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Jagirdar H, Nwobi NH, Swanevelder R, Cockeran R, Bruhn R, Kaidarova Z, Bravo MD, van den Berg K, Custer BS, Vassallo R, Ding Y, Panagiotoglou D, Russell WA. Blood donor return behavior in South Africa and the United States before and during the COVID-19 pandemic. Transfusion 2024; 64:1492-1502. [PMID: 38940011 DOI: 10.1111/trf.17934] [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: 01/24/2024] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Studies preceding the COVID-19 pandemic found that slower time-to-return was associated with first-time, deferred, and mobile drive blood donors. How donor return dynamics changed during the COVID-19 pandemic is not well understood. METHODS We analyzed visits by whole blood donors from 2017 to 2022 in South Africa (SA) and the United States (US) stratified by mobile and fixed environment, first-time and repeat donor status, and pre-COVID19 (before March 2020) and intra-COVID19. We used Kaplan-Meier curves to characterize time-to-return, cumulative incidence functions to analyze switching between donation environments, and Cox proportional hazards models to analyze factors influencing time-to-return. RESULTS Overall time-to-return was shorter in SA. Pre-COVID19, the proportion of donors returning within a year of becoming eligible was lower for deferred donors in both countries regardless of donation environment and deferral type. Intra-COVID19, the gap between deferred and non-deferred donors widened in the US but narrowed in SA, where efforts to schedule return visits from deferred donors were intensified, particularly for non-hemoglobin-related deferrals. Intra-COVID19, the proportion of donors returning within a year in SA was higher for deferred first-time donors (>81%) than for successful first-time donors (80% at fixed sites; 69% at mobile drives). CONCLUSIONS The pandemic complicated efforts to recruit new donors and schedule returning visits after completed donations. Concerted efforts to improve time-to-return for deferred donors helped mitigate donation loss in SA during the public health emergency.
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Affiliation(s)
- Huzbah Jagirdar
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Nkasiobi H Nwobi
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | | | - Riana Cockeran
- South African National Blood Service, Johannesburg, South Africa
| | - Roberta Bruhn
- Vitalant Research Institute, San Francisco, California, USA
- University of California, San Francisco, California, USA
| | | | | | - Karin van den Berg
- South African National Blood Service, Johannesburg, South Africa
- Division of Clinical Haematology, University of the Free State, Bloemfontein, South Africa
| | - Brian S Custer
- Vitalant Research Institute, San Francisco, California, USA
- University of California, San Francisco, California, USA
| | | | - Yichuan Ding
- Desautels Faculty of Management, McGill University, Montreal, Quebec, Canada
| | | | - W Alton Russell
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
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2
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Hess AS. What's in Your Transfusion? A Bedside Guide to Blood Products and Their Preparation. Anesthesiology 2024; 140:144-156. [PMID: 37639622 DOI: 10.1097/aln.0000000000004655] [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: 08/31/2023]
Abstract
An understanding of the contents of blood products and how they are modified before transfusion will help any physician. This article will review five basic blood products and the five most common product modifications.
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Affiliation(s)
- Aaron S Hess
- Departments of Anesthesiology and Pathology & Transfusion Medicine, University of Wisconsin-Madison, Madison, Wisconsin
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Godbey EA, Thibodeaux SR. Ensuring safety of the blood supply in the United States: Donor screening, testing, emerging pathogens, and pathogen inactivation. Semin Hematol 2019; 56:229-235. [PMID: 31836028 DOI: 10.1053/j.seminhematol.2019.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Safety of the blood supply has been a critical aspect of the transfusion medicine field since its inception, including infections that can be passed to a blood product recipient. Reactive efforts to identify potentially infected blood products are used throughout the blood donation process and afterward. Before donation, potential donors are provided educational materials about infection risks, examined and then screened through a series of questions that help temporarily, permanently, or indefinitely defer donors who could harbor acute and/or chronic infections. During donation, aseptic technique and diversion pouches reduce the potential to introduce bacteria into the blood product. Before transfusion, the blood products are tested for several infectious diseases by serology, nucleic acid testing, or a combination. During transfusion, the patient is monitored closely, and suspected transfusion reactions should be reported and investigated. The FDA regularly publishes guidance documents to incorporate knowledge gained regarding transfusion-transmitted infections, so that information can be shared and practices updated so that transfusion-related patient care can be optimized over time. Pathogen reduction processes are being developed and deployed that provide a proactive approach to both recognized and emerging pathogens.
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Affiliation(s)
| | - Suzanne R Thibodeaux
- Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.
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Gillet P, Neijens E. An Original Approach to Evaluating the Quality of Blood Donor Selection: Checking Donor Questionnaires and Analyzing Donor Deferral Rate. Front Med (Lausanne) 2018; 5:74. [PMID: 29619370 PMCID: PMC5871657 DOI: 10.3389/fmed.2018.00074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/06/2018] [Indexed: 11/16/2022] Open
Abstract
Blood donor selection is a cornerstone for blood transfusion safety, designed to safeguard the health of both donors and recipients. In the Service du Sang, Belgian Red Cross, French and German-speaking part of Belgium (SFS), health professionals (HPs) are allowed to interview donors on their own after formal qualification. This qualification is afterward evaluated by means of two complementary quality indicators: monitoring of donor health questionnaires (DHQs) and analysis of donor deferral rate. The study aims to evaluate the degree to which both quality indicators may be useful and appropriate tools to evaluate the quality of blood donor selection. An analysis performed on 2016 data showed that noncompliance detected by means of DHQ monitoring seems to be more frequent in HPs who conduct a low number of interviews compared to all HPs as a group (5.67 vs. 3.23%; p < 0.001). Deferral rates are also higher in HPs with a lower activity compared to HPs who interview more donors (14.80 vs. 13.00%, p < 0.001). Furthermore, statistically differences are observed between the type of blood donation venue in terms of the global deferral rate (for instance fixed site vs. schools: 11.9 vs. 19.5%; p < 0.001), and specific reasons for deferral (such as sexual risk behavior and travel in at-risk areas, the differences being highly significant between each category of blood donation venue; p < 0.001). Providing the HPs with feedback on these findings was an opportunity to draw their attention to some aspects of the selection process in order to improve it.
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Mariano Gislon da Silva R, Kupek E, Peres KG. [Prevalence of blood donation and associated factors in Florianópolis, Southern Brazil: a population-based study]. CAD SAUDE PUBLICA 2013; 29:2008-16. [PMID: 24127095 DOI: 10.1590/0102-311x00174312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 04/25/2013] [Indexed: 11/21/2022] Open
Abstract
The main objectives of this study were to estimate the prevalence of blood donation and to identify associated factors. A populated-based cross-sectional study was carried out (n = 1,720) including subjects 20 to 59 years of age in Florianópolis, Santa Catarina State, Brazil. Blood donation any time in life and in the previous year was reported by 30.6% and 6.2% of respondents, respectively. Among the latter, 31.8% reported repeat donation (at least twice in the previous year), 80.4% reported voluntary donation, and 15.9% replacement donation. Multivariate Poisson regression (p < 0.05) showed that male gender, black or brown self-reported skin color, higher age group, higher educational level, and living with other blood donors were all associated with ever donating blood, whereas younger age, single marital status, and higher educational level were associated with donating in the previous year. We found higher prevalence of blood donation in the previous year and higher percentage of young donors in this group, as well as lower percentage of replacement donors than previously reported in Brazil.
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Sümnig A, Lembcke H, Weber H, Deitenbeck R, Greffin K, Bux J, Greinacher A. Evaluation of a New German blood donor questionnaire. Vox Sang 2013; 106:55-60. [DOI: 10.1111/vox.12088] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/19/2013] [Accepted: 08/21/2013] [Indexed: 11/29/2022]
Affiliation(s)
- A. Sümnig
- Institut für Immunologie und Transfusionsmedizin; Universität Greifswald; Greifswald Germany
| | - H. Lembcke
- Institut für Psychologie; Universität Greifswald; Greifswald Germany
| | - H. Weber
- Institut für Psychologie; Universität Greifswald; Greifswald Germany
| | | | - K. Greffin
- Institut für Psychologie; Universität Greifswald; Greifswald Germany
| | - J. Bux
- German Red Cross Blood Service West; Hagen Germany
| | - A. Greinacher
- Institut für Immunologie und Transfusionsmedizin; Universität Greifswald; Greifswald Germany
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Zou S, Stramer SL, Dodd RY. Donor Testing and Risk: Current Prevalence, Incidence, and Residual Risk of Transfusion-Transmissible Agents in US Allogeneic Donations. Transfus Med Rev 2012; 26:119-28. [DOI: 10.1016/j.tmrv.2011.07.007] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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James AB, Hillyer CD, Shaz BH. Demographic differences in estimated blood donor eligibility prevalence in the United States. Transfusion 2011; 52:1050-61. [DOI: 10.1111/j.1537-2995.2011.03416.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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O'Brien SF, Zou S, Laperche S, Brant LJ, Seed CR, Kleinman SH. Surveillance of transfusion-transmissible infections comparison of systems in five developed countries. Transfus Med Rev 2011; 26:38-57. [PMID: 21944935 PMCID: PMC7134890 DOI: 10.1016/j.tmrv.2011.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Most industrialized countries maintain surveillance programs for monitoring transmissible infection in blood donations, revising approaches to methodology and risk assessment as new threats emerge. A comparison of programs in the United States, Canada, France, the UK, and Australia indicates that they have similar function, although the structure of blood programs vary as does the extent and nature of formal ties with public health. The emergence of HIV in the late 1970s and early 1980s was key in recognizing that surveillance systems specific to blood transfusion were essential. Hence, most industrialized countries monitor transfusion-transmissible infections in donors and evaluate the impact of new testing and of predonation screening strategies. Emerging infections since HIV have had different transmission pathways and challenged blood programs to draw upon resources for a rapid and effective response, with recognition that the original focus on sexual/drug-related risk of HIV and hepatitis was inadequate. The focus of surveillance programs on new and emerging pathogens fulfills a key role in risk assessment and policy formulation. The precise nature of such activities varies by country because of the structure of the blood programs and surveillance systems, the strategic focus of the blood programs, and the epidemiology of disease in each country.
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Affiliation(s)
- Sheila F O'Brien
- National Epidemiology and Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario, Canada K1G 4J5. sheila.o'
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Patavino GM, de Almeida-Neto C, Liu J, Wright DJ, Mendrone-Junior A, Ferreira MIL, Carneiro ABDF, Custer B, Ferreira JE, Busch MP, Sabino EC. Number of recent sexual partners among blood donors in Brazil: associations with donor demographics, donation characteristics, and infectious disease markers. Transfusion 2011; 52:151-9. [PMID: 21756264 DOI: 10.1111/j.1537-2995.2011.03248.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Brazilian blood centers ask candidate blood donors about the number of sexual partners in the past 12 months. Candidates who report a number over the limit are deferred. We studied the implications of this practice on blood safety. STUDY DESIGN AND METHODS We analyzed demographic characteristics, number of heterosexual partners, and disease marker rates among 689,868 donations from three Brazilian centers between July 2007 and December 2009. Donors were grouped based on maximum number of partners allowed in the past 12 months for each center. Chi-square and logistic regression analysis were conducted to examine associations between demographic characteristics, number of sex partners, and individual and overall positive markers rates for human immunodeficiency virus (HIV), human T-lymphotropic virus Types 1 and 2, hepatitis B virus, hepatitis C virus, and syphilis. RESULTS First-time, younger, and more educated donors were associated with a higher number of recent sexual partners, as was male sex in São Paulo and Recife (p<0.001). Serologic markers for HIV and syphilis and overall were associated with multiple partners in São Paulo and Recife (p<0.001), but not in Belo Horizonte (p=0.05, p=0.94, and p=0.75, respectively). In logistic regression analysis, number of recent sexual partners was associated with positive serologic markers (adjusted odds ratio [AOR], 1.2-1.5), especially HIV (AOR, 1.9-4.4). CONCLUSIONS Number of recent heterosexual partners was associated with HIV positivity and overall rates of serologic markers of sexually transmitted infections. The association was not consistent across centers, making it difficult to define the best cutoff value. These findings suggest the use of recent heterosexual contacts as a potentially important deferral criterion to improve blood safety in Brazil.
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Abstract
PURPOSE OF REVIEW In the United States, blood donation rates of African-Americans are 25-50% of that of white individuals. As African-Americans make up an ever increasing and now substantial minority, and African-American recipients of blood transfusion, both specialized, such as sickle cell disease patients, and general hospitalized patients, have a better chance of receiving phenotype-matched or appropriate red blood cell units when there is a significant percentage of products in the inventory from African-American donors, it is important to understand the reason for the observed difference. RECENT FINDINGS Possible reasons for this discrepancy in donation rates include increased rates of donor deferral and ineligibility; increased barriers to donation, such as fear and distrust; and different marketing and education strategies. Thus, to increase the blood availability to African-American recipients, the reasons for these donation rate differences must be better understood and subsequently addressed through improved blood donor recruitment programs. The majority of African-American donor recruitment programs have focused on donating for sickle cell disease patients, particularly children, which have been of limited success. SUMMARY Significant improvements in African-American donor recruitment are needed to adequately meet the demand of African-American patients as well as the entire population.
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Affiliation(s)
- Beth H Shaz
- New York Blood Center, New York, New York 10065, USA.
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Eder AF, Menitove JE. Blood donations' past, present, and future: TRANSFUSION's golden anniversary. Transfusion 2010; 50:TRF2807. [PMID: 20667043 DOI: 10.1111/j.1537-2995.2010.02807.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anne F Eder
- From the American Red Cross, Biomedical Services, National Headquarters, Holland Laboratory, Rockville, Maryland; and the Community Blood Center of Greater Kansas City, Kansas City, Missouri
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Shaz BH, James AB, Hillyer KL, Schreiber GB, Hillyer CD. Demographic variations in blood donor deferrals in a major metropolitan area. Transfusion 2010; 50:881-7. [PMID: 19951315 DOI: 10.1111/j.1537-2995.2009.02501.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Presenting blood donors are screened to ensure both their safety and that of the recipients of blood products. Donors with identified risks are deferred from donating blood either temporarily or permanently. Minorities are underrepresented as donors in the United States and this may in part be a result of increased donor deferral rates in minorities compared to white individuals. STUDY DESIGN AND METHODS Data consisted of deferred and successful blood donor presentations to the American Red Cross Southern Region in the metropolitan Atlanta area in 2004 to 2008. Bivariate and multivariate analyses were conducted by race/ethnicity, age group, and sex. RESULTS A total of 586,159 voluntary donor presentations occurred in 2004 to 2008, of which 79,214 (15.6%) resulted in deferral. In the age 16 to 69 years subset (98.3% of the presentations), deferred presentations were mostly women (78.2%). The most common reason for donor deferral was low hemoglobin (62.6%). The donor deferral rate varied by race/ethnicity, age, and sex: whites (11.1%), Hispanics (14.1%), and African Americans (17.9%); 16- to 19-year-olds (17.0%) and 50- to 59-year-olds (11.7%); and females (20.0%) and males (6.2%). Compared to whites and Hispanics, African American females had the highest deferral rate in each age group. CONCLUSIONS Minorities are disproportionately impacted by blood donor deferrals. Methods to decrease blood donor deferral rates among African Americans are needed.
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Affiliation(s)
- B H Shaz
- Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA 30322, USA.
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Notari IV EP, Zou S, Fang CT, Eder AF, Benjamin RJ, Dodd RY. Age-related donor return patterns among first-time blood donors in the United States. Transfusion 2009; 49:2229-36. [DOI: 10.1111/j.1537-2995.2009.02288.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Goldman M, Xi G, Yi QL, Fan W, O'Brien SF. Reassessment of deferrals for tattooing and piercing. Transfusion 2009; 49:648-54. [PMID: 19171003 DOI: 10.1111/j.1537-2995.2008.02037.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND In August 2005, the Canadian Blood Services decreased the deferral period for tattooing and ear or body piercing from 12 to 6 months. This study assessed the impact of this change on blood safety and availability. STUDY DESIGN AND METHODS The prevalence of these activities was assessed on an anonymous mail-out survey of 40,000 recent donors. Transmissible disease (TD) marker rates were calculated using the National Epidemiology Donor Database. A case-control study was performed comparing risk factors in TD-positive donors with matched controls. Donor deferral rates were assessed before and after the change in deferral period. RESULTS The prevalence rates of tattoo, ear piercing, and body piercing were 13.7, 53.6, and 10.4 percent in survey respondents, respectively, with up to 0.7 percent of activity likely to represent deferrable risk. TD marker rate was low and stable at 21.6 per 100,000 donations before and 19.2 per 100,000 donations after the change in deferral length. Remote tattoo was associated with hepatitis C virus (HCV) risk (odds ratio, 5.43; 95% confidence interval, 1.82-16.2), but neither recent tattoo nor piercing was a risk factor for HCV or hepatitis B virus. Shortening of the deferral period reduced deferrals by 20 percent for tattoo and 32 percent for piercing. CONCLUSION There was no measurable adverse effect on safety and a positive but less than expected effect on blood availability after shortening the deferral period for tattoo and piercing. The length of other temporary deferrals should be reassessed, since their current contribution to blood safety may be negligible.
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Affiliation(s)
- Mindy Goldman
- Canadian Blood Services Donor and Transplantation Services, University of Ottawa, Ottawa, Ontario, Canada.
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Zou S, Musavi F, Notari EP, Rios JA, Trouern-Trend J, Fang CT. Donor deferral and resulting donor loss at the American Red Cross Blood Services, 2001 through 2006. Transfusion 2008; 48:2531-9. [DOI: 10.1111/j.1537-2995.2008.01903.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leiby DA, Nguyen ML, Notari EP. Impact of donor deferrals for malaria on blood availability in the United States. Transfusion 2008; 48:2222-8. [DOI: 10.1111/j.1537-2995.2008.01825.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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