non-endemic areas since 2000. The health outcomes were quantified using disability-adjusted life years. The costs of non-returning donors due to deferral were also included. Deterministic and probabilistic sensitivity analyses were conducted to account for data uncertainty. The residual risks for all strategies were so low that the costs, mortality and morbidity associated with TTM are almost negligible. The overall costs were predominantly influenced by the costs of non-returning blood donors. As a result, removal of malaria testing and applying a 28-day deferral for at-risk donors were the least costly and most cost-effective of all the options considered. The current screening strategy for malaria in blood donors in Australia is not an efficient use of healthcare resources. Partial or total removal of malaria testing would bring significant cost savings without significantly compromising blood safety.

Assessing the risk of transfusion-transmitted variant Creutzfeldt-Jakob disease: a European perspective.

Several countries have recently reassessed the international risk of variant Creutzfeldt-Jakob disease (vCJD) transmission through transfusion of blood and blood components (red blood cells, platelets and plasma) and relaxed donor deferrals based on geographic and transfusion exposure in countries formerly considered to be high risk, such as the UK. In this regard, the European Blood Alliance organised a consensus meeting of experts and involved professionals to discuss current knowledge, epidemiological data, prevention and various methods for assessing the risk of transfusion-transmitted vCJD, as well as to develop an appropriate position on possible approaches to address these challenges in Europe. Participants reached a consensus that the current risk of transfusion-transmitted vCJD associated with blood donors who either travelled to or received transfusions in the UK during the vCJD outbreak is minimal. In addressing such risks, it would be pragmatic that assessments and guidelines are developed by European expert bodies, rather than individual assessments by Member States. Regardless of the approach used, European or national, a qualitative risk assessment based on a review and analysis of available data, considering all the uncertainties and experiences of other countries, would provide crucial information to reassess blood donation strategies regarding the transfusion-associated vCJD risk.

Analysis of Rates and Reasons of Whole Blood Donor Deferral at a Tertiary Care Hospital

Background: Safe blood donors form the backbone of safe blood transfusion services. Donor eligibility policies are a critical layer of blood safety designed to ensure selection of healthy donors and to protect recipients from any harm. Aim: Analysis of rates and reasons of blood donor deferral at a tertiary care hospital in north India. Methodology: The present study is a retrospective study done in a tertiary care centre in Jammu region. The data was collected over a period of 2 years from January 2018 to December 2019.The various causes for deferral of the donor from donation were collected from donor deferral register which was recorded using regular questionnaire- based interview in the registration card followed by thorough medical history elicitation and minimal physical examination. Result: The total number of potential donors screened during the study period were 4728, out of which 532 were deferred because of various reasons. The deferral rate was calculated to be 11.25%.The mean age of deferred donors was 31.2±8.4 years. Most common cause for deferral both among males and females was low Haemoglobin level (less than 12.5gm %) i.e., 28.58%, followed by alcohol intake in last 24 hrs i.e., 11.09%, history of medication (6.2%); medical causes (5.83%); and Jaundice 5.26%. Deferral rate was found to be more among replacement donors (18.98%) than voluntary donors (6.62%). The permanent deferral was 16.65%. Conclusion: The deferral rate in this study is comparable to the deferral rates in other centres. The data will be very essential and helpful in testing the applicability of donor selection criteria. By identification of the causes for temporary deferrals, appropriate measures can be put in place to motivate and inform these potential donors to return for blood donation at a later date after the underlying cause has been rectified. Keywords: Blood donor deferral, permanent deferral, temporary deferral

Construction of a decision model for donor testing in cases of suspected antibody-mediated transfusion-related-acute-lung-injury.

To propose a rational basis for donor testing in cases of suspected antibody-mediated transfusion-related lung injury (AMT). Anti-leukocyte antibodies in donated blood are established causes of transfusion-related lung injury (TRALI). However, the question of whether to test donors for antibodies is not identical to whether the case meets definition criteria for TRALI. There is a balance between the potential benefits of testing and the costs of donor deferral and investigation. We propose that a decision-making process based on optimising the balance between risk and benefit requires a subjective choice of the relative value of different outcomes of testing. We have developed a formal decision model to illustrate how these choices affect testing decisions. Using a Bayesian probability model, we show that the diagnostic benefit and TRALI prevention benefit of testing donors have a complex interrelationship with the number of implicated donors and clinical suspicion of antibody-mediated TRALI (AMT) and that rational testing choices vary according to value assigned to outcomes. The challenges to the use of a formal decision model for clinical testing are discussed and conclude that a formal model is a useful consensus-building tool for improving consistency and openness in decision making.

A risk prediction model for vasovagal reactions in whole blood donors including the physical and psychological factors: Results from a case–control study done in a regional blood transfusion center

Abstract: BACKGROUND AND OBJECTIVES: Blood centers strive to maintain a safe and adequate supply of blood products from healthy volunteer donors. Primary responsibility of a medical officer is to assess donor risk for vasovagal reaction (VVR) and alert the phlebotomist. The study attempts to identify the significant risk factors of VVR which may help in decision-making. METHODS: This was a case–control study including blood donors donating 350 ml Whole blood in Department of Transfusion Medicine, Medical College, Thiruvananthapuram from December 19, 2017 to June 31, 2018. Donors who suffered VVRs during or after blood donation were considered as cases and compared with controls. The prevalence of risk factors such as age, sex, number of previous donations, body mass index (BMI), blood volume, sleep duration, food intake, fear and anxiety, and pain perception was compared between the groups. RESULTS: 174 cases and 348 controls were studied. Most of the donors were < 35 years of age (63.2%) younger age groups (18–25 year) had a higher odds of VVR (5.54 with 95% confidence interval [CI] 2.4–12.5). First time donations carried an increased risk of VVR with an ODDs ratio of 5.8 (3.81–9.131) compared to repeat donors. Around 45% of cases were first timers whereas only 12% of controls were first time donors. There was a significantly higher rate of reactions in donors who had episodes of VVRs in the previous donations. Odds 1.99 (CI 1.09–3.74) other risk factors identified were female gender (6.3, 95% CI 2–20), lack of sleep at previous night (32.9; CI 16.17–67.18), and high BMI > 27.5/m2 with odds ratio 2.5 (1.4–4.3). Having an estimated blood volume < 3500 ml also was associated with higher odds of VVRs. CONCLUSION: In spite of having a strict criteria for donor deferral based on risk factors, vasovagal reactions still occur and risk factors are prevalent in blood donor population. Special attention should be given to donors having one more of such risk factors and attempts should be made to avert VVRs.

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.

Blood safety markers in Dutch donors after relaxation of deferral for men who have sex with men: re-emergence of syphilis and HIV pre-exposure prophylaxis use.

Less discriminatory donor selection policies for men who have sex with men (MSM) may impact transfusion safety in terms of higher residual risks for known transfusion-transmitted infections (TTIs), increased vulnerability toward new TTIs that are also transmitted via sex, and HIV infections masked by pre-exposure prophylaxis (PrEP). TTI trends in Dutch donors were studied over a 13-year period (2011-2023), characterized by successive relaxations of MSM deferral criteria. Structured posttest counseling was performed to determine risk factors in TTI-positive donors. PrEP drug levels were measured in 9977 donations from male donors living in urban areas and in 67 donors with active or resolved syphilis. HIV incidence (from 5.8 to 1.5 per 1,000,000 donor years (DY)) and HBV incidence (from 12.4 to 4.5 per 1,000,000 DY) in Dutch donors decreased with less stringent MSM deferral criteria, while syphilis prevalence (from 26.4 to 44.1 per 100,000 new donors) and syphilis incidence (from 18.3 to 46.3 per 1,000,000 DY) increased over time. The proportion of MSM-related syphilis rose from 2% to 32% in new donors and from 12% to 27% in repeat donors. PrEP was detected in 2 of 9977 (0.02%) donations from male donors living in urban areas, and in 1 of 39 (2.6%) male donors with syphilis. To date, phasing out donor deferral for MSM had no significant impact on transfusion safety in the Netherlands. However, rising syphilis rates and (recent) PrEP use in the blood donor population, albeit rare, suggest an influx of donors with higher sexual risk profiles and requires intensified TTI surveillance in donors.

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.

New tatt? We're ok with that! Relaxing the tattoo deferral for plasmapheresis donors maintains safety and increases donations.

Tattooing is one of the leading donor deferral reasons in Australia. Until September 2020, donors were deferred from all donation types for 4 months after a tattoo. At this time, our guideline changed such that donations of plasma for further manufacture were accepted immediately, provided the tattoo was administered in a licensed or regulated Australian establishment. We examined the effects of this change. Donors with a tattoo deferral in the 2 years before or after the guideline change were identified and followed up until 3 November 2022. Between the two periods, we compared blood-borne virus (BBV) incidence, donor return, and the number of donors and donations regained after deferral. The incidence of BBV infection in donors after a tattoo deferral was zero in both periods. To exceed a residual risk of 1 in 1 million for hepatitis C virus, 190 donors would need to be infected yearly from a tattoo. Donors returned to donate significantly faster after the change (median return 85 days compared with 278 days). An extra 187 donations per 10,000 person-years of observation were gained, yielding a total of 44,674 additional plasma donations nationally 0-4 months after getting a tattoo. Allowing plasma donations immediately post-tattoo resulted in a substantial donation gain with no adverse safety effect. Lifeblood subsequently reduced the deferral for transfusible component donations to 7 days for tattoos in Australian licensed/regulated establishments.

Deferral of blood donors who have ever stayed in a Trypanosoma cruzi endemic area: An international survey.

Trypanosoma cruzi is the etiologic agent of Chagas disease (CD), an anthropozoonosis from the American continent that progresses from an acute phase to an indeterminate phase, followed by a chronic symptomatic phase in around 30% of patients. In countries where T. cruzi is not endemic, many blood transfusion services test blood donors who have stayed in an endemic country ('at-risk stay')-even if they do not present with other risk factors. However, the efficiency of this approach has been questioned. On 18 September 2023, a worldwide survey was distributed among employees of blood transfusion services. The questions mainly pertained to CD's endemicity in the blood services' region, the current testing policy for T. cruzi and the number of confirmed positive results among donors with a prior at-risk stay alone (i.e., without other risk factors for T. cruzi infection). Twenty-six recipients completed the survey. Of the 22 (84.6%) blood services that operated in a non-endemic region, 9 (42.9%) tested donors for T. cruzi, including 8 (88.9%) that considered the travel history or the duration of the stay (alone) in their testing algorithm ('study blood services'). Over 93 years of observation among all study blood services, 2 donations from donors with an at-risk stay alone and 299 from those with other risk factors were confirmed positive for T. cruzi. The study findings question the utility of testing blood donors who have stayed in an endemic country without other risk factors.

Modeling US blood donor deferrals under a policy of individual risk assessment for HIV risk sexual behavior.

In May 2023, the Food and Drug Administration (FDA) released final guidance for blood donor eligibility that recommended the elimination of 3-month deferral for men who have sex with men (MSM) and the related deferral for women who have sex with MSM. In its place, FDA introduced an individual risk assessment policy of asking all presenting blood donors, regardless of sex or gender, if they have had a new partner or more than one sexual partner in the last 3 months and deferring those who also report anal sex (penile-anal intercourse) during this period. We modeled the possible impact of this policy on the US blood donor base. We developed a computational model to estimate the percentage of blood donors who would be deferred under a policy of individual HIV risk assessment. The model incorporated demographic information about donors and national survey data on HIV risk behaviors and included age and sex distributions and dependencies. Our model estimates that approximately 1.2% of US blood donors would be deferred under the individual HIV risk assessment paradigm. The model predicts a relatively minor effect of replacing the time-based deferral for MSM with individual risk-based deferral for sexual behavior. As US blood centers implement this new policy, the effect may be mitigated by donor gains, which warrant further study. The new policy is unlikely to adversely affect the availability of blood and blood components.

Endemic viral infections in immunocompromised hosts: Dengue, Chikungunya, Zika.

Arbovirus infections are a challenge for immunocompromised hosts who travel to or live in endemic regions or who receive organs or tissues from donors who travel or live in such areas. This review addresses Dengue (DENV), Chikungunya (CHIKV), and Zika (ZIKV) infections in hematological patients, hematopoietic cell or solid organ transplant recipients, and people with HIV (PWH). Transmission is mainly due through Aedes mosquito bite. DENV and ZIKV may also be transmitted through blood, tissues or donor grafts. Clinical manifestations are quite similar and diagnosis requires laboratory confirmation to provide appropriate management. The best diagnostic method is PCR since serology may present false negative results in immunocompromised patients, or cross-reactivity as in the case of DENV and ZIKV. There is no specific treatment for any of these infections. Educational and preventive measures are the best strategy: vector control, knowledge of the vector's habits, protection against mosquito bites, avoiding travel to endemic areas or with a current epidemic, and avoiding nonvector transmission according to local recommendations for donor deferral. Vaccination, currently only available for DENV, has not yet been studied in immunocompromised patients and is not currently recommended.

THE EVALUATION OF PATTERN OF WHOLE BLOOD DONOR DEFERRALS IN A TERTIARY CARE CENTER OF NORTH INDIA

Objectives: Donor recruitment is critical to the supply of safe and adequate blood/blood components to meet patient’s need; the first and most crucial step to provide safe blood is proper selection of blood donors. Blood donor selection criteria are designed to ensure the donor as well as the recipient’s health. The objective of this study is to analyze the various causes of donor deferral, study their frequency pattern and to suggest changes to retain and retrieve donors in future. Methods: A retrospective study on analysis of deferred donors of whole blood was conducted in a blood center at tertiary care hospital in North India. The study included blood donors deferred from January 2022 to December 2022. Results: A total of 27,121 donors were registered for whole blood donation and 4534 (16.71%) were deferred. Female deferral (41.67%) was more as compared to male deferral (15.11%). Temporary deferrals (n=4238 [93.47%]) were significantly higher than permanent deferrals (n=296 [6.5%]). The most common reason for temporary deferral was anemia (n = 940 [20.7%]) while that for permanent deferral was jaundice (n=179 [3.94%]). Conclusion: Analyzing the causes, frequency and deferral pattern of blood donors will help to guide the recruitment and retention efforts to maintain a healthy donor pool at large.

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.

Effect of COVID-19 Vaccine on Blood Donor Deferral Patterns in PIMS, Islamabad

Objective: To evaluate the effect of COVID-19 vaccine on overall donor deferral patterns in PIMS, Islamabad. Study Design: Cross-sectional descriptive study. Settings: This study was carried out at Blood Bank of Pakistan Institute of Medical Sciences (PIMS), Islamabad Pakistan. Duration: January 2019 to December 2021. Methods: The participants for donation were included in this cross-sectional study on the basis of certain criteria by taking their previous medical history physical examination, COVID-19 vaccination status, and transfusion-transmissible infections (TTI) screening results. All those donors who don’t meet these criteria were deferred. On the basis of causes, deferrals were categorized into temporary or permanent. Results: This study included a total of 84,669 potential donors during a period of three years (January 2019- December 2021), out of which 82,072 donors met inclusion criteria and donated blood during this period whereas 2597 donors were deferred. The overall deferred rate was 3.2% (n=2,717), out of which 13% (n=342) were deferred permanently and87% (n=2375) were deferred temporarily. The leading cause of permanent deferral includes hepatitis C (n=142), hepatitis B (n=106) and cardiac diseases (n=94). On the other hand, leading causes of temporary deferrals include COVID-19 vaccination, being under weight, underage, low HB, short gap, fatty veins and fever. Conclusion: The identification of deferrals is an important step for safe transfusions and helps to formulate criteria for efficient donor selection. The current study indicates a 3.2% deferral rate for blood donors and demands preventive steps for both donor and patient safety against HBV, HCV and AIDS.

Prevalence and Causes of Blood Deferral in Tertiary Care Teaching Hospital Islamabad

Background: A blood transfusion is a vital and potentially life-saving operation in modern therapeutic and surgical procedures; yet, it requires a sufficient supply of safe blood from a healthy donor. In addition to laboratory testing of blood bags for infectious illnesses, appropriate, safe, and healthy donor selection is required. On the other hand, the loss of valuable blood components that are accessible for transfusion results from fit donors deferring. Understanding the reasons for both temporary and permanent deferrals can help us prevent this, put our knowledge into practice. The current study aimed to assess the incidence and reasons behind blood donor deferrals at Islamabad teaching hospital that provides tertiary care. Methods: This cross-sectional study was conducted at Dr. Akbar Niazi Teaching Hospital’s blood bank. All Blood donors reporting to donate blood at a blood bank between the periods of 1st September 2020 to 24th December 2021 were included in the study. The data was obtained by interviewing the donors using specially designed Performa. The collected data of deferred blood donors was analyzed using SPSS version 21. Results: Out of a total of 2054 blood donors, 523 (25.5%) were deferred due to different reasons and ineligible to donate blood. Out of 523 deferred donors, 455(87%) were males and 68(13%) were females. The average age of the blood donors was 26(4.2%) and most blood donors were between 20 to 40 years age. The common causes for deferral were low hemoglobin (41.3%), recent COVID-19 vaccination (12.6%) and increased TLC (7.1%). Hepatitis B virus 39(7.5%), Hepatitis C virus (4.4%), HIV 5(1.0%) and Syphilis 18 (3.4%). Conclusion: The most frequent reasons for delay were elevated TLC count, recent COVID-19 immunization, and low hemoglobin levels. The cornerstone of a safe blood supply is the donor education on self-exclusion and strict selection criteria.