Donor Reaction Rates Research Articles

Adverse reactions to the Donation of Platelet by Apheresis and Related Factors in a Tertiary Level Care Blood Center

Background and Objectives: Although blood donation by apheresis is very safe, it is essential to identify the adverse reactions that happen and address the factors related to it so as to improve the donation experience both to the donors and the center accepting donations. This study was designed to assess the frequency of adverse reaction in donors undergoing apheresis for platelet donation and delineate the factors associated with the occurrence of such adverse donor reactions, if any. Methodology: This was an analytical retrospective study on the available data of all the donors who donated single-donor apheretic platelets in our blood center from January 2014 to October 2018. Results: The overall donor reaction rate was 8.3%, with the majority (4.7%) being a local reaction in the form of a hematoma. The other 3.6% were systemic reactions, among which 2.1% were citrate reactions and 1.5% vasovagal reactions (VVRs). The variables associated with a VVR were body weight <75 kg and diastolic blood pressure of <70 mmHg, whereas for citrate-related toxicities, it was the duration of the procedure and the amount of anticoagulant used. 4.7% of them were localized reactions in the form of the hematoma, which were more common in first-time donors. Conclusion: Adverse donor reactions to plateletpheresis are notable (8.3%) but generally mild. Auditing them to look for factors associated helps us review the policies and improve competencies among the staff to improve the safety of donors.

Implementation of measures to reduce vasovagal reactions: Donor participation and results

There are several strategies to reduce donor reactions. We report donor participation and reaction rates before and after implementing multiple measures at Canadian Blood Services. We introduced a structured program of 500 mL of water and a salty snack pre-donation and applied muscle tension (AMT) during donation. Donors were not deferred for out of range blood pressure (BP); however, BP was measured in first time donors. Time on the donation chair post-donation was decreased from 5 to 2 min for repeat donors. We assessed participation rates using our quarterly survey of 10,000 recent donors. We extracted vasovagal reactions with loss of consciousness (LOC) from our operational database and compared pre-implementation (Oct 12,018-March 31,2019) and post-implementation (Oct 12,019-March 31,2020) periods. Survey response rates varied from 11% to 16%. The percentage of donors who drank the water and ate the salty snack increased from 58% to 82% and 44% to 70% over 4 quarters; those performing AMT increased from 24% to 41%. Reactions decreased from 19.07 per 10,000 (744 reactions in 390,123 donations) to 14.04 per 10,000 (537 in 382,382 donations) (p < .0001). No first-time donors with high BP (n = 684) but 5 with low BP (n = 718) had reactions, CI were very large. Achieving optimal participation was challenging. After implementation of a donor wellness initiative based on best practice, rates of vasovagal reactions with LOC decreased by 25%. A larger dataset is necessary to assess the safety contribution of BP deferrals when other mitigation measures are in place.

Rapidly Establishing a Hospital-Based Convalescent Plasma Collection Center With the Alyx Apheresis Collection Device

The effort to collect convalescent plasma from individuals who recovered from COVID-19 began in earnest during the spring of 2020. Either whole blood or apheresis donations were obtained, the latter yielding higher numbers of units per donor per collection and more frequent collections. The NorthShore University HealthSystem blood donor center purchased 2 Alyx (Fresenius Kabi) apheresis plasma collection devices and quickly implemented them in order to collect COVID-19 convalescent plasma. Apheresis-experienced and inexperienced phlebotomists operated the instruments. Donors were collected >14 days from symptom resolution and all donors were negative by SARS-CoV-2 nasopharyngeal swab. Both internal metrics of performance as well as a post donation survey were used to evaluate the feasibility implementing this collection program. During the first 100 days of the collection program, 650 plasma units were collected. In particular, during the first week of the program, 38 units were collected and distributed to hospitals under the emergency investigational new drug and expanded access program. Fifty-one donors (15%) were deferred due to vital signs out of range or donor screening questions. Thirty-one donors (10%) were deferred due to positive nasopharyngeal swab. Lower than target yield occurred in 16.6% of collections due to donor reactions or flow errors. Donors rated the overall program lower, but not the staff, when they reported symptoms related to collection. In conclusion, a hospital-based apheresis convalescent plasma collection program can be rapidly implemented. Donor reaction rates and vein infiltration rates should be carefully monitored for each phlebotomist.

ADVERSE DONOR REACTION PATTERN IN A TERTIARY CARE BLOOD CENTER IN SOUTH INDIA

Aims &amp; Objective Primary objective is to assess the frequency and pattern of donor reaction in our blood center and secondary objective is to assess the factors associated with vaso-vagal reaction (VVR). Materials &amp; Methods Retrospective observational study conducted by Blood Center of Sree Gokulam Medical College, Trivandrum. Details of the donors of the last 4 year (January 2015 to December 2019) including donor reaction details, age, gender, weight, donation status, type of donation and Blood Pressure(BP) were included in the study and were analyzed using IBM SPSS Version 21 Results &amp; Discussion Out of 10,647 donors, the overall donor reaction rate is 1% while in-house and camps reaction rate were 0.96% and 3.49%. Donor reaction rate in males and females were 0.99% and 1.03%. Out of 105 reactions, 70.75 % were VVR and 19 % were Hematoma. VVR rate is 0.74. Most common VVR occurred was mild type. Young age, first time donation and voluntary donation were found to be predisposing factor for VVR. VVR rate was not associated with gender, weight and Blood Pressure (BP) of the donor. VVR in post donation phase was associated with low BP and severe VVR was not associated with low BP. Conclusion Overall reaction rate and VVR rate were 1.0% and 0.74%. Young age, first time donation and voluntary donation were found to be predisposing factor for VVR. It is important to contact donors to report any missed delayed reaction.

A novel caffeic acid-based deep eutectic solvent as caffeoyl donor to enhance glycerol caffeates synthesis

Glycerol caffeates (GC) is one kind of hydrophilic caffeoyl derivatives, which can be synthesized by the reaction of solid caffeic acid (CA) with different caffeoyl acceptors. The poor solubility of solid CA in the reaction resulted in great mass transfer limitation, low yield and time-consuming. In the work, in order to improve reaction efficiency, a novel liquid CA-based deep eutectic solvent (DES) was prepared and firstly used as caffeoyl donor for GC synthesis. Several solid acids were used as catalysts and the maximum GC yield (~55%) was achieved using NKC-9 as catalyst. Compared with solid CA as caffeoyl donor, CA conversion and initial reaction rate can be enhanced using liquid CA-based DES as caffeoyl donor. Especially at low temperature, initial CA conversion rate of liquid CA-based DES at 70 °C was 7 times that of solid CA. And the maximum CA conversion (~91%) was 2 times that of CA (44.6 ± 3.0%). When liquid CA-based DES was used as caffeoyl donor, the effect of external mass transfer limitation can also be neglected, and the activation energies of CA conversion and glyceryl monocaffeate formation (70.66 and 65.38 kJ/mol) were lower than those (83.31 and 80.41 kJ/mol) of solid CA. These indicated that liquid CA-based DES was favorable for hydrophilic GMC and GDC selective formations.

Young donor health and safety: are we doing enough?

In some countries, blood collection is permitted from donors as young as 16 years of age. Young donors represent a unique challenge for blood collection organizations as they must balance their need for these donors against protecting the health and safety of this potentially vulnerable donor population. As young donors have become increasingly important to ensuring the adequacy of the blood supply, donor haemovigilance programmes found that they were disproportionally affected by adverse blood donation reactions. These findings served as the impetus for many blood collection organizations to implement interventions to reduce donor reaction rates in the younger age groups. While blood collectors have made great strides in reducing the rates of immediate adverse reactions of blood donation, less attention has been paid to possible long‐term consequences of iron deficiency. With increased reliance on young donors to provide a significant part of the blood supply, it is of the utmost importance that these donors have a good experience when they donate blood and do not suffer any adverse health and safety effects from their altruistic act. Adverse donor reactions and iron deficiency still pose threats to the health and safety of young donors. Continued research is needed in both of these areas to adequately protect young donors.

Current Status for Report of Blood Donor Reactions in South Korea

Background: There is no comprehensive report on the donor reaction rate among blood donors in South Korea. We attempted to analyze the patterns and rates of immediate blood donor reactions and the current status of the reporting system in our country. Methods: Immediate donor reaction rate was defin...

Safety and frequency of whole blood donations from elderly donors

Within the coming decades, a steadily growing demand for blood products will face a shrinking blood donor population in many countries. After increasing the donor age of repeat donors for whole blood donation (WB) from 68 to 70 years in 2009 in our Blood Service, we investigated whether this is sufficient as a safe and effective strategy to sustain future blood supply. Between 1 March 2009 and 28 February 2011, WB donations from donors aged between 69 and 70 and their proportion of total donations in 2010 were determined. We analysed adverse reaction rates in donors with respect to sex and age and calculated mean annual donation frequencies. Of all invited donors, 32·5% responded and contributed 0·98% (men) and 0·56% (women) to all WB units collected in 2010. The overall and systemic adverse reaction rate per 1·000 WB donations declined by age [men: 1·10 (95%CI: 0·84-1·35) vs. 0 (0-0·8), P < 0·0001; 0·99 (0·75-1·23) vs. 0 (0-0·8), P < 0·0001 and women: 1·80 (1·46-2·14) vs. 1·12 (0·1-2·66), P < 0·0001; 1·47 (1·17-1·78) vs. 1·12 (-0·43-2·66), P = 0·0004]. Mean donation frequencies were strongly correlated with increasing age (men: r = 0·953, P < 0·0001; women: r = 0·913, P < 0·0001) with peak values for 70-year-old male: 2·53 ± 1·37 vs. 1·79 ± 1·05, P < 0·0001 and female donors: 2·15 ± 1·06 vs. 1·52 ± 0·78, P < 0·0001. Elderly donors have very low adverse reaction frequencies and are highly committed to donate blood. Thus, we consider donations from repeat donors aged 69-70 safe and suggest it a powerful short- to midterm strategy to, at least partially, overcome the challenges of the demographic change.

Interventions to reduce the vasovagal reaction rate in young whole blood donors

There have been multiple reports concerning the predictors of fainting reactions in blood donors, but few attempts to reduce the rates of fainting reactions with concomitant rigorous attempts to monitor the success of the interventions. We used a retrospective observational cohort study design, comparing the likelihood of reaction from 213,031 allogeneic whole blood donations made by 17- to 22-year-old donors in two separate 12-month periods before and after the implementation of interventions to reduce reactions. The interventions were 1) a limit on the maximum percentage of estimated blood volume young donors could donate, 2) encouraging applied muscle tension during donation, and 3) providing approximately 500 mL of water before donation. Reactions were defined by severity and time in relation to the end of phlebotomy and documented according to standard procedures. Data analysis included comparison of stratified reaction rates and multivariable logistic regression analysis. The interventions decreased the aggregate reaction rates in male and female donors by 24% (p < 0.0001). There was a 25% decrease in delayed reactions (p = 0.0006) and a 38% decrease in off-site reactions (p = 0.001) in female donors. The impact of the three interventions together on reaction rate was greater than the combined impact of exercises and water provision. Multivariable modeling showed that the interventions reduced reactions but did not prevent their occurrence in identified higher risk groups. The interventions to reduce vasovagal reactions in whole blood donors were effective. Future efforts to reduce reactions in blood donors can build on the strengths and avoid the weaknesses identified while conducting and analyzing the data from this study.

Vasovagal reactions in ‘at risk’ donors: A univariate analysis of effect of age and weight on the grade of donor reactions

Introduction It is well known that young age, low weight, and first time donation status increase the probability of having a reaction but the effect of these ‘risk’ factors on the grade of reaction has not been well studied. Aim To evaluate the prevalence of these factors in blood donation setup, to identify ‘at risk’ donors with age less than 30 years and weight less than 60 kg and to assess whether there is any contributory role of these risk factors in predicting the grade of reaction. Materials and methods A retrospective analysis of 30370 donations was done during 15 month study period. Results Donor reaction rate of 1.6% was observed in this study of which 7% experienced reaction of moderate and severe grade. Reaction rate among male and female donors were 1.5% and 3.7% respectively. Female gender was found to be an independent predictor for donor reaction even after nullifying the effect of the blood volume drawn. Incidence of vasovagal reaction in ‘at risk’ donors was 2.0% in contrast to 0.96% in ‘general’ donor population. Age had a significant affect on reaction rate ( p = .035) and all grades of reaction decreased with the age of the donor. Age was found to be a significant predictor of the grade of reaction ( p = .008). The effect of weight on the reaction rate as well as on the grade was found to be insignificant (1.5% in ‘at risk’ donors vs. 1.6% in ‘general’ donors with p > 0.05). Conclusion 1. Age is a significant factor that can predict the rate as well as the grade of reaction; 2. Weight does not predict the grade of reaction, 3. Gender is an independent predictor of donor reaction, with females having 2.5 fold higher chances of reaction. These factors are important for blood collection staff to recognize such ‘at risk’ donors, and to give more attention to them to reduce donor reaction.

The effect of a 473‐mL (16‐oz) water drink on vasovagal donor reaction rates in high‐school students

Recent clinical studies found that a water drink prevented orthostatic hypotension in healthy subjects subjected to a tilt-table test. A water drink was tested as a method to decrease vasovagal donor reactions in high-school students. A total of 8894 high-school donations in Fall 2004 and 2005 were assigned to groups receiving or not receiving a 473-mL water drink after acceptance for whole-blood donation. In addition, 4340 donations in 2004 were reduced to 2895 donations ("balanced 2004 group") with an algorithm that equally balanced the donors between the water and no water arms. The donor reaction rate was 9.9 percent (349 reactions/3534 donations) in donors given a water drink versus 12.5 percent (668 reactions/5360 donations; p = 0.0002) in donors not given a water drink. Donors given a water drink had a 21 percent reduction in their donor reaction rate. The main benefit of water was in Caucasian, first-time donors. In the balanced 2004 group, the donor reaction rate was 10.6 percent (153 reactions/1438 donations) in donors given a water drink versus 14.8 percent (216 reactions/1457 donations; p = 0.0008) in donors not given a water drink. Donors given a water drink in the balanced 2004 group had a 28 percent reduction in their donor reaction rate. The use of water did not interfere with donor processing and was judged by collection staff as easy to implement. A 473-mL water drink decreased the vasovagal donor reaction rate in high-school donors by 21 percent, but to varying degrees in different subpopulations.

Donor reactions in high‐school donors: the effects of sex, weight, and collection volume

The high incidence of donor reactions in first-time, 17-year-old Caucasian whole-blood donors makes this group ideal for the study of donor reactions. Donor reaction rates were retrospectively evaluated in 7274 first-time, 17-year-old Caucasian whole-blood donors based on observations recorded at the collection sites. The effect of sex and weight on donor reactions was determined. In addition, a model was developed to estimate how different blood collection volumes would affect donor reaction rates. The donor reaction rate was 12.0 percent (870/7274). Female donors overall had a higher donor reaction rate than male donors (16.7% vs. 7.3%) and also had a higher donor reaction rate than male donors at each 20-lb weight interval in the range from 110 to 189 lb. A model suggested that a change in the blood-unit volume from 450 to 500 mL would increase donor reaction rates by 18 percent in either female or male donors, whereas a reduction in the blood-unit volume from 500 to 400 mL would decrease donor reaction rates by 29 and 27 percent in female and male donors, respectively. First-time, 17-year-old Caucasian female donors had a higher donor reaction rate than male donors overall and at equivalent donor weights. In the range of present US blood-unit volumes, a change in collection of as little as 50 mL could have a significant impact on blood donor reaction rates in high-school students.

Estimating the probability of a blood donation adverse event based on 1000 interviewed whole‐blood donors

Estimating the probability that a donor will have or not have an adverse event is useful for staff knowledge to give blood donors reassurance upon request. One-thousand donors from the general donor pool were interviewed for seven potential adverse events 3 weeks after a 525-mL whole-blood phlebotomy. The four most common adverse events were bruise (22.7%), sore arm (10.0%), fatigue (7.8%), and donor reaction (7.0%). A stepwise logistic regression analysis was performed based on five donor characteristics that were studied: age, weight, sex, race, and first-time donor status. The contribution of each significant or marginally significant factor to each adverse event was quantified. For donor reaction, weight (p < 0.0001) and age (p = 0.015) were significant contributors, and first-time donor status (p = 0.054) was a marginally significant contributor. An equation was derived, and the donor reaction rate can be estimated for a group based on the donor's weight, age, and first-time donor status. Similar analyses were performed for fatigue, sore arm, and bruise. Based on the derived formulas and with the use of a spreadsheet, data can be entered and the probability that a donor will have (or not have) a donor reaction, fatigue, sore arm, or bruise can be estimated.

Reaction rates in allogeneic donors

In Canada and several other countries, there is an upper age limit for blood donation. In order to evaluate the safety of whole blood donation in elderly Canadian allogeneic donors, we analysed reaction rates following whole blood donation. Reactions rates in allogeneic whole blood donors who donated at Canadian Blood Services were reviewed retrospectively. Rates were analysed by age, donation frequency and by donation frequency for each age group. A total of 5478 reactions were available for analysis in 469 837 donors. The highest rate of mild reactions occurred in donors less than 20 years of age. Moderate and severe reactions decreased with increasing age and with donation frequency. Age-adjusted rates for mild reactions were less frequent in donors aged 66-77 years than in donors younger than 20 years. Although age-adjusted moderate reactions varied with donation frequency, after seven donations, rates were not increased for donors aged 60 years or older (0.61% for donors aged less than 20 years compared to 0.03% for donors aged 60-65 years compared to 0% for donors aged 66-71 years). Age-adjusted rates for severe reactions generally did not increase with donation frequency. These results confirm the safety of whole blood donation in regular donors who are 66-71 years of age.

Perioperative autologous blood donation in children

Autologous blood donation in children has become a standard of care. Children have to live with the life-time complications associated with allogeneic blood including the transmission of known and unknown pathogens, and the impact of alloimmunization on future blood transfusions, organ transplants and pregnancies. Donor reaction, allogeneic exposure and utilization rates in pediatric preoperative autologous donation (PAD) programs are as good if not better than reported in adult literature. Children are very resilient when undergoing extreme isovolemic hemodilution (IHD). PAD, IHD and intraoperative blood recovery appear to be useful components of a pediatric blood conservation program. Prospective, randomized studies addressing the specific needs of children are required to properly define their perioperative role.

Effect of Polymorphic Transition on Molecular Diffusion in Some Molecular Complexes, as Evidenced by Exchange Reaction Rate and by Electrical Resistivity

Abstract Marked increases in electron donor and acceptor-exchange reaction rates and also large differences in the temperature dependence of the electrical resistivity of polycrystalline compactions between the first and the second heating processes indicate the enhanced molecular diffusion near and above the polymorphic transition temperatures of some molecular complexes.

A study of criteria for blood donor deferral.

Donor deferral rates in regional blood centers vary from 5 to 24 per cent, reducing by more than 1,250,000 the number of units of volunteer blood available for transfusion in the nation each year. Those criteria for donor deferral which are intended to exclude donors likely to suffer a "donor reaction" are based partially on untested hypotheses and tradition. In a six-month prospective study, we adopted more liberal criteria for donor acceptance. During this period, donor reaction rates did not increase, and the deferral rate fell from 10 to 7 per cent. Our findings suggest that less restrictive criteria can be used for donor selection without compromising donor safety. If all blood centers reduced their deferral rates to 7 per cent, the nation's blood supply would be increased by more than 500,000 units annually.

Blood donor eligibility, recruitment, and retention.

To study the motivation and actions of potential and active blood donors, a literature search, a limited survey, and associated analytic efforts were undertaken. It is estimated that 61 million of the 114 million age‐eligible donors meet Red Cross criteria of health‐eligibility. The 1971 donor participation rate, calculated as the percentage ratio of active donors to eligible donors, was estimated to be between 8 and 9 per cent. Total collections appear to be increasing at a stable rate of 1 per cent per year and 15 per cent of each year's collections apparently come from first‐time donors. Thus, 14 per cent of those who donate blood in any given year must replace other donors who have stopped donating. Roughly 25 per cent of those who are health‐eligible to donate blood have done so in the last ten years. Literature and survey analyses indicate that donor reaction rates are considerably underestimated by most collectors. A limited survey showed that the main reason for nonparticipation is fear, while common reasons for discontinuing participation are adverse reaction and medical disqualification.