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Meulenbeld A, Toivonen J, Vinkenoog M, Brits T, Swanevelder R, de Clippel D, Compernolle V, Karki S, Welvaert M, van den Hurk K, van Rosmalen J, Lesaffre E, Janssen M, Arvas M. Predicting haemoglobin deferral using machine learning models: Can we use the same prediction model across countries? Vox Sang 2024. [PMID: 38637123 DOI: 10.1111/vox.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Personalized donation strategies based on haemoglobin (Hb) prediction models may reduce Hb deferrals and hence costs of donation, meanwhile improving commitment of donors. We previously found that prediction models perform better in validation data with a high Hb deferral rate. We therefore investigate how Hb deferral prediction models perform when exchanged with other blood establishments. MATERIALS AND METHODS Donation data from the past 5 years from random samples of 10,000 donors from Australia, Belgium, Finland, the Netherlands and South Africa were used to fit random forest models for Hb deferral prediction. Trained models were exchanged between blood establishments. Model performance was evaluated using the area under the precision-recall curve (AUPR). Variable importance was assessed using SHapley Additive exPlanations (SHAP) values. RESULTS Across the validation datasets and exchanged models, the AUPR ranged from 0.05 to 0.43. Exchanged models performed similarly within validation datasets, irrespective of the origin of the training data. Apart from subtle differences, the importance of most predictor variables was similar in all trained models. CONCLUSION Our results suggest that Hb deferral prediction models trained in different blood establishments perform similarly within different validation datasets, regardless of the deferral rate of their training data. Models learn similar associations in different blood establishments.
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Affiliation(s)
- Amber Meulenbeld
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jarkko Toivonen
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Marieke Vinkenoog
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Tinus Brits
- Business Intelligence, South African National Blood Service, Johannesburg, South Africa
| | - Ronel Swanevelder
- Business Intelligence, South African National Blood Service, Johannesburg, South Africa
| | | | - Veerle Compernolle
- Dienst voor het Bloed, Belgian Red Cross Ugent, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Surendra Karki
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Marijke Welvaert
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Katja van den Hurk
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Mart Janssen
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Mikko Arvas
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
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2
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Karregat JHM, Ekroos S, Castrén J, Arvas M, van den Hurk K. Iron status in Dutch and Finnish blood donor and general populations: A cross-cohort comparison study. Vox Sang 2024. [PMID: 38622934 DOI: 10.1111/vox.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND AND OBJECTIVES Blood donors are at risk of developing iron deficiency (ID) (ferritin <15 μg/L, World Health Organization definition). Blood services implement different strategies to mitigate this risk. Although in Finland risk group-based iron supplementation is in place, no iron supplementation is provided in the Netherlands. We aim to describe differences in ferritin levels and ID prevalence in donor and general populations in these countries. MATERIALS AND METHODS Six cohorts, stratified based on sex, and for women age, in the Netherlands and Finland were used to evaluate differences in ferritin levels and ID between donor populations (Donor InSight-III and FinDonor 10,000) and general populations (Prevention of Renal and Vascular End-Stage Disease [PREVEND], FinRisk 1997 and Health 2000) and newly registered Dutch donors. Multivariable logistic regression was used to quantify associations of various explanatory factors with ID. RESULTS In total, 13,443 Dutch and 13,933 Finnish subjects were included. Donors, except for women aged ≤50 years old in Finland, had lower median ferritin levels compared with the general population and new donors. Dutch regular blood donors had higher or similar prevalence of ID as compared with the Dutch general population, including new donors. In contrast, Finnish donors showed similar prevalence of ID compared with the general population, except for a markedly lower prevalence in ≤50-year-old women who routinely receive iron supplements when donating. CONCLUSION Iron status in blood donors differs from that in the general population. The Finnish blood service donor management policy, for example, iron supplementation for risk groups, seemingly protects young female blood donors from developing ID.
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Affiliation(s)
- Jan H M Karregat
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sofie Ekroos
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Castrén
- Finnish Red Cross Blood Service (FRCBS), Research and Development, Helsinki, Finland
| | - Mikko Arvas
- Finnish Red Cross Blood Service (FRCBS), Research and Development, Helsinki, Finland
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
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3
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Quee FA, Lathori AZ, Sijtsma B, Bruijns S, van den Hurk K. Increasing the upper age limit for blood donation: Perspectives from older donors. Vox Sang 2024. [PMID: 38586908 DOI: 10.1111/vox.13629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND AND OBJECTIVES In the Netherlands, as of April 2018, the upper age limit for blood donation has been raised from 69 to 79 years, providing an opportunity to study older donors' perspectives regarding donating at older age. This study aims to explore whether older donors agree with the increase of the age limit, if they feel obliged to continue donating, to identify their motivators and barriers for donating blood and describe donation-related experiences and complications. MATERIALS AND METHODS An online survey was distributed among Dutch blood donors aged 68-73 years. The survey contained questions regarding the increase of the upper age limit, motivations and barriers for donating, donation-related experiences and obligatory feelings to continue donating. RESULTS Six hundred sixty donors (55%) were included in the analyses, including 38 stopped donors. Most donors (92%) agreed with the increase of the upper age limit. Approximately 63% of participating donors felt obliged to continue donating, especially women with high education. Donors indicated they felt healthy enough to keep donating (95%), and 72% thought it is good for their health to keep donating. Few donors reported that they found it hard to keep donating (5%) or indicated that they did not feel healthy enough to donate or thought it was not safe for them anymore (3.4%). CONCLUSION Most of the older donors agree with the increase of the upper age limit for blood donation, report only few and minor donation-related experiences or complications and are highly motivated to continue their donor career at an older age.
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Affiliation(s)
- Franke A Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Berdine Sijtsma
- Department of Donor Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Sanne Bruijns
- Department of Donor Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
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4
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van den Hurk K. Advancing resilience and sustainability in plasma collections and plasma-derived medicinal product accessibility. Vox Sang 2024; 119:93. [PMID: 38353852 DOI: 10.1111/vox.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Katja van den Hurk
- Vox Sanguinis, Amsterdam, The Netherlands
- Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health and the Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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5
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Schroyens N, D'aes T, De Buck E, Mikkelsen S, Tiberghien P, van den Hurk K, Erikstrup C, Compernolle V, Van Remoortel H. Safety and protection of plasma donors: A scoping review and evidence gap map. Vox Sang 2024; 119:110-120. [PMID: 37814964 DOI: 10.1111/vox.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND AND OBJECTIVES As part of a large-scale project to safely increase plasma collection in Europe, the current scoping review identifies the existing evidence (gaps) on adverse events (AEs) and other health effects in plasmapheresis donors, as well as factors that may be associated with such events/effects. MATERIALS AND METHODS We searched six databases and three registries. Study characteristics (publication type, language, study design, population, outcomes, associated factors, time of assessment, duration of follow-up, number and frequency of donations, convalescent plasma [y/n], setting and location) were synthesized narratively and in an interactive evidence gap map (EGM). RESULTS Ninety-four research articles and five registrations were identified. Around 90% were observational studies (57 controlled and 33 uncontrolled), and most of them were performed in Europe (55%) or the United States (20%). Factors studied in association with donor health included donor characteristics (e.g., sex, age) (n = 27), cumulative number of donations (n = 21), donation frequency (n = 11), plasma collection device or programme (n = 11), donor status (first time vs. repeat) (n = 10), donation volume per session (n = 8), time in donation programme (n = 3), preventive measures (n = 2) or other (n = 9). CONCLUSION The current scoping review provides an accessible tool for researchers and policymakers to identify the available evidence (gaps) concerning plasmapheresis donation safety. Controlled prospective studies with long-term donor follow-up are scarce. Furthermore, additional experimental studies comparing the health effects of different donation frequencies are required to inform a safe upper limit for donation frequency.
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Affiliation(s)
- Natalie Schroyens
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Tine D'aes
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Pierre Tiberghien
- Etablissement Français du Sang, Saint-Denis, France
- Université de Franche-Comté, EFS, INSERM, UMR Right, Besançon, France
| | - Katja van den Hurk
- Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Veerle Compernolle
- Belgian Red Cross, Blood Services, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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6
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Karregat JHM, Blokhuis D, Quee FA, van den Hurk K. Iron supplementation: A qualitative study on the perception of blood donors, blood collection staff and donor physicians. Vox Sang 2024; 119:16-26. [PMID: 37861453 DOI: 10.1111/vox.13547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND AND OBJECTIVES Iron supplementation is an effective strategy to mitigate donation-induced iron deficiency in blood donors. However, evidence on the perception of individuals involved in blood donation on iron supplementation as a blood service policy is lacking. This study aimed to evaluate the knowledge and perception of whole blood donors (donors), blood collection staff (collection staff) and donor physicians (physicians) regarding donation-induced iron loss and iron supplementation. MATERIALS AND METHODS Online focus group discussions had four to six participants and followed a structured questioning approach. All participants had to be fluent in Dutch to participate, and donors had donated at least five times. Sixteen donors, eight collection staff members and four physicians participated in this study. Recordings were transcribed, coded and analysed using a grounded theory approach. RESULTS Awareness of donation-induced iron loss was limited in donors. Donors and physicians were predominantly positive towards iron supplementation; the primary motivator for donors was to prevent deferral and reduce iron-deficiency-related symptoms. Improving donor health was the main argument for physicians to advocate iron supplementation. Staff had a critical view on iron supplementation as a policy, as they perceived it as unethical and possibly ineffective. A knowledge gap might underlie their concerns. CONCLUSION Most individuals involved in blood donation are positive towards iron supplementation as a blood service policy. If implemented, guidance and monitoring is desired and adequate education of all stakeholders is required.
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Affiliation(s)
- Jan H M Karregat
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Dayna Blokhuis
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Franke A Quee
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
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7
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Van Remoortel H, van den Hurk K, Compernolle V, O'Leary P, Tiberghien P, Erikstrup C. Very-high frequency plasmapheresis and donor health-absence of evidence is not equal to evidence of absence. Transfusion 2023; 63:2358-2361. [PMID: 37982361 DOI: 10.1111/trf.17601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023]
Affiliation(s)
- Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Brussels, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Katja van den Hurk
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Veerle Compernolle
- Blood Services, Belgian Red Cross, Brussels, Belgium
- Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | | | - Pierre Tiberghien
- European Blood Alliance, Brussels, Belgium
- Etablissement Français du Sang, La Plaine Saint-Denis, France
- EFS, INSERM, UMR Right, Université de Franche-Comté, Besançon, France
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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8
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Vinkenoog M, Toivonen J, Brits T, de Clippel D, Compernolle V, Karki S, Welvaert M, Meulenbeld A, van den Hurk K, van Rosmalen J, Lesaffre E, Arvas M, Janssen M. An international comparison of haemoglobin deferral prediction models for blood banking. Vox Sang 2023. [PMID: 36924102 DOI: 10.1111/vox.13426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/04/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Blood banks use a haemoglobin (Hb) threshold before blood donation to minimize donors' risk of anaemia. Hb prediction models may guide decisions on which donors to invite, and should ideally also be generally applicable, thus in different countries and settings. In this paper, we compare the outcome of various prediction models in different settings and highlight differences and similarities. MATERIALS AND METHODS Donation data of repeat donors from the past 5 years of Australia, Belgium, Finland, the Netherlands and South Africa were used to fit five identical prediction models: logistic regression, random forest, support vector machine, linear mixed model and dynamic linear mixed model. Only donors with five or more donation attempts were included to ensure having informative data from all donors. Analyses were performed for men and women separately and outcomes compared. RESULTS Within countries and overall, different models perform similarly well. However, there are substantial differences in model performance between countries, and there is a positive association between the deferral rate in a country and the ability to predict donor deferral. Nonetheless, the importance of predictor variables across countries is similar and is highest for the previous Hb level. CONCLUSION The limited impact of model architecture and country indicates that all models show similar relationships between the predictor variables and donor deferral. Donor deferral is found to be better predictable in countries with high deferral rates. Therefore, such countries may benefit more from deferral prediction models than those with low deferral rates.
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Affiliation(s)
- Marieke Vinkenoog
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Leiden Institute of Advanced Computer Science, Leiden University, Leiden, The Netherlands
| | - Jarkko Toivonen
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Tinus Brits
- Business Intelligence, South African National Blood Service, Johannesburg, South Africa
| | | | - Veerle Compernolle
- Dienst voor het Bloed, Belgian Red Cross Ugent, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Surendra Karki
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Marijke Welvaert
- Research and Development, Australian Red Cross Lifeblood, Sydney, Australia
| | - Amber Meulenbeld
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | | | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Mikko Arvas
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Mart Janssen
- Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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9
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Kreft IC, Hoogendijk AJ, van der Zwaan C, van Alphen FPJ, Boon-Spijker M, Prinsze F, Meijer AB, de Korte D, van den Hurk K, van den Biggelaar M. Mass spectrometry-based analysis on the impact of whole blood donation on the global plasma proteome. Transfusion 2023; 63:564-573. [PMID: 36722460 DOI: 10.1111/trf.17254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Biomonitoring may provide important insights into the impact of a whole blood donation for individual blood donors. STUDY DESIGN AND METHODS Here, we used unbiased mass spectrometry (MS)-based proteomics to assess longitudinal changes in the global plasma proteome, after a single blood donation for new and regular donors. Subsequently, we compared plasma proteomes of 76 male and female whole blood donors, that were grouped based on their ferritin and hemoglobin (Hb) levels. RESULTS The longitudinal analysis showed limited changes in the plasma proteomes of new and regular donors after a whole blood donation during a 180-day follow-up period, apart from a significant short-term decrease in fibronectin. No differences were observed in the plasma proteomes of donors with high versus low Hb and/or ferritin levels. Plasma proteins with the highest variation between and within donors included pregnancy zone protein, which was associated with sex, Alfa 1-antitrypsin which was associated with the allelic variation, and Immunoglobulin D. Coexpression analysis revealed clustering of proteins that are associated with platelet, red cell, and neutrophil signatures as well as with the complement system and immune responses, including a prominent correlating cluster of immunoglobulin M (IgM), immunoglobulin J chain (JCHAIN), and CD5 antigen-like (CD5L). DISCUSSION Overall, our proteomic approach shows that whole blood donation has a limited impact on the plasma proteins measured. Our findings suggest that plasma profiling can be successfully employed to consistently detect proteins and protein complexes that reflect the functionality and integrity of platelets, red blood cells, and immune cells in blood donors and thus highlights its potential use for donor health monitoring.
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Affiliation(s)
- Iris C Kreft
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
| | - Arie J Hoogendijk
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
| | - Carmen van der Zwaan
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
| | - Floris P J van Alphen
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
| | - Mariette Boon-Spijker
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
| | - Femmeke Prinsze
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Alexander B Meijer
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
- Department of Biomolecular Mass Spectrometry and Proteomics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Dirk de Korte
- Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Maartje van den Biggelaar
- Laboratory of Proteomics, Department of Molecular Hematology, Sanquin Research, Amsterdam, The Netherlands
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10
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Vinkenoog M, de Groot R, Lakerveld J, Janssen M, van den Hurk K. Individual and environmental determinants of serum ferritin levels: A structural equation model. Transfus Med 2022; 33:113-122. [PMID: 37009681 DOI: 10.1111/tme.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/24/2022] [Accepted: 07/26/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Serum ferritin levels are increasingly being used to assess iron stores. Considerable variation in ferritin levels within and between individuals has been observed, but our current understanding of factors that explain this variation is far from complete. We aim to combine multiple potential determinants in an integrative model, and investigate their relative importance and potential interactions. METHODS We use ferritin measurements collected by Sanquin Blood Bank on both prospective (N = 59 596) and active blood donors (N = 78 318) to fit a structural equation model with three latent constructs (individual characteristics, donation history, and environmental factors). Parameters were estimated separately by sex and donor status. RESULTS The model explained 25% of ferritin variance in prospective donors, and 40% in active donors. Individual characteristics and donation history were the most important determinants of ferritin levels in active donors. The association between environmental factors and ferritin was smaller but still substantial; higher exposure to air pollution was associated with higher ferritin levels, and this association was considerably stronger for active blood donors than for prospective donors. DISCUSSION In active donors, individual characteristics explain 20% (17%) of ferritin variation, donation history explains 14% (25%) and environmental factors explain 5% (4%) for women (men). Our model presents known ferritin determinants in a broader perspective, allowing for comparison with other determinants as well as between new and active donors, or between men and women.
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Affiliation(s)
- Marieke Vinkenoog
- Transfusion Technology Assessment, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
- Leiden Institute of Advanced Computer Science Leiden University Leiden The Netherlands
| | - Rosa de Groot
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC VU University Amsterdam The Netherlands
- Upstream Team, Amsterdam UMC VU University Amsterdam The Netherlands
| | - Mart Janssen
- Transfusion Technology Assessment, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
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11
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Paalvast Y, Moazzen S, Sweegers M, Hogema B, Janssen M, van den Hurk K. A computational model for prediction of ferritin and haemoglobin levels in blood donors. Br J Haematol 2022; 199:143-152. [PMID: 35855538 DOI: 10.1111/bjh.18367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
Blood donors are at risk of iron deficiency anaemia. While this risk is decreased through ferritin-based deferral, ideally ferritin monitoring should also aid in optimising donation frequencies. We extended an existing model of haemoglobin (Hb) synthesis with iron homeostasis and validated the model on a cohort of 300 new donors whose ferritin levels were measured from stored blood samples collected over a 2-year period. We then used the donor's gender, body weight, height, and baseline Hb and ferritin levels to predict subsequent Hb and ferritin levels. The prediction error was within measurement variability in 88% of Hb level predictions and 64% of ferritin level predictions. A sensitivity analysis of the model revealed that baseline ferritin level was the most important in predicting future ferritin levels. Finally, we used the model to calculate the annual donation frequency at which donors would keep their ferritin level >15 ng/ml when measured after donating for 2 years. The mean annual donation frequency would then be 1.9 for women and 4.1 for men. The computational model, requiring baseline values only, can predict future Hb and ferritin levels remarkably well. This enables determination of optimal donation frequencies for individual donors at the start of their donation career.
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Affiliation(s)
- Yared Paalvast
- Donor Medicine, Sanquin Blood Bank, Amsterdam, the Netherlands
| | - Sara Moazzen
- Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, the Netherlands.,Molecular Epidemiology Research Group, MDC Berlin-Buch, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Maike Sweegers
- Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Boris Hogema
- Donor Medicine Research - Blood-borne Infections, Sanquin Research, Amsterdam, the Netherlands
| | - Mart Janssen
- Donor Medicine Research - Transfusion Technology Assessment, Sanquin Research, Amsterdam, the Netherlands
| | - Katja van den Hurk
- Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, the Netherlands
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12
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Quee F, O'Brien SF, Prinsze F, Steele WR, Grégoire Y, Cutajar A, Wendel S, Compernolle V, Goldman M, van den Hurk K. Whole blood donor return rates after deferral for tattooing or body piercing-Survey across blood donation services: The BEST collaborative study. Vox Sang 2022; 117:1085-1089. [PMID: 35706056 DOI: 10.1111/vox.13328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES To protect transfusion recipients from transfusion-transmissible infections, blood donors are deferred from donating after recent tattooing or piercing. To explore to what extent and how this deferral impacts donor availability, we performed an international study to investigate how many donors were deferred for a recent tattoo or piercing and how many of these donors returned to donate. MATERIALS AND METHODS We surveyed blood centre members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative and the European Blood Alliance Donor Studies Working Group on their numbers of donations, tattoo and piercing deferrals, and return rates in the year 2017. RESULTS Eight blood centres participated. Overall, deferral rates were lower for repeat donors compared to new donors. Repeat donors were more likely to return than new donors. Women and young donors were more often deferred than male and older donors. Men were more demotivated by tattoo or piercing deferral, resulting in lower return rates compared to women. Return rates differed greatly between blood centres. CONCLUSION Tattoo and piercing deferrals lead to missed donations and result in lower return rates. However, the numbers vary largely internationally, probably due to cultural and policy differences. Shortening deferral periods after tattooing or piercing may reduce the impact on donor availability, which should be investigated in single-centre studies.
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Affiliation(s)
- Franke Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Femmeke Prinsze
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Whitney R Steele
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
| | - Yves Grégoire
- Epidemiology and Statistics, Héma-Québec, Quebec City, Quebec, Canada
| | | | | | - Veerle Compernolle
- Belgian Red Cross, Blood Services, Mechelen, Belgium and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mindy Goldman
- Donation Policy and Studies, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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13
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Hahn B, Quee F, Prinsze FJ, Gregoire Y, O'Brien SF, Germain M, van de Laar T, Zaaijer HL, van den Hurk K. Balancing non-discriminatory donor selection and blood safety in the Netherlands: Evaluation of an individual risk assessment of sexual behavior. Transfusion 2022; 62:1241-1250. [PMID: 35502143 DOI: 10.1111/trf.16896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND To better balance the safety of the blood supply and the inclusion of men who have sex with men (MSM), further improvements are needed to the risk management strategy employed in the Netherlands to reduce transfusion-transmissible infections (TTIs). A gender-neutral individual risk assessment could provide a solution by determining donor eligibility based on sexual behaviors known to increase the risk of TTIs. Our objective is to estimate the proportion of blood donors that would be deferred by such an assessment, as well as their discomfort answering such questions. STUDY DESIGN AND METHODS Two surveys were distributed in May 2020 to assess sexual behavior in blood donors in the last 4, 6, and 12 months, as well as their discomfort reporting such information. A combination of both surveys measured the extent to which discomfort was associated with reporting sexual behavior. A high-risk sexual behavior pattern was defined as having had multiple sexual partners and having engaged in anal sex, without consistent condom use. RESULTS Of all 2177 participating whole blood donors, 0.8% report engaging in high-risk sexual behaviors over the last 4 months and would therefore be ineligible to donate. When accounting for the additional proportion of donors that reported such questions would stop them from donating, 2.0% and 3.2% of female and male donors, respectively, would be lost. DISCUSSION Gender-neutral eligibility criteria based on high-risk sexual behaviors may reduce the overall number of eligible donors in the Netherlands, but could make blood donation more accessible to a broader group of donors.
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Affiliation(s)
- Brett Hahn
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | - Franke Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | - Femmeke J Prinsze
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | | | | | | | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands.,Laboratory of Medical Microbiology, OLVG, Amsterdam, the Netherlands
| | - Hans L Zaaijer
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands.,Department of Clinical Virology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
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14
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Quee FA, Peffer K, ter Braake AD, van den Hurk K. Cardiovascular benefits for blood donors? A systematic review. Transfus Med Rev 2022; 36:143-151. [DOI: 10.1016/j.tmrv.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
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15
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Karregat J, Sweegers MG, Quee FA, Weekamp HH, Swinkels DW, Novotny VMJ, Zaaijer HL, van den Hurk K. Ferritin-guided iron supplementation in whole blood donors: optimal dosage, donor response, return and efficacy (FORTE)-a randomised controlled trial protocol. BMJ Open 2022; 12:e056316. [PMID: 35264362 PMCID: PMC8915278 DOI: 10.1136/bmjopen-2021-056316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Frequent whole blood donors have an increased risk of developing iron deficiency. Iron deficiency can have detrimental health effects when left untreated. Donation intervals are commonly too short to replenish iron stores and extending these reduces donor availability. Oral iron supplementation is known to shorten iron store recovery time but may also induce gastrointestinal complaints. We aim to optimise the effectiveness of iron supplements while minimising the risks of side effects. Therefore, we will evaluate the impact of different iron supplementation protocols in terms of dosage and frequency on ferritin and haemoglobin levels, gastrointestinal side effects, iron deficiency-related symptoms and donor return compared with placebo supplementation. METHODS Twelve hundred whole blood donors with ferritin levels ≤30 µg/L are included into a double-blind, randomised controlled trial. Participants are randomly allocated to one of six arms, administering capsules containing 0 mg, 30 mg or 60 mg of iron, either on alternate days or daily for 56 days. At baseline and 56, 122 and 182 days of follow-up, ferritin and haemoglobin levels are measured, and compliance, donor return, dietary iron intake, gastrointestinal, iron deficiency-related symptoms and general health are assessed by questionnaire. ETHICS AND DISSEMINATION This study will provide a comprehensive overview of the effects of different frequencies and dosages of administration of iron supplements on iron status and health effects, thereby considering individual differences in treatment adherence and lifestyle. The outcome will provide scientific evidence to guide the debate if and how oral iron supplements may support the recovery of whole blood donors with low ferritin levels. TRIAL REGISTRATION NUMBER NL8590; The Dutch trial registry.
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Affiliation(s)
- Jan Karregat
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Maike G Sweegers
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Franke A Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Henriëtte H Weekamp
- Medical Donor Affairs, Sanquin Blood Supply Foundation, Zwolle, Noord-Holland, The Netherlands
| | - Dorine W Swinkels
- Department of Laboratory Medicine, Radboud University Nijmegen, Nijmegen, Gelderland, The Netherlands
- Center for Iron Disorders Sanquin, Sanquin Blood Supply Foundation, Amsterdam, Noord-Holland, The Netherlands
| | - Vĕra M J Novotny
- Department of Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, Noord-Holland, The Netherlands
| | - Hans L Zaaijer
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Department of Clinical Virology, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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16
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Pandey S, Gorlin JB, Townsend M, Van Buren N, Leung JNS, Lee CK, van den Hurk K, Casamitjana N, Valles R, Alonso E, Miller YM, Richard P, Woimant G, Tiberghien P, Zhiburt E, Butler-Foster T, Goldman M, Nissen-Meyer LSH, Espinosa A, Kamel H, Bravo M, Filho LA, Pecego M, Germain M, Rabusseau I, Shinar E, Raz H, Choudhury N, Bhatnagar N, Hurt K, Lopez M, Reik RA, Nie Y, Hung Y, Pheello L, Dunbar N. International Forum on Gender Identification and Blood Collection: Responses. Vox Sang 2022; 117:E21-E43. [PMID: 34545590 DOI: 10.1111/vox.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
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17
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Vinkenoog M, Steenhuis M, Brinke AT, van Hasselt JGC, Janssen MP, van Leeuwen M, Swaneveld FH, Vrielink H, van de Watering L, Quee F, van den Hurk K, Rispens T, Hogema B, van der Schoot CE. Associations Between Symptoms, Donor Characteristics and IgG Antibody Response in 2082 COVID-19 Convalescent Plasma Donors. Front Immunol 2022; 13:821721. [PMID: 35296077 PMCID: PMC8918483 DOI: 10.3389/fimmu.2022.821721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/03/2022] [Indexed: 12/13/2022] Open
Abstract
Many studies already reported on the association between patient characteristics on the severity of COVID-19 disease outcome, but the relation with SARS-CoV-2 antibody levels is less clear. To investigate this in more detail, we performed a retrospective observational study in which we used the IgG antibody response from 11,118 longitudinal antibody measurements of 2,082 unique COVID convalescent plasma donors. COVID-19 symptoms and donor characteristics were obtained by a questionnaire. Antibody responses were modelled using a linear mixed-effects model. Our study confirms that the SARS-CoV-2 antibody response is associated with patient characteristics like body mass index and age. Antibody decay was faster in male than in female donors (average half-life of 62 versus 72 days). Most interestingly, we also found that three symptoms (headache, anosmia, nasal cold) were associated with lower peak IgG, while six other symptoms (dry cough, fatigue, diarrhoea, fever, dyspnoea, muscle weakness) were associated with higher IgG concentrations.
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Affiliation(s)
- Marieke Vinkenoog
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, Netherlands
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, Netherlands
| | - Maurice Steenhuis
- Department of Immunopathology, Sanquin Research, Amsterdam, Netherlands
- Landsteiner Laboratory, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Anja ten Brinke
- Department of Immunopathology, Sanquin Research, Amsterdam, Netherlands
- Landsteiner Laboratory, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - J. G. Coen van Hasselt
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands
| | - Mart P. Janssen
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, Netherlands
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, Netherlands
| | - Matthijs van Leeuwen
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, Netherlands
| | - Francis H. Swaneveld
- Department of Transfusion Medicine, Sanquin Blood Supply, Amsterdam, Netherlands
| | - Hans Vrielink
- Department of Transfusion Medicine, Sanquin Blood Supply, Amsterdam, Netherlands
| | - Leo van de Watering
- Department of Transfusion Medicine, Sanquin Blood Supply, Amsterdam, Netherlands
| | - Franke Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, Netherlands
| | - Theo Rispens
- Department of Immunopathology, Sanquin Research, Amsterdam, Netherlands
- Landsteiner Laboratory, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Boris Hogema
- Department of Virology, Sanquin Diagnostic Services, Amsterdam, Netherlands
| | - C. Ellen van der Schoot
- Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory Amsterdam University Medical Centre, Amsterdam, Netherlands
- *Correspondence: C. Ellen van der Schoot,
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18
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Prinsze FJ, de Groot R, Timmer TC, Zalpuri S, van den Hurk K. Donation-induced iron depletion is significantly associated with low hemoglobin at subsequent donations. Transfusion 2021; 61:3344-3352. [PMID: 34596892 DOI: 10.1111/trf.16688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Blood donation is associated with a loss of hemoglobin (Hb)-bound iron. Hb levels recover relatively fast by using stored iron. However, it takes more time to replenish iron stores, potentially resulting in iron deficiency. STUDY DESIGN Hb and ferritin levels were measured in 5056 new, first-time, and repeat whole blood donors. We investigated whether increasing numbers of donations are associated with lower ferritin levels. Furthermore, we tested whether low ferritin levels are associated with low-Hb deferral at the subsequent donation attempt by performing logistic regression adjusted for age and stratified by sex. RESULTS Whereas mean Hb levels are relatively stable, ferritin levels significantly decrease with increasing numbers of donations and were approximately 50% lower for donors with >50 donations compared with those with 2-10 donations. Despite the poor correlation of ferritin and Hb levels, cross-sectional, iron-deficient donors (ferritin <15 ng/ml) had 21.8 (8.5-55.6) higher odds in men, 10.1 (6.1-16.5) in premenopausal women, and 11.7 (5.2-26.4) in postmenopausal women for Hb deferral at a subsequent visit. DISCUSSION To conclude, repeated donations may induce iron deficiency, which corresponds with an over tenfold increased risk of having insufficiently restored Hb levels at a subsequent donation attempt. Longer donation intervals and/or higher dietary or supplemental iron intake are warranted to prevent accumulated iron depletion and subsequent low-Hb deferral in whole blood donors.
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Affiliation(s)
- Femmeke J Prinsze
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Rosa de Groot
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Tiffany C Timmer
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Saurabh Zalpuri
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, the Netherlands.,UCB Pharma, Real World Evidence, Breda, the Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, the Netherlands
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19
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Pandey S, Gorlin JB, Townsend M, Van Buren N, Leung JNS, Lee CK, van den Hurk K, Casamitjana N, Valles R, Alonso E, Miller YM, Richard P, Woimant G, Tiberghien P, Zhiburt E, Butler-Foster T, Goldman M, Nissen-Meyer LSH, Espinosa A, Kamel H, Bravo M, Filho LA, Pecego M, Germain M, Rabusseau I, Shinar E, Raz H, Choudhury N, Bhatnagar N, Hurt K, Lopez M, Reik RA, Nie Y, Hung Y, Pheello L, Dunbar N. International Forum on Gender Identification and Blood Collection: Summary. Vox Sang 2021; 117:447-456. [PMID: 34545579 DOI: 10.1111/vox.13192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
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20
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Karki S, Gemelli CN, Davison TE, Masser BM, Marks DC, Bell K, Liu B, Hayen A, van den Hurk K, Irving DO. Willingness of blood donors in Australia to provide additional data and blood sample for health research. Transfusion 2021; 61:2855-2861. [PMID: 34423437 DOI: 10.1111/trf.16629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Many blood collection agencies are generating important data on donor health outcomes using large-scale blood donor cohort studies. Such studies can be very effective when donors provide access to linkage of their data to external health databases, and storage and genomic testing of their blood sample. In this study, we aimed to assess the willingness of Australian blood donors to provide additional data and blood sample for donation-related and other health research. STUDY DESIGN AND METHODS We invited 2017 donors to complete a survey using four methods (postal letter, postal letter and email, email only, and in-center recruitment). The survey asked for information on demographics, lifestyle behaviors, health, experience and attitude to blood donation, and willingness to give blood sample and additional data for research. RESULTS Response rates ranged from 23.8% for email only to 77.2% for in-center recruitment. Of those who responded (n = 827), 95.5% indicated they would be willing to provide a blood sample for donation and transfusion-related research. Of these, >90.0% were willing for their sample to be used in research involving genetic testing and other health-related topics. Also, >90.0% were willing to consent for linkage of their information to external health databases. CONCLUSIONS Donors surveyed reported a high willingness to participate in health research by completing surveys, allowing linkage to external datasets, and providing a blood sample. These findings provide strong support for future longitudinal research studies with Australian blood donors.
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Affiliation(s)
- Surendra Karki
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,School of Population Health, UNSW Australia, Sydney, New South Wales, Australia
| | - Carley N Gemelli
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Tanya E Davison
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,Silver Chain Group, Melbourne, Western Australia, Australia
| | - Barbara M Masser
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Katy Bell
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Bette Liu
- School of Population Health, UNSW Australia, Sydney, New South Wales, Australia
| | - Andrew Hayen
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - David O Irving
- Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
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21
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Langi Sasongko P, van den Hurk K, van Kraaij M, Rouwette EAJA, Marchau VAWJ, Janssen MP. Not a crystal ball: Mapping opportunities and threats for the future demand of red blood cells in the Netherlands using a scenario approach. Transfusion 2021; 61:2356-2367. [PMID: 34058022 DOI: 10.1111/trf.16532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND As Western blood transfusion practices are changing, there is interest and need in anticipating the future demand of blood products and how a blood establishment can actively prepare for various long-term developments. This article provides an overview of how a scenario approach was used to prioritize key categories of drivers for the future demand of red blood cells and the organizational implications thereof for Sanquin, the Dutch national blood establishment. STUDY DESIGN AND METHODS Based on previously identified drivers from interviews and a literature review (Step 1), we conducted scenario sessions and a survey to rank a list of drivers ("themes") with its related opportunities and threats (Step 2), to identify mitigating measures per theme through focus groups (Step 3). RESULTS In Step 2, 10 themes were found that were classified in terms of importance and uncertainty. These were plotted on a two-dimensional graph with an ellipse to indicate the interquartile ranges per theme. Experts rated the top three most important themes to be the blood supply organization, precision medicine, and red blood cell replacements. In Step 3, focus groups identified specific mitigating measures per theme. These measures had parallel ideas, such as the need for an innovative mentality, internal and external communication and collaboration, and building Sanquin's reputation and trust with the public. CONCLUSION Having identified the most important themes with suggestions for mitigating measures, Sanquin can take steps to become adaptive and proactive. Other blood establishments may also use a scenario approach to create contextualized long-term strategies.
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Affiliation(s)
- Praiseldy Langi Sasongko
- Department of Donor Medicine Research, Transfusion Technology Assessment, Sanquin Research, Amsterdam, The Netherlands.,Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Marian van Kraaij
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Mart P Janssen
- Department of Donor Medicine Research, Transfusion Technology Assessment, Sanquin Research, Amsterdam, The Netherlands
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22
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Germain M, Grégoire Y, Custer BS, Goldman M, Bravo M, Kamel H, Davison K, Field S, van den Hurk K, van de Laar TJW, Irving DO, Jones A, Liumbruno G, Morley S, O'Brien SF, Pillonel J, Steinsvåg CT, Takanashi M, Tsuno NH, Vesga Carasa MA, Wendel S, Vassallo RR, Tiberghien P. An international comparison of HIV prevalence and incidence in blood donors and general population: a BEST Collaborative study. Vox Sang 2021; 116:1084-1093. [PMID: 33835513 DOI: 10.1111/vox.13107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different jurisdictions in relation to those rates in the general population and differences in deferral practices. MATERIALS AND METHODS Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody-positive donations and nucleic acid testing (NAT)-only-positive donations was broken down according to first-time or repeat donor status, along with the relevant denominators. RESULTS There is a modest correlation between HIV prevalence among first-time donors and HIV prevalence in the general population. However, rates of HIV-positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT-only-positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons. CONCLUSION Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.
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Affiliation(s)
- Marc Germain
- Medical affairs and Innovation, Héma-Québec, Québec, Canada
| | - Yves Grégoire
- Medical affairs and Innovation, Héma-Québec, Québec, Canada
| | - Brian S Custer
- Vitalant Research Institute, Vitalant, San Francisco, CA, USA
| | - Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, Canada
| | | | - Hany Kamel
- Medical Affairs, Vitalant, Scottsdale, AZ, USA
| | | | | | | | | | - David O Irving
- Research and Development, Australian Red Cross Blood Service, Melbourne, Australia
| | | | | | - Sarah Morley
- New Zealand Blood Service, Auckland, New Zealand
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Canada
| | - Josiane Pillonel
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | | | | | | | | | | | | | - Pierre Tiberghien
- Établissement Français du Sang, La Plaine Saint-Denis, France.,Inserm UMR 1098 RIGHT, Université de Franche-Comté, Établissement Français du Sang, Besançon, France
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23
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Goldman M, Townsend M, Magnussen K, Lozano M, Nissen-Meyer LSH, Lee CK, Leung JNS, Takanashi M, McKay J, Kvist M, Robitaille N, Deschênes J, Di Angelantonio E, McMahon A, Roberts D, Maghsudlu M, Castrén J, Tiberghien P, Woimant G, Morel P, Kamel H, Bravo M, Shinar E, Gendelman V, Raz H, Wendel S, Fachini R, Quee F, van den Hurk K, Wiersum J, Grima KM, Speedy J, Bruun MT, Dunbar NM. International Forum on Mitigation Strategies to Prevent Faint and Pre-faint Adverse Reactions in Whole Blood Donors: Responses. Vox Sang 2021; 116:e1-e24. [PMID: 33754360 DOI: 10.1111/vox.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | | | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong SAR
| | | | - Minoko Takanashi
- Japanese Red Cross Society, Blood Service Headquarters, Tokyo, Japan
| | | | | | | | | | | | - Amy McMahon
- National Health Service Blood and Transplant (NHSBT), Cambridge, UK
| | - David Roberts
- National Health Service Blood and Transplant (NHSBT), Cambridge, UK
| | | | | | | | | | - Pascal Morel
- Etablissement Français du Sang, La Plaine St-Denis, France
| | | | | | | | | | | | | | | | | | | | | | | | - Joanna Speedy
- Australian Red Cross Lifeblood, Melbourne, Vic., Australia
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van den Hurk K, Merz EM, Prinsze FJ, Spekman ML, Quee FA, Ramondt S, Slot E, Vrielink H, Huis in ’t Veld EM, Zaaijer HL, Hogema BM. Low awareness of past SARS-CoV-2 infection in healthy plasma donors. Cell Rep Med 2021; 2:100222. [PMID: 33681828 PMCID: PMC7917439 DOI: 10.1016/j.xcrm.2021.100222] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/15/2020] [Accepted: 02/19/2021] [Indexed: 01/05/2023]
Abstract
Awareness of infection with SARS-CoV-2 is crucial for the effectiveness of COVID-19 control measures. Here, we investigate awareness of infection and symptoms in relation to antibodies against SARS-CoV-2 in healthy plasma donors. We asked individuals donating plasma across the Netherlands between May 11th and 18th 2020 to report COVID-19-related symptoms, and we tested for antibodies indicative of a past infection with SARS-CoV-2. Among 3,676 with antibodies, and from questionnaire data, 239 (6.5%) are positive for SARS-CoV-2 antibodies. Of those, 48% suspect no COVID-19, despite the majority reporting symptoms; 11% of seropositive individuals report no symptoms and 27% very mild symptoms at any time during the first peak of the epidemic. Anosmia/ageusia and fever are most strongly associated with seropositivity. Almost half of seropositive individuals do not suspect SARS-CoV-2 infection. Improved recognition of COVID-19 symptoms, in particular, anosmia/ageusia and fever, is needed to reduce widespread SARS-CoV-2 transmission.
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Affiliation(s)
- Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | - Eva-Maria Merz
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Sociology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Femmeke J. Prinsze
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | - Marloes L.C. Spekman
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Sociology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Franke A. Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | - Steven Ramondt
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Communication Science, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ed Slot
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Medical Affairs, Sanquin Corporate Staff, Sanquin Research, Amsterdam, the Netherlands
| | - Hans Vrielink
- Unit of Transfusion Medicine, Sanquin Blood Bank, Amsterdam, the Netherlands
| | - Elisabeth M.J. Huis in ’t Veld
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, the Netherlands
| | - Hans L. Zaaijer
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, the Netherlands
| | - Boris M. Hogema
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
- Department of Virology, Sanquin Diagnostic Services, Amsterdam, the Netherlands
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25
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Young P, Crowder L, Steele W, Irving D, Pink J, Kutner JM, Yokoyama APH, Van Buren N, O'Sullivan NW, Sayers M, Alcantara RM, van den Hurk K, Wiersum-Osselton J, Shaz B. Frequency of rare, serious donor reactions: International perspective. Transfusion 2021; 61:1780-1788. [PMID: 33665853 DOI: 10.1111/trf.16333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Severe blood donor adverse events are rare, but due to their rarity studying them can be difficult. To get an accurate estimate of their frequency and rate in the donor population it may be necessary to combine donation data across countries. STUDY DESIGN AND METHODS International blood collection organizations (BCOs) provided data on rare/severe donor reactions as well as denominator information for their donor populations from 2015 to 2017. Donor reactions were classified using standardized definitions. RESULTS BCOs from six countries provided reaction data for more than 22 million donations. A total of 480 rare reactions were reported of which 76.7% were imputed as definite and 11% probable. Rates of rare reactions were higher in females and first-time donors. Systemic rare reactions were the most common reaction type, accounting for over three quarters of reactions reported. Of systemic reactions, vasovagal reactions with loss of consciousness and injury or off-site (n = 350) made up the majority and occurred 1.53 per 100,000 donations. For the 22.3% that were localized reactions, the majority of these were cellulitis (n = 71, 0.31 per 100,000 donations) followed by deep venous thrombosis (n = 21, 0.09 per 100,000 donations). CONCLUSION Pulling together data from multiple BCOs across countries allows for a better understanding of rare reactions, such as vasovagal reaction with injury or cellulitis, and for generating a reliable incidence rate for air embolism or compartment syndrome. However, gaps remain due to missing elements such as unknown donor status or location of reaction.
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Affiliation(s)
- Pampee Young
- American Red Cross, Washington, District of Columbia, USA
| | - Lauren Crowder
- American Red Cross, Washington, District of Columbia, USA
| | - Whitney Steele
- American Red Cross, Washington, District of Columbia, USA
| | - David Irving
- Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Joanne Pink
- Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Jose Mauro Kutner
- Cell Therapy and Hemotherapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Nancy Van Buren
- Memorial Blood Centers, New York Blood Center Enterprises, Saint Paul, Minnesota, USA
| | | | | | | | | | | | - Beth Shaz
- Duke University, Durham, North Carolina, USA
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26
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Spekman MLC, Ramondt S, Quee FA, Prinsze FJ, Huis In 't Veld EMJ, van den Hurk K, Merz EM. New blood donors in times of crisis: Increased donation willingness, particularly among people at high risk for attracting SARS-CoV-2. Transfusion 2021; 61:1822-1829. [PMID: 33634876 PMCID: PMC8013484 DOI: 10.1111/trf.16334] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 01/13/2023]
Abstract
Background Traditionally, during crises the number of new blood donors increases. However, the current coronavirus disease 2019 (COVID‐19) pandemic created additional barriers to donate due to governmental prevention measures and increased personal health risks. In this report, we examined how the pandemic affected new donor registrations in the Netherlands, especially among groups with higher risk profiles for severe COVID‐19. Additionally, we explored the role of media for blood donation and new donor registrations. Study Design and Methods We analyzed new donor registrations and attention for blood donation in newspapers and on social media from January until May 2020, in comparison to the same period in 2017 to 2019. Results After the introduction of nationwide prevention measures, several peaks in new donor registrations occurred, which coincided with peaks in media attention. Interestingly, people with a higher risk profile for COVID‐19 (e.g., due to age or region of residence) were overrepresented among new registrants. Discussion In sum, the first peak of the current pandemic has led to increased new blood donor registrations, despite the associated increased health risks. Time and future studies will have to tell whether these new donors are one‐off ‘pandemic’ donors or if they will become regular, loyal donors.
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Affiliation(s)
- Marloes L C Spekman
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Steven Ramondt
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Communication Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - Franke A Quee
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Femmeke J Prinsze
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Elisabeth M J Huis In 't Veld
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Eva-Maria Merz
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands
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27
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Timmer T, Tanck M, Penkett C, Stirrups K, Gleadall N, de Kort W, van der Schoot E, van den Hurk K. Genetic determinants of ferritin, haemoglobin levels and haemoglobin trajectories: results from Donor InSight. Vox Sang 2021; 116:755-765. [PMID: 33491795 DOI: 10.1111/vox.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Blood donors might develop iron deficiency as approximately 250 mg of iron is lost with every donation. Susceptibility to iron deficiency and low haemoglobin levels differs between individuals, which might be due to genetic variation. Therefore, the aim of this study was to investigate associations between single nucleotide polymorphisms (SNPs) and haemoglobin trajectories, haemoglobin levels and ferritin levels in blood donors. MATERIALS AND METHODS In 2655 donors participating in the observational cohort study Donor InSight-III (2015-2017), haemoglobin and ferritin levels were measured in venous EDTA whole blood and plasma samples, respectively. Haemoglobin trajectories (stable/declining) were determined by fitting growth-mixture models on repeated pre-donation capillary haemoglobin measurements. Genotyping was done using the UK Biobank - version 2 Axiom Array. Single SNP analyses adopting an additive genetic model on imputed genetic variants were performed for haemoglobin trajectories, haemoglobin levels and ferritin levels. Conditional analyses identified independent SNPs. RESULTS Twelve, twenty and twenty-four independent SNPs were associated with haemoglobin trajectories, haemoglobin levels and ferritin levels respectively (P < 1 x 10-5 ). Rs112016443 reached genome-wide significance for ferritin levels, which influences WDSUB1 expression. CONCLUSION Rs112016443 was genome-wide significantly associated with ferritin levels in Dutch donors. Further validation studies are needed, as well as studies towards underlying mechanisms and predicting iron deficiency using SNPs.
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Affiliation(s)
- Tiffany Timmer
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Christopher Penkett
- Department of Haematology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.,NIHR BioResource, Cambridge Biomedical Campus, Cambridge University Hospitals, Cambridge, UK
| | - Kathleen Stirrups
- Department of Haematology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.,NIHR BioResource, Cambridge Biomedical Campus, Cambridge University Hospitals, Cambridge, UK
| | - Nicholas Gleadall
- Department of Haematology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.,Cambridge Biomedical Campus, NHS Blood and Transplant, Cambridge, UK
| | - Wim de Kort
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ellen van der Schoot
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
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28
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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29
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Sandner S, Merz EM, van den Hurk K, van Kraaij M, Mikkelsen C, Ullum H, Clement M. Validation of a standardized donor health questionnaire across substances of human origin. Vox Sang 2020; 116:645-655. [PMID: 33326613 DOI: 10.1111/vox.13054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES A donor health questionnaire (DHQ) aims to ensure the safety of donors and recipients of transfusions or transplantations with blood components, plasma-derived medicinal products, tissues, haematopoietic stem cells and medically assisted reproduction (in short substances of human origin; SoHO). Currently, many different DHQs exist across countries and SoHO. TRANSPOSE (TRANSfusion and transplantation PrOtection and SElection of donors) developed and validated a standardized DHQ to use across countries and SoHO. We tested whether participants understand the questions and provide honest answers. METHODS For the validation of the standardized DHQ, two demographically representative online surveys were conducted in Germany (N = 3329) and Austria (N = 3432). We surveyed whether participants understood each DHQ question and would answer the questions truthfully. We used experimental settings to test whether there is a difference between mode of administration (print vs. online), the order of the questions (subject vs. chronological order), and the positioning of the general state of health question (beginning vs. end) in the DHQ. Using regression models, we tested the DHQ's impact on participant mood after completion and on socially desirable response behaviour. RESULTS Participants understood the DHQ questions well and would answer them honestly. Nevertheless, the data show different levels of understanding and honesty when responding. Administration mode was the only characteristic that had a significant influence on mood, with the online version resulting in a more favourable mood in comparison to the printed version. CONCLUSION The DHQ was well understood and had a low dishonest tendency. Our findings can serve as an impulse for further research on DHQ criteria across other SoHO and countries.
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Affiliation(s)
- Sabrina Sandner
- Research Group on Health Marketing, Institute for Marketing, University of Hamburg, Hamburg, Germany
| | - Eva-Maria Merz
- Research Group on Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Center for Philanthropic Studies, Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Research Group on Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Marian van Kraaij
- Research Group on Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michel Clement
- Research Group on Health Marketing, Institute for Marketing, University of Hamburg, Hamburg, Germany
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30
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Goldman M, Townsend M, Magnussen K, Lozano M, Nissen-Meyer LS, Lee CK, Leung JNS, Takanashi M, McKay J, Kvist M, Robitaille N, Deschênes J, Di Angelantonio E, McMahon A, Roberts D, Maghsudlu M, Castrén J, Tiberghien P, Woimant G, Morel P, Kamel H, Bravo M, Shinhar E, Gendelman V, Raz H, Wendel S, Fachini R, Quee F, van den Hurk K, Wiersum J, Grima K, Speedy J, Bruun M, Dunbar N. Vox Sanguinis International Forum on Mitigation Strategies to Prevent Faint and Pre-faint Adverse Reactions in Whole Blood Donors: Summary. Vox Sang 2020; 116:351-359. [PMID: 33245787 DOI: 10.1111/vox.13037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, ON, Canada
| | | | - Karin Magnussen
- Immunology & Transfusion Medicine, Innlandet Hospital Trust, Lillehammer, Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy Dunbar
- Blood Bank, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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31
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Mikkelsen C, Mori G, van Walraven SM, Castrén J, Zahra S, MacLennan S, Seidel K, Fontana S, Veropalumbo E, Cannata L, Pupella S, Kvist M, Happel M, Korkalainen P, Chandrasekar A, Paulus U, Bokhorst A, Wulff B, Fernandez-Sojo J, Eguizabal C, Urbano F, Vesga MA, van Kraaij M, Merz EM, van den Hurk K, Hansen MB, Slot E, Ullum H. How donor selection criteria can be evaluated with limited scientific evidence: lessons learned from the TRANSPOSE project. Vox Sang 2020; 116:342-350. [PMID: 33191514 DOI: 10.1111/vox.13028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Donor selection criteria (DSC) are a vital link in the chain of supply of Substances of Human Origin (SoHO) but are also subject to controversy and differences of opinion. Traditionally, DSC have been based on application of the precautionary principle. MATERIALS AND METHODS From 2017 to 2020, TRANSPOSE (TRANSfusion and transplantation PrOtection and SElection of donors), a European research project, aimed to identify discrepancies between current DSC by proposing a standardized risk assessment method for all SoHO (solid organs excluded) and all levels of evidence. RESULTS The current DSC were assessed using a modified risk assessment method based on the Alliance of Blood Operators' Risk-based decision-making framework for blood safety. It was found that with limited or diverging scientific evidence, it was difficult to reach consensus and an international standardized method for decision-making was lacking. Furthermore, participants found it hard to disregard their local guidelines when providing expert opinion, which resulted in substantial influence on the consensus-based decision-making process. CONCLUSIONS While the field of donation-safety research is expanding rapidly, there is an urgent need to formalize the decision-making process regarding DSC. This includes the need for standardized methods to increase transparency in the international decision-making process and to ensure that this is performed consistently. Our framework provides an easy-to-implement approach for standardizing risk assessments, especially in the context of limited scientific evidence.
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Affiliation(s)
- Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gaia Mori
- Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | | | | | - Sharon Zahra
- Scottish National Blood Transfusion Service, Edinburgh, Scotland
| | | | | | - Stefano Fontana
- Interregional Blood Transfusion Service SRC, University of Lausanne, Berne, Switzerland
| | - Eva Veropalumbo
- Centro Nazionale Sangue, Istituto Superiore di Sanità, Rome, Italy
| | - Livia Cannata
- Centro Nazionale Sangue, Istituto Superiore di Sanità, Rome, Italy
| | | | - Maria Kvist
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Solna, Sweden
| | - Marjan Happel
- TRIP Hemovigilance and Biovigilance Office, Leiden, the Netherlands
| | | | | | | | - Arlinke Bokhorst
- TRIP Hemovigilance and Biovigilance Office, Leiden, the Netherlands
| | - Birgit Wulff
- Institute of Legal Medicine, University Medical Center Hamburg, Hamburg, Germany
| | | | - Cristina Eguizabal
- Bioef-Fundacion Vasca de Innovacion e Investigation Sanitarias-Osakidetza-Centro Vasco de Transfusión y Tejidos Humanos, Galdakao, Spain
| | - Fernando Urbano
- Bioef-Fundacion Vasca de Innovacion e Investigation Sanitarias-Osakidetza-Centro Vasco de Transfusión y Tejidos Humanos, Galdakao, Spain
| | - Miguel Angel Vesga
- Bioef-Fundacion Vasca de Innovacion e Investigation Sanitarias-Osakidetza-Centro Vasco de Transfusión y Tejidos Humanos, Galdakao, Spain
| | | | - Eva-Maria Merz
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam, the Netherlands.,Department of Sociology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Katja van den Hurk
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam, the Netherlands
| | - Morten Bagge Hansen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ed Slot
- Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
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32
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Timmer TC, de Groot R, Rijnhart JJ, Lakerveld J, Brug J, Perenboom CW, Baart AM, Prinsze FJ, Zalpuri S, van der Schoot CE, de Kort WL, van den Hurk K. Dietary intake of heme iron is associated with ferritin and hemoglobin levels in Dutch blood donors: results from Donor InSight. Haematologica 2020; 105:2400-2406. [PMID: 33054080 PMCID: PMC7556674 DOI: 10.3324/haematol.2019.229450] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 11/12/2019] [Indexed: 11/25/2022] Open
Abstract
Whole blood donors, especially frequently donating donors, have a risk of iron deficiency and low hemoglobin levels, which may affect their health and eligibility to donate. Lifestyle behaviors, such as dietary iron intake and physical activity, may influence iron stores and thereby hemoglobin levels. We aimed to investigate whether dietary iron intake and questionnaire-based moderate-to-vigorous physical activity were associated with hemoglobin levels, and whether ferritin levels mediated these associations. In Donor InSight-III, a Dutch cohort study of blood and plasma donors, data on heme and non-heme iron intake (mg/day), moderate-to-vigorous physical activity (10 minutes/day), hemoglobin levels (mmol/L) and ferritin levels (μg/L) were available in 2,323 donors (1,074 male). Donors with higher heme iron intakes (regression coefficients (β) in men and women: 0.160 and 0.065 mmol/L higher hemoglobin per 1 mg of heme iron, respectively) and lower non-heme iron intakes (β: -0.014 and -0.017, respectively) had higher hemoglobin levels, adjusted for relevant confounders. Ferritin levels mediated these associations (indirect effect (95% confidence interval) in men and women respectively: 0.074 (0.045; 0.111) and 0.061 (0.030; 0.096) for heme and -0.003 (-0.008;0.001) and -0.008 (-0.013;-0.003) for non-heme). Moderate-to-vigorous physical activity was negatively associated with hemoglobin levels in men only (β: -0.005), but not mediated by ferritin levels. In conclusion, higher heme and lower non-heme iron intake were associated with higher hemoglobin levels in donors, via higher ferritin levels. This indicates that donors with high heme iron intake may be more capable of maintaining iron stores to recover hemoglobin levels after blood donation.
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Affiliation(s)
- Tiffany C. Timmer
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health, Amsterdam
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Rosa de Groot
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam
- Amsterdam UMC, Location VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam
| | - Judith J.M. Rijnhart
- Amsterdam UMC, Location VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam
| | - Jeroen Lakerveld
- Amsterdam UMC, Location VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam
| | - Johannes Brug
- National Institute for Public Health and the Environment, Bilthoven
- University of Amsterdam, Amsterdam School of Communication Research (ASCoR), Amsterdam
| | - Corine W.M. Perenboom
- Wageningen University and Research, Division of Human Nutrition and Health, Wageningen
| | - A. Mireille Baart
- Wageningen University and Research, Division of Human Nutrition and Health, Wageningen
| | - Femmeke J. Prinsze
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam
| | - Saurabh Zalpuri
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam
| | - C. Ellen van der Schoot
- Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam, the Netherlands
| | - Wim L.A.M. de Kort
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health, Amsterdam
| | - Katja van den Hurk
- Sanquin Research, Department of Donor Medicine Research - Donor Studies, Amsterdam
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Sweegers MG, Zalpuri S, Quee FA, Huis In 't Veld EMJ, Prinsze FJ, Hoogendijk EO, Twisk JWR, van Weert AWM, de Kort WLAM, van den Hurk K. Ferritin measurement IN Donors-Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND'EM): study protocol for a stepped wedge cluster randomised trial. Trials 2020; 21:823. [PMID: 32998766 PMCID: PMC7528293 DOI: 10.1186/s13063-020-04648-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 07/31/2020] [Indexed: 11/15/2022] Open
Abstract
Background Blood donors are at risk for reduced iron stores, because of which donor iron monitoring received increased attention in the last decade. Despite the importance for donor health, international consensus on an appropriate policy for iron monitoring is lacking. Therefore, we conduct a trial to evaluate to what extent ferritin-guided donation intervals are effective in increasing haemoglobin and ferritin levels, decreasing low-haemoglobin deferral, increasing donor return and improving the health of whole blood donors in the Netherlands. Methods Sanquin Blood Bank is implementing ferritin-guided donation intervals to prevent donors from increasing iron loss at repeated donations. Using a stepped wedge cluster randomised trial approach, the design involves a random crossover of 29 clusters of blood collection centres from the existing policy without ferritin measurements to a ferritin-guided donation interval policy. This new policy includes ferritin measurements for all new donors and at every 5th whole blood donation, extending donation intervals to 6 months if ferritin is 15–≤ 30 ng/mL and to 12 months if ferritin is < 15 ng/mL. We measure ferritin levels of whole blood donors from stored plasma samples and collect haemoglobin levels and information on low-haemoglobin deferral and donor return from the donor database before, during and after the implementation period. We measure donor health during and after the implementation period using questionnaires, assessing physical and mental wellbeing and iron deficiency- and donation-related symptoms. We use multilevel analyses to investigate differences in ferritin and haemoglobin levels, low-haemoglobin deferral rates, donor return and donor health from whole blood donors, between blood collection centres that have versus those that have not yet implemented the ferritin-guided donation interval policy. Discussion This stepped wedge cluster randomised trial will provide insight into the effectiveness of ferritin-guided donation intervals in lowering iron deficiency, decreasing donor deferrals due to low haemoglobin and improving donor health. We will evaluate a policy that is implemented nationwide in a real-life setting. Our study is therefore not limited to a small experimental setting and the results will guide policymakers seeking an appropriate policy for iron monitoring. Trial registration The Dutch trial registry NTR6738. Registered on 29 September 2017. Retrospectively registered.
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Affiliation(s)
| | | | - Franke A Quee
- Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Elisabeth M J Huis In 't Veld
- Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Cognitive Science & Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | | | - Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Centre, 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
| | - Anton W M van Weert
- National Screening Laboratory Sanquin, Sanquin Research and Labservices, Amsterdam, The Netherlands
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Vinkenoog M, van den Hurk K, van Kraaij M, van Leeuwen M, Janssen MP. First results of a ferritin-based blood donor deferral policy in the Netherlands. Transfusion 2020; 60:1785-1792. [PMID: 32533600 PMCID: PMC7496980 DOI: 10.1111/trf.15906] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Whole blood donors are at risk of becoming iron deficient. To monitor iron stores, Sanquin implemented a new deferral policy based on ferritin levels, in addition to the traditional hemoglobin measurements. METHODS Ferritin levels are determined in every fifth donation, as well as in all first-time donors. Donors with ferritin levels <15 ng/mL (WHO threshold) are deferred for 12 months; those ≥15 and ≤30 ng/mL for 6 months. The first results were analyzed and are presented here. RESULTS The results show that 25% of women (N = 20151, 95% CI 24%-25%) and 1.6% of men (N = 10391, 95% CI 1.4%-1.8%) have ferritin levels ≤30 ng/mL at their first blood center visit. For repeat (non-first-time) donors, these proportions are higher: 53% of women (N = 28329, 95% CI 52%-54%) and 42% of men (N = 31089, 95% CI 41%-43%). After a 6-month deferral, in 88% of returning women (N = 3059, 95% CI 87%-89%) and 99% of returning men (N = 3736, 95% CI 98%-99%) ferritin levels were ≥15 ng/mL. After a 12-month deferral, in 74% of returning women (N = 486, 95% CI 70%-78%) and 95% of returning men (N = 479, 95% CI 94%-97%) ferritin levels increased to ≥15 ng/mL. CONCLUSION Deferral of donors whose pre-donation ferritin levels were ≤30 ng/mL might prevent donors from returning with ferritin levels <15 ng/mL. This policy is promising to mitigate effects of repeated donations on iron stores.
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Affiliation(s)
- Marieke Vinkenoog
- Donor Medicine Research, Sanquin ResearchAmsterdamThe Netherlands
- Leiden Institute of Advanced Computer ScienceLeiden UniversityLeidenThe Netherlands
| | | | | | - Matthijs van Leeuwen
- Leiden Institute of Advanced Computer ScienceLeiden UniversityLeidenThe Netherlands
| | - Mart P. Janssen
- Donor Medicine Research, Sanquin ResearchAmsterdamThe Netherlands
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van Bilsen WPH, Zaaijer HL, Matser A, van den Hurk K, Slot E, Schim van der Loeff MF, Prins M, van de Laar TJW. Infection Pressure in Men Who Have Sex With Men and Their Suitability to Donate Blood. Clin Infect Dis 2020; 68:1001-1008. [PMID: 30052873 DOI: 10.1093/cid/ciy596] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Deferral of men who have sex with men (MSM) from blood donation is highly debated. We therefore investigated their suitability to donate blood. METHODS We compared the antibody prevalence of 10 sexually and transfusion-transmissible infections (TTIs) among 583 MSM and 583 age-matched repeat male blood donors. MSM were classified as low risk (lr) or medium-to-high risk (hr) based on self-reported sexual behavior and as qualified or unqualified using Dutch donor deferral criteria. Infection pressure (IP) was defined as the number of antibody-reactive infections, with class A infections (human immunodeficiency virus-1/2, hepatitis B virus, hepatitis C virus, human T-cell lymphotropic virus-1/2, syphilis) given double weight compared to class B infections (cytomegalovirus, herpes simplex virus-1/2, human herpesvirus 8, hepatitis E virus, parvovirus B19). RESULTS Donors had a lower median IP than qualified lr-MSM and qualified hr-MSM (2 [interquartile range {IQR}, 1-2] vs 3 [IQR, 2-4]; P < .001). Low IP was found in 76% of donors, 39% of qualified lr-MSM, and 27% of qualified hr-MSM. The prevalence of class A infections did not differ between donors and qualified lr-MSM but was significantly higher in qualified hr-MSM and unqualified MSM. Recently acquired class A infections were detected in hr-MSM only. Compared to blood donors, human herpesviruses were more prevalent in all MSM groups (P < .001). CONCLUSIONS IP correlates with self-reported risk behavior among MSM. Although lr-MSM might form a low threat for blood safety with regard to class A infections, the high seroprevalence of human herpesviruses in lr-MSM warrants further investigation.
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Affiliation(s)
- Ward P H van Bilsen
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Hans L Zaaijer
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands
| | - Amy Matser
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Ed Slot
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands
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Baart AM, van den Hurk K, de Kort WLAM, Huis In 't Veld EMJ. Impact of risk-dependent interventions on low haemoglobin deferral rates in whole blood donors. Vox Sang 2020; 115:171-181. [PMID: 31912518 DOI: 10.1111/vox.12885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Blood donors with a relatively low haemoglobin (Hb) level at their previous donation attempt have an increased risk of Hb deferral at the subsequent donation attempt. The aim of this study was to investigate whether the interventions prolongation of donation interval and/or a dietary advice decrease the Hb deferral rate. METHODS 11 897 whole blood donors with Hb levels from below to 0·2 mmol/l above the cut-off level for donation received either no intervention, a prolongation of the donation interval to six or twelve months, a dietary advice, or both. Deferral rates for low Hb levels at the subsequent donation attempt were compared in the different intervention groups. Additionally, the effects of the interventions on Hb deferral risk and donor return for a subsequent donation attempt were analysed using generalized estimating equations. RESULTS The Hb deferral rate was substantially lower in the group that received a prolongation of the donation interval to six months than in the Control Group (12·9% vs. 6·3% in men and 20·4% vs. 13·4% in women). However, the additional benefit of twelve over 6-month interval prolongation was small, and no benefit of a dietary advice showed up. On the other hand, receiving a dietary advice increased the likelihood of donor return for a subsequent donation attempt. CONCLUSION Implementation of a protocol for the prolongation of donation intervals to six months for donors with Hb levels from below to slightly above the cut-off level for donation may reduce the deferral rate for low Hb levels while keeping donor lapse at a minimum.
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Affiliation(s)
- A Mireille Baart
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands
| | - Katja van den Hurk
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands
| | - Wim L A M de Kort
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands
| | - Elisabeth M J Huis In 't Veld
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands.,Department of Cognitive Science & Artificial Intelligence, Tilburg University, Tilburg, the Netherlands
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Baart AM, Timmer T, de Kort WLAM, van den Hurk K. Lifestyle behaviours, ethnicity and menstruation have little added value in prediction models for low haemoglobin deferral in whole blood donors. Transfus Med 2019; 30:16-22. [PMID: 31782196 DOI: 10.1111/tme.12651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 11/04/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the added value of questionnaire-based predictors to existing prediction models for low haemoglobin (Hb) deferral in whole blood donors. BACKGROUND Prediction models for Hb deferral risk can be applied in the invitation process of donors for a blood donation. Existing prediction models are based on routinely collected data. The model performance might be improved by the addition of predictive factors. METHODS The added value of food consumption, smoking, physical activity, ethnicity and menstruation in the prediction of Hb deferral was assessed by comparing the existing models with extended models using the following measures: model X2 , concordance (c)-statistic and net reclassification improvement (NRI). RESULTS Addition of one candidate predictor to the models did not substantially improve the model performance. Addition of multiple new candidate predictors significantly increased the model X2 (from 137 to 159 for men, and from 157 to 199 for women) and resulted in a non-significant increase of the c-statistic (from 0.85 to 0.87 for men, and from 0.78 to 0.81 for women). The NRI for men was 11.4% and for women 1.5% after addition of multiple predictors. CONCLUSION Addition of lifestyle behaviours, ethnicity or menstruation to prediction models for low Hb deferral in whole blood donors improved the model performance, but not substantially. For easy use in practice, we do not recommend addition of the investigated predictors to the prediction models.
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Affiliation(s)
- A Mireille Baart
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands
| | - Tiffany Timmer
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands.,Landsteiner Laboratory and Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim L A M de Kort
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands
| | - Katja van den Hurk
- Donor Medicine Research Group, Sanquin Research, Amsterdam, the Netherlands
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Prinsze FJ, van de Laar T, Slot E, de Jong M, Bokhorst A, de Kort W, Zaaijer H, van den Hurk K. No increased risk of transfusion-transmissible infections after tattooing, body piercing, or acupuncture among blood donors in the Netherlands. Transfusion 2019; 59:2575-2583. [PMID: 31228271 DOI: 10.1111/trf.15421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the Netherlands, needle-related events (NREs) including tattoos, piercings, and acupuncture are a reason for temporary blood donor deferral. This study aims to evaluate whether donors with recent NREs had a higher risk of transfusion-transmissible infections (TTIs) compared to donors without recent NREs. STUDY DESIGN AND METHODS Data from 2006 through 2015 on all blood donation attempts in the Netherlands were collected. Multivariate regression models (for repeated measurements) were used to assess the associations between recent NREs and the acquisition of TTIs. Posttest counseling data were used to determine the most likely risk factor in TTI-positive new and repeat donors. RESULTS Recent NREs were documented in 97,518 out of 9,266,036 (1.1%) donation attempts; 14,097 (14.5%) NREs resulted in NRE-based donor deferral. Recent NREs reported pre-donation were not associated with an increased risk for TTIs. A total of 29 out of 287 TTI-positive donors (11 repeat donors, 18 new donors) reported a recent NRE pre- and/or post-donation. Recent NREs, all needle-stick injuries, were the likely route of transmission in 12 out of 287 (4.2%) of TTI-positive donors. The donor health questionnaire (DHQ) identified only 1 out of 12 TTI-linked NREs. Non-return after NRE deferral, any deferral, or no deferral was 24, 15, and 5%, respectively. DISCUSSION Recent tattoos, body piercings, or acupuncture were not associated with an increased risk for TTIs in Dutch donors. Given the lower return rates of donors following a temporary NRE-based deferral, we advocate ending blood donor deferral policies for acupuncture, tattooing, and body piercings, but not needle-stick injuries, in countries where these practices can be considered safe.
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Affiliation(s)
- Femmeke J Prinsze
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Laboratory of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Ed Slot
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Maarten de Jong
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Arlinke Bokhorst
- Department of Medical Donor Affairs, Sanquin Blood Bank, Amsterdam, The Netherlands.,TRIP National Hemovigilance and Biovigilance Office, Leiden, The Netherlands
| | - Wim de Kort
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Hans Zaaijer
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Clinical Virology (CINIMA), Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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de Groot R, Hoenink JC, Mackenbach JD, den Braver NR, Pinho MGM, Brassinga D, Prinsze FJ, Timmer TC, de Kort WLAM, Brug J, van den Hurk K, Lakerveld J. The association between population density and blood lipid levels in Dutch blood donors. Int J Health Geogr 2019; 18:3. [PMID: 30717744 PMCID: PMC6360723 DOI: 10.1186/s12942-019-0167-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 01/28/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In low and middle-income countries (LMIC), the total and LDL cholesterol and triglyceride levels of residents of urban areas are reported to be higher than those of rural areas. This may be due to differences in lifestyle behaviors between residents of urban areas and rural areas in LMIC. In this study, our aims were to (1) examine whether or not LDL cholesterol, total/HDL ratios and triglyceride levels of individuals in densely populated areas are higher than those of individuals living in less-densely populated areas in a high-income country (HIC) and (2) investigate the potential mediating roles of physical activity and sedentary behavior. METHODS We used cross-sectional data from 2547 Dutch blood donors that participated in Donor InSight-III. Linear regression was used to analyze the association between population density and LDL cholesterol, total/HDL cholesterol ratio and HDL cholesterol. The mediating roles of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were investigated in a subsample (n = 740) for which objectively measured MVPA/sedentary behavior data was available. Multiple mediation with linear regression analyses were performed and the product-of-coefficients method was used to calculate direct and indirect effects. RESULTS Mean LDL cholesterol and median total cholesterol/HDL cholesterol ratio and triglyceride levels were 2.89, 3.43 and 1.29 mmol/L, respectively. Population density was not associated with LDL cholesterol [β 0.00 (- 0.01; 0.01)], log transformed total/HDL cholesterol ratio [β 1.00 (1.00; 1.00)] and triglyceride levels [β 1.00 (0.99; 1.00)]. No statistically significant direct or indirect effects were found. CONCLUSION Contrary to previous findings in LMIC, no evidence was found that population density is associated with blood lipid levels in blood donors in the Netherlands or that MVPA and sedentary behavior mediate this association. This may be the result of socioeconomic differences and, in part, may be due to the good health of the study population and the relatively high population density in the Netherlands. Also, compared to LMIC, differences in physical activity levels in more versus less populated areas may be less pronounced in HIC.
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Affiliation(s)
- Rosa de Groot
- Department of Donor Medicine - Donor Studies, Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1089A, 1081 BT Amsterdam, The Netherlands
| | - Jody C. Hoenink
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1089A, 1081 BT Amsterdam, The Netherlands
| | - Joreintje D. Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1089A, 1081 BT Amsterdam, The Netherlands
| | - Nicole R. den Braver
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1089A, 1081 BT Amsterdam, The Netherlands
| | - Maria G. M. Pinho
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1089A, 1081 BT Amsterdam, The Netherlands
| | - Darshan Brassinga
- Department of Donor Medicine - Donor Studies, Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands
| | - Femmeke J. Prinsze
- Department of Donor Medicine - Donor Studies, Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands
| | - Tiffany C. Timmer
- Department of Donor Medicine - Donor Studies, Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands
- Landsteiner Laboratory, Amsterdam UMC – Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Public Health, Academic Medical Center Amsterdam UMC – Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Wim L. A. M. de Kort
- Department of Donor Medicine - Donor Studies, Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands
- Department of Public Health, Academic Medical Center Amsterdam UMC – Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Johannes Brug
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine - Donor Studies, Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1089A, 1081 BT Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
- Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, The Netherlands
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de Groot R, van den Hurk K, Schoonmade LJ, de Kort WLAM, Brug J, Lakerveld J. Urban-rural differences in the association between blood lipids and characteristics of the built environment: a systematic review and meta-analysis. BMJ Glob Health 2019; 4:e001017. [PMID: 30740247 PMCID: PMC6347938 DOI: 10.1136/bmjgh-2018-001017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/28/2022] Open
Abstract
Introduction The built environment defines opportunities for healthy eating and physical activity and may thus be related to blood lipids. The aim of this study is to systematically analyse the scientific evidence on associations between built-environment characteristics and blood lipid levels in adults. Methods PubMed, EMBASE and Web of Science were searched for peer-reviewed papers on population-based studies up to 9 October 2017. We included studies that reported on built-environment characteristics and blood lipid levels in adult populations (≥18 years). Two reviewers independently screened titles/abstracts and full-texts of papers and appraised the risk of bias of included studies using an adapted version of the Quality Assessment Tool for Quantitative Studies. We performed meta-analyses when five or more studies had sufficient homogeneity in determinant and outcome. Results After screening 6902 titles/abstracts and 141 potentially relevant full-text articles, we included 50 studies. Forty-seven studies explored associations between urban versus rural areas with blood lipid levels. Meta-analyses on urban versus rural areas included 133 966 subjects from 36 studies in total. Total cholesterol levels were significantly and consistently higher in urban areas as compared with rural areas (mean difference 0.37 mmol/L, 95% CI 0.27 to 0.48). Urban/rural differences in high density lipoprotein cholesterol were inconsistent across studies and the pooled estimate showed no difference (0.00 mmol/L 95% CI −0.03 to 0.04). Low density lipoprotein (LDL) cholesterol and triglyceride levels were higher in urban than in rural areas (mean difference 0.28, 95% CI 0.17 to 0.39 and 0.09, 95% CI 0.03 to 0.14, respectively). Conclusions Total and LDL cholesterol levels and triglycerides were consistently higher in residents of urban areas than those of rural areas. These results indicate that residents of urban areas generally have less favourable lipid profiles as compared with residents of rural areas. Prospero registration number CRD42016043226.
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Affiliation(s)
- Rosa de Groot
- Department of Donor Medicine – Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine – Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Linda J Schoonmade
- Department of Medical Library, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Wim L A M de Kort
- Department of Donor Medicine – Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Johannes Brug
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Dijkstra A, van den Hurk K, Bilo HJG, Slingerland RJ, Vos MJ. Repeat whole blood donors with a ferritin level of 30 μg/L or less show functional iron depletion. Transfusion 2018; 59:21-25. [DOI: 10.1111/trf.14935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Henk J. G. Bilo
- Department of Internal MedicineIsala Hospital Zwolle The Netherlands
- Department of Internal MedicineUniversity Medical Center Groningen Groningen The Netherlands
| | - Robbert J. Slingerland
- Department of Clinical ChemistryIsala Hospital Zwolle The Netherlands
- European Reference Laboratory for GlycohemoglobinIsala Hospital Zwolle The Netherlands
| | - Michel J. Vos
- Department of Clinical ChemistryIsala Hospital Zwolle The Netherlands
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43
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van Sambeeck JHJ, de Wit PD, Luken J, Veldhuisen B, van den Hurk K, van Dongen A, Koopman MMW, van Kraaij MGJ, van der Schoot CE, Schonewille H, de Kort WLAM, Janssen MP. A Conceptual Framework for Optimizing Blood Matching Strategies: Balancing Patient Complications Against Total Costs Incurred. Front Med (Lausanne) 2018; 5:199. [PMID: 30090809 PMCID: PMC6069448 DOI: 10.3389/fmed.2018.00199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/18/2018] [Indexed: 01/06/2023] Open
Abstract
Alloimmunization is currently the most frequent adverse blood transfusion event. Whilst completely matched donor blood would nullify the alloimmunization risk, this is practically infeasible. Current matching strategies therefore aim at matching a limited number of blood groups only, and have evolved over time by systematically including matching strategies for those blood groups for which (serious) alloimmunization complications most frequently occurred. An optimal matching strategy for controlling the risk of alloimmunization however, would balance alloimmunization complications and costs within the entire blood supply chain, whilst fulfilling all practical requirements and limitations. In this article the outline of an integrated blood management model is described and various potential challenges and prospects foreseen with the development of such a model are discussed.
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Affiliation(s)
- Joost H J van Sambeeck
- Department of Transfusion Technology Assessment, Sanquin Research, Amsterdam, Netherlands.,Center for Healthcare Operations Improvement and Research, University of Twente, Enschede, Netherlands
| | - Puck D de Wit
- Department of Donor Studies, Sanquin Research, Amsterdam, Netherlands
| | - Jessie Luken
- Sanquin Diagnostic Services, Amsterdam, Netherlands
| | - Barbera Veldhuisen
- Sanquin Diagnostic Services, Amsterdam, Netherlands.,Sanquin Research and Landsteiner Laboratory, Department of Experimental Immunohematology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | | | - Anne van Dongen
- Department of Donor Studies, Sanquin Research, Amsterdam, Netherlands
| | - Maria M W Koopman
- Department of Transfusion Medicine, Sanquin Blood Bank, Amsterdam, Netherlands
| | - Marian G J van Kraaij
- Department of Transfusion Medicine, Sanquin Blood Bank, Amsterdam, Netherlands.,Department of Donor Affairs, Sanquin Blood Bank, Amsterdam, Netherlands.,Department of Clinical Transfusion Research, Sanquin Research, Amsterdam, Netherlands
| | - C Ellen van der Schoot
- Sanquin Research and Landsteiner Laboratory, Department of Experimental Immunohematology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Henk Schonewille
- Sanquin Research and Landsteiner Laboratory, Department of Experimental Immunohematology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Wim L A M de Kort
- Department of Donor Studies, Sanquin Research, Amsterdam, Netherlands.,Department of Social Medicine, Academic Medical Center, Amsterdam, Netherlands
| | - Mart P Janssen
- Department of Transfusion Technology Assessment, Sanquin Research, Amsterdam, Netherlands
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44
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van den Hurk K, van Kraaij MGJ, Zalpuri S. Lessons from the INTERVAL study. Lancet 2018; 391:2604-2605. [PMID: 30070219 DOI: 10.1016/s0140-6736(18)30795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/19/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Katja van den Hurk
- Department of Donor Studies, Sanquin Research, Amsterdam 1066CX, Netherlands.
| | - Marian G J van Kraaij
- Units Donor Affairs and Transfusion Medicine, Sanquin Blood Bank, Amsterdam, Netherlands
| | - Saurabh Zalpuri
- Department of Donor Studies, Sanquin Research, Amsterdam 1066CX, Netherlands
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45
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Schotten N, Zalpuri S, Pasker-de Jong PCM, Swinkels DW, van den Hurk K, de Kort WLAM, van Kraaij MGJ, van Noord PAH. Utility of zinc protoporphyrin in management of whole blood donors. Transfusion 2018; 58:692-700. [PMID: 29377138 DOI: 10.1111/trf.14480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Deferral for low hemoglobin (Hb) increases the likelihood that donors do not return for future donations. Zinc protoporphyrin (ZPP) has been described as a sensitive marker of iron-deficient erythropoiesis, before Hb decreases. It is a relatively cheap, rapid, and easy-to-perform measurement in a drop of whole blood. To assess the utility of ZPP measurement in donor management we examined whether ZPP and Hb levels among first-time donors differ from repeat donors. We further explored whether ZPP increases over subsequent donations at a donor population level and whether increasing ZPP levels coincide with decreasing Hb levels and donor deferral. STUDY DESIGN AND METHODS We included first-time (n = 4983) and repeat (n = 3533) whole blood donors from the ZPP and Iron in the Netherlands Cohort (ZINC) study. ZPP and Hb were measured at each subsequent donation during a 4-year period after inclusion in the study. RESULTS Median ZPP levels were higher in repeat than in first-time donors. In first-time donors, especially women, ZPP levels were increased with a corresponding decline in Hb levels over subsequent donations. ZPP levels were increased among first-time donors deferred for low Hb. CONCLUSION Our results suggest that adding ZPP to Hb measurements in the daily blood collection setting, especially for first-time donors and first-time female donors may add to the identification of a donor subpopulation with low functional iron stores.
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Affiliation(s)
- Nienke Schotten
- Department Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Saurabh Zalpuri
- Department Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Pieternel C M Pasker-de Jong
- Department Donor Studies, Sanquin Research, Amsterdam, the Netherlands.,Meander Academy, Meander Medical Center, Amersfoort, the Netherlands
| | - Dorine W Swinkels
- Translational Metabolic Laboratory, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Wim L A M de Kort
- Department Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Marian G J van Kraaij
- Departments of Donor Affairs and Transfusion Medicine, Sanquin Blood Bank, Amsterdam, the Netherlands
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46
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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: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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47
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Goldman M, Steele WR, Di Angelantonio E, van den Hurk K, Vassallo RR, Germain M, O'Brien SF. Comparison of donor and general population demographics over time: a BEST Collaborative group study. Transfusion 2017; 57:2469-2476. [PMID: 28871601 DOI: 10.1111/trf.14307] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/30/2017] [Accepted: 05/30/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND We compared donor and general population demographics over time to provide insight into current donation patterns and the future adequacy of the blood supply. STUDY DESIGN AND METHODS Seventeen blood center members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative from 12 countries provided the number of donors and people in the general population by demographic category for 2001 and 2011, changes in age criteria, and percentage of first-time donors. We calculated the median age of donors and the general population and determined the percentage of each group in age and sex cohorts. RESULTS Age criteria vary, with upper limits recently liberalized in several countries. In 2011, the percentage of first-time donors ranged from 10% to 41%. The median age of the donor and general population increased from 2001 to 2011 in most countries, as did the percentage of the general population over 60. The youngest donor cohort is overrepresented to a variable degree; this tendency increased over time. Although still underrepresented, older donors contributed more in 2011. A large middle-aged cohort is aging at a rate exceeding the progression of time, while 25- to 45-year-olds are relatively underrepresented. CONCLUSIONS All participating countries are experiencing aging of their general population. Donor demographics differ substantially between countries; this can be only partly explained by population demographics and age criteria. Many countries have an aging middle-aged donor and population cohort and are increasingly relying on their youngest donors to contribute disproportionately to the blood supply.
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Affiliation(s)
| | | | - Emanuele Di Angelantonio
- University of Cambridge, and National Institute for Health Research (NIHR) Blood and Transplant Research Unit in Donor Health and Genomics, Cambridge, UK
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Bontekoe IJ, van der Meer PF, van den Hurk K, Verhoeven AJ, de Korte D. Platelet storage performance is consistent by donor: a pilot study comparing "good" and "poor" storing platelets. Transfusion 2017; 57:2373-2380. [PMID: 28703861 DOI: 10.1111/trf.14238] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/03/2017] [Accepted: 05/17/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND In retrospective studies, it has been shown that differences in storage variables of platelet (PLT) concentrates (PCs) are partially donor dependent. It was our aim to prospectively determine the donor effect on PLT quality. STUDY DESIGN AND METHODS Based on quality control data of outdated apheresis PCs, male donors were selected with at least one PC with a pH value of more than 7.0 ("good," n = 6) or one PC with a pH value of less than 6.7 ("poor," n = 6) on Day 8. These donors donated a PC (Trima Accel, Terumo) and completed a short questionnaire about their health and lifestyle. PCs were stored for 12 days and analyzed at regular intervals for in vitro quality. RESULTS Donor characteristics were comparable, except that zero of six good and four of six poor donors reported high blood pressure and/or high cholesterol/fat and/or use of medicines. Lactate production in good PCs was lower than that in poor PCs (0.09 ± 0.03 mmol/day/1011 PLTs vs. 0.13 ± 0.04 mmol/day/1011 PLTs, p < 0.05) resulting in a higher pH from Day 5 onward. At the end of storage, the good PCs showed lower CD62P expression, lower phosphatidylserine exposure, and higher mitochondrial membrane potential. PLT functional properties were only slightly different. Despite having lower pH, the poor PCs also fulfilled European Guidelines during 7-day storage. CONCLUSION Platelet storage performance is consistent when donors are dichotomized as having good or poor storing PLTs. Metabolic differences are perhaps due to different functionality of the mitochondria. More research is needed to establish the underlying causes and the implications for donors and blood products.
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Affiliation(s)
- Ido J Bontekoe
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
| | - Pieter F van der Meer
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands.,Center for Clinical Transfusion Research, Sanquin Blood Supply, Leiden, the Netherlands
| | | | - Arthur J Verhoeven
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, the Netherlands
| | - Dirk de Korte
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands.,Department of Blood Cell Research, Sanquin Research
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Abstract
INTRODUCTION In the Netherlands, there is a constant shortage in donor organs, resulting in long waiting lists. The decision to register as organ donor is associated with several demographic, cultural, and personal factors. Previous research on attitudes and motivations toward blood and organ donations provided similar results. RESEARCH QUESTION The current study investigated demographic, cultural, and personal determinants of organ donation registration among current Dutch blood donors. DESIGN We used data from Donor InSight (2012; N = 20 063), a cohort study among Dutch blood donors, to test whether age, gender, religious and political preferences, donor attitude, and altruism predicted organ donor registration among current blood donors. RESULTS Organ donors were more often represented in the blood donor population compared to the general Dutch population. Women showed a higher propensity to be registered as organ donor. Higher education as well as higher prosocial value orientation, prosocial behavior, that is, doing volunteer work, and awareness of need significantly associated with being registered as organ donor. Religious denomination negatively predicted organ donation registration across all faiths. DISCUSSION Results are discussed in light of cultural context, and possible implications for improving information provision and recruitment are mentioned.
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Affiliation(s)
- Eva-Maria Merz
- 1 Department of Donor Studies, Sanquin Research, Amsterdam, the Netherlands.,2 Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Katja van den Hurk
- 1 Department of Donor Studies, Sanquin Research, Amsterdam, the Netherlands
| | - Wim L A M de Kort
- 1 Department of Donor Studies, Sanquin Research, Amsterdam, the Netherlands.,3 Department of Social Medicine, Amsterdam Medical Center, Amsterdam, the Netherlands
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50
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Baart AM, de Kort WL, van den Hurk K, Pasker-de Jong PC. Hemoglobin assessment: precision and practicability evaluated in the Netherlands-the HAPPEN study. Transfusion 2016; 56:1984-93. [DOI: 10.1111/trf.13546] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A. Mireille Baart
- Department of Donor Studies; Sanquin Research; Amsterdam the Netherlands
| | - Wim L.A.M. de Kort
- Department of Donor Studies; Sanquin Research; Amsterdam the Netherlands
| | - Katja van den Hurk
- Department of Donor Studies; Sanquin Research; Amsterdam the Netherlands
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