Blood Transfusion Service Research Articles

Exploring the increasing need for plasma collection: Perspectives of voluntary nonremunerated donors on payment for plasma in Canada.

The aim of this paper is to understand how voluntary nonremunerated plasma donors in Canada view payment for plasma and the emerging commercial sector. There is a growing global demand for plasma, to produce plasma-derived medical products. Source plasma for these products is collected through voluntary nonremunerated donation, sometimes by a national blood service, or by a commercial plasma collector, remunerating donors. This paper presents findings from qualitative semi-structured interviews with source plasma donors in three new source plasma centres in Canada. Interview data were analysed using abductive analysis, an interpretivist approach that builds on grounded theory. This study indicates that there are a range of perspectives on payment for plasma and the emerging commercial sector, from disinterest in payment, to opposition to payment based on the belief that it could undermine donating to help others, and risk public health and safety. One fifth of participants are open to CBS paying donors if it is necessary to increase national sufficiency of plasma. Almost two thirds of participants are opposed to commercial plasma collection in Canada, claiming that it could undermine Canada's public healthcare system, raising questions about transparency and accountability of the commercial plasma industry. Findings point to important areas for future study, on publicly collected source plasma, the emerging commercial plasma sector, and the role of the donor as a social actor in a complex political system.

Impact of the COVID-19 Pandemic on Blood Donation Patterns: A Systematic Review and Meta-Analysis.

Blood centers, which are arguably the backbone of every hospital, depend on blood donors for a constant and regular supply of blood. Like many other fields, the COVID-19 pandemic severely affected blood donations. In this article, we aim to systematically search the studies done on blood donation during the COVID-19 pandemic period, analyze the pandemic's effect on blood donation, and examine the methodology used to overcome the problem. We performed a systematic review and meta-analysis to investigate the effect of the COVID-19 pandemic on blood donation. Two independent reviewers searched different databases, such as PubMed, ProQuest, Scopus, and Google Scholar. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Joanna Briggs Institute critical appraisal checklist for overall study characteristics. We included a total of 15 studies. There was an overall decrease in blood donation of 25%, with some regions showing a decrease of as much as 71%. However, some regions were able to experience a 2-10% increase in blood donation after taking stringent and early measures to prevent such decreases. The COVID-19 pandemic and consequent lockdown greatly affected blood transfusion services, resulting in a progressive decline in blood donations that threatened the lives of many patients who were fully dependent on blood transfusion. However, by making appropriate and early decisions and taking action, policymakers and the rest of society can prevent such shortages, potentially saving millions of lives.

Impact of the COVID-19 Pandemic on Blood Transfusion Service: A case study from Kolkata, India

Background: The emergence of coronavirus disease (COVID-19) has posed a significant threat to public health all over the world and it has been a difficult challenge for blood banks in India to cope with the situation. In this study, the effect of the COVID-19 pandemic on the blood transfusion service of India has been assessed. Method: The present study is conducted in a stand-alone community blood bank situated in the city of Kolkata, India. A comparative evaluation of supply, demand, and utilization of blood components by analysing pre-pandemic and post-pandemic data from 2017 to 2020 has been presented. Result: As no blood donation camp could be organized due to the country-wide lockdown along with restrictions in mobility and large gatherings during the initial period after the outbreak of the pandemic, a significant reduction of 80.35% in blood collection was observed. The demand for the Packed Red Blood Cell was decreased by 75% due to the postponement of elective surgeries and non-urgent clinical interventions. Blood utilization patterns also changed as 40% of the Packed Red Blood Cell was issued to thalassemia patients during this period. Conclusion: Based on the evaluation of blood bank performance under pre-pandemic and post-pandemic conditions, recommendations such as spreading public awareness, maintaining sufficient safety stock, proper training of blood banking staff, communicating with nearby hospitals, donors, and medical professionals have been identified to be helpful to mitigate the adverse effects of extreme situations such as a pandemic.

Evaluation of interventions to prevent vasovagal reactions among whole blood donors: rationale and design of a large cluster randomised trial

BackgroundVasovagal reactions (VVRs) are the most common acute complications of blood donation. Responsible for substantial morbidity, they also reduce the likelihood of repeated donations and are disruptive and costly for blood services. Although blood establishments worldwide have adopted different strategies to prevent VVRs (including water loading and applied muscle tension [AMT]), robust evidence is limited. The Strategies to Improve Donor Experiences (STRIDES) trial aims to reliably assess the impact of four different interventions to prevent VVRs among blood donors.MethodsSTRIDES is a cluster-randomised cross-over/stepped-wedge factorial trial of four interventions to reduce VVRs involving about 1.4 million whole blood donors enrolled from all 73 blood donation sites (mobile teams and donor centres) of National Health Service Blood and Transplant (NHSBT) in England. Each site (“cluster”) has been randomly allocated to receive one or more interventions during a 36-month period, using principles of cross-over, stepped-wedge and factorial trial design to assign the sequence of interventions. Each of the four interventions is compared to NHSBT’s current practices: (i) 500-ml isotonic drink before donation (vs current 500-ml plain water); (ii) 3-min rest on donation chair after donation (vs current 2 min); (iii) new modified AMT (vs current practice of AMT); and (iv) psychosocial intervention using preparatory materials (vs current practice of nothing). The primary outcome is the number of in-session VVRs with loss of consciousness (i.e. episodes involving loss of consciousness of any duration, with or without additional complications). Secondary outcomes include all in-session VVRs (i.e. with and without loss of consciousness), all delayed VVRs (i.e. those occurring after leaving the venue) and any in-session non-VVR adverse events or reactions.DiscussionThe STRIDES trial should yield novel information about interventions, singly and in combination, for the prevention of VVRs, with the aim of generating policy-shaping evidence to help inform blood services to improve donor health, donor experience, and service efficiency.Trial registrationISRCTN: 10412338. Registration date: October 24, 2019.

A Questionnaire Study to Assess the Belief and Barrier to Blood Donation and the Influence of Educational Intervention on Urban and Rural Patients.

Blood transfusion services are an essential part of any healthcare delivery system in today's clinical world with advanced medicines because blood is in high demand during various medical emergencies. Improving knowledge and hastening the development of a positive attitude toward blood donation in society should be the goal of developing an efficient strategy for sustaining a safe and adequate blood supply. The study aims to explore the knowledge, attitude, and motivation toward blood donation among urban and rural patients attending the outreach program. Patients who attended the outreach program held by the Dental College of Uttar Pradesh were subjected to a questionnaire survey to determine their level of knowledge regarding blood donation. Further, an education-based intervention was done among the camp patients to assess the change in their learning after the intervention. The difference between the individual responses prior to and following the intervention was analyzed using the chi-square test. p≤0.05 was considered statistically significant. Urban patients comprise 186 males (44.28%) and 234 females (55.72%). Among the rural patients, 205 (45.55%) were males and 245 were females (54.45%). About 48.80% of the urban patients and 48.88% of the rural patients were Hindus while the remaining were Muslims. Only 22.14% of urban patients and 16.88% of rural patients had donated blood till now. The comparison after the intervention for rural patients showed a significant improvement in the level of knowledge and awareness. Although it is quite common knowledge that rural people require more awareness and education related to health, after the conduction of our study, we have resolute evidence that demands thorough IEC and health information activities for the welfare of rural people and to diminish the divide.

Blood transfusions post kidney transplantation are associated with inferior allograft and patient survival-it is time for rigorous patient blood management.

Patient Blood Management (PBM), endorsed by the World Health Organisation is an evidence-based, multi-disciplinary approach to minimise inappropriate blood product transfusions. Kidney transplantation presents a particular challenge to PBM, as comprehensive evidence of the risk of transfusion is lacking. The aim of this study is to investigate the prevalence of post-transplant blood transfusions across multiple centres, to analyse risk factors for transfusion and to compare transplant outcomes by transfusion status. This analysis was co-ordinated via the UK Transplant Registry within NHS Blood and Transplant (NHSBT), and was performed across 4 centres. Patients who had received a kidney transplant over a 1-year period, had their transfusion status identified and linked to data held within the national registry. Of 720 patients, 221(30.7%) were transfused, with 214(29.7%) receiving a red blood cell (RBC) transfusion. The proportion of patients transfused at each centre ranged from 20% to 35%, with a median time to transfusion of 4 (IQR:0-12) days post-transplant. On multivariate analysis, age [OR: 1.02(1.01-1.03), p=0.001], gender [OR: 2.11(1.50-2.98), p<0.0001], ethnicity [OR: 1.28(1.28-2.60), p=0.0008], and dialysis dependence pre-transplant [OR: 1.67(1.08-2.68), p=0.02], were associated with transfusion. A risk-adjusted Cox proportional hazards model showed transfusion was associated with inferior 1-year patient survival [HR 7.94(2.08-30.27), p=0.002] and allograft survival [HR: 3.33(1.65-6.71), p=0.0008], and inferior allograft function. RBC transfusions are common and are independently associated with inferior transplant outcomes. We urge that further research is needed to understand the mechanisms behind the outcomes, to support the urgent development of transplant-specific anaemia guidelines.

Comparison of Volunteer Non-Remunerated Donors and Replacement Donors.

There are mainly two types of blood donor in Nepal i.e., Voluntary Non-Remunerated Donor and Replacement Donor. The main aim of this study is to compare between Voluntary Non-Remunerated Donor and Replacement Donor. This is retrospective and cross-sectional study conducted in the blood transfusion Service, Tribhuvan University Teaching Hospital. The study was conducted on both Voluntary Non-Remunerated Donor and Replacement Donor who came to blood transfusion Service and voluntary blood donation program. All the blood donors donating in blood transfusion Service were considered as the study population. Out of total 25951 donors, there were 15565(60.02%) Voluntary Non-Remunerated Donor and 10386(39.97%) Replacement Donor. On the whole, there were 21938(84.59%) male donors and 3995(15.40%) female donors. The male Replacement Donor was 14273(93.12%) followed by a male Voluntary Non-Remunerated Donor 7582(73.71%). The female Voluntary Non-Remunerated Donor was 2703(67.65 %) followed by female Replacement Donor 1292(32.34 %). This study concludes that the Voluntary Non-Remunerated Donor is quite low, in comparison to Replacement Donor. 100 % Voluntary Non-Remunerated Donor could not be achieved due to lack of awareness about health and voluntary type of blood donation.

Analysis of donor hemoglobin levels at the blood transfusion service of Dr. Sardjito Hospital, Yogyakarta

Introduction: Blood service is a health service that utilizes human blood as a basic ingredient for humanitarian and non-commercial purposes. Donors in Indonesia are required to have a minimum Hemoglobin (Hb) level of 12.5 g/dL in accordance with National Regulations. It aims to ensure that the donor can tolerate the loss of blood without the appearance of anemia symptoms. This study aims to analyze the Hb levels of donors at the Blood Transfusion Service of Dr. Sardjito Hospital, Yogyakarta, Indonesia. Method: This analytic observational study applied a retrospective design. The data of 62,221 donors were taken from the donor database of the Blood Transfusion Service of Dr. Sardjito Hospital. The inclusion criteria were donors aged ≥ 17 years and met other donor selection criteria. Donors with incomplete data were excluded. The chi-Square test was performed using the SPSS version 22. The p &lt; 0.05 was considered significant. Results: The subjects were dominated by male donors, i.e., 48,348 (77.7%), and the most Hb level were 14.1-15.5 g/dL. This range of Hb levels was identified as the highest proportion in all age groups. The Hb levels of 14.1-15.5 g/dL were determined in 5,874 (39.6%) blood group A, 7,332 (39%) blood group B; 1,830 (39.6%) blood group AB and 9,486 (39.5%) blood group O donors. Conclusions: There was a significant difference in the proportion of donors based on Hb levels, sexes, ABO groups, Rhesus D groups, donation types, and donor statuses (p &lt; 0.001).

Prevalence of ABO and Rh Blood Groups Among Blood Donors in Jiblah University Hospital in Ibb Province Yemen

Background: The ABO and Rhesus (Rh) blood group system are the most important blood group systems in Transfusion Medicine, genetic studies and in legal medicine study. The distribution of the ABO and Rhesus blood groups is vital for the effective operation and planning of blood banks and secure blood transfusion services. Objective: To determine the prevalence of ABO Rh blood groups among blood donors in Jiblah University Hospital in Ibb province, Yemen. Methods: A retrospective study was conducted at Blood bank of Jiblah university hospital in Ibb city, Yemen from January 2021 to August 2023. Blood groups typing of 4853 blood donors was carried out using Slide Agglutination (antigen-antibody) method with antisera anti-A, anti-B, and anti-D. Age and sex of participants were considered. SPSS version 20 was used for data analysis. Results: The most common blood group was O (55.54%) and AB was the least common (1.71%). The prevalence of Rhpositive and Rh-negative was 80% and 20% respectively. There were statistically significant association between ABO blood groups and Rh blood group (P = 0.000). Conclusion: The overall phenotypic frequencies of ABO blood groups were O&gt;A&gt;B&gt;AB and O+&gt;A+&gt;O-&gt;B+&gt;A-&gt;AB+&gt;B-&gt;ABwas found to be the order of blood group frequency in the current study. There was a statistical association between ABO blood group system and Rh system.

Hepatitis E virus as a transfusion transmitted infection-current status

Objectives: Hepatitis E virus (HEV) infection is growing worldwide and presents a new threat to the blood transfusion services across the world. The present review tries to explore how the transfusion medicine community is responding to the threat. Materials and Methods: The major papers and important case reports were culled from PubMed, Science Direct, Embase related to this infection, and transfusion medicine since 2005 were explored and relevant articles were discussed with emphasis on epidemiology, infection, prevalence in donor population, susceptible recipients, prevention, and future development. Results: There are eight genotypes of this virus with different host, transmission biology, and clinical infection. Chronic infections are more common with Genotype 3 and Genotype 4 which are prevalent in Europe and transmitted by pig and meats cooked from this animal. Genotype 5 and 6 has not yet been linked to human transmission. Genotype 1 and Genotype 2 cause epidemic form of this infection and are common in developing countries. Immunosuppressed and chronic liver disease patients get chronic or severe infection. Pregnant ladies develop fulminant hepatitis with high mortality. The virus is transmitted by blood products but severe infection is uncommon. Many European countries, USA, Canada are using Nucleic Acid Testing (NAT) based technology to screen their donors as Individual Donor-NAT or Minipool NAT with varying efficiency. Large part of the world as yet has not taken any active measure to contain this infection through transfusion. A vaccine is available, effective but is not widely used as more studies are needed. Cross immunity does happen between genotypes and presence of immunoglobulin G antibody in blood protects against serious infection. Alanine transaminase level corresponds with viremia in asymptomatic but infected individuals. Conclusion: The HEV is an emerging but important threat to transfusion medicine service. Important information regarding this infection is still lacking. However, there is a need to develop robust safety algorithm to counter this threat and make transfusion safer.

An Overview of Blood Transfusion Services in Palestine

Blood transfusion is a vital component of the health-care system, especially considering the ongoing violent Palestinian-Israeli conflict that increases the need to maintain sufficient availability of safe blood for medical emergencies. We assessed the elements of blood transfusion services (BTS) against the guidelines of the World Health Organization guidelines to identify the achievements and gaps of the Palestinian BTS. Before the provision of the Palestinian Authority in 1994, BTS was provided by one blood bank and lacked any legislative or regulatory framework. Currently, BTS is overseen by the Palestinian Ministry of Health (MoH). There are 32 functional blood banks in the West Bank. Fourteen functional blood banks are overseen by MoH including the Central Blood Bank, which takes the role of a reference blood bank and 13 hospital-based blood banks. BTS in Palestine still lacks some of the major components required for a good national effective and safe BTS such as legislative and regulatory frameworks that are integrated within the national health system, defined standards and national guidelines on the clinical use of blood components, a national comprehensive quality assurance program for BTS, and a hemovigilance system to capture data on adverse events. In addition, there are no national blood donor programs or educational programs for staff in place.

Adverse Blood Transfusion Reaction Reporting at a Tertiary Care Hospital, Bhutan

Background and Objectives: Even though Blood Transfusion Service is considered as life-saving intervention, it is associated with the occurrence of uneventful reactions from the transfusion of blood and blood units. Bhutan Blood Bank is fragmented with different levels of services provided which leads to varied levels of adverse blood transfusion reaction reported. Study on the hemovigilance system at tertiary care hospital is conducted so as to study the frequency and types of reactions over a period of three years from 1st January 2019 to 31st December 2021. Methods: All ATRs occurring within a period of 3 years were studied according to the Blood Bank standard operating procedure. Adverse transfusion events related to blood and blood units were analyzed and classified on the basis of their clinical features and laboratory tests. Descriptive statistics were used to represent the adverse transfusion reactions. Results: During this period, a total of 19,961 blood and blood components were issued and 120 adverse transfusion events were reported. Most reaction reported were febrile non-hemolytic transfusion reaction, FNHTR (59.2%) followed by allergic reaction (22.5%) occurring predominantly in females (93%). Packed red cells were the common component causing adverse events (83 %) with most observable in Group A (42.5%) blood units. Conclusion: Febrile and allergic reactions are the most common type of reaction reported. Although such reaction type is least harmful but fatal reaction can occur and preventive measures must be taken to avoid such reactions. This preliminary study indicates the importance of having continuous monitoring and quality assessment scheme in addressing the issues of adverse transfusion reaction. Furthermore, establishing a hospital transfusion committee is vital for delivery of safe and efficient blood transfusion services.

Prevalence and Causes of Deferrals among Repeat Blood Donors in Dar es Salaam Tanzania

A well-functioning blood transfusion service is essential for effective health-care delivery. Despite the fact that blood transfusions can save lives, the role of blood transfusion services is to assure the supply of safe blood from healthy donors.

140: Safety of endoscopic surveillance of the transplanted small intestine: A 15 years experience of a large UK Transplant center

140: Safety of endoscopic surveillance of the transplanted small intestine: A 15 years experience of a large UK Transplant center

Role of antibody screening in high titre group O donors

Red Cells, Fresh Frozen Plasma (FFP) and Platelets (RDP/SDP) prepared from donors with group O may have high titers of anti-A, anti-B and/or anti-A,B antibodies. When such components given to non-group O patients, this high titre can result in haemolytic transfusion reactions (HTRs). Such group O donors are generally termed ‘high-titer group O donors. Significant amounts of ABO antigen being present on the platelet surface and anti-ABO iso-agglutinins being present in the donor’s plasma, Platelet transfusions need to take into account the issues. Although relatively rare, but acute intravascular haemolytic transfusion reaction has been caused by passive transfer of anti-A and anti-B antibodies, present in group O donors. This study aimed to identify the prevalence of high titre antibodies in group O donors. Thus, titre are performed in randomly selected group O donors from different gender and age group to identify best available source of products for Platelet and follow up transfusions.: Randomly selected 100 O blood group donors were included in the study. Samples from these donors were tested for ABO antibody (both IgM and IgG) titres using conventional tube technique at RT and 37°C at Indirect Antiglobulin phase. Statistical analysis was performed using two sample t-test and anova test.Donors included in the present study were mainly male (85%) donors. ABO antibody titres ranged from 0 to 2048. In the present study, Anti-B (IgG) titer is significantly higher than other antibodies in both genders.There are a large proportion of group O donors having high titres of antibodies and hence a routine pretransfusion screening for such antibodies can prevent the development of hemolytic transfusion reaction by issuing only low titre components for out of group transfusions.Each Blood Transfusion Service should establish a policy for testing and issue of group O platelets to non-O group recipient to avoid chances of development of adverse transfusion reaction.

#6327 ACCEPT OR DECLINE? A STATISTICAL APPROACH TO AID DECISION MAKING

Abstract Background and Aims The clinician-patient decision of whether to accept or decline an offered deceased donor kidney is one of the most complex in transplantation. Though many attempts have been made to risk stratify based on donor and recipient characteristics as well as other methods, reliance on clinical intuition remains high. We used a novel statistical modelling technique to better understand potential outcomes for patients following acceptance or decline of a deceased donor organ offer in the UK. Method We obtained UKTR data held by NHS Blood and Transplant (NHSBT) on adult patients listed for kidney transplantation in the UK, deceased donor kidney offers and post-transplant outcomes. Multivariable models to demonstrate 5-year transplant survival (a composite of graft and patient survival) for patients from the point of offering and post-transplant survival were developed using a Cox proportional hazard techniques. Waiting time to a “better” offer was modelled using a micro-simulation approach for patients and donors with different profiles, incorporating the points system from the current UK kidney offering scheme. Rates of patients arriving on the waiting list, leaving the list and being transplanted were obtained to facilitate this, as well as characteristics of waitlisted patients and organ donors. Simulations were then run to ascertain potential outcomes from the point of offer for an index patient for scenarios characterised by offers from donors with differing profiles. Results Figure 1 demonstrates the outcomes of an index patient if they accept an organ offer from a donor with the demonstrated characteristics compared with potential outcomes if the next offer is accepted. Figure 2 uses the same techniques but demonstrates outcomes if a kidney from a donor with ‘worse’ characteristics is offered. Conclusion This study demonstrates a novel method to help visualise potential outcomes for patients listed for deceased donor kidney transplantation. With further input from patient and clinician perspectives, this work has potential to be beneficial in facilitating discussions between patients and clinicians regarding decision making at the time of organ offering and may ultimately improve organ utilisation.

Blood transfusion for children in sub-Saharan Africa: 200 years on

In 1818, James Blundell completed the first successful human blood transfusion. This life-saving medical intervention has revolutionised patient care globally in the past two centuries. Nevertheless, many challenges remain in implementing safe blood transfusion procedures, particularly in sub-Saharan Africa 1 Ala F Allain JP Bates I et al. External financial aid to blood transfusion services in sub-Saharan Africa: a need for reflection. PLoS Med. 2012; 9e1001309 Crossref PubMed Scopus (53) Google Scholar where demand predominantly centres on acute paediatric severe anaemia and haemorrhagic complications of pregnancy and trauma. Severe anaemia, when the haemoglobin concentration drops below 6 g/dL, is very common in children admitted to hospital in sub-Saharan Africa. Infectious diseases, nutritional deficiencies, and sickle cell anaemia are the major underlying causes of anaemia. Outcomes remain unsatisfactory, with high mortality and high hospital readmission rates within 6 months of initial admission. 2 Phiri KS Calis JC Faragher B et al. Long term outcome of severe anaemia in Malawian children. PLoS One. 2008; 3e2903 Crossref PubMed Scopus (75) Google Scholar World Blood Donor Day on June 14, 2023, calls for donors to “Give blood, give plasma, share life, share often”. Not only is this a day to celebrate the charitable contributions of blood donors, it is an important opportunity to raise awareness that every pint of blood donated results in critically important life-sustaining therapy, especially for children in sub-Saharan Africa.

Exploring Staff Attitudes Towards Unspecified Kidney Donors in the United Kingdom: Results From the BOUnD Study.

Unspecified kidney donation (UKD) has made substantial contributions to the UK living donor programme. Nevertheless, some transplant professionals are uncomfortable with these individuals undergoing surgery. This study aimed to qualitatively explore the attitudes of UK healthcare professionals towards UKD. An opportunistic sample was recruited through the Barriers and Outcomes in Unspecified Donation (BOUnD) study covering six UK transplant centres: three high volume and three low volume centres. Interview transcripts were analysed using inductive thematic analysis. The study provided comprehensive coverage of the UK transplant community, involving 59 transplant professionals. We identified five themes: staff's conception of the ethics of UKD; presence of the known recipient in the donor-recipient dyad; need for better management of patient expectations; managing visceral reactions about the "typical" unspecified kidney donor; complex attitudes toward a promising new practice. This is the first in-depth qualitative study of attitudes of transplant professionals towards UKD. The data uncovered findings with strong clinical implications for the UKD programme, including the need for a uniform approach towards younger candidates that is adhered to by all transplant centres, the need to equally extend the rigorous assessment to both specified and unspecified donors, and a new approach to managing donor expectations.

Re-examine the transfusion transmitted risk of SARS-CoV-2 virus during a major COVID-19 outbreak in 2022.

Although no case of COVID-19 transmission through transfusion has been reported, blood transfusion service (BTS) continues to implement pre-donation and post-donation measures to minimise the risk. In year 2022, when local healthcare system was badly impacted by a major outbreak, it opened an opportunity to re-examine the viraemia risk in these asymptomatic donors. Records were retrieved from blood donors who reported COVID-19 after donation and follow-up was also made for recipients who received their blood. Blood samples at donation were tested for SARS-CoV-2 viraemia by single-tube nested real-time RT-PCR assay designed to detect most SARS-CoV-2 variants including the prevailing delta and omicron variants. From 1 January to 15 August 2022, the city with 7.4 M inhabitants recorded 1 187 844 COVID-19 positive cases and 125 936 successful blood donations were received. 781 donors reported to the BTS after donation with 701 being COVID-19 related (including close contact and symptoms respiratory tract infection). 525 COVID-19 were positive at the time of call back or follow-up. Of the 701 donations, they were processed into 1480 components with 1073 discarded upon donors' call back. For remaining 407 components, no recipient was found to have adverse event or COVID-19 positive. 510 samples from the above 525 COVID-19 positive donors were available and all tested negative for SARS-CoV-2 RNA. With the negative SARS-CoV-2 RNA in blood donation samples and follow up data in transfusion recipients, the risk of transfusion transmitted COVID-19 appears negligible. However, current measures remains important in securing blood safety with ongoing surveillance of their effectiveness.

The UK kidney donor risk index poorly predicts long-term transplant survival in paediatric kidney transplant recipients.

The UK kidney offering scheme introduced a kidney donor risk index (UK-KDRI) to improve the utility of deceased-donor kidney allocations. The UK-KDRI was derived using adult donor and recipient data. We assessed this in a paediatric cohort from the UK transplant registry. We performed Cox survival analysis on first kidney-only deceased brain-dead transplants in paediatric (<18 years) recipients from 2000-2014. The primary outcome was death-censored allograft survival >30 days post-transplant. The main study variable was UK-KDRI derived from seven donor risk-factors, categorised into four groups (D1-low risk, D2, D3 and D4-highest risk). Follow-up ended on 31-December-2021. 319/908 patients experienced transplant loss with rejection as the main cause (55%). The majority of paediatric patients received donors from D1 donors (64%). There was an increase in D2-4 donors during the study period, whilst the level of HLA mismatching improved. The KDRI was not associated with allograft failure. In multi-variate analysis, increasing recipient age [adjusted HR and 95%CI: 1.05(1.03-1.08) per-year, p<0.001], recipient minority ethnic group [1.28(1.01-1.63), p<0.05), dialysis before transplant [1.38(1.04-1.81), p<0.005], donor height [0.99 (0.98-1.00) per centimetre, p<0.05] and level of HLA mismatch [Level 3: 1.92(1.19-3.11); Level 4: 2.40(1.26-4.58) versus Level 1, p<0.01] were associated with worse outcomes. Patients with Level 1 and 2 HLA mismatches (0 DR +0/1 B mismatch) had median graft survival >17 years regardless of UK-KDRI groups. Increasing donor age was marginally associated with worse allograft survival [1.01 (1.00-1.01) per year, p=0.05]. Adult donor risk scores were not associated with long-term allograft survival in paediatric patients. The level of HLA mismatch had the most profound effect on survival. Risk models based on adult data alone may not have the same validity for paediatric patients and therefore all age-groups should be included in future risk prediction models.