Donor Selection Criteria Research Articles

Safety and Outcomes in 100 Consecutive Donation After Circulatory Death Liver Transplants Using a Protocol That Includes Thrombolytic Therapy.

Donation after circulatory death (DCD) liver transplantation (LT) reportedly yields inferior survival and increased complication rates compared with donation after brain death (DBD). We compare 100 consecutive DCD LT using a protocol that includes thrombolytic therapy (late DCD group) to an historical DCD group (early DCD group n = 38) and a cohort of DBD LT recipients (DBD group n = 435). Late DCD LT recipients had better 1- and 3-year graft survival rates than early DCD LT recipients (92% vs. 76.3%, p = 0.03 and 91.4% vs. 73.7%, p = 0.01). Late DCD graft survival rates were comparable to those of the DBD group (92% vs. 93.3%, p = 0.24 and 91.4% vs. 88.2%, p = 0.62). Re-transplantation occurred in 18.4% versus 1% for the early and late DCD groups, respectively (p = 0.001). Patient survival was similar in all three groups. Ischemic-type biliary lesions (ITBL) occurred in 5%, 3%, and 0.2% for early DCD, late DCD, and DBD groups, respectively, but unlike in the early DCD group, in the late DCD group ITBL was endoscopically managed and resolved in each case. Using a protocol that includes a thrombolytic therapy, DCD LT yielded patient and graft survival rates comparable to DBD LT.

199 - Impact of Donor Characteristics on Transplant Outcome Following Haploidentical Hematopoietic Cell Transplantation Utilizing Post-Transplant Cyclophosphamide: Improving Donor Selection Criteria

199 - Impact of Donor Characteristics on Transplant Outcome Following Haploidentical Hematopoietic Cell Transplantation Utilizing Post-Transplant Cyclophosphamide: Improving Donor Selection Criteria

Organ transplantation from marginal and non-standard risk donors: ethical requisites for consent from recipients.

In order to close the gap between available organs and patients needing transplants, the selection criteria for donors have gradually become more relaxed and many countries have defined expanded criteria for donor variables. However, the use of organs from marginal and non-standard risk donors poses considerable ethical issues. The acceptability of the risk/benefit ratio depends primarily on a clinical assessment, and information given to the recipient and his/her eventual consent are crucial. Some of the requisites concerning information and consent are mandatory. Once these requisites have been defined in binding regulations, adequate margins must be allowed for their personalisation and to account for the unique nature of each physician/patient relationship. Each decision should be specific for a particular person, and it must be accepted that similar clinical situations may give rise to differing solutions that are nonetheless agreed by the physician and the patient.

Experiences of renal transplants from donors with renal cell carcinoma afterex vivopartial nephrectomy

PurposeRoutine evaluation of kidney donors occasionally reveals an incidental renal mass with an otherwise satisfactory kidney function. The use of such a kidney with an enhancing mass for transplantation is a matter of debate owing to a possible risk of transmission of donor malignancies. We report our experience of kidney transplants from donors with renal cell carcinoma, after ex vivo resection of the renal mass.MethodsTwo women aged 44 and 56 years were diagnosed with enhancing renal masses measuring 0.9 cm and 0.7 cm, respectively, during donor evaluation for kidney transplantation. Both patients and their families were informed of a potential risk of recurrent renal cell carcinoma following transplantation.ResultsRenal function test results of both donors satisfied the living donor selection criteria. Laparoscopic live donor nephrectomy was performed with ex vivo resection of renal masses on the bench table. Immediate pathological analysis revealed a renal cell carcinoma with a margin of normal renal parenchyma before transplantation. Regimens based on mammalian target of rapamycin inhibitors, which are known for their antitumoral properties, were used for immunosuppression in both recipients. None of the recipients showed recurrence or metastasis during the follow-up period, which was longer than 3 years after transplantation.ConclusionIn light of the ongoing shortage of kidney donors, kidneys with small renal cell carcinoma could be considered for transplantation after appropriate removal of the lesion, with a very low risk of recurrent disease.

Seroprevalence and Trends of Transfusion Transmissible Infections in Blood Donors in Andaman and Nicobar Islands- An Institutional Retrospective Study.

Transfusion Transmissible Infections (TTIs) such as Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV), Hepatitis C Virus (HCV) and syphilis pose a threat to blood safety in a developing country like India. To determine the prevalence of TTIs among healthy donors in Andaman and Nicobar Islands, India, and to further help in determination of the population subset to be focused on for enhancing blood donor pool. This retrospective cross-sectional study was conducted on all voluntary and replacement donors in a tertiary health care centre in Andaman and Nicobar Islands for a period of three years. Donor blood was screened for HIV, HBV, HCV, Syphilis and malarial parasite using rapid kits and ELISA. Out of 12,118 donors, 97.01% were males and 2.99% were females. 9409 (77.64%) were voluntary donors and 2709 (22.35%) were replacement donors. Majority of the screened donors belonged to 25 to 40 age group. Out of 12,118 donors, 265 (2.18%) were seropositive. Among them, 8 (0.066%) were HIV positive, 15 (0.124%) HCV positive, 128 (1.056%) HBsAg positive, 30 (0.247%) Syphilis positive and 84 (0.693%) were positive for malarial antigen. Yearly prevalence of seropositivity was 2.370%, 2.113% and 2.082% for three consecutive years. With high prevalence of TTIs among healthy donors, safe blood transfusion is still a challenge in developing countries. This continues to place unacceptable burden on health sector. There is a need for encouragement of voluntary blood donation, strict donor selection criteria and sensitive screening tests to minimize TTIs in Indian setting.

Evolving Criteria for Donor Selection for Transplants in Acute Myeloid Leukemia

Background The best donor for a haematopoietic cell transplant in a person with acute myeloid leukaemia (AML) in 1st remission is controversial. Prior data indicate similar outcomes after transplants from HLA-haplotype-matched relatives, HLA-identical siblings and HLA-matched unrelated donors.Methods We analyzed data from persons with intermediate- or high-risk AML in 1st complete remission (CR1) treated in a prospective, multi-centre study.Results 602 consecutive subjects received a transplant from an HLA-haplotype-matched relative (N=328) or an HLA-identical sibling (N=274). 4 year leukaemia-free survivals were 78% (95% confidence interval [CI], 73, 83%) and 80% (75, 85%; P=0.39). In multivariate analyses younger donor/recipient age (donor<30y-receipient<30y) was associated with less transplant-related-mortality (TRM) (hazard ratio [HR)=0.25; [0.06, 1.00]; P=0.05) whereas female-to-male transplants (HR=1.93; [1.10, 3.38; P=0.02) and donor-recipient ABO major-mismatch transplants (HR=1.95 [1.12, 3.38; P=0.02) were correlated with higher TRM. A risk score was generated based on donor/recipient age, gender and ABO-incompatibility. The scoring system predicted TRM and survival. TRMs were 5% (3, 7%), 15% (10, 20%) and 20% (4, 36%) for subjects with scores of 0-1, 2 and 3 (trend comparison P<0.001). 4 year survivals were 85% (81, 89%), 77% (71, 83%), and 75% (59, 91%; trend comparison P=0.04).Conclusions In contrast to the lack of impact of HLA-disparity on transplant outcomes, selection of the best donor needs to consider D/R age, sex and ABO-incompatibility combined together. Our data suggest choosing young, male, ABO match/minor-mismatch donors is reasonable. Transplants from older female-to-male and from ABO major-mismatched donors should probably be avoided. DisclosuresNo relevant conflicts of interest to declare.

Analysis of Donor Deferral in 101 Voluntary Blood Donation (VBD) Camps by Tertiary Care Hospital of North-Western India

INTRODUCTION Safe Blood banking in INDIA is upcoming modern medicine. Stringent pre-screening of the blood donors is essential to ensure quality of donors and to avoid risk of transfusion transmitted diseases to the recipient .Donor deferral is bad experience for both the blood donor as well as the blood bank and leaves them with negative feelings for blood donation process. These donors are less likely to return for blood donation in future [1][2] . Thus, every blood centre has to balance between acceptable quality and desired quantity. The criteria for prospective blood donor selection and deferral in India are provided by the Drugs and Cosmetic Act 1940 [3] . It is very essential to study and analyze the reasons for such deferral among prospective donors in order to categorize them into temporary and permanent deferrals and to find the causes in particular region. Few studies done in India in the past have provided different common reasons for deferral of whole blood donors, highlighting differing demographic profile in different parts of the country. [4,5,6,7] The objective of this study is to assess the current rate and reasons for donor deferral in north western India so that temporarily deferred donors with corrective reasons can be identified, properly informed and guided to improve their quality and thus later on donate blood. So the study was done in 101 Voluntary Blood Donation (VBD) camps over a period of 5 months at blood bank, SMS Hospital, Department of Immunohaematology and Blood Transfusion SMS HOSPITAL, JAIPUR.

Doit-on revoir, sur des bases éthiques, les conditions d’accès à des hommes ayant eu des relations sexuelles avec des hommes au don du sang ?

In France, men who have sex with men (MSM) were “permanently deferred” of blood donation. This measure reflected the fact that according to scientific research data, MSM have a higher risk to be infected notably by the human immunodeficiency virus. This “permanent postponement” was the subject of much debate as discrimination criterion. Can ethics be the basis for the reexamination of conditions of access of MSM to blood donation? It seems that ethics can and should in fact be reconvened in the reflections. The donor selection criteria should be regularly reviewed in the light of emerging risks. The exclusion must be reexamined, questioned again, remembering the reality and not enclosing blood transfusion in a secure dynamic unsuited to the reality of the risk. Also, it appears capital to keep the debate in mind, far exceeding that of blood donation to involve more that a legitimate search for equality and justice in a society. The debate must take account of these elements of reality, without leave to fascinate at the risk of providing an unadjusted answer to the original problem. Ethics seems to invite us in these discussions as they show the axes of reflection or problematization channels. Far from closing the debate, it opens the latter to new areas and participates in the advance of ideas, thus constituting a main actor.

Choosing the right criteria for donor health and safety

Blood transfusion services (BTS) have the responsibility to collect and provide safe blood, and also to deliver sufficient quantity to their health systems. Among the key elements to ensure the safety and adequacy of the blood supply is the collection of blood from voluntary, non‐remunerated blood donors, with an established national system for blood donor selection criteria for all types of donations and a rigorous process to assess the suitability of prospective donors. Blood donors are healthy volunteers who give either whole blood or blood components by apheresis with altruistic motives. However, choosing the right criteria for blood donors’ health and safety is an extremely important issue that could have an impact on donors and blood donation. Therefore, regular assessment of donor suitability should be undertaken in accordance with the national criteria for blood donor selection. These criteria should be consistently applied in every blood donation establishment, on each occasion of donation, to all blood donors. If a truly evidence‐based approach were to be adopted, blood centres would continue to monitor donor reactions to validate the safety of the current approaches or modify them as appropriate. Careful evaluation and selection of blood donors involves proactive and protective measures in assuring donor health and safety and indirectly results in an effective outcome in BTS. This article focuses on donor selection criteria that exist for the purpose of protecting the donor. It consists a review of current international standards and practices.

Update on donor recruitment and management in blood service

Voluntary non‐remunerated blood donation is the cornerstone of modern blood service which depends largely on community support and participation. Over the years, several efforts have been made on the adequacy of blood donation and blood safety. Although, significant improvement in blood safety profile has been seen, challenges in safety and adequacy still abound in every country. Since blood transfusion will never diminish, a balance between matching the right blood supply and managing the donors’ expectation need serious consideration. Besides, counteracting factors including ageing population/donors, population migration, socio‐economic factors and the increasing stringent donor selection criteria could definitely add to the difficulties. At the same time, the traditional intention for donation – ‘Give Blood Save Lives’ is no longer adequate nowadays, to reflect their expectations. Therefore, transfusion services have been working on ways to refresh and revisit the current donor recruitment and its management. Wide spread use of social media and data analysis in blood donation settings are typical examples which enabled them have a totally different approach in reaching and understanding donor behaviours. While those can either be passively originated from the donors or proactively disseminated from the blood service, they all create a dynamic and interactive culture among donors, blood services and the communities at large. With proper strategies, targeted donors (right age, sex, blood groups or others) are reached, donate blood and return to subsequent donation at their expectation. In summary, some challenges and possible solutions have been discussed to allow blood service operators revisit their needs as well as adapt and revise for their own applications.

Pathogen reduction technology – is it time?

With the application of stringent donor selection criteria and screening tests, the risk of the so‐called traditional transfusion‐transmitted infections has dramatically decreased. However, breakthrough cases are still being reported. Known pathogens that are not screened for and emerging pathogens represent a constant threat. Moreover, bacterial contamination remains the major infectious risk in blood transfusion. Pathogen reduction (PR) technology represents a proactive approach to our blood safety paradigm. PR technology for platelets and plasma has been approved in Europe for more than 10 years. Although PR efficacy against non‐enveloped viruses and spore forming bacteria is less satisfactory, these technologies show a robust PR capability for a broad spectrum of pathogens. According to current data, transfusion reactions after transfusion of treated platelets are comparable to that of non‐treated platelets and transfusion of treated platelets does not increase bleeding. Since PR technologies target nucleic acids, they inactivate leucocytes, thereby preventing non‐infectious risks like transfusion‐associated graft‐versus‐host disease and febrile non‐haemolytic transfusion reactions. Despite the multiple risks averted through pathogen reduction, the cost to implement these technologies remains a major issue. On the other hand, pathogen reduction could be an alternative to bacterial screening and gamma irradiation. Furthermore, cessation of some of the current screening items and modification of some donor exclusion criteria might be possible, especially when PR technology for red blood cells or whole blood becomes available. Therefore, if we consider all correlated efforts involved to make blood transfusion safe, the introduction of the PR technology might prove to be beneficial.

Donor preoperative oxygen delivery and post-extubation hypoxia impact donation after circulatory death hypoxic cholangiopathy.

To evaluate donation after circulatory death (DCD) orthotopic liver transplant outcomes [hypoxic cholangiopathy (HC) and patient/graft survival] and donor risk-conditions. From 2003-2013, 45 DCD donor transplants were performed. Predonation physiologic data from UNOS DonorNet included preoperative systolic and diastolic blood pressure, heart rate, pH, SpO2, PaO2, FiO2, and hemoglobin. Mean arterial blood pressure was computed from the systolic and diastolic blood pressures. Donor preoperative arterial O2 content was computed as [hemoglobin (gm/dL) × 1.37 (mL O2/gm) × SpO2%) + (0.003 × PaO2)]. The amount of preoperative donor red blood cell transfusions given and vasopressor use during the intensive care unit stay were documented. Donors who were transfused ≥ 1 unit of red-cells or received ≥ 2 vasopressors in the preoperative period were categorized as the red-cell/multi-pressor group. Following withdrawal of life support, donor ischemia time was computed as the number-of-minutes from onset of diastolic blood pressure < 60 mmHg until aortic cross clamping. Donor hypoxemia time was the number-of-minutes from onset of pulse oximetry < 80% until clamping. Donor hypoxia score was (ischemia time + hypoxemia time) ÷ donor preoperative hemoglobin. The 1, 3, and 5 year graft and patient survival rates were 83%, 77%, 60%; and 92%, 84%, and 72%, respectively. HC occurred in 49% with 16% requiring retransplant. HC occurred in donors with increased age (33.0 ± 10.6 years vs 25.6 ± 8.4 years, P = 0.014), less preoperative multiple vasopressors or red-cell transfusion (9.5% vs 54.6%, P = 0.002), lower preoperative hemoglobin (10.7 ± 2.2 gm/dL vs 12.3 ± 2.1 gm/dL, P = 0.017), lower preoperative arterial oxygen content (14.8 ± 2.8 mL O2/100 mL blood vs 16.8 ± 3.3 mL O2/100 mL blood, P = 0.049), greater hypoxia score >2.0 (69.6% vs 25.0%, P = 0.006), and increased preoperative mean arterial pressure (92.7 ± 16.2 mmHg vs 83.8 ± 18.5 mmHg, P = 0.10). HC was independently associated with age, multi-pressor/red-cell transfusion status, arterial oxygen content, hypoxia score, and mean arterial pressure (r(2) = 0.6197). The transplantation rate was greater for the later period with more liberal donor selection [era 2 (7.1/year)], compared to our early experience [era 1 (2.5/year)]. HC occurred in 63.0% during era 2 and in 29.4% during era 1 (P = 0.03). Era 2 donors had longer times for extubation-to-asystole (14.4 ± 4.7 m vs 9.3 ± 4.5 m, P = 0.001), ischemia (13.9 ± 5.9 m vs 9.7 ± 5.6 m, P = 0.03), and hypoxemia (16.0 ± 5.1 m vs 11.1 ± 6.7 m, P = 0.013) and a higher hypoxia score > 2.0 rate (73.1% vs 28.6%, P = 0.006). Easily measured donor indices, including a hypoxia score, provide an objective measure of DCD liver transplantation risk for recipient HC. Donor selection criteria influence HC rates.

Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives.

Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.

Correlation of Allograft Weight to Recipient Body Weight Index on Renal Function in Kidney Transplantation

BackgroundThe function of renal transplant grafts can be modified by many factors. In one study of graft weight/weight of the recipient, it was concluded to avoid renal transplantation in patients with kidneys with a low ratio between the graft and recipient weight (<2.5 g/kg). ObjectiveThe objective of this study was to describe the association between renal allograft weight and renal function 1 month after renal transplantation in the Mexican population. Material and MethodsWe studied patients who underwent transplantation from living or cadaveric donors with 1 month of follow-up with a functioning graft. An observational, retrospective, analytic study from January 1, 2014 to November 1, 2014 was conducted. Graft weight, donor weight, recipient weight, age, donor gender, recipient creatinine, and renal function were recorded. ResultsA total of 88 patients were included: 35 women (39.8%) and 53 men (60.2%). Sixty (68%) received kidneys from living donors and 28 (31.8%) from deceased donors. Mean recipient body mass index (BMI) was 24.7 (±2.6). Mean graft weight was 152 g (±33.9). Creatinine at 1 month post-transplantation was 1.6 mg/dL (±2.0). Using a linear regression model cold ischemia time was related to serum creatinine at 1 month post-transplantation (P = .020). Using multivariate analysis, significance was observed with respect to these indexes and recipient renal function. Recipient gender also was related and showed statistical significance (P = .015). ConclusionsRenal graft function depends on many factors including the amount of functional renal mass and nephrons required according to the recipient's weight. The donor kidney weigt (DKW) / receptor body weigt (RBW) index should be considered as selection criteria of donors.

Sero - Prevalence of Viral Transfusion-transmissible Infections amongst voluntary Blood donors

This study aimed to determine the Sero-prevalence of viral transfusion-transmissible Infectious diseases among blood donors, namely immunodeficiency virus, hepatitis B and C transmissible infections (TTIs like HBV, HCV.) HIV (Human immune viruses.). sero-prevalence of viral transmissible infections. The donated blood for specific antibodies for infections agents. Can largely reduce the risk of TTIs, virus among blood donors. The study was carried out in the blood bank at Khartoum Teaching Hospital, centre, Sudan. Screening of blood samples for hepatitis B surface Antigen (HBsAg), Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) Antibodies were done using (ELISA) enzyme link immunoassay. The study included (1184) voluntary Blood donors, all were males. The overall prevalence of viral transfusion transmissible Infections were (11.84%). The sero-prevalence for antibody against HIV (6) and hepatitis C Virus was positive in 8 (0.06) and (0.08%) donors respectively while HBsAg was detected in 98 (9.8%) donors. situation that need for strict criteria for selection of blood donors and also methods of laboratory assays. Services are high in Sudan due to the endemicity of infections like malaria, nutritional problem and obstetrical emergencies associated with blood loss. Little is known about the level of these infections in Sudan so; this study was conducted to investigate the sero-prevalence of transfusion transmissible viral infectious diseases in particular human B and hepatitis Immunodeficiency, hepatitis C viruses. The mode of transmission for HIV, HBV and HCV is the same and includes unsafe Sexual sharp materials Contact, using contaminated with body fluid, mother to Child and transfusion of blood and blood Products.

Maternal obesity associated with increase in natural killer T cells and CD8+ regulatory T cells in cord blood units.

One of the major limitations of umbilical cord blood (UCB) as hematopoietic stem cell source is its restricted cell number. In mothers who are candidates for stem cell donation, there are variables that affect the quantity and quality of UCB units. The aim of this study was to determine if obstetric, maternal, and fetal factors modify the number of lymphocyte subsets in UCB units. This was a prospective, observational study. In UCB units, the numbers of CD34, NK, NKT, iNKT, Type 1 dendritic cells (DCs), Type 2 DCs, T γδ, T CD4+, T CD8+ lymphocytes, CD4+CD25+FoxP3+, and CD8+CD25+FoxP3+ T regulatory (Treg) cells were quantified by flow cytometry. Fifty-four UCB units were included; the donors' mean weight was 75 kg (range, 52 to 102 kg) and they had a mean body mass index (BMI) of 30 kg/m(2) (range 22 to 40 kg/m(2) ), of which 12 (22%) had a normal BMI, 14 (26%) were overweight, and 28 (52%) were obese. The mean number of CD34+ cells was 4.45 × 10(6) (range, 0.7 × 10(6) to 20.5 × 10(6) ). The number of NKT, CD3+, CD4+, CD8+, and CD8+CD25+FoxP3+ Treg cells was significantly higher in overweight or obese mothers; CD34+ cells were decreased in the same group. The number of iNKT and CD34+ cells was decreased in newborns weighing above the average. Maternal factors such as BMI, and fetal factors such as weight at birth, should be added to the selection criteria of UCB donors.

Follow-up rates of living kidney donor in Japan: A single center study.

Long-term follow-up of kidney donors is needed not only for the individual donor's benefit but also to establish analyzable databases to improve the selection criteria for future donors. We collected data including the date of transplantation, the date of the last follow-up, donor's age, sex, their relationship to the recipient, renal function, proteinuria, and the prevalence of hypertension. Of 124 donors, 52 donors were not being followed up. The mean duration of follow-up was 4.3 ± 3.6 years. Follow-up rates were 83.9%, 74.6%, and 59.2% at 1 year, 2 years, and 5 years postdonation, respectively. Of those not being followed up, 75% dropped out. Follow-up rates did not differ between parent and spouse donors 5 years (57.1% vs. 71.4%; P = 0.4) postdonation. Similarly, follow-up rates at 5 years did not differ between donors aged 60 years or older and those younger than 60 (57.5% vs. 61.3%; P = 0.6). Of 72 donors being followed up, 75.0% had estimated glomerular filtration rate of <60 mL/min/1.73 m2, 8.3% had proteinuria, and 41.7% had hypertension requiring medication. There is a limitation to the endeavor of each transplant center to follow-up all their donors. Long-term donor follow-up in Japan requires a national registration system and mandates transplant center participation.

A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India.

With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. Records of single donor apheresis were retrospectively analysed from 1st January 2010 to 31st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included - age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors.

Blood donor selection and deferral pattern as an important tool for blood safety in a tertiary care hospital

Context:Blood donor selection criteria based on science and regulatory rules influence donor as well recipient safety and demographics.Aim:To evaluate and analyze the blood donor deferral pattern and its causes among blood donors in a tertiary care hospital blood bank and to review its influence on blood safety.Settings and Design:Hospital based blood bank, retrospective analysis.Subjects and Methods:The data available as donor deferral record over a period of 13 years from 2001 to 2013 was analyzed.Results:The blood donor deferral rate was 11.5%, the deferral rate in various categories was 4.8%, 4.7%, 1.6%, and 0.3% in Category 1, Category 2, Category 3, and Category 4, respectively. The majority of deferrals were temporary deferrals (62.8%) of young donors. The maximum number of donors deferred (28.2%) due to a history of jaundice (permanent) followed by 19.4% due to low hemoglobin (temporary). History of malaria, intake of medicines, infections, underweight, last blood donation within 3 months (temporary deferral), and history of heart and lung diseases, diabetes, and with suspicious identity (permanent deferral) were other major causes identified.Conclusion:The pattern of donor deferral identified is an important tool for blood safety and also provides key areas to focus on a region or policy formulation nationally for donor selection as well ensure donor safety. The value of determining donor deferral pattern by the categories described is in calling back donors deferred due to temporary reasons and can help retain pool of motivated blood donors.

Seroprevalence of transfusion-transmitted infections (TTIs) in blood donors: a study from central India

Background: Transmission of infectious diseases such as HIV, hepatitis, syphilis, and others through donated blood needs a serious monitoring to provide safe blood for transfusion, which forms an integral part of medical and surgical therapy. Objective: To access the seroprevalence of transfusion-transmitted infections (TTIs) in Malwa region and assess the level of blood safety. Material and Methods: A prospective observational study was conducted for the duration of 12 months. The known seropositive donors for any of these infections (HIV, HBV, HCV, syphilis, and malaria) and hemoglobin less than 12.5 g% were excluded. All donor samples were screened for HIV, HBsAg, and anti-HCV by ELISA methods; syphilis and malaria screening was done by card test. Result: Among the total 4,007 donors, 92% were replacement donors while 8% were voluntary donors. Female donors comprised only 1.62%; the remaining 98.38% were male donors. The donor population was mostly in the young age group of 18–30 years (69.1%). Totally, 2.05% (n = 83) blood bags were seropositive for TTI. HBV was the most common TTI (1.77% bags); HIV was the second most common TTI (0.14% bags); HCV was detected in 0.099% bags, whereas syphilis was the least common TTI (0.04% bags). Conclusion: Two to 3% of healthy donors are seropositive for TTI and reveal potential of transmitting them through transfusion. Thus, strict and proper donor selection criteria and screening with higher-generation ELISA kits can help to identify and avoid transfusion of infectious blood products.