Repeat Donors Research Articles

Iron Store of Repeat Plasma and Platelet Apheresis Donors.

Repeat apheresis donation causes a noticeable loss of whole blood: through routine blood tests with every donation as well as through residual blood left within the used apheresis set. While the effect of blood loss on donor iron stores has been widely researched for whole blood donations, fewer and especially contradictory results exist for apheresis donors. A retrospective analysis of the donor blood samples (Department of Transfusion Medicine, University Hospital Erlangen) of the past 11 years (n = 52.976) was performed. Serum ferritin and hemoglobin were used to detect iron deficiency. Values at admission were compared to values measured at the donations. To investigate the impact of the donation frequency, this frequency was calculated for every single donor (for the whole duration of 11 years as well as for each individual year). Correlation and regression analyses between frequency and iron parameters were performed. A special group were long-time repeat donors, whose changes in ferritin values were analyzed in comparison to the first-ever ferritin value before the first donation. All donor groups show significantly lower mean ferritin and hemoglobin values after repeated donations than at admission. Interestingly, there are much more iron-depleted females in the control group than there are iron-depleted males. The correlation and regression analysis showed a significant relationship between donation frequency and iron-deficiency in males, but not in females. The analysis of the long-time repeat donors showed that the relative ferritin value dropped more in males than in females. When comparing iron-depleted long-time donors, females tend to be iron-depleted much more often even before the first donation. Repeat apheresis donation has a noticeable effect on the iron store of the blood donor, leading to a high percentage of iron-deficient donors, especially in women. The very small correlation between donation frequency and iron depletion for females is most likely due to the fact that women tend to be iron-deficient even before the first donation. Because of the natural variation of inter-donation-intervals, the calculated donation frequency might not be that exact. As a result, the correlation between donation frequency and iron stores might be higher than suggested by this work.

Retain Donors by Sharing Past Donation Use: Evidence from Red Cross Blood Donors

Although effective appeals for donors are essential for blood donation services, few studies have investigated which appeals work best, particularly for repeat donors. We address this research gap by proposing and testing a strategy that incorporates information on the use of the past donation in redonation appeals. In three field studies in collaboration with Red Cross Blood Donation Services, we analyze this effect empirically. We examine how managers can successfully implement past donation use appeals by identifying the moderating effects of donor experience and timing of the appeals. Our results confirm that past donation use appeals increase future donations more effectively than simple thank-you appeals. Moreover, this positive effect increases with donor experience; our results show that experienced donors especially appreciate feedback provided by past donation information. In addition, we find that timing of the appeals matters: the positive effect of past donation use information is reduced when appeals are sent shortly before the next possible donation date. Our results provide clear implications for charities seeking to improve donor retention.

Mathematical Model to Assess Potential Reduced Specificity When Switching to New Screening Assays at Blood Donation Centers.

Switching to new infectious disease blood donor screening assays can precipitate an initial decrease in specificity in an established donor population followed by an increase of specificity, referred to as a "cleaning effect". We developed a mathematical model to simulate this and to measure the stabilization of specificity. A modified exponential distribution curve was created to show the impact of donation frequency on the cleaning of the donor pool. Other parameters (e.g., number of donations from repeat donors/donations per month, average and minimum times between donations, retention of regular repeat donors, ratio of false positives for regular repeat donors/first-time donors and specificity of newly introduced assays) were also used to simulate the rise and fall in number of additional false positives. The mathematical model created was compared with real-world data from a South African blood donation center. In the mathematical model, the degree and duration of the cleaning effect were influenced by certain parameters. A longer time interval between donations resulted in a higher number of deferred blood donations than a shorter time interval, if deferred after a 1st, 2nd or 3rd false positive result prior to a stable plateau of specificity. Real-world data on false positive, discarded donations from a South African blood donation center were consistent with numbers from the mathematical model. The mathematical model can identify and describe any "cleaning effect" observed upon switching to a new infectious disease blood screening assay, allowing affected blood donation centers to prepare and adjust, while specificity is stabilized.

Donation testing and transfusion transmissible infections

Donation testing and transfusion transmissible infections

Epidemiologia das doenças infecciosas e parasitárias em candidatos à doação de sangue

O objetivo da pesquisa foi identificar o perfil epidemiológico de candidatos à doação de sangue do Hemocentro de Sergipe entre 2012 e 2017. Foram avaliadas variáveis sociodemográficas e de sorologia reagente das infecções transmitidas pela transfusão sanguínea de todos os candidatos a doação. Foram registrados 157.549 candidatos à doação, predominantemente do sexo masculino (71,7%), com faixa etária de 26-36 anos (36,1%) e considerados candidatos de repetição (72,6%). A prevalência de sorologia reagente foi de 5,4%, destacando-se Hepatite B (43,8%), Sífilis (28,7%) e HIV (16,7%). Os indivíduos com sorologia positiva, majoritariamente de primeira doação (p < 0,05), apresentaram quase 5 vezes mais chances de serem reagentes, comparados com doadores de repetição. A avaliação local dos hemocentros é reflexo da condição da população em relação às doenças infecto parasitárias e pode ser de extrema relevância para definir campanhas de saúde que incluam a importância da doação de sangue e a prevenção destas doenças.

Endoscopies, blood‐borne viruses and blood donors: time to move on from precaution

Based on the Council of Europe directive which dictates regulatory requirements in Australia, blood donors are currently deferred from donating for 4months after an endoscopic procedure if either polyps were removed or a biopsy sample was taken. We aimed to assess the incidence of blood-borne viruses (BBVs) (HIV, hepatitis B and C) in blood donors who donated after an endoscopic procedure and evaluate the risk to blood safety through risk modelling. Donors from 1/1/2013 to 31/12/2017 with an endoscopy deferral on their blood donor file with pre- and post-BBV testing were analysed to determine an incidence of BBVs using standard methods. The standard blood donor cohort was used as a comparator group. Using the incidence of endoscopies and BBV risk, the total residual risk estimate of allowing donors to return postendoscopy without restriction was calculated. The incidence of a BBV postendoscopy in this large cohort of 16,283 where testing has been confirmed postendoscopy was zero (95% CI 0-0·000105). The upper confidence interval of the zero events is 10·5 per 100000 donations. Total positive donations from 2017 repeat donors were 1·87 per 100000 (95% CI 0·0000117-0·0000277). Sensitivity analysis demonstrated that the residual risk remained negligible under realistic worst-case scenarios. A BBV endoscopy deferral is not required for blood safety in Australia. The presented data has enabled us to submit a request for an exemption to our regulator, which has been approved and the policy change subsequently implemented by Lifeblood on 4/4/2020.

10-year analysis of human immunodeficiency virus incidence in first-time and repeat donors in Brazil.

Incidence in first-time and repeat blood donors is an important measure of transfusion-transmitted HIV infection (TT-HIV) risk. This study assessed HIV incidence over time at four large blood centres in Brazil. Donations were screened and confirmed using serological assays for HIV from 2007 to 2016, and additionally screened by nucleic acid testing from 2011 forward. Limiting antigen (LAg) avidity testing was conducted on HIV seroreactive samples from first-time donors to classify whether an infection was recently acquired. We calculated incidence in first-time donors using the mean duration of recent infection and in repeat donors using classical methods. Time and demographic trends were assessed using Poisson regression. Over the 10-year period, HIV incidence in first-time donors was highest in Recife (45·1/100000 person-years (105 py)) followed by São Paulo (32·2/105 py) and then Belo Horizonte (23·3/105 py), and in repeat donors was highest in Recife (33·2/105 py), Belo Horizonte (27·5/105 py) and São Paulo (17·0/105 py). Results from Rio de Janeiro were available from 2013 to 2016 with incidence in first-time donors of 35·9/105 py and repeat donors from 2011 to 2016 of 29·2/105 py. Incidence varied by other donor demographics. When incidence was considered in 2-year intervals, no significant trend was evident. Overall residual risk of TT-HIV was 5·46 and 7·41 per million units of pRBC and FFP transfused, respectively. HIV incidence in both first-time and repeat donors varied by region in Brazil. Clear secular trends were not evident.

Donation related fears predict vasovagal reactions and donor attrition among high school donors.

This longitudinal study of high school whole blood donors examined relationships among donation-related fears assessed prior to donation, vasovagal reactions to donation, and the proportion of donors who attempted another donation over the subsequent 60 weeks. Data regarding vasovagal reactions and attempted donation were obtained from donor records of 530 female and 342 male high school donors who answered questions about five types of fear (ie, of blood draw, needles, seeing blood, feeling pain, or fainting) prior to their index donation. Each type of fear was associated with an increased risk of vasovagal reactions (all P < .001) and a smaller percentage of attempted donations was seen among those who reported at least one type of fear (53%) as compared to those who did not report any fear (62.1%); P = .022; β = -0.374, OR = 0.69; 95% CI, 0.50-0.94. Path analyses of the relationships among fear, vasovagal reaction, and attempted donation revealed significant indirect effects for each type of fear. Specifically, donors who reported fear were at increased odds of experiencing a vasovagal reaction, which, in turn, was associated with decreased odds of attempting a repeat donation. Donation-related fears are associated with reduced donor return rates, and this effect is mediated through an increased risk for vasovagal reactions. For both practical and ethical reasons, blood collectors are encouraged to identify and intervene with fearful donors to reduce the likelihood of negative donation-related symptoms and enhance donor retention.

Inaptidão clínica e sorológica entre doadores de sangue em um serviço de hemoterapia

Objetivo: Estimar a frequência das causas de inaptidão entre candidatos à doação de sangue no serviço de hemoterapia de um hospital universitário, no Estado do Rio de Janeiro. Método: Trata-se de estudo seccional de campo, exploratório descritivo, com abordagem quantitativa e amostragem por conveniência, realizado entre novembro de 2018 e março de 2020. Os dados sociodemográficos e clínico-laboratoriais foram obtidos através da aplicação de um questionário pré-estruturado e consulta ao sistema de hemoterapia utilizado no serviço (sistema Hemote Plus®). O tamanho da amostra considerou a média de doadores nos últimos 5 anos e um erro amostral de 5%. Aplicou-se o teste qui-quadrado de Pearson para as análises bivariadas, considerando-se um nível de significância de 5%. Resultados: Dos 400 respondentes, 25 (6,3%) informaram múltipla parceria nos últimos 12 meses e 42 (10,5%) nunca terem utilizado preservativo. A frequência geral de inaptidão observada foi de 77 casos (19,25%), sendo anemia a mais frequente (18,2%), seguida pela inaptidão sorológica (16,9%) e 11,7% relacionadas a comportamento sexual de risco. Doadores de repetição apresentam maior motivação para doar voluntariamente 178 (81,3%) e tendem a confiar plenamente nos resultados de exames 260 (73,7%), em relação aos doadores de primeira vez. Conclusão: As prevalências de inaptidão por sorologias positivas e comportamento sexual de risco ratificam a necessidade de práticas educativas voltadas a grupos específicos, visando minimizar o descarte de bolsas de sangue. O estímulo à fidelização do doador pode ser uma potente ferramenta para a garantia da qualidade do sangue doado.

Effectiveness of the post-donation instruction sheet in conveying information to repeat blood donors.

Written materials are commonly used for blood donor education. While pre-donation materials are largely standardized across US blood collectors, the post-donation instruction sheet (PDIS) is variable and few have been evaluated to assess their effectiveness in conveying information as reflected by donors' attention, understanding and recall. An online survey was sent to two independent randomly selected samples of repeat donors, before and after implementation of the enhanced PDIS. A total of 12935 blood donors responded (33·4% response rate). Most donors did not read the entire PDIS - 34·3% less than half and 18·1% none. Of the 10593 donors who reported reading any of the PDIS, 97·8% recalled instructions about immediate post-donation care (e.g. extra fluids/no exercise) and 88·0% to call with questions/problems. However, only 50·1% remembered reading about what to do if you felt dizzy/faint and 32·4% about care for bruises. Recall rates in every area were similar before and after revision; except after revision, more donors remembered seeing information about maintaining iron and fewer that you should call the centre back with additional health information (P<0·0001). Blood collectors rely heavily on written materials to convey instructions to donors. Most repeat donors do not read the entire PDIS, and many do not recall important information. More donors recalled seeing how to maintain iron with the enhanced PDIS, but recall deficits remained on how to care for adverse reactions. Written materials alone appear to be insufficient to educate some donors about new or updated topics.

Hepatitis B Virus Nucleic Acid Amplification Testing Assay in Detecting Window Period and Occult Hepatitis B Virus Infections in Blood Donors

SummaryTo reduce the residual risk of transfusion-transmitted infections, nucleic acid amplification testing (NAT) of donated blood with higher sensitivity for HBV, HCV, and HIV 1/2 was implemented in Bulgaria at the end of 2019. This study aimed to assess the clinical sensitivity of HBsAg testing and NAT testing of donated blood to detect all forms of HBV infection. A total of 9498 consecutive blood donations collected for six months, from February 10 to July 17, 2020, from first-time and repeat donors at the Regional Center of Transfusion Hematology Pleven, Bulgaria, were screened for HBsAg and HBV DNA. The detection of HBsAg was performed by enzyme-linked immunoassay and chemiluminescent immunoassay. Detection of HBV DNA was performed using the HIV1/2 /HCV / HBV multiplex Procleix Ultrio Elite assay in a fully automated and integrated Procleix Panther System. The overall HBsAg prevalence was 0.05%. HBV DNA was detected in 25 blood units (0.26%), but only 12 (0.13%) were found positive after repeat testing and were confirmed by a discriminatory test. The other 13 units were false positive, with the initial reactive result and negative results after repeat testing. HBV DNA’s overall incidence was significantly higher in HBsAg-positive donors than the HBsAg- negative (Fisher exact p=0.0063). In our study, blood donations were not tested for anti-HBc and anti-HBs, so it is difficult to determine whether HBV DNA-positive/HBsAg-negative results were associated with the early phase of infection or persistent occult infection. There was no statistical difference in the incidence of HBV DNA between repeat-donors (0.16%) and first-time donors (0.06%) (Fisher exact test p=0.239 NS), and also between the incidence in female donors (0.12%) and male donors (0.13%) (Fisher exact test p=1.0 NS). The results of this study showed a low rate of detection of the hepatitis B virus in donated blood. NAT testing demonstrates higher sensitivity for the detection of HBV, as compare to HBsAg screening.

Feasibility of a pilot program for COVID-19 convalescent plasma collection in Wuhan, China.

BACKGROUNDA novel coronavirus has caused an international outbreak. Currently, there are no specific therapeutic agents for coronavirus infections. Convalescent plasma (CP) therapy is a potentially effective treatment option.METHODSPatients who had recovered from COVID‐19 and had been discharged from the hospital for more than 2 weeks were recruited. COVID‐19 convalescent plasma (CCP)‐specific donor screening and selection were performed based on the following criteria: 1) aged 18‐55 years; 2) eligible for blood donation; 3) diagnosed with COVID‐19; 4) had two consecutive negative COVID‐19 nasopharyngeal swab tests based on PCR (at least 24 hr apart) prior to hospital discharge; 5) had been discharged from the hospital for more than 2 weeks; and 6) had no COVID‐19 symptoms prior to convalescent plasma donation. In addition, preference was given to CCP donors who had a fever lasting more than 3 days or a body temperature exceeding 38.5°C (101.3°F), and who donated 4 weeks after the onset of symptoms. CCP collection was performed using routine plasma collection procedures via plasmapheresis. In addition to routine donor testing, the CCP donorsʼ plasma was also tested for SARS‐CoV‐2 nucleic acid and S‐RBD‐specific IgG antibody.RESULTSOf the 81 potential CCP donors, 64 (79%) plasma products were collected. There were 18 female donors and 46 male donors. There were 34 first‐time blood donors and 30 repeat donors. The average time between CCP collection and initial symptom onset was 49.1 days, and the average time between CCP collection and hospital discharge was 38.7 days. The average volume of CCP collected was 327.7 mL.All Alanine transaminase (ALT) testing results met blood donation requirements. HIV Ag/Ab, anti‐HCV, anti‐syphilis, and HBsAg were all negative; NAT for HIV, HBV, and HCV were also negative. In addition, all of the CCP donorsʼ plasma units were negative for SARS‐CoV‐2 RNA. Of the total 64 CCP donors tested, only one had an S‐RBD‐specific IgG titer of 1:160, all others had a titer of ≥1:320.CONCLUSIONBased on a feasibility study of a pilot CCP program in Wuhan, China, we demonstrated the success and feasibility of CCP collection. In addition, all of the CCP units collected had a titer of ≥1:160 for S‐RBD‐specific IgG antibody, which met the CCP quality control requirements based on the Chinese national guidelines for CCP.

First results of a ferritin-based blood donor deferral policy in the Netherlands.

BACKGROUNDWhole blood donors are at risk of becoming iron deficient. To monitor iron stores, Sanquin implemented a new deferral policy based on ferritin levels, in addition to the traditional hemoglobin measurements.METHODSFerritin levels are determined in every fifth donation, as well as in all first‐time donors. Donors with ferritin levels <15 ng/mL (WHO threshold) are deferred for 12 months; those ≥15 and ≤30 ng/mL for 6 months. The first results were analyzed and are presented here.RESULTSThe results show that 25% of women (N = 20151, 95% CI 24%‐25%) and 1.6% of men (N = 10391, 95% CI 1.4%‐1.8%) have ferritin levels ≤30 ng/mL at their first blood center visit. For repeat (non‐first‐time) donors, these proportions are higher: 53% of women (N = 28329, 95% CI 52%‐54%) and 42% of men (N = 31089, 95% CI 41%‐43%). After a 6‐month deferral, in 88% of returning women (N = 3059, 95% CI 87%‐89%) and 99% of returning men (N = 3736, 95% CI 98%‐99%) ferritin levels were ≥15 ng/mL. After a 12‐month deferral, in 74% of returning women (N = 486, 95% CI 70%‐78%) and 95% of returning men (N = 479, 95% CI 94%‐97%) ferritin levels increased to ≥15 ng/mL.CONCLUSIONDeferral of donors whose pre‐donation ferritin levels were ≤30 ng/mL might prevent donors from returning with ferritin levels <15 ng/mL. This policy is promising to mitigate effects of repeated donations on iron stores.

Secular Trends and Geographic Maps of Hepatitis C Virus Infection among 4 Million Blood Donors in Taiwan from 1999 to 2017.

The prevalence of hepatitis C virus (HCV) infection in Taiwan was approximately 4% a decade ago, much higher than the worldwide average. This study aimed to assess the HCV burden among 4 million voluntary blood donors after 2 decades of prevention and treatment policies. We retrieved screening results for anti‐HCV and HCV RNA from the Database for Evaluating Voluntary Taiwanese Eligible Donors. First‐time blood donors who donated blood after 1999 and repeat donors who donated blood more than once between 2013 and 2017 were included to estimate HCV prevalence and incidence, respectively. The Cox proportional hazards model was used to estimate hazard ratios. Geographic variation in HCV prevalence and incidence in 364 townships was also analyzed. The prevalence study included 3,656,598 first‐time donors. The overall crude prevalence of anti‐HCV decreased from 15.5 to 4.5 per 1,000 donors between 1999 and 2017. Younger birth cohorts had a significantly lower prevalence of anti‐HCV. The majority of townships (64.3%) in Taiwan showed a significantly decreased prevalence. The incidence study included 1,393,014 repeat donors followed for 3,436,607 person‐years. Ninety‐eight donors seroconverted to HCV RNA positivity, resulting in an HCV incidence of 2.9 per 100,000 person‐years. Donors living in townships where HCV RNA prevalence was greater than 2 per 1,000 had at least 2.5‐fold greater risk of new HCV infection. Conclusion: HCV prevalence in Taiwanese first‐time blood donors decreased by 71% in the last 2 decades. However, townships with higher HCV prevalence also showed higher HCV incidence and require more active intervention.

Establishment of the first platelet-donor registry in Argentina.

Platelet transfusions are necessary to prevent and treat haemorrhages in thrombocytopenic patients or those with severe platelet dysfunction. In Latin American countries, including Argentina, blood supplies from voluntary non-remunerated blood donors remain dependent on family replacement donors, since altruistic repeat donors are exceptional and platelet donors are very scarce. The aim of this study was to recruit a group of frequent, voluntary, altruistic blood donors and determine their human platelet antigen (HPA)-genotype in order to establish the first registry of HPA-typed voluntary platelet donors in Argentina. In this study, we invited and recruited voluntary blood donors who attended the Fundación Banco Central de Sangre between July 2016 and July 2017. DNA was extracted from K2EDTA anticoagulated whole blood and genotyping was performed by polymerase chain reaction, using sequence-specific primers to type the HPA-1 to -6, -9 and -15 systems. A subset of samples was also tested using a commercial HPA-TYPE kit. Donors were invited to join the National Register of Haematopoietic Stem Cell Donors of Argentina. A cohort of 500 platelet donors was recruited and characterised and a database with their personal information, including their genotype for the most relevant HPA alloantigens, was created. Eight of the 500 donors (1.6%) were HPA-1a negative. HPA allelic variants -4b, -6b and -9b were detected for the first time in our population. There was 100% concordance between our in-house assay and the commercial kits in the subset of 150 donor samples assayed in parallel. The efforts made to recruit, characterise and register voluntary platelet donors will provide the first sustainable source of HPA and human leukocyte antigen-typed platelets for compatible transfusions in the country. Remarkably, we identified a higher percentage of HPA-1a-negative donors than previously detected in the Argentinean population.

Retrospective cohort studies of repeat donors reveal donor‐dependent variability in the recovery of transfused platelets

The in vivo recovery of transfused platelets is variable and often unpredictable. Although many recipient-dependent factors are well described, donor-dependent variables remain poorly understood. To explore donor-dependent variables we conducted 2 retrospective studies of platelet transfusion outcomes in repeat donors. One study analyzed multiple autologous, radiolabeled platelet transfusions, and a second study analyzed multiple clinical platelet transfusions from a small cohort of repeat donors. In 36 subjects, multiple within-subject determinations of recovery and survival of radiolabeled autologous platelets revealed a relative consistency in platelet recoveries within donors compared to the range of recoveries among donors. Intraclass correlation coefficients for platelet recovery were 43% to 93%. In 524 ABO-compatible clinical platelet transfusions derived from seven donors, a linear mixed-effects model revealed significant donor-dependent differences in corrected count increments for units stored for 4 or 5 days. These two studies indicate reproducible donor-dependent differences in transfused platelet recovery, suggesting a possible heritable influence on the quality of transfused platelets.

The frequent and the unusual red cell phenotypes in Indian blood donors: A quest for rare donors

A clinically significant red cell alloantibody is capable of accelerated destruction of red cells bearing the corresponding antigen. Knowledge of prevalence of these antigens is necessary for performing day to day work and for research in immunohematology. The primary aim of this study was to find the prevalence of 18 clinically significant blood group antigens in blood donors. Secondary objectives were to motivate and create a database of accessible, volunteer O blood group donors and to register rare donors with existing registries. A cross-sectional observational study was conducted in the department of Transfusion Medicine at a large tertiary care hospital in India from October 2016 to May 2018 with a planned sample size of 4800. Study population included healthy blood donors of either gender coming for blood donation to the blood centre. A total of 6678 samples were included in the study. First time donors were 21.41 % while 78.59 % were repeat donors. Voluntary donors constituted 15.81 % while replacement donors were 84.19 %. Male donors were 89.82 % while female donors were 10.18 %. The antigen, phenotype and gene frequencies were calculated. An extended phenotyped voluntary donor database was created and four rare donors were identified. One of these rare donors was registered with the International Rare Donor Panel (IRDP) and rest were registered in a local registry. This study might help enhance the confidence of blood banks in finding appropriate units for patients with unexpected antibodies or with rare phenotypes. It also paves a way for registering rare donors locally and internationally.

Malaria parasitemia among blood donors in Uganda.

Malaria remains a leading transfusion associated infectious risk in endemic areas. However, the prevalence of malaria parasitemia has not been well characterized in blood donor populations. This study sought to determine the prevalence of Plasmodium in red blood cell (RBC) and whole blood (WB) units after the rainy season in Uganda. Between May and July 2018, blood was collected from the sample diversion pouch of 1000 WB donors in Kampala and Jinja, Uganda. The RBC pellet from ethylenediamine tetraacetic acid (EDTA) anticoagulated blood was stored at -80°C until testing. DNA was extracted and nested PCR was used to screen samples at the genus level for Plasmodium, with positive samples further tested for species identification. Malaria parasitemia among asymptomatic, eligible blood donors in two regions of Uganda was 15.4%; 87.7% (135/154) of infections were with P. falciparum, while P. malariae and P. ovale were also detected. There were 4.3% of blood donors who had mixed infection with multiple species. Older donors (>30 years vs. 17-19 years; aPR = 0.31 [95% CI = 0.17-0.58]), females (aPR = 0.60 [95% CI = 0.42-0.87]), repeat donors (aPR = 0.44 [95% CI = 0.27-0.72]) and those donating near the capital city of Kampala versus rural Jinja region (aPR = 0.49 [95% CI = 0.34-0.69]) had a lower prevalence of malaria parasitemia. A high proportion of asymptomatic blood donors residing in a malaria endemic region demonstrate evidence of parasitemia at time of donation. Further research is needed to quantify the risk and associated burden of transfusion-transmitted malaria (TTM) in order to inform strategies to prevent TTM.

Incidence and analysis of blood donor adverse reactions – an opportunity to establish a donor vigilance programme at an institution in Eastern India

Background and objectivesBlood donors are the essential pillars for safe blood transfusion service. This study aimed to analyse the spectrum of blood donor adverse events (AE) and design strategies for their prevention; to improve donor safety and increase donation frequency; and to encourage the establishment of a donor vigilance across different blood centres.Material and methodsA prospective study was conducted within the Department IHBT over eighteen months on whole blood (voluntary/replacement) and aphaeresis donors who were selected as per the national guidelines. Statistical analysis was done using Spss software.ResultsAltogether, 576 AE were observed in 11 371 donors, with significantly higher rate in plateletpheresis [61 in 314 donors] than WB donation. First time (451/4551), replacement (172/2894), female (158/1535) and young donors (18–40 years) (485/7969) were significantly prone to AE. Generalized vasovagal reactions (n = 349) were the commonest AE followed by haematoma. The onset of AE was mainly during postdonation period. Vasovagal reactions were significantly high in first time (P = 0·0001), replacement (P = 0·0001), female (P = 0·0001), young (18–40 years) (P = 0·0001) and low body weight donors (45–54 kg) (P = 0·0001) when compared to repeat, voluntary, male, older and heavier donors. Haematoma was found significantly higher in aphaeresis [P = 0·0001], first time [P = 0·0001] and heavier donors [P = 0·0001] as compared to WB, repeat and low body weight donors.ConclusionWe attempted to identify the spectrum of donor AE at our institution and also propose certain preventive measures, which would help in reducing the frequency of these AE. It is an evidence‐based approach to guide other blood centres and motivate them to establish their own donor vigilance.

Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading.

A new national donor safety initiative was introduced in Australia in 2018, which aimed to encourage all whole blood donors to water load and to use applied muscle tension. This study evaluated the effect of this initiative on the rate of vasovagal reactions (VVR). Routinely collected data were used to identify whole blood donations and any associated VVRs before (n = 167,056 donations) and after implementation (n = 215,572 donations). Multivariate logistic regression analyses were performed to evaluate the differences in VVR rates. The total rate of VVRs declined from 22.5 per 1000 donations to 20.6 per 1000 donations after implementation, a reduction of 8% (p < 0.001). The rate of presyncopal reactions decreased by 8% in new donors and 12% in repeat donors. No impact was observed on the rate of syncope in any of the groups. The multivariate logistic regression analysis demonstrated the odds of experiencing a presyncopal reaction was reduced by 13% following implementation, with no significant effects on syncope. The findings of this study support the use of water loading and applied muscle tension in routine whole blood collection to reduce the incidence of VVRs.