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Van Remoortel H, Van de Sande D, Maes D, Khoudary J, Tavernier V, Tiberghien P, De Buck E, Compernolle V. The efficacy and effectiveness of drinking interventions to reduce vasovagal reactions in blood donors: A systematic review and meta-analysis. Vox Sang 2024. [PMID: 39237120 DOI: 10.1111/vox.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND AND OBJECTIVES Blood establishments strive to ensure the safety and comfort of blood donors while minimizing adverse events. This review aims to assess the efficacy and effectiveness of eating and/or drinking interventions before, during and/or after blood donation in reducing vasovagal reactions (VVRs). MATERIALS AND METHODS We analysed randomized and non-randomized controlled trials comparing eating and/or drinking interventions to no intervention, placebo or usual practice on (pre-)syncopal VVRs and related symptoms. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to assess the risk of bias and overall certainty of the evidence. RESULTS Pre-donation water ingestion likely results in reduced on-site VVRs, compared to no water (2 fewer per 100 donors, moderate-certainty evidence). A pre-donation isotonic drink likely results in reduced VVRs, compared to usual practice (2 fewer per 100 donors, moderate-certainty evidence). Pre-donation salt-loaded sweetened lemon water may result in fewer off-site VVRs, compared to sweetened lemon water only (1 fewer per 100 donors, low-certainty evidence). Pre-donation water and a gel cap containing sucrose with 250 mg caffeine may result in fewer blood donor reaction ratings, compared to pre-donation water only (low-certainty evidence). CONCLUSIONS Pre-donation plain water ingestion or isotonic drink probably results in a large reduction in on-site and off-site VVRs. Pre-donation water ingestion with caffeine consumption or salt supplementation may result in a VVR reduction, compared to water ingestion only. Future large trials are required to increase the certainty of the effect of these and other interventions in the prevention of VVRs.
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Affiliation(s)
- Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | | | - Dieter Maes
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Jina Khoudary
- Belgian Red Cross, Blood Services, Mechelen, Belgium
| | | | - Pierre Tiberghien
- Etablissement Français du Sang, La Pleine St Denis, France
- EFS, INSERM, UMR Right, Université de Franche-Comté, Ghent, Besançon, France
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Veerle Compernolle
- Belgian Red Cross, Blood Services, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Balaskas S, Rigou M, Xenos M, Mallas A. Behavioral Intentions to Donate Blood: The Interplay of Personality, Emotional Arousals, and the Moderating Effect of Altruistic versus Egoistic Messages on Young Adults. Behav Sci (Basel) 2024; 14:731. [PMID: 39199127 PMCID: PMC11351904 DOI: 10.3390/bs14080731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/01/2024] Open
Abstract
Human blood is one of the most valuable and irreplaceable goods in modern medicine. Although its necessity increases daily, one of the most significant challenges we have to overcome is a scarcity of willing blood donors. Volunteer motives and attitudes have been studied for decades, but it is now considered vital to grasp the many aspects that will increase the effectiveness of attracting new blood donors. This study focuses on the impact of emotional arousal produced by advertising messages, as well as the determining role of altruistic and egoistic incentives in deciding behavior. We also incorporated the element of personality to investigate how personality traits influence behavioral intention to donate blood. To this end, a quantitative non-experimental correlational 2 × 2 experimental design (positive vs. negative emotional appeal; altruistic vs. egoistic message) was implemented with the participation of 462 respondents who were shown a total of 12 advertisements (ads) promoting blood donation. The data were analyzed using structural equation modeling, with a focus on the direct impacts on donation intentions, the role of emotional arousals and attitude towards the ads as mediators and the moderating effect of the message. The empirical results of our hypotheses revealed that only Honesty-Humility had a strong direct impact on behavioral intention to donate, while Emotionality and Agreeableness did not have any direct effect. On the other hand, attitudes towards advertisements significantly and directly influenced positive and negative emotional arousals, respectively. Furthermore, if we consider these two variables alone, they can be found to exert a direct impact on BI. Mediation analysis showed that attitudes towards the advertisements and emotional arousals partially mediated the relation between Honesty-Humility and Behavioral Intention, thus confirming partial mediation. With respect to Emotionality and Agreeableness, mediation was found to be full since these factors only affected BI through a mediated path, which confirmed full mediation. Furthermore, the moderation analysis highlighted that the type of message (altruistic vs. egoistic) significantly moderated the relationship between both emotional arousals and BI. In particular, positive emotional arousal's influence is strengthened when it is aligned with altruistic messages, while negative emotional arousal's influence is weakened if it follows an altruistic message. These findings illustrate that using positive emotions will be more beneficial for increasing people's donation intentions than bringing negative ones, which implies that message framing has a hidden impact on donation decisions.
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Affiliation(s)
- Stefanos Balaskas
- Department of Management Science and Technology, University of Patras, 26334 Patras, Greece;
| | - Maria Rigou
- Department of Management Science and Technology, University of Patras, 26334 Patras, Greece;
| | - Michalis Xenos
- Department of Computer Engineering and Informatics, University of Patras, 26504 Patras, Greece; (M.X.); (A.M.)
| | - Andreas Mallas
- Department of Computer Engineering and Informatics, University of Patras, 26504 Patras, Greece; (M.X.); (A.M.)
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Thijsen A, Gemelli CN, Hyde MK, Thorpe R, Masser BM. A rapid review of strategies to manage low iron levels in adults donating whole-blood: A focus on donor behaviour. Transfus Med 2024; 34:243-256. [PMID: 39031713 DOI: 10.1111/tme.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/21/2024] [Accepted: 06/11/2024] [Indexed: 07/22/2024]
Abstract
In recognition of the impact of whole-blood donation on body iron stores, there has been an increased focus assessing the efficacy of strategies to minimise the risk of iron deficiency (ID). Whilst donor behaviour is an important determinant of success, this literature is yet to be fully synthesised to help guide blood collection agencies when implementing these strategies into routine practice. This rapid review identifies strategies for management of low iron, how they have been communicated to donors, donor compliance with advice, donor use of external health services and their effect on donor retention. Web of Science, Medline, CINAHL and Wiley online library databases were searched from 2012 to November 2023, with 29 studies meeting inclusion criteria. Five iron management strategies were identified: oral iron supplementation (IS), education, dietary advice, lengthening inter-donation interval and switching donation type. Most studies (n = 16) focused on IS, with only four reporting how they communicated this to donors. Donor use of IS was high in controlled research environments but has not been evaluated when implemented into routine practice. None of the four studies on dietary advice included findings on donor acceptability. The proportion of donors consulting their doctor about a low iron result or their risk of ID was found to be suboptimal. However, in general, the identified strategies and communications had a positive effect on donor retention. More evidence is needed on how to increase donor knowledge and awareness of donation-related risk of ID as well as to identify how to effectively communicate strategies to donors to ensure optimal acceptability and use.
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Affiliation(s)
- Amanda Thijsen
- Research & Development, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Carley N Gemelli
- Research & Development, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Melissa K Hyde
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Rachel Thorpe
- Research & Development, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Barbara M Masser
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Research & Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
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Aydogan M, Yuksel M, Akal F, Kurt Yuksel M. A Teleconference With Related Donors Years After Allogeneic Hematopoietic Stem Cell Transplantation. EXP CLIN TRANSPLANT 2024; 22:559-567. [PMID: 39223814 DOI: 10.6002/ect.2023.0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVES During and after allogeneic hematopoietic stem cell donation, donors may experience adverse events. This situation can increase anxiety of candidate donors. Time to return to daily life routine and work, presentation of comorbid diseases in follow-up, and donor opinions are topics of interest. MATERIALS AND METHODS We conducted a 14-question survey among related stem cell donors between January 2010 and March 2019 by telephone interview. RESULTS Of 257 related donors, 175 (68.1%) were interviewed; 87 (49.7%) were female and 88 (50.3%) were male. Among donors interviewed, 144 (82.3%) donated from only peripheral blood. After harvesting of stem cells, adverse events included hip pain (38.7%), bone pain (57.2%) during mobilization, and paresthesia (28.9%) during apheresis. After apheresis, 2 serious adverse events were reported in 2 (1.3%) female donors (1 salpingo-oophorectomy and 1 nephrectomy). Splenomegaly was observed in 1 male donor (0.7%). Among donors interviewed, 77 (44%) reported being able to perform daily activities on the same day. The shortest time to daily activity was in the peripheral blood group, and the longest was in the bone marrow group (P = .001). Among working donors, 23 (27.4%) returned to work on the same day; all were peripheral blood donors. Among donors interviewed, 114 (65.1%) wanted to volunteer to donate again. One donor (0.6%) expressed guilt after donation, and 162 (92.6%) recommended other people to be stem cell donors. During the follow-up period, musculoskeletal-joint diseases increased after donation (P = .012). CONCLUSIONS It is important to raise awareness in society about stem cell donation and to reduce the concerns among donor candidates. Although most of the adverse events after donation are temporary and mild, a few serious adverse events in donors have been observed. Stem cell donation does not cause loss of daily activity or inability to return to the work force.
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Affiliation(s)
- Merve Aydogan
- >From the Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey
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Mol BM, Verwer MC, Fijnheer R, Florie J, Groot OA, Hietbrink F, Nijkeuter M, Vonken EJPA, van Weel V, de Kleijn DPV, de Borst GJ. Predictors of bleeding complications during catHeter-dirEcted thrombolysis for peripheral arterial occlusions (POCHET). PLoS One 2024; 19:e0302830. [PMID: 38722842 PMCID: PMC11081216 DOI: 10.1371/journal.pone.0302830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/13/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION The risk of major bleeding complications in catheter directed thrombolysis (CDT) for acute limb ischemia (ALI) remains high, with reported major bleeding complication rates in up to 1 in every 10 treated patients. Fibrinogen was the only predictive marker used for bleeding complications in CDT, despite the lack of high quality evidence to support this. Therefore, recent international guidelines recommend against the use of fibrinogen during CDT. However, no alternative biomarkers exist to effectively predict CDT-related bleeding complications. The aim of the POCHET biobank is to prospectively assess the rate and etiology of bleeding complications during CDT and to provide a biobank of blood samples to investigate potential novel biomarkers to predict bleeding complications during CDT. METHODS The POCHET biobank is a multicentre prospective biobank. After informed consent, all consecutive patients with lower extremity ALI eligible for CDT are included. All patients are treated according to a predefined standard operating procedure which is aligned in all participating centres. Baseline and follow-up data are collected. Prior to CDT and subsequently every six hours, venous blood samples are obtained and stored in the biobank for future analyses. The primary outcome is the occurrence of non-access related major bleeding complications, which is assessed by an independent adjudication committee. Secondary outcomes are non-major bleeding complications and other CDT related complications. Proposed biomarkers to be investigated include fibrinogen, to end the debate on its usefulness, anti-plasmin and D-Dimer. DISCUSSION AND CONCLUSION The POCHET biobank provides contemporary data and outcomes of patients during CDT for ALI, coupled with their blood samples taken prior and during CDT. Thereby, the POCHET biobank is a real world monitor on biomarkers during CDT, supporting a broad spectrum of future research for the identification of patients at high risk for bleeding complications during CDT and to identify new biomarkers to enhance safety in CDT treatment.
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Affiliation(s)
- Barend M. Mol
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten C. Verwer
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rob Fijnheer
- Department of Hematology, Meander Medical Center, Amersfoort, The Netherlands
| | - Jasper Florie
- Department of Interventional Radiology, Meander Medical Center, Amersfoort, The Netherlands
| | - Oscar A. Groot
- Intensive Care Department, Meander Medical Center, Amersfoort, The Netherlands
| | - Falco Hietbrink
- Department Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mathilde Nijkeuter
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Evert-Jan P. A. Vonken
- Department of Interventional Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vincent van Weel
- Department of Vascular Surgery, Meander Medical Center, Amersfoort, The Netherlands
| | | | - Gert J. de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
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Meher R, Patidar GK, Chaurasia R, Pandey HC, Hazarika A. Prevention strategies for vasovagal reaction in whole blood donors: A quadri-armed randomised control trial. Transfus Med 2024; 34:20-29. [PMID: 38165089 DOI: 10.1111/tme.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/10/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Vasovagal reaction (VVR) is a frequently encountered generalised donor adverse reaction, associated with donor deterrence towards future donation. Several mitigation strategies for prevention of VVR were tried but still not standardised. This quadri-armed randomised study evaluated the utility of water ingestion, applied muscle tension (AMT) and combination of both in preventing the VVR among blood donors. METHODS A quadri-armed randomised controlled trial was performed on 4320 whole blood donors. Blood donors of 18-65 years of age were randomised into four groups based on the interventions performed i.e., control with no intervention (Group 1, n = 1081), water ingestion (Group 2, n = 1082), AMT (Group 3, n = 1070) and combined intervention (Group 4, n = 1087). VVR during and immediately after blood donation were observed along with assessment of risk factors in blood donors and the effectiveness of interventions were analysed. RESULTS The incidence of VVR observed 1.6% in our study, with the highest occurrence in the control group (2.5%) and the lowest in the combined intervention group (0.9%). Multivariable logistic regression revealed that the control group donors faced a 1.38-fold greater risk of VVR compared to those receiving interventions (OR: 1.38, 95% CI: 1.10-1.75). Other risk factors included younger age (OR: 1.5, 95% CI: 1.05-2.17), first-time donation (OR: 5.7, 95% CI: 1.66-5.74), prior history of VVR (OR: 2.5, 95% CI: 10.4-101.52). DISCUSSION/CONCLUSION The combined approach of water ingestion and AMT proved significantly more effective in VVR prevention compared to individual interventions.
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Affiliation(s)
- Radheshyam Meher
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Gopal Kumar Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Chaurasia
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Pandey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anjali Hazarika
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
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Jiang Y, Lin J, Ding R, Li L, Chi H, Zhang L, Xia X, Yu Y, Pi H. A new risk predictive scoring system of vasovagal reactions in patients with preoperative autologous blood donation. Transfus Apher Sci 2023; 62:103791. [PMID: 37633760 DOI: 10.1016/j.transci.2023.103791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Vasovagal response (VVR) is the most common adverse reaction during blood donation and it is the main element for the safety of the patients with preoperative autologous blood donation (PABD). Accurate identification high-risk group is of great significance for PABD. Our study aimed to establish a scoring system based on the nomogram to screen the high-risk population and provide evidence for preventing the occurrence of VVRs. MATERIALS AND METHODS A number of 4829 patients underwent PABD between July 2017 and June 2020 in the first medical center of Chinese PLA Hospital were recruited, 3387 of whom were included in the training group (70 %; 108 VVRs patients vs 3279 Non-VVRs patients), 1442 were included in the validation group (30 %; 46 VVRs patients vs 1396 Non-VVRs patients). The data were analyzed by univariate and multivariate logistic regression. The nomogram of the scoring system was created by using the RMS tool in R software. RESULTS Seven variables including BMI, hematocrit, pre-phlebotomy heart rate and systolic blood pressure, history of blood donation, age group and primary disease were selected to build the nomogram, which was shown as prediction model. And the score was 0-1 for BMI, 0-2 for hematocrit, systolic blood pressure, heart rate and no blood donation history, 0-10 for age, 0-3 for primary disease. When the total cutoff score was 11, the predictive system for identifying VVRs displayed higher diagnostic accuracy. The area under the curve, specificity, and sensitivity of the training group were 0.942, 82.41 % and 97.17 %, respectively, whereas those of the validation group were 0.836, 78.26 % and 78.15 %, respectively. CONCLUSION A risk predictive scoring system was successfully developed to identify high-risk VVRs group form PABD patients that performed well.
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Affiliation(s)
- Ying Jiang
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jie Lin
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ruiqing Ding
- Key Lab of High Confidence Software Technologies (Peking University), Ministry of Education School of Computer Science, Peking University, Beijing, China
| | - Lingling Li
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongxu Chi
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Leiying Zhang
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xingqiu Xia
- Beijing HealSci Technology Co., Ltd., Beijing, China
| | - Yang Yu
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Hongying Pi
- Health Service Training Center, Chinese PLA General Hospital, Beijing, China.
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Zhao P, Dong D, Dong R, Zhou Y, Hong Y, Xiao G, Li Z, Su X, Zheng X, Liu X, Zhang D, Li L, Liu Z. Development and validation of a nomogram for predicting the risk of vasovagal reactions after plasma donation. J Clin Apher 2023; 38:622-631. [PMID: 37466252 DOI: 10.1002/jca.22074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Vasovagal reactions (VVRs) are the most common adverse reactions and are frequently associated with serious donor adverse events. Even mild VVRs can lead to a significant reduction in the likelihood of subsequent donations. The purpose of this study is to explore the factors related to the occurrence of VVRs after plasma donation and to construct a nomogram to identify individuals at risk for VVRs to improve the safety of plasma donors. MATERIALS AND METHODS We collected the donation data from July 2019 to June 2020 from a plasma center in Sichuan, China, to explore the independent risk factors for vasovagal reactions. From these data, we constructed and validated a predictive model for vasovagal reactions. RESULTS VVRs after plasma donation occurred 737 times in 120 448 plasma donations (0.66%). Gender, season, donor status, weight, pulse, duration of donation, and cycle were independent risk factors for VVRs (P< 0.05). The concordance index (C-index) of a logistic model in the derivation cohort was 0.916, with a Hosmer-Lemeshow goodness-of-fit probability of 0.795. The C-index of a logistic model in the validation cohort was 0.916, with a Hosmer-Lemeshow goodness-of-fit probability of 0.224. The calibration curve showed that the predicted results were in good agreement with the actual observed results. CONCLUSION This study preliminarily constructed and verified a prediction model for VVRs after plasma donation. The model nomogram is practical and can identify high-risk donors.
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Affiliation(s)
- Peizhe Zhao
- Department of Blood Transfusion, Taiyuan Blood Center, Taiyuan, Shanxi Province, People's Republic of China
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, People's Republic of China
- Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan Province, People's Republic of China
| | - Demei Dong
- Department of Quality Control, Beijing Tiantan Biological Products Co., Ltd, Beijing, People's Republic of China
| | - Rong Dong
- Department of Plasma Apheresis, Jianyang Rongsheng Apheresis Plasma Co., Ltd, Jianyang, Sichuan Province, People's Republic of China
| | - Yuan Zhou
- Department of Blood Transfusion, Taiyuan Blood Center, Taiyuan, Shanxi Province, People's Republic of China
| | - Yan Hong
- Department of Plasma Apheresis, Shifang Rongsheng Apheresis Plasma Co., Ltd, Shifang, Sichuan Province, People's Republic of China
| | - Guanglin Xiao
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, People's Republic of China
| | - Zhiye Li
- Department of Blood Transfusion, Taiyuan Blood Center, Taiyuan, Shanxi Province, People's Republic of China
| | - Xuelin Su
- Department of Plasma Apheresis, Jianyang Rongsheng Apheresis Plasma Co., Ltd, Jianyang, Sichuan Province, People's Republic of China
| | - Xingyou Zheng
- Department of Plasma Apheresis, Jianyang Rongsheng Apheresis Plasma Co., Ltd, Jianyang, Sichuan Province, People's Republic of China
| | - Xia Liu
- Department of Plasma Apheresis, Jianyang Rongsheng Apheresis Plasma Co., Ltd, Jianyang, Sichuan Province, People's Republic of China
| | - Demei Zhang
- Department of Blood Transfusion, Taiyuan Blood Center, Taiyuan, Shanxi Province, People's Republic of China
| | - Ling Li
- Department of Blood Transfusion, Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan Province, People's Republic of China
| | - Zhong Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, People's Republic of China
- Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan Province, People's Republic of China
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Rudokaite J, Ong LLS, Onal Ertugrul I, Janssen MP, Huis In 't Veld EMJ. Predicting vasovagal reactions to needles with anticipatory facial temperature profiles. Sci Rep 2023; 13:9667. [PMID: 37316637 DOI: 10.1038/s41598-023-36207-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/31/2023] [Indexed: 06/16/2023] Open
Abstract
Around one-third of adults are scared of needles, which can result in adverse emotional and physical responses such as dizziness and fainting (e.g. vasovagal reactions; VVR) and consequently, avoidance of healthcare, treatments, and immunizations. Unfortunately, most people are not aware of vasovagal reactions until they escalate, at which time it is too late to intervene. This study aims to investigate whether facial temperature profiles measured in the waiting room, prior to a blood donation, can be used to classify who will and will not experience VVR during the donation. Average temperature profiles from six facial regions were extracted from pre-donation recordings of 193 blood donors, and machine learning was used to classify whether a donor would experience low or high levels of VVR during the donation. An XGBoost classifier was able to classify vasovagal groups from an adverse reaction during a blood donation based on this early facial temperature data, with a sensitivity of 0.87, specificity of 0.84, F1 score of 0.86, and PR-AUC of 0.93. Temperature fluctuations in the area under the nose, chin and forehead have the highest predictive value. This study is the first to demonstrate that it is possible to classify vasovagal responses during a blood donation using temperature profiles.
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Affiliation(s)
- Judita Rudokaite
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands.
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.
- Department of Cognitive Science & Artificial Intelligence, Tilburg University, PO Box 90153, Warandelaan 2 (Room D147), 5000 LE, Tilburg, The Netherlands.
| | - L L Sharon Ong
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | - Itir Onal Ertugrul
- Department of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands
| | - Mart P Janssen
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Elisabeth M J Huis In 't Veld
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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Kim YJ, Cho JH. A study on blood donor characteristics and preferred environment of South Koreans during the COVID-19 pandemic: A conjoint analysis. Front Public Health 2023; 11:1138430. [PMID: 37006588 PMCID: PMC10056210 DOI: 10.3389/fpubh.2023.1138430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
ObjectiveThe COVID-19 pandemic has caused a decrease in the number of blood donors worldwide, posing a global problem. Therefore, this study investigates people who have continuously participated in blood donation during the COVID-19 pandemic and collects basic information as a reference for maintaining stable amounts of blood during future pandemics.MethodsThe participants of this study were selected from the population of South Korea through stratified sampling considering region and age distributions. Owing to the COVID-19 pandemic, the participants were recruited online through Embrain, an online research and survey company, from June 1 to June 28, 2021. Data were collected from a total of 1,043 participants and used in the study.ResultsThe results of this study showed that there was a difference between the donors group and non-donors group in factors such as donation attitude (F = 73.342, p < 0.001), donation knowledge (F = 6.530, p < 0.01), and preventive health behavior (F = 12.352, p < 0.001). Overall, blood donors showed favorable attitude toward and considerable knowledge of blood donation as well as a high level of preventive health behavior. The environment most preferred by people who participated in blood donation during the COVID-19 pandemic was “going with family to a blood donation center that gives out free gifts in a region far away with no confirmed cases,” which showed the highest utility (utility = 0.734).ConclusionEven during pandemics, donation attitude, donation knowledge, and preventive health behavior can serve as key factors affecting participation in blood donation. Additionally, blood donation centers that donors can visit with their families represent a favorable environment for the promotion of blood donation during pandemics.
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Predicting Vasovagal Reactions to Needles from Facial Action Units. J Clin Med 2023; 12:jcm12041644. [PMID: 36836177 PMCID: PMC9965413 DOI: 10.3390/jcm12041644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Merely the sight of needles can cause extreme emotional and physical (vasovagal) reactions (VVRs). However, needle fear and VVRs are not easy to measure nor prevent as they are automatic and difficult to self-report. This study aims to investigate whether a blood donors' unconscious facial microexpressions in the waiting room, prior to actual blood donation, can be used to predict who will experience a VVR later, during the donation. METHODS The presence and intensity of 17 facial action units were extracted from video recordings of 227 blood donors and were used to classify low and high VVR levels using machine-learning algorithms. We included three groups of blood donors as follows: (1) a control group, who had never experienced a VVR in the past (n = 81); (2) a 'sensitive' group, who experienced a VVR at their last donation (n = 51); and (3) new donors, who are at increased risk of experiencing a VVR (n = 95). RESULTS The model performed very well, with an F1 (=the weighted average of precision and recall) score of 0.82. The most predictive feature was the intensity of facial action units in the eye regions. CONCLUSIONS To our knowledge, this study is the first to demonstrate that it is possible to predict who will experience a vasovagal response during blood donation through facial microexpression analyses prior to donation.
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12
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Ibrahim NN, Mohd Noor NH, Zulkafli Z. Prevalence and factors associated with vasovagal reaction among whole blood donors in hospital Universiti Sains Malaysia. Transfus Clin Biol 2023; 30:238-243. [PMID: 36702200 DOI: 10.1016/j.tracli.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
Adverse donor reactions (ADR) are common to occur during the blood donation process. The most common is vasovagal reactions (VVR) and it cause negative impact in the donor return rate. The aim of this study is to determine the prevalence of VVR among blood donors and to study its associated factors, at Hospital University Sains Malaysia (USM). This retrospective case-control study was conducted from June 2018, until June 2021. Data was extracted from the blood bank database system and from donor adverse reaction form. Donors who developed adverse donor reactions were chosen and without VVR were chosen at random as controls. A total of 159 donors, out of 35 134 donors were reported to have VVR which resulted in an overall prevalence of 0.45 %. Dizziness or mild VVR were the most frequently observed adverse reactions, accounting for approximately 87/159 (54.7 %) of all adverse reactions. Multiple logistic regression (MLR) analysis showed VVR were significantly associated with age, female gender, first-time donor, and 450 ml volume of blood collected. The prevalence of vasovagal reactions among blood donors in this study was low which was similar to a few previous studies. Although it was low, still it is very important to reduce risks to a minimum so that the donor return rate could be maintained. The information regarding its associated factors can be used to identify high-risk donors to prevent the incidence in the future.
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Affiliation(s)
- Nur Nasuha Ibrahim
- Department of Hematology and Transfusion Medicine Unit, School of Medical Science, Health Campus, University Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Noor Haslina Mohd Noor
- Department of Hematology and Transfusion Medicine Unit, School of Medical Science, Health Campus, University Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Zefarina Zulkafli
- Department of Hematology and Transfusion Medicine Unit, School of Medical Science, Health Campus, University Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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13
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Lewin A, Deschênes J, Rabusseau I, Thibeault C, Renaud C, Germain M. Pre-donation water and salty snacks to prevent vasovagal reactions among blood donors. Transfusion 2023; 63:156-162. [PMID: 36345887 DOI: 10.1111/trf.17173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Minimizing the risk of vasovagal reactions (VVRs) can prevent donor harms and improve donor return. We report the results of a program to reduce VVR rates. STUDY DESIGN AND METHODS The program was implemented on June 11, 2017 and consisted in drinking water and eating a salty snack before donating blood, plasma, or platelets. All donations made during the "pre-program period" (October 11, 2015-June 10, 2017) and "post-program period" (June 11, 2017-May 11, 2019) were included. Study outcomes comprised VVRs (any severity) and syncopal VVRs, whether employee- or donor-reported. An interrupted time series (ITS) analysis proxied causality based on the "pre-program trend," the "immediate trend" (i.e., immediately before versus after the program), and the "post-program trend". The relative risk (RR) of VVR (along with confidence intervals [CIs]) was reported, overall and stratified by subgroups based on age, sex, donor type (i.e., first-time versus repeat), and donation type (i.e., whole blood versus apheresis). RESULTS The monthly VVR rate (any severity) dropped from 4.6% in the pre-program period to 4.3% in the post-program period, and never reached its pre-program level. The ITS analysis revealed a statistically significant and increasing pre-program trend (RR [95% CI] = 1.011 [1.002-1.020]), a statistically significant and decreasing immediate trend (RR [95% CI] = 0.848 [0.743-0.969]), and a non-statistically-significant and stable post-program trend (RR [95% CI] = 0.999 [0.993-1.006]). Similar trends were observed for nearly all high- and low-risk subgroups. No statistically significant trend was observed for syncopal VVRs. DISCUSSION These results suggest that the herein-described program durably reduced the incidence of VVRs (any severity) by ~15%.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada.,Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jessyka Deschênes
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Isabelle Rabusseau
- Medical Affairs and Innovation, Héma-Québec, Québec City, Quebec, Canada
| | | | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Québec City, Quebec, Canada
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14
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Thijsen A, Masser B, Davison TE, van Dongen A, Williams LA. Beyond fear: A longitudinal investigation of emotions and risk of a vasovagal reaction in first-time whole-blood donors. Transfusion 2023; 63:163-170. [PMID: 36310443 DOI: 10.1111/trf.17169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Fear is a recognized predictor of vasovagal reactions (VVRs) in blood donors. However, less is known about the role of other emotions, including positive emotions, that donors might experience. The aim of this study was to identify the emotions experienced in center that predict onsite VVRs, and to determine at what point during the donation appointment, the experience of these emotions is most influential. STUDY DESIGN AND METHODS A sample of 442 first-time whole-blood donors (57.7% female; mean ± SD age 30.7 ± 11.7 years) completed a survey in the waiting area and before venepuncture in the donation chair to assess their current emotional experience. The survey data were matched with routinely-collected demographic, donation, and donor adverse event information. A generalized estimating equations model was used to identify emotions associated with the occurrence of a VVR. RESULTS A total of 56 (12.7%) participants experienced a VVR. The occurrence of a VVR was significantly associated with lower love/closeness/trust (OR: 0.53, 95%CI: 0.34-0.82) and higher scared/fearful/afraid (OR: 1.96, 95%CI: 1.18-3.25) states. Significant interaction effects suggested that the effect of scared/fearful/afraid decreased while stressed/nervous/overwhelmed increased from the waiting area to before venepuncture on the likelihood of a VVR. DISCUSSION To effectively reduce donor VVR risk, blood collection agencies need to address a broader range of emotions at different points during the donation process.
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Affiliation(s)
- Amanda Thijsen
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia.,Monash Art, Design and Architecture, Monash University, Melbourne, Victoria, Australia
| | - Anne van Dongen
- Psychology, Health, and Technology, Twente University, Enschede, the Netherlands
| | - Lisa A Williams
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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15
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Liu B, Dong D, Wang Z, Gao Y, Yu D, Ye S, Du X, Ma L, Cao H, Liu F, Zhang R, Li C. Analysis of influencing factors of serum total protein and serum calcium content in plasma donors. PeerJ 2022; 10:e14474. [PMID: 36523465 PMCID: PMC9745925 DOI: 10.7717/peerj.14474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022] Open
Abstract
Background and objectives The adverse effects of plasma donation on the body has lowered the odds of donation. The aim of this study was to investigate the prevalence of abnormal serum calcium and total serum protein related to plasma donation, identify the influencing factors, and come up with suggestions to make plasma donation safer. Methods Donors from 10 plasmapheresis centers in five provinces of China participated in this study. Serum samples were collected before donation. Serum calcium was measured by arsenazo III colorimetry, and the biuret method was used for total serum protein assay. An automatic biochemical analyzer was used to conduct serum calcium and total serum protein tests. Results The mean serum calcium was 2.3 ± 0.15 mmol/L and total serum protein was 67.75 ± 6.02 g/L. The proportions of plasma donors whose serum calcium and total serum protein were lower than normal were 20.55% (815/3,966) and 27.99% (1,111/3,969), respectively. There were significant differences in mean serum calcium and total serum protein of plasma donors with different plasma donation frequencies, gender, age, regions, and body mass index (BMI), (all p < 0.05). Logistic regression analysis revealed that donation frequencies, age, BMI and regions were significantly associated with a higher risk of low serum calcium level, and donation frequencies, gender, age and regions were significant determinants factors of odds of abnormal total serum protein. Conclusions Donation frequencies, gender, age, regions, and BMI showed different effects on serum calcium and total serum protein. More attention should be paid to the age, donation frequency and region of plasma donors to reduce the probability of low serum calcium and low total serum protein.
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Affiliation(s)
- Bin Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Demei Dong
- Beijing Tiantan Biological Products Co., Ltd, Chengdu, China
| | - Zongkui Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Yang Gao
- Beijing Tiantan Biological Products Co., Ltd, Chengdu, China
| | - Ding Yu
- Rongsheng Pharmaceuticals Co., Ltd, Chengdu, China
| | - Shengliang Ye
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Xi Du
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Li Ma
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Haijun Cao
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Fengjuan Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Rong Zhang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
| | - Changqing Li
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
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16
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Hofmann A, Shander A, Blumberg N, Hamdorf JM, Isbister JP, Gross I. Patient Blood Management: Improving Outcomes for Millions While Saving Billions. What Is Holding It Up? Anesth Analg 2022; 135:511-523. [PMID: 35977361 DOI: 10.1213/ane.0000000000006138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Patient blood management (PBM) offers significantly improved outcomes for almost all medical and surgical patient populations, pregnant women, and individuals with micronutrient deficiencies, anemia, or bleeding. It holds enormous financial benefits for hospitals and payers, improves performance of health care providers, and supports public authorities to improve population health. Despite this extraordinary combination of benefits, PBM has hardly been noticed in the world of health care. In response, the World Health Organization (WHO) called for its 194 member states, in its recent Policy Brief, to act quickly and decidedly to adopt national PBM policies. To further support the WHO's call to action, this article addresses 3 aspects in more detail. The first is the urgency from a health economic perspective. For many years, growth in health care spending has outpaced overall economic growth, particularly in aging societies. Due to competing economic needs, the continuation of disproportionate growth in health care spending is unsustainable. Therefore, the imperative for health care leaders and policy makers is not only to curb the current spending rate relative to the gross domestic product (GDP) but also to simultaneously improve productivity, quality, safety of patient care, and the health status of populations. Second, while PBM meets these requirements on an exceptional scale, uptake remains slow. Thus, it is vital to identify and understand the impediments to broad implementation. This includes systemic challenges such as the so-called "waste domains" of failure of care delivery caused by malfunctions of health care systems, failure of care coordination, overtreatment, and low-value care. Other impediments more specific to PBM are the misperception of PBM and deeply rooted cultural patterns. Third, understanding how the 3Es-evidence, economics, and ethics-can effectively be used to motivate relevant stakeholders to take on their respective roles and responsibilities and follow the urgent call to implement PBM as a standard of care.
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Affiliation(s)
- Axel Hofmann
- From the Faculty of Health and Medical Sciences, Discipline of Surgery, The University of Western Australia, Perth, Western Australia, Australia.,Institute of Anesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Aryeh Shander
- Department of Anesthesiology, Critical Care and Hyperbaric Medicine, Englewood Health, Englewood, New Jersey.,College of Medicine, University of Florida, Gainesville, Florida.,School of Medicine at Mount Sinai, New York, New York.,Rutgers University, Newark, New Jersey
| | - Neil Blumberg
- Department of Pathology and Laboratory Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Jeffrey M Hamdorf
- From the Faculty of Health and Medical Sciences, Discipline of Surgery, The University of Western Australia, Perth, Western Australia, Australia
| | - James P Isbister
- School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Irwin Gross
- Department of Medicine, Eastern Maine Medical Center, Bangor, Maine
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17
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Esefeld M, Sümnig A, Alpen U, Grabe HJ, Greinacher A. A Cross-Sectional Study of Blood Donors' Psychological Characteristics over 8 Weeks. Transfus Med Hemother 2022; 49:67-74. [PMID: 35611382 PMCID: PMC9082199 DOI: 10.1159/000517566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/27/2021] [Indexed: 09/17/2023] Open
Abstract
Background Previous studies suggest that blood donation impacts blood donors' psychological state, with either positive or negative effects, such as feeling more energetic or more exhausted. It has not yet been described how long these effects last. Materials and Methods This prospective cohort study consisted of a qualitative and a quantitative part: (1) Psychological characteristics which changed after blood donation were identified by structured interviews of regular whole blood donors (n = 42). Based on this, a questionnaire addressing 7 psychological dimensions was established. (2) The psychological state of 100 blood donors was assessed after blood donation by applying the questionnaire 15-30 min before and during donation, as well as 15-30 min, 6 h, 24 h, 72 h, 1 week, and 8 weeks after donation. The resulting changes were summarized to a score. Furthermore, potential correlations of the score with pre-donation blood pressure, hemoglobin, or body mass index were calculated. Results Seven items were identified which changed in at least 25% of blood donors (mood, concentration, satisfaction, resilience, spirit of initiative, physical well-being, energy level). In the 100 blood donors, the well-being score increased (positive effects, n = 23), showed minor changes (n = 53), or decreased (negative effects, n = 24). The positive effects lasted for about 1 week and the negative effects for 3 days. Conclusion While the frequency of psychological effects following blood donation identified by our study was comparable to others, the changes of the psychological state in our donors were traceable for a longer period than previously acknowledged.
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Affiliation(s)
- Max Esefeld
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Ariane Sümnig
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
- MVZ Labor Greifswald GmbH, Greifswald, Germany
| | - Ulf Alpen
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Andreas Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
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18
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Abreu TAM, Oliveira AST, Ferreira RRF, Correia SMV, Morais MSSQ, Soares R, Flamínio M, Mesa-Sanchez I, Gopegui RR, de Matos AJF. Feline blood donation adverse reactions: classification and description of acute and delayed reactions in a donor population. J Feline Med Surg 2022; 24:284-289. [PMID: 34100661 PMCID: PMC10812243 DOI: 10.1177/1098612x211020295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This article aims to analyse the safety of feline blood donation by describing the frequency and nature of any adverse reactions and their causes, as well as propose measures to decrease the incidence of adverse reactions. METHODS In this prospective study, any blood donor adverse reactions detected by the clinical staff during and immediately after donation were recorded. The owners of the cats were also surveyed by a veterinary practitioner or veterinary nurse 5 days after donation, using a predefined questionnaire to assess for any clinical or behavioural changes. Data were collected between January 2019 and March 2020 from blood donors enrolled in an animal blood bank programme. RESULTS Of 3690 blood donations from 1792 feline donors assessed, post-donation reactions were reported in 1.14% (n = 42): 0.22% (n = 8) were acute reactions, which included weakness, pallor, tachypnoea and open-mouth breathing; and 0.92% (n = 34) were delayed post-donation reactions, with 0.16% involving cutaneous (haematomas and skin rashes, n = 6), 0.68% involving behavioural (n = 25) and 0.08% involving digestive (emesis and inappetence, n = 3) signs. CONCLUSIONS AND RELEVANCE The low incidence of post-donation reactions in this study is encouraging, suggesting that a well-established protocol and competent staff can help to ensure a high level of safety in a feline donor programme and, in turn, increase the confidence of cat owners.
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Affiliation(s)
- Tiago AM Abreu
- Animal Blood Bank, Porto, Portugal
- HVBJ – Hospital Veterinário Bom Jesus, Braga, Portugal
| | | | - Rui RF Ferreira
- Animal Blood Bank, Porto, Portugal
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências e Tecnologias Agrárias e Agro-Alimentares (ICETA), Universidade do Porto (UP), Portugal
| | | | | | | | | | | | - Rafael R Gopegui
- Department of Animal Medicine and Surgery, Veterinary Faculty, Autonomous University of Barcelona, Barcelona, Spain
| | - Augusto JF de Matos
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências e Tecnologias Agrárias e Agro-Alimentares (ICETA), Universidade do Porto (UP), Portugal
- Department of Veterinary Clinics, Institute for Biomedical Sciences of Abel Salazar, University of Porto, Porto, Portugal
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19
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de Farias CLG, de Oliveira Alves LB, Mendrone-Junior A, de Araújo Arrais C, Duran A, Rocha V, de Almeida-Neto C. The impact of immediate adverse donation reactions on the return of volunteers undergoing platelet apheresis. Transfus Apher Sci 2022; 61:103424. [DOI: 10.1016/j.transci.2022.103424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/22/2022] [Accepted: 03/13/2022] [Indexed: 11/25/2022]
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20
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Dietrich G. Optimierung der Depotführung für Erythrozytenkonzentrate in Krankenhäusern. TRANSFUSIONSMEDIZIN 2022. [DOI: 10.1055/a-1034-8719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungBlutdepots ohne eigene Herstellung müssen Versorgungssicherheit garantieren, dabei aber auch eine möglichst geringe Verfallsrate sicherstellen. Für die Anzahl der zu bevorratenden
Erythrozytenkonzentrate (EK) der verschiedenen Blutgruppen wird folgendes Berechnungsmodell gefunden: 1. Die örtliche Verteilung der AB0-Blutgruppen im Patientenkollektiv kann mit dem
Hardy-Weinberg-Gesetz auf Plausibilität überprüft werden. 2. Der Beobachtungszeitraum ist die durchschnittliche Restlaufzeit von der Lieferung bis zum Ende der Haltbarkeit. 3. Der
Erwartungswert für die Fallzahl transfundierter Patienten einer bestimmten Blutgruppe gehorcht einer Binomialverteilung. 4. Die Anzahl transfundierter Erythrozytenkonzentrate pro Patient ist
geometrisch verteilt. 5. Eine Matrix wird gebildet, deren Zellen das Produkt aus Fallzahl (3.) und EK pro Fall (4.) und somit die Anzahl der benötigten EK enthalten. Nur letztgenannte sind
für die Führung des Blutdepots interessant. Subtrahiert man die Zahl der im Beobachtungszeitraum (2.) benötigten EK von der Depotgröße, erhält man den Verfall. Der Vorrat von EK der
Blutgruppe 0 bemisst sich an der maximal zu erwartenden Zahl benötigter Konserven für einen Fall bis zur nächstmöglichen Lieferung, wenn der durchschnittliche Depotumsatz diesen Wert nicht
übersteigt. Er kann somit insbesondere in peripheren Krankenhäusern mit Akutversorgung die oben beschriebene Kalkulation deutlich überschreiten. Für Blutgruppe A gilt dieser Grundsatz nicht,
wenn auch kompatible (0 auf A) Transfusionen stattfinden sollen. Binomial ist bei kleiner Anzahl nach links – das heißt gegen Null – schief verteilt. Dies betrifft in jedem Fall AB, bei
jährlichem Depotumsatz unter ungefähr 1000 EK aber auch Blutgruppe B. Möchte man den Verfall vermeiden, darf man die betroffenen Blutgruppen nicht – zumindest nicht in dem notwendigen Umfang
– bevorraten und muss dann majorkompatibel transfundieren. Die Unterschiede der einzelnen AB0-Blutgruppen in Herstellung (Blutgruppenverteilung in der Spenderpopulation) und der Bevorratung
in Krankenhaus-Blutdepots sind hierin begründet. Entsprechende Überlegungen gelten gleichermaßen für den Rhesusfaktor D. Die oft emotional geführte Debatte über die zu bevorratende Anzahl an
EK kann mittels dieses mathematischen Modells auf eine rationale Grundlage zurückgeführt werden. Das Rechenmodell ist mit einem einfachen Tabellenkalkulationsprogramm möglich. Das Blutdepot
bestimmt damit den optimalen Bestand. Für die Blutspendedienste ergibt sich hieraus die Möglichkeit, die Kunden individuell, das heißt umsatzabhängig, zu beraten und gegebenenfalls den Preis
entsprechend zu gestalten. Im Rahmen der Qualitätssicherung können abteilungs- oder krankenhausspezifische Besonderheiten im Transfusionsverhalten dargestellt werden.
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21
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Rahman MM, Karki S, Hayen A. A methods review of the "healthy donor effect" in studies of long-term health outcomes in blood donors. Transfusion 2022; 62:698-712. [PMID: 34989411 DOI: 10.1111/trf.16791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Md Morshadur Rahman
- School of Public Health, University of Technology Sydney, Sydney, Australia.,Department of Statistics, University of Dhaka, Dhaka, Bangladesh.,Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Surendra Karki
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia.,School of Population Health, UNSW, Sydney, Australia
| | - Andrew Hayen
- School of Public Health, University of Technology Sydney, Sydney, Australia
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22
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Orru' S, Poetzsch K, Hoffelner M, Heiden M, Funk MB, Keller-Stanislawski B, Oberle D. Blood Donation-Related Adverse Reactions: Results of an Online Survey among Donors in Germany (2018). Transfus Med Hemother 2021; 48:272-283. [PMID: 34803571 DOI: 10.1159/000516049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/19/2021] [Indexed: 01/28/2023] Open
Abstract
Introduction According to German legislation, reports of suspected serious adverse reactions (AR) associated with the donation of blood and its components are continuously being evaluated by the Paul-Ehrlich-Institut. This survey aimed at providing a more complete picture of the AR associated with the donation of blood and blood components. Materials and Methods Eligible donors had the opportunity to anonymously report all AR occurring during or after their last donation by completing an online questionnaire. Reported AR were classified according to the Standard for Surveillance of Complications Related to Blood Donation. Donors' self-assessment of AR seriousness was compared with the official severity classification as laid down by German legislation. Besides a descriptive statistical analysis, a multiple logistic analysis was performed to identify risk factors for AR. Results A total of 8,138 data records were evaluated. Slightly more males (57.9%) participated in the survey and, except for donors aged ≥60 years, all age groups were equally represented. The majority of participants were whole blood donors (85.4%), repeat donors (97.2%), and stayed under observation in the blood establishment (BE) for more than 5 min (63.1%) after donation. Most participants did not report any reaction (72.5%), whereas 2,237 reported at least one AR (27.5%), 475 of whom underwent apheresis and 1,762 donated whole blood. Most AR occurred after leaving the BE (64.4%). Only a minority of participants required medical treatment (5.1%) or assessed the experienced AR as serious (3.9%). The most frequently reported donor AR were haematoma and other local reactions (57.6%). Vasovagal reactions without and with loss of consciousness were developed in 17 and 2% of the participants, respectively, whilst 7.6% experienced citrate reactions. New AR (i.e., allergic reactions and symptoms associated with iron deficiency) were reported as well. The occurrence of AR was linked to risk factors (i.e., female gender, young age, first-time donation, and thrombocytapheresis). Discussion This survey yielded a more comprehensive AR spectrum, revealed a prolonged time to symptom onset, and identified risk factors for AR. This novel information could be implemented in an amended informed consent addressing common and rare AR.
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Affiliation(s)
- Stefano Orru'
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Kay Poetzsch
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Marcus Hoffelner
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Margarethe Heiden
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Markus B Funk
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Doris Oberle
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
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Broadwater DR, Krause KA, Lynch DT, Kendelhardt JD. Are Bradycardic Donors More Likely to Have Adverse Outcomes During Blood Donation? Mil Med 2021; 188:e1018-e1021. [PMID: 34668966 DOI: 10.1093/milmed/usab416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/10/2021] [Accepted: 10/13/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION In order to decrease adverse donor reactions during blood donation, volunteers are screened to safely donate according to the U.S. Food and Drug Administration standards. Volunteers must be normocardic, with a pulse between 50 and 100 beats per minute. Bradycardic volunteers with a pulse lower than 50 beats per minute who otherwise meet requirements may donate with physician approval. Blood donors in military settings tend to be younger and more physically fit than the average donor population, resulting in a higher percentage of bradycardic donors. The relationship between bradycardia and adverse donor reactions has not been well studied. Herein, we aim to compare post-donation adverse reactions and the ability to complete donation between normocardic and bradycardic donors. MATERIALS AND METHODS Institutional review board approval was obtained. Records from a single blood donor center located on a large military installation in 2019 were retrospectively reviewed for vital signs, demographics, hemoglobin, and donor reactions. Donors were categorized as normocardic or bradycardic. The two groups were statistically compared using a χ2 test. RESULTS Of the 1,601 donors in the study period, 1,514 qualified for donation. Mean age was 26.6 years (range, 17-72 years), with a male to female ratio of 2.1:1. Of these, 1,478 were normocardic and 26 were bradycardic. There was no significant difference in adverse reactions between the two groups (5.6% in bradycardic donors versus 3.6% in normocardic donors, n = 1,514, χ21 = 0.39, P = .53) or percentage of incomplete donations (5.9% in bradycardic and 5.65% in normocardic, n = 1,514, χ21 = 0.003, P = .96). CONCLUSIONS Donors with bradycardia are as safe to donate as normocardic donors. In the absence of comorbidities, blood donor centers should ensure their policies consider donation for volunteers with bradycardia.
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Affiliation(s)
- Devin R Broadwater
- Department of Pathology and Area Laboratory Services, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), San Antonio, TX 78234, USA
| | - Katherine A Krause
- Department of Pathology and Area Laboratory Services, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), San Antonio, TX 78234, USA
| | - David T Lynch
- Department of Pathology and Area Laboratory Services, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), San Antonio, TX 78234, USA
| | - Jason D Kendelhardt
- Department of Pathology and Area Laboratory Services, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), San Antonio, TX 78234, USA
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24
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Gyuris P, Gáspár BG, Birkás B, Csókási K, Kocsor F. Help Is in Your Blood-Incentive to "Double Altruism" Resolves the Plasma Donation Paradox. Front Psychol 2021; 12:653848. [PMID: 34566745 PMCID: PMC8458749 DOI: 10.3389/fpsyg.2021.653848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022] Open
Abstract
Blood donation is considered as one of the purest forms of altruism. Plasma donation, in contrast, despite being a similar process, is mostly a paid activity in which donors are compensated for their contribution to the production of therapeutic preparations. This creates a so-called "plasma paradox:" If remuneration is promised for a socially useful effort, volunteers with altruistic motives might be deterred. At the same time, regular plasma donors who pursue the monetary benefits of donation might drop out if remuneration stops. The same controversy can be caught in the messages of most plasma donation companies as well: They promise a monetary reward (MR), and at the same time, highlight the altruistic component of donation. In this study, we tested the assumption that emphasizing the social significance enhances the willingness to donate blood plasma more effectively than either MR or the combination of these two incentives. This had to be rejected since there was no significant difference between the three scenarios. Furthermore, we also hypothesized that individuals might be more motivated to donate plasma if there is a possibility of offering an MR toward other socially beneficial aims. We found an increased willingness to donate in scenarios enabling "double altruism", that is, when donating plasma for therapeutic use and transferring their remuneration to nongovernmental organizations, is an option. We propose relying on double altruism to resolve the plasma paradox, and suggest that it could serve as a starting point for the development of more optimized means for donor recruitment.
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Affiliation(s)
- Petra Gyuris
- Institute of Psychology, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
| | - Baksa Gergely Gáspár
- Institute of Psychology, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
| | - Béla Birkás
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Krisztina Csókási
- Institute of Psychology, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
| | - Ferenc Kocsor
- Institute of Psychology, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
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25
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Fraile N, Fernández-Cano E, Ramos A, López-Aguilar JC, Jiménez-Moreno ME, Pereira A. Vasovagal syncope after blood donation in active duty military personnel of the Spanish Army. Transfusion 2021; 61:2925-2929. [PMID: 34414580 DOI: 10.1111/trf.16603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/11/2021] [Accepted: 07/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND All studies of vasovagal syncope (VVS) after blood donation have been performed with civilian donors. We hypothesized that military donors have a lower incidence of VVS and a particular set of predisposing factors. STUDY DESIGN AND METHODS Retrospective case-control study matching every case of VVS seen from 2011 to 2019 with two controls without VVS from the same blood drive. We used the odds ratio (OR) and its 95% confidence interval (CI), estimated by multivariate logistic regression, to identify independent predictors of VVS. RESULTS There were 105 episodes of VVS among 65.481 whole blood donations (0.15%). VVS was more frequent among donors from military academies than from other military units (0.37% vs. 0.10%, p < .001) and in collections conducted in mobile inside setups than in mobile buses (0.23% vs. 0.06%, p < .001). In the multivariate analysis, the only independent predictors of VVS were the status of first-time donor (OR 2.6, 95% CI 1.5-4.4; p < .001) and pre-donation systolic blood pressure (SBP) < 120 mm Hg (OR 1.9, 95% CI 1.1-3.3; p = .01). Donors with both risk factors had a 5.5-fold increased risk of VVS than donors without any risk factor. Age and female sex were not predictive of VVS. DISCUSSION Active duty military blood donors have a lower incidence of VVS than that reported in civilian donors. First-time donors and donors with SBP < 120 mm Hg should be temporarily deferred when immediate reincorporation to hazardous or strenuous duty tasks after donation is inescapable.
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Affiliation(s)
- Nuria Fraile
- Blood Transfusion Center of the Spanish Army, Madrid, Spain
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26
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Toss F, Zhao J, Sjölander A, Edgren G. Short-term health outcomes following whole blood donation: A nationwide, retrospective cohort study. Transfusion 2021; 61:2347-2355. [PMID: 33982278 DOI: 10.1111/trf.16445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blood donation is associated with a number of adverse events. Most of these are both uncommon and nonsevere, leading to mild discomfort for the donor at worst. However, adverse events occurring outside of the donation facility have largely not been studied. In this study, we aim to further the understanding by performing the first large-scale analysis of short-term risks following whole blood donation. METHODS We set up a nationwide cohort of donors who donated whole blood between 1987 and 2018. Analyses were conducted using conditional logistic regression in a self-comparison design, where each donor was compared only to themselves, considering the 30-day risk of 16 outcomes following whole blood donation. Outcomes included cardiac/vascular diseases such as myocardial infarction, unspecified conditions such as fainting, accidents or external causes of injury, and death. RESULTS A total of 963,311 donors were included; of whom, 19,670 experienced at least one of the outcomes within 30 days of a blood donation. For fainting and hypotonia, we observed transient 2- to 5-fold risk increases on the day of donation and the subsequent 2-3 days. Importantly, the risk increase for the most pronounced effect corresponded to less than one additional events of fainting per 200,000 blood donations. Risks of all other outcomes were either unaffected or lower than expected right after blood donation. DISCUSSION To conclude, we found no evidence of new or unexpected short-term health effects after blood donation and confirmed that risks of hypotension-related events requiring hospital care are present but small.
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Affiliation(s)
- Fredrik Toss
- Division of Clinical Immunology, Department of Clinical Microbiology, Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Jingcheng Zhao
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gustaf Edgren
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Södersjukhuset, Stockholm, Sweden
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27
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Sweegers MG, Twisk JWR, Quee FA, Ferguson E, van den Hurk K. Whole blood donors' post-donation symptoms diminish quickly but are discouraging: Results from 6-day symptom diaries. Transfusion 2021; 61:811-821. [PMID: 33483960 DOI: 10.1111/trf.16220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Whole blood donors may experience post-donation symptoms such as fatigue, dizziness, or headache after blood donation, which could influence donor retention. We aimed to examine post-donation symptoms during 1 week after whole blood donation, investigate donor characteristics associated with symptoms, and evaluate associations between symptoms and donor return. METHODS During 1 week, whole blood donors who donated successfully at one of the collection centers in The Netherlands were invited to participate. Three thousand seventy six donors filled in a diary, assessing post-donation symptoms during days 1 to 6 after donation. We used linear mixed models analyses to determine the change in post-donation symptoms after donation for male and female donors separately. Furthermore, we investigated associations between post-donation symptoms and donors' physical characteristics using multivariable regression and determined associations between symptoms and donor return. RESULTS Donors reported fatigue as the most common symptom, with approximately 3% of donors experiencing severe problems at the first day after donation. Multiple symptoms improved significantly up to day 3 after whole blood donation. Age, BMI, blood pressure (male donors), and blood volume (female donors) were significantly associated with post-donation symptoms. Donors with less fatigue after whole blood donation were more likely to return for their next donation within 31 days after receiving an invitation. CONCLUSION Post-symptoms improve up to 3 days after whole blood donation. Our results may help blood collection centers to identify donors more prone to post-donation symptoms and provide personalized information about the presence and course of post-donation symptoms, possibly increasing donor return rates.
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Affiliation(s)
- Maike G Sweegers
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Centre, Amsterdam, The Netherlands
| | - Franke A Quee
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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28
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Torreiter PP, Macher S, Matzhold EM, Resch B, Klaritsch P, Körmöczi GF, Polin H, Neuhold L, Schönbacher M, Schlenke P, Wagner T. Ethical Issues and Management of Fetal Hemolytic Anemia Caused by Anti-Rh17 in a Multipara with Rare -D- Phenotype. Transfus Med Hemother 2021; 48:183-187. [PMID: 34177424 DOI: 10.1159/000513124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 11/17/2020] [Indexed: 11/19/2022] Open
Abstract
Background The development of allo-anti-Rh17 (anti-Hr0) in a -D- phenotype whose red blood cells (RBCs) lack CcEe antigens is most likely triggered by transfusion, transplantation, or pregnancy. Gene conversion is the predominating factor in generating RHD-CE-D and RHCE-D-CE hybrids like -D-. Methods We report here immunohematological and obstetrical data from 2 of the 5 pregnancies of a 24-year-old woman presenting with the -D- phenotype with anti-Rh17. Blood group typing, antibody screening, antibody differentiation, direct antiglobulin test (DAT), and antibody titers were performed by routine gel technology and tube testing. Additionally, molecular genetic analysis was performed. Fetal surveillance was done by sonographic evaluation of the fetal middle cerebral artery peak systolic velocity (MCA-PSV). Results Blood group typing showed O, C-c-D+E-e- and the DAT was negative. DNA sequencing revealed homozygosity for an RHCE-D(3-9)-CE null allele. Anti-Rh17 titers in the fourth pregnancy remained between 1:8 and 1:128, and no signs for a fetal anemia were observed. However, in the fifth pregnancy, the antibody titers increased up to 1:4,096. Signs of moderate fetal anemia were detected and cesarean section was performed at 34 + 6 weeks of gestation. The newborn presented with hemolytic anemia (cord blood hemoglobin [Hb] = 8.5 mg/dL). She received 2 compatible (small) packed RBC concentrates, phototherapy, and intravenous immunoglobulins. Conclusion Our case shows that the risk for hemolytic complications increases with the number of pregnancies of sensitized women. Only people who also lack CcEe antigens are compatible as donors. The role of such rare donors as lifesavers, their freedom, and voluntariness conflict with the urgent need for compatible blood.
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Affiliation(s)
- Patrick P Torreiter
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Susanne Macher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Eva-Maria Matzhold
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Bernhard Resch
- Divison of Neonatology, Medical University of Graz, Graz, Austria
| | - Philipp Klaritsch
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Günther F Körmöczi
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Helene Polin
- Red Cross Transfusion Service of Upper Austria, Linz, Austria
| | - Leopold Neuhold
- Institute of Ethics and Sociology, University of Graz, Graz, Austria
| | - Marlies Schönbacher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
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29
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Gybel-Brask M, Nordsborg NB, Goetze JP, Johansson PI, Secher NH, Bejder J. The central blood volume as measured by thoracic electrical impedance and plasma proANP is not compromised by donation of 900 mL of blood in men. Transfus Med 2020; 30:450-455. [PMID: 33030269 DOI: 10.1111/tme.12727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate whether the donation of 900 mL of blood reduces the central blood volume (CBV) assessed by thoracic electrical impedance (TI) and plasma pro-atrial natriuretic peptide (proANP). BACKGROUND Donation of 450 mL of blood carries a 1% risk of a vasovagal reaction. Withdrawal of 900 mL of blood decreases cardiac output; however, the effect on CBV remains unknown. METHODS/MATERIALS A randomised, single-blinded, placebo-controlled, crossover design was used, where 21 healthy semi-recumbent men donated 2 × 450 mL blood or were sham-phlebotomised. Changes in CBV were estimated by proANP and TI at 1.5 (TI1.5 ) and 100 (TI100 ) kHz, reflecting extracellular volume and (regional) total body water, respectively, and the index value (IDX; 1/T1.5 -1/TI100 ) was used to estimate changes in intracellular (red cell) volume. Systolic, diastolic and mean arterial blood pressure; heart rate; stroke volume; cardiac output; and systemic vascular resistance were monitored. After completion of the study, 1000 mL of isotonic saline was infused. RESULTS Changes (mean% ± SD) in TI1.5 , TI100 and IDX were similar after 450 mL (-0.2 ± 1.6%, 0.0 ± 1.1%, -0.4 ± 10.1%) and 900 mL (0.1 ± 1.6%, 0.2 ± 1.5% and -2.0 ± 15.8%) of blood donation compared to after a sham donation of 450 mL (-0.9 ± 1.2%, -0.5 ± 1.5% and -0.1 ± 6.1%) and 900 mL (-1.2 ± 1.5%, -0.6 ± 1.3% and 0.5 ± 9.9%). In addition, changes in plasma proANP were similar after 450 and 900 mL of blood donation (-0.8 ± 6.7% and -7.6 ± 7.9%) as after sham donations (1.3 ± 7.3% and -4.5 ± 5.6%). Monitoring haemodynamic variables revealed that stroke volume decreased after the donation of 900 mL of blood (-12 ± 12 mL) compared to sham donations. CONCLUSION During a 900-mL blood loss in semi-recumbent men, CBV measured by TI and plasma proANP is not affected.
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Affiliation(s)
- Mikkel Gybel-Brask
- Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Pär I Johansson
- Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Surgery, Division of Acute Care Surgery, Centre for Translational Injury Research (CeTIR), University of Texas Medical School at Houston, Houston, Texas, USA.,Center for Systems Biology, The School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Niels H Secher
- Department of Anesthesiology & The Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Bejder
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
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30
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Thijsen A, Davison TE, Speedy J, Hoad V, Masser B. Offering new and returned donors the option to give plasma: implications for donor retention and donor adverse events. Vox Sang 2020; 116:273-280. [PMID: 32702163 DOI: 10.1111/vox.12977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES In 2018, Australian Red Cross Lifeblood changed its plasmapheresis eligibility criteria to allow donors to donate plasma without the requirement of a prior successful whole blood donation. This study evaluated the impact of this policy change on donor retention and donor safety. MATERIALS AND METHODS All donors who had attempted to give their first plasma or whole blood donation from January to June 2018 were included in this retrospective cohort study. Donor characteristics and adverse events were analysed for this index donation, and the cohort was followed for 18 months to analyse time to return, subsequent donation frequency and predictors of return. RESULTS Male and younger donors provided a significantly greater proportion of first donation plasma than females and older donors. New donors who gave plasma had the highest rate of donor adverse events, including vasovagal reactions and phlebotomy injuries. Nevertheless, donor retention was not affected, with more new donors returning and at a greater subsequent donation frequency after a plasma donation compared to new donors donating whole blood. First-time plasma donors who had previously donated whole blood, however, had greater and quicker rates of return, and more subsequent donations. CONCLUSION Offering new donors the option to give plasma had a positive effect on donor return and subsequent donation frequency. Removing the requirement of a prior whole blood donation is a viable way to increase plasma collections although the combined effect of new donor status and plasmapheresis procedure on adverse event risk needs to be considered.
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Affiliation(s)
- Amanda Thijsen
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, NSW, Australia
| | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, NSW, Australia
| | - Joanna Speedy
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, NSW, Australia
| | - Veronica Hoad
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, NSW, Australia
| | - Barbara Masser
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, NSW, Australia.,School of Psychology, The University of Queensland, Brisbane, QLD, Australia
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31
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Thijsen A, Masser B, Davison TE. Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading. Transfusion 2020; 60:918-921. [DOI: 10.1111/trf.15701] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/18/2019] [Accepted: 12/28/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Amanda Thijsen
- Clinical Services and ResearchAustralian Red Cross Lifeblood Sydney New South Wales Australia
| | - Barbara Masser
- Clinical Services and ResearchAustralian Red Cross Lifeblood Brisbane Queensland Australia
- School of PsychologyThe University of Queensland Brisbane Queensland Australia
| | - Tanya E. Davison
- Clinical Services and ResearchAustralian Red Cross Lifeblood Melbourne Victoria Australia
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32
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Iqbal H, Tameez Ud Din A, Tameez Ud Din A, Chaudhary FMD, Younas M, Jamil A. Frequency and Causes of Deferral among Blood Donors Presenting to Combined Military Hospital Multan. Cureus 2020; 12:e6657. [PMID: 32082957 PMCID: PMC7017926 DOI: 10.7759/cureus.6657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background & Aim It is of great importance to carefully choose appropriate donors according to strict eligibility criteria, so as to guarantee an adequate and safe blood supply. The aim of this study was to determine the rate of deferral in blood donors and evaluate the different causes of deferral in Multan. Materials & Methods This prospective study was carried out at the Blood Bank of Combined Military Hospital (CMH) Multan. All donors who came for the donation of blood from 1st February to 30th September 2019 were evaluated after taking their consent. The data was analyzed to determine the frequency and causes of deferral using Statistical Package for the Social Sciences (SPSS) version 20. Results Among 3348 individuals presenting for blood donation, 433 (12.9%) were deferred (427 males and only six females). The mean age of deferred individuals was 28.96 + 6.42 years. The youngest individual was 18 years, while the eldest one was 51 years of age. Almost 65% of the individuals were less than 30 years of age. The most frequent cause of deferral was low hemoglobin. Anemia was the leading cause of deferral in more than half of the individuals (n = 221). Hepatitis C virus (HCV) infection was the second most frequent cause of deferral, seen in 83 (19.2%), followed by hepatitis B virus (HBV) infection (n = 49, 11.3%), syphilis (n = 36, 8.3%), thrombocytopenia (n = 18, 4.2%), and active infection (n = 14, 3.2%). Other rarer causes included early donation, thrombocytosis, polycythemia, pancytopenia, malaria, allergies, insulin, and tuberculosis. Conclusion Deferral for blood donation is a significant problem in Multan and accounts for almost 13% of all prospective blood donors. Our results stress the importance of addressing the problem of anemia which is the most prevalent cause of temporary deferral for blood donation in this region of the world.
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Affiliation(s)
- Hamid Iqbal
- Hematology, Combined Military Hospital Multan, Multan, PAK
| | | | | | | | - Muhammad Younas
- Chemical Pathology, Combined Military Hospital Multan, Multan, PAK
| | - Abdur Jamil
- Internal Medicine, Central Michigan University, Saginaw, USA
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Jonsson AB, Rygård SL, Anhøj J, Johansson PI, Perner A, Møller MH. Use of red blood cells in Danish intensive care units: A population-based register study. Acta Anaesthesiol Scand 2019; 63:1357-1365. [PMID: 31361335 DOI: 10.1111/aas.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/27/2019] [Accepted: 07/23/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Red blood cell (RBC) transfusion is common in the intensive care unit (ICU). Recent trials have shown that a restrictive transfusion strategy is safe in most patients, and recent guidelines recommend such a strategy in most ICU patients. It is unknown if this has translated into a change in clinical practice. METHODS We conducted a population-based register study of RBC transfusions in ICUs in the Danish Capital Region between 1st of January 2011 and 31st of December 2016 by linking data from the regional blood bank and the Danish Intensive Care Database. We used crude data and run- and control-charts to analyse changes in the number of RBC transfusions. RESULTS We included 27 835 ICU admissions of which 6936 received 40 889 RBC units. The crude use was 36.2 RBC units per one-hundred patient bed-days in 2011 vs 29.8 in 2016. The run-chart analysis did not confirm a change in the total use of RBC units in all ICUs combined, and we observed no change in the proportion of transfused patients or in the use of RBCs among transfused patients. Sensitivity analyses showed decreased use of RBC units in two general ICUs, and a reduced use of RBC units among medical ICU patients. CONCLUSIONS In this population-based register study, we did not with certainty observe changes over time in the use of RBC transfusions in all patients in all ICUs in the Danish Capital Region. A reduction in RBC use may have occurred in some general ICUs and in medical ICU patients.
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Affiliation(s)
| | - Sofie Louise Rygård
- Department of Intensive Care Copenhagen University Hospital Rigshospitalet Denmark
| | - Jacob Anhøj
- Centre for Diagnostic Investigation Copenhagen University Hospital Rigshospitalet Denmark
| | - Pär Ingemar Johansson
- Section for Transfusion Medicine Copenhagen University Hospital Rigshospitalet Denmark
| | - Anders Perner
- Department of Intensive Care Copenhagen University Hospital Rigshospitalet Denmark
- Centre for Research in Intensive Care (CRIC) Copenhagen Denmark
| | - Morten Hylander Møller
- Department of Intensive Care Copenhagen University Hospital Rigshospitalet Denmark
- Centre for Research in Intensive Care (CRIC) Copenhagen Denmark
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Zalpuri S, Schotten N, Baart AM, Watering LM, Hurk K, Kraaij MG. Iron deficiency–related symptoms in whole blood donors: a systematic review. Transfusion 2019; 59:3275-3287. [DOI: 10.1111/trf.15509] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Saurabh Zalpuri
- Department Donor StudiesSanquin Research Amsterdam The Netherlands
| | - Nienke Schotten
- Department Donor StudiesSanquin Research Amsterdam The Netherlands
| | | | - Leo M. Watering
- Sanquin ResearchCentre for Clinical Transfusion Research Leiden The Netherlands
| | - Katja Hurk
- Department Donor StudiesSanquin Research Amsterdam The Netherlands
| | - Marian G.J. Kraaij
- Sanquin Blood BankUnits Donor Affairs and Transfusion Medicine Amsterdam The Netherlands
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35
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Thijsen A, Masser B, Gemelli CN, Davison TE. Trends in return behavior after an adverse event in Australian whole blood and plasma donors. Transfusion 2019; 59:3157-3163. [DOI: 10.1111/trf.15475] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Amanda Thijsen
- Clinical Services and ResearchAustralian Red Cross Blood Service Sydney New South Wales Australia
| | - Barbara Masser
- Clinical Services and ResearchAustralian Red Cross Blood Service Brisbane Queensland Australia
- School of PsychologyThe University of Queensland Brisbane Queensland Australia
| | - Carley N. Gemelli
- Clinical Services and ResearchAustralian Red Cross Blood Service Melbourne Victoria Australia
| | - Tanya E. Davison
- Clinical Services and ResearchAustralian Red Cross Blood Service Melbourne Victoria Australia
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36
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Masser B, Ferguson E, Merz EM, Williams L. Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood. Transfus Med Hemother 2019; 47:175-185. [PMID: 32355478 DOI: 10.1159/000501917] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/03/2019] [Indexed: 11/19/2022] Open
Abstract
Background Research on the recruitment and retention of blood donors has typically drawn on a homogeneous set of descriptive theories, viewing the decision to become and remain a donor as the outcome of affectively cold, planned, and rational decision-making by the individual. While this approach provides insight into how our donors think about blood donation, it is limited and has not translated into a suite of effective interventions. In this review, we set out to explore how a broader consideration of the influences on donor decision-making, in terms of affect, memory, and the context in which donation takes place, may yield benefit in the way we approach donor recruitment and retention. Summary Drawing on emerging research, we argue for the importance of considering the implications of both the positive and the negative emotions that donors experience and we argue for the importance of directly targeting affect in interventions to recruit nondonors. Next, we focus on the reconstructed nature of memory and the factors that influence what we remember about an event. We discuss how these processes may impact the retention of donors and the potential to intervene to enhance donors' recollections of their experiences. Finally, we discuss how our focus on the individual has led us to neglect the influence of the context in which donation takes place on donor behavior. We argue that the amassing of comprehensive large data sets detailing both the characteristics of the individuals and the context of their giving will ultimately allow for the more effective deployment of resources to improve recruitment and retention. Key Messages In suggesting these directions for future research, our want is to move beyond the ways in which we have traditionally described blood donation behavior with the aim of improving our theorizing about donors while improving the translational value of our research.
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Affiliation(s)
- Barbara Masser
- School of Psychology, The University of Queensland, St. Lucia, Queensland, Australia.,Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Eva-Maria Merz
- Department of Donor Medicine, Sanquin Research, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lisa Williams
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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Salvadori U, Sandri M, Cemin R, Al‐Khaffaf A, Daves M, Maniscalco F, Hueber R, Troi C, Griessmair A, Ploner F, Egger K, Kuehebacher G, Gentilini I, Vecchiato C. Effect of a liberal versus a restrictive pre‐donation blood pressure policy on whole‐blood donor adverse reactions. Vox Sang 2019; 114:317-324. [DOI: 10.1111/vox.12772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/18/2019] [Accepted: 02/19/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ugo Salvadori
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | | | - Roberto Cemin
- Department of Cardiology Central Hospital of Bolzano Bolzano Italy
| | - Ahmad Al‐Khaffaf
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Massimo Daves
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Francesco Maniscalco
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Rudolf Hueber
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Christina Troi
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Astrid Griessmair
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Franz Ploner
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Karl Egger
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Gottfried Kuehebacher
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Ivo Gentilini
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
| | - Cinzia Vecchiato
- Department of Immunohaematology and Transfusion Central Hospital of Bolzano Bolzano Italy
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Timmer TC, de Groot R, Habets K, Merz EM, Prinsze FJ, Atsma F, de Kort WLAM, van den Hurk K. Donor InSight: characteristics and representativeness of a Dutch cohort study on blood and plasma donors. Vox Sang 2018; 114:117-128. [PMID: 30590867 PMCID: PMC7379571 DOI: 10.1111/vox.12731] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/23/2018] [Accepted: 11/03/2018] [Indexed: 12/21/2022]
Abstract
Background and Objectives More insight into donor health and behaviour may contribute to more efficient and focused strategies regarding donor care and management. Donor InSight (DIS) is a Dutch cohort study of blood and plasma donors. We aimed to outline the objectives and methods of DIS, describe the cohort, and compare it to the active Dutch donor population. Materials and Methods In 2007‐2009 (DIS‐I, n = 31 338) and 2012‐2013 (DIS‐II, 34 826, of whom 22 132 also participated in DIS‐I) questionnaire data on demographics, donation, lifestyle, family composition, health and disease were collected. A second follow‐up (DIS‐III, n = 3046), including donors with differing haemoglobin trajectories, was completed in 2015‐2016. DIS‐III includes data on genetic determinants, iron and red cell indices. Representativeness of the DIS‐I sample for the entire Dutch donor population was assessed by comparing characteristics of both. Results Donor InSight was initially set up because of a need for more detailed information and evidence as a basis for decision‐making in blood banks. DIS‐I sample is comparable to the total Dutch donor population in terms of age, body mass index, haemoglobin level, blood pressure, blood type and donation behaviour. Conclusion Donor InSight is a cohort study representative of the Dutch donor population. It provides evidence to support evidence‐based decision making.
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Affiliation(s)
- Tiffany C Timmer
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Rosa de Groot
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Karin Habets
- Regional Emergency Healthcare Network, Radboudumc, Nijmegen, The Netherlands
| | - Eva-Maria Merz
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femmeke J Prinsze
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Femke Atsma
- Scientific Institute for Quality of Healthcare, Radboudumc, Nijmegen, the Netherlands
| | - Wim L A M de Kort
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
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Indications and use of therapeutic phlebotomy in polycythemia vera: which role for erythrocytapheresis? Leukemia 2018; 33:279-281. [PMID: 30518810 PMCID: PMC6326952 DOI: 10.1038/s41375-018-0304-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 09/16/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022]
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Abstract
The critical care and perioperative settings are high consumers of blood products, with multiple units and different products often given to an individual patient. The recommendation of this review is always to consider the risks and benefits for a specific blood product for a specific patient in a specific clinical setting. Optimize patient status by treating anemia and preventing the need for red blood cell transfusion. Consider other options for correction of anemia and coagulation disorders and use an imperative non-overtransfusion policy for all blood products.
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41
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Thijsen A, Masser B. Vasovagal reactions in blood donors: risks, prevention and management. Transfus Med 2017; 29 Suppl 1:13-22. [DOI: 10.1111/tme.12488] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/19/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Thijsen
- Clinical Services and ResearchAustralian Red Cross Blood Service Sydney New South Wales Australia
| | - B. Masser
- Clinical Services and ResearchAustralian Red Cross Blood Service Brisbane Queensland Australia
- School of PsychologyThe University of Queensland Brisbane Queensland Australia
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42
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van den Hurk K, Zalpuri S, Prinsze FJ, Merz EM, de Kort WLAM. Associations of health status with subsequent blood donor behavior-An alternative perspective on the Healthy Donor Effect from Donor InSight. PLoS One 2017; 12:e0186662. [PMID: 29049357 PMCID: PMC5648214 DOI: 10.1371/journal.pone.0186662] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 10/05/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION In donor health research, the 'Healthy Donor Effect' (HDE) often biases study results and hampers their interpretation. This refers to the fact that donors are a selected 'healthier' subset of a population due to both donor selection procedures and self-selection. Donors with long versus short donor careers, or with high versus low donation intensities are often compared to avoid this HDE, but underlying health differences might also cause these differences in behaviour. Our aim was to estimate to what extent a donor´s perceived health status associates with donation cessation and intensity. METHODS All active whole blood donors participating in Donor InSight (2007-2009; 11,107 male; 12,616 female) were included in this prospective cohort study. We performed Cox survival and Poisson regression analyses to assess whether self-reported health status, medication use, disease diagnosed by a physician and recently having consulted a general practitioner (GP) or specialist were associated with (time to) donation cessation and donation intensity. RESULTS At the end of 2013, 44% of the donors in this study had stopped donating. Donors in self-rated good health had a 15% lower risk to stop donating compared to donors in perceived poorer health. Medication use, disease diagnoses and consulting a GP were associated with a 20-40% increased risk to stop donating and a lower donation intensity, when adjusting for age, number of donations and new donor status. Both men and women reporting good health made on average 10% more donations. CONCLUSION Donors with a "good" health status were less likely to stop donating blood and tended to donate blood more often than donors with perceived poorer health status. This implies that the HDE is an important source of selection bias in studies on donor health and this includes studies where comparisons within donors are made. This HDE should be adjusted for appropriately when assessing health effects of donation and donors' health status may provide estimates of future donation behavior.
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Affiliation(s)
- Katja van den Hurk
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Saurabh Zalpuri
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- * E-mail:
| | - Femmeke J. Prinsze
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Eva-Maria Merz
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Wim L. A. M. de Kort
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands
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43
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Amrein K, Macher S, Schröck M, Schlenke P, Drexler C. Iron deficiency in blood donors: perceptions and management among general practitioners and internists. Transfusion 2017; 57:2548-2549. [DOI: 10.1111/trf.14297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 06/30/2017] [Accepted: 07/02/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Karin Amrein
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of GrazGraz Austria
| | - Susanne Macher
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGraz Austria
| | - Martin Schröck
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of GrazGraz Austria
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGraz Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGraz Austria
| | - Camilla Drexler
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGraz Austria
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44
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Retrospective analysis of capillary hemoglobin recovery in nearly 1 200 000 blood donor returns. Blood Adv 2017; 1:961-967. [PMID: 29296737 DOI: 10.1182/bloodadvances.2016004218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/20/2017] [Indexed: 12/27/2022] Open
Abstract
Measuring the concentration of capillary hemoglobin (cHb) is a standard procedure before blood donation. To further assess the time period needed for cHb recovery after blood donation and to have a more in-depth understanding of features of recovery, we used data-mining tools in a large, retrospective data pool containing all 1 163 524 donor returns that took place in Finland in 2010 to 2015. The results show that the average recovery times for cHb to return back to the level preceding donation were substantially longer, over 200 days in all age groups, than were the minimum allowed donation intervals. cHb recovery was especially poor in women under the age of 30 who returned to donate soon after the minimum allowed donation interval. It was of interest that frequent donors recovered substantially faster, with the average recovery times of ∼100 days in men and ∼200 days in women, than did infrequent donors, suggesting that there is a subpopulation of donors who can donate frequently without fear of iron deficiency. Return interval in fact explained only 1% of the variation in cHb recovery, which points to unknown, individual features, such as genetic or lifestyle factors, warranting further studies and suggesting that simply extending the allowed donation intervals may not suffice to improve cHb recovery. The study demonstrates that data mining of blood bank records is a powerful tool for depicting features of blood donor population.
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Grau K, Vasan SK, Rostgaard K, Bialkowski W, Norda R, Hjalgrim H, Edgren G. No association between frequent apheresis donation and risk of fractures: a retrospective cohort analysis from Sweden. Transfusion 2017; 57:390-396. [PMID: 27859323 PMCID: PMC5754008 DOI: 10.1111/trf.13907] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 09/02/2016] [Accepted: 09/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Citrate anticoagulation during apheresis induces transient alterations in calcium homeostasis. It is unknown whether the repeated, transient alterations in calcium homeostasis experienced by repeated apheresis donors affects bone turnover to increase fracture risk. Our aim was to investigate the risk of osteoporotic and nonosteoporotic fracture among voluntary, frequent apheresis donors. STUDY DESIGN AND METHODS All apheresis donors were identified from the Scandinavian Donations and Transfusions database (SCANDAT2), which includes information on over 1.6 million blood donors from Sweden and Denmark from the years 1968 and 1981, respectively. Only data from Sweden were used for these analyses. Information on fractures was obtained by linking SCANDAT2 to hospital registers. Poisson regression was used to compute incidence rate ratios of fractures in relation to the cumulative number of apheresis donations, both overall and in fixed time windows. RESULTS In total, 140,289 apheresis donors (67,970 women and 72,319 men) were identified from the SCANDAT2 database and were followed for up to 23 years. We observed no association between the frequency of apheresis donation and the risk of fracture either in the overall study period or during fixed-length time windows. The incidence rate ratio of fractures in donors who had made 100 or more cumulative apheresis donations was 0.99 (95% confidence interval, 0.92-1.06) compared with donors who had made from 9 to 24 donations. The results were similar in analyses stratified by sex and restricted to postmenopausal women. CONCLUSIONS The absence of an association between repeated apheresis donation and fracture risk indicates that apheresis collection is safe with regard to bone health.
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Affiliation(s)
- Katrine Grau
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Senthil K Vasan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Walter Bialkowski
- Blood Research and Medical Sciences Institutes, BloodCenter of Wisconsin, Milwaukee, WI, USA
| | - Rut Norda
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
- Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gustaf Edgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Hematology Centre, Karolinska University Hospital, Stockholm, Sweden
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Yunce M, Erdamar H, Bayram NA, Gok S. One more health benefit of blood donation: reduces acute-phase reactants, oxidants and increases antioxidant capacity. J Basic Clin Physiol Pharmacol 2016; 27:653-657. [PMID: 27089416 DOI: 10.1515/jbcpp-2015-0111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 02/26/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND One of the most important problems in finding blood donors is the inadequacy of volunteer number. To overcome this problem, one of the solutions we suggest is innovating new health benefits of blood donation. The aim of the present study is to investigate the effects of blood donation on oxidative status markers and acute-phase reactants. METHODS A total of 96 healthy volunteers were recruited into the study. Blood samples were withdrawn 5 min before and 24 h after the blood donation. Serum nitric oxide, malondialdehyde levels, and activity of superoxide dismutase and myeloperoxidase were measured spectrophotometrically. Serum levels of high-sensitive C-reactive protein and pentraxin-3 as acute-phase reactants were measured by enzyme-linked immunosorbent assay kits. RESULTS We found statistically significant lower pentraxin-3 and high-sensitive C-reactive protein levels and higher superoxide dismutase activity and nitric oxide level 24 h after blood donation in serum of blood donor when compared with before blood donation. CONCLUSIONS These findings suggest that blood donation affected oxidative status and acute-phase reactants in donors. Blood donation removes oxidants and decreases oxidative stress by elevating antioxidant enzyme such as superoxide dismutase. This is one more health benefit or reason why we should donate blood. Further large-scale studies should evaluate this mechanism and compare the same effect of wet cupping therapy.
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47
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Macher S, Drexler C, Lindenau I, Sareban N, Schlenke P, Amrein K. High-dose intravenously administered iron versus orally administered iron in blood donors with iron deficiency: study protocol for a randomised, controlled trial. Trials 2016; 17:527. [PMID: 27793204 PMCID: PMC5084417 DOI: 10.1186/s13063-016-1648-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/07/2016] [Indexed: 01/01/2023] Open
Abstract
Background About 2–3 % of the population participates in blood donation programmes. Each whole blood donation or ten apheresis donations cause a loss of 200–250 mg of iron. As a result, one of the most common risks of regular blood donors is iron deficiency. Although this has been known for decades, in most countries, iron status is currently not assessed or treated in this population. Premenopausal women are particularly affected, as they have lower iron reserves and higher daily requirements. Besides anaemia, iron deficiency may lead to fatigue and impaired cognitive and physical performance. Current iron preparations for intravenous administration are well tolerated and allow for application of large doses up to 1 g in one visit. Our hypothesis is that in blood donors with iron deficiency, intravenously administered iron is more efficient and as safe as oral iron supplementation. Since anaemia is one of the most frequent reasons for permanent or intermittent donor deferral, maintaining an iron-replete donor pool may help to prevent shortages in blood supply and to avoid iron deficiency-related comorbidities. Methods/design In this randomised clinical trial we include male and female blood donors aged ≥18 and ≤65 years with a ferritin value of ≤30 ng/ml. Stratified by gender, participants are randomized with a web-based randomisation tool in a 1:1 ratio to either 1 g of intravenously administered ferric carboxymaltose or 10 g of iron fumarate supplements at one to two daily doses of 100 mg each. Eight to 12 weeks after the first visit, iron status, blood count and symptoms are assessed in both groups. The primary endpoint is the difference in transferrin saturation (%) following the intervention between both groups. Secondary endpoints include other parameters of iron metabolism and red blood cell count, the number of patients with drug-related adverse events, and subjective symptoms including those of the restless legs syndrome, quality of life, and fatigue. Discussion Iron supplementation administered intravenously in non-anaemic but iron-deficient blood donors could represent an effective strategy to protect blood donors from comorbidities related with iron deficiency and therefore improve blood donor wellbeing. Furthermore, iron supplementation will help to maintain an iron-replete blood donor pool. Trial registration EudraCT: 2013-000327-14, Clinical Trials Identifier: NCT01787526. Registered on 6 February 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1648-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Susanne Macher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Camilla Drexler
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Ines Lindenau
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria.,Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Karin Amrein
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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Politis C, Wiersum JC, Richardson C, Robillard P, Jorgensen J, Renaudier P, Faber JC, Wood EM. The International Haemovigilance Network Database for the Surveillance of Adverse Reactions and Events in Donors and Recipients of Blood Components: technical issues and results. Vox Sang 2016; 111:409-417. [PMID: 27658188 DOI: 10.1111/vox.12447] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/03/2016] [Accepted: 08/09/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The International Haemovigilance Network's ISTARE is an online database for surveillance of all adverse reactions (ARs) and adverse events (AEs) associated with donation of blood and transfusion of blood components, irrespective of severity or the harm caused. ISTARE aims to unify the collection and sharing of information with a view to harmonizing best practices for haemovigilance systems around the world. MATERIALS AND METHODS Adverse reactionss and adverse events are recorded by blood component, type of reaction, severity and imputability to transfusion, using internationally agreed standard definitions. RESULTS From 2006 to 2012, 125 national sets of annual aggregated data were received from 25 countries, covering 132.8 million blood components issued. The incidence of all ARs was 77.5 per 100 000 components issued, of which 25% were severe (19.1 per 100 000). Of 349 deaths (0.26 per 100 000), 58% were due to the three ARs related to the respiratory system: transfusion-associated circulatory overload (TACO, 27%), transfusion-associated acute lung injury (TRALI, 19%) and transfusion-associated dyspnoea (TAD, 12%). Cumulatively, 594 477 donor complications were reported (rate 660 per 100 000), of which 2.9% were severe. CONCLUSIONS ISTARE is a well-established surveillance tool offering important contributions to international efforts to maximize transfusion safety.
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Affiliation(s)
- C Politis
- Coordinating Haemovigilance Centre (SKAE), Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - J C Wiersum
- TRIP National Hemovigilance and Biovigilance Office, Leiden, The Netherlands
| | - C Richardson
- Panteion University of Social and Political Sciences, Athens, Greece
| | | | - J Jorgensen
- Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | - J-C Faber
- LuxConsulTrans®, Banglamung, Thailand
| | - E M Wood
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia
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Blood donors' physical characteristics are associated with pre- and post-donation symptoms - Donor InSight. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 15:405-412. [PMID: 27416579 DOI: 10.2450/2016.0023-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/06/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Observational data suggest that some donors might benefit from donating while others may be harmed. The aim of this study was to investigate the prevalence and potential, routinely measured, determinants of pre- and post-donation symptoms. MATERIALS AND METHODS In Donor InSight, questionnaire data from 23,064 whole blood donors (53% female) were linked to routinely measured data on donors' physical characteristics (haemoglobin, blood pressure, body mass index and estimated blood volume) from the Dutch donor database. Absolute and relative associations between donors' physical donor and the presence of pre- and post-donation symptoms were studied using multivariable logistic regression. RESULTS Pre-donation symptoms (lack of energy, headaches) were reported by 3% of men and 3% of women. Five percent of men and 4% of women reported positive post-donation symptoms (feeling fit, fewer headaches). Negative symptoms (fatigue, dizziness) were more common, occurring in 8% of men and 19% of women. All the studied donors' physical characteristics were positively associated with pre- and positive post-donation symptoms and negatively associated with negative symptoms. Body mass index was most consistently and independently associated with symptoms. DISCUSSION Donors' physical characteristics, in particular body mass index, were consistently associated with pre- and post-donation symptoms. This indicates that subgroups of donors more and less tolerant to donation might be identifiable using routinely measured data. Further research is warranted to study underlying mechanisms and potential strategies to predict and prevent donor reactions.
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50
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Fisher SA, Allen D, Dorée C, Naylor J, Di Angelantonio E, Roberts DJ. Interventions to reduce vasovagal reactions in blood donors: a systematic review and meta-analysis. Transfus Med 2016; 26:15-33. [DOI: 10.1111/tme.12275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/16/2015] [Accepted: 12/24/2015] [Indexed: 11/30/2022]
Affiliation(s)
- S. A. Fisher
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine; University of Oxford; Oxford UK
| | - D. Allen
- Blood Research Group; NHS Blood and Transplant; Oxford UK
| | - C. Dorée
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine; University of Oxford; Oxford UK
| | - J. Naylor
- Blood Supply; NHS Blood and Transplant; Leeds UK
| | - E. Di Angelantonio
- Department of Public Health and Primary Care; University of Cambridge; Cambridge UK
| | - D. J. Roberts
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine; University of Oxford; Oxford UK
- Blood Research Group; NHS Blood and Transplant; Oxford UK
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