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1.
Abstract: A cohort of 467 volunteer blood donors who were found to be EIA+/WB- was studied longitudinally for up to two years. EIA screening for anti-HIV and WB testing, regardless of the EIA result, was performed on all 769 subsequent donation events of this cohort to ascertain the consistency of test results over time. The following results were obtained: 1) 8.8% of subsequent donation events were EIA+; 2) Most donors who returned were found to be EIA-/WB-; 3) EIA-/WB? (indeterminate) was 14.5 times more common than EIA+/WB?; 4) EIA and WB results were generally inconsistent from donation to donation; 5) No donor was found to be WB+. These results suggest that, in a volunteer donor population, an EIA+/WB- result may have little value in predicting anti-HIV test results and AIDS infectivity in a future donation. The current practice of not using blood donated subsequently by EIA+/WB- donors unless a re-entry testing scheme is satisfactorily completed should be reconsidered.  相似文献   

2.
BACKGROUND: It is important to understand donor return behavior. Converting first‐time donors to become repeat donors is essential for maintaining an adequate blood supply. STUDY DESIGN AND METHODS: Characteristics of 241,552 whole blood (WB) donations from first‐time and repeat donors who donated in 2008 at the five blood centers in China were compared. A subset of 54,394 WB donors who donated between January 1 and March 31, 2008, were analyzed for their return behavior in 2008 after the index donation using logistic regression. RESULTS: Of all donations, 64% were from first‐time donors. Donors with self‐reported previous donations tended to be male, older, and married; donated larger volume (≥300 mL); and were heavier in weight. Among donors who donated from January to March 2008, 14% returned for subsequent WB donations by the end of 2008. The number of previous donations and blood collection location were the two strongest predictors for making subsequent donations. Donors with one, two to three, and more than three previous donations were 3.7, 5.7, and 11.0 times more likely to return than first‐time donors. Those who donated in a blood collection vehicle were four times more likely to return than those who donated at a blood center. Being female, younger, and of a lower education level (middle school or less) were positively associated with subsequent return blood donation during the follow‐up period observed in this study. CONCLUSION: Most of the Chinese blood supply is from first‐time donors. Strategies aimed at encouraging current donors to become repeat donors are needed.  相似文献   

3.
BACKGROUND: Incidence rates (IRs) for viral infections may vary with the frequency of donation among repeat, community, whole-blood (WB) donors, with IRs thought to be lower among donors with higher frequency of donation. STUDY DESIGN AND METHODS: IRs for HIV, HTLV, HCV, and HBV infection were stratified by frequency of donation among 868,403 repeat WB donors who gave approximately 4 million donations at five United States blood centers from 1991 through 96. All donors had given at least 2 donations during those years, with the first donation being nonreactive on confirmatory testing. Frequency of donation was measured in three ways: by the number of donations per year; at the time of donation, by the number of donations given within the preceding 2-year period; and by the number of donations given from 1991 through 1993. RESULTS: The IRs for HIV, HCV, and HBV infection did not appear to differ among donors with lower or higher numbers of donation per year. However, the IR for HTLV infection decreased as the number of donations per year increased (p = 0.0004). IRs for all viral markers remained stable, regardless of the number of donations given within the 2-year period before the donation. Although IRs for HIV, HTLV, and HCV infection did not vary by the number of donations given in 1991 through 1993, the IR for HBV infection appeared to be lower in donors who gave more donations in that period (p = 0.01). CONCLUSION: These findings do not provide evidence of a lower IR for transfusion-transmissible viral infections among repeat WB donors who give more frequently. Abbreviated screening histories for frequent repeat donors might not be advisable.  相似文献   

4.
Rader AW  France CR  Carlson B 《Transfusion》2007,47(6):995-1001
BACKGROUND: Although reactions to whole-blood (WB) donation are known to decrease donor retention, potential effects of reactions to automated double red cell (2RBC) donation upon retention have not been investigated. STUDY DESIGN AND METHODS: The authors investigated effects of donor status (first-time, experienced) and reactions (absent, present) upon retention of all male allogeneic WB and 2RBC donors (n = 45,296) donating within the American Red Cross Central Ohio Region during a 12-month period. Donor age, race, and status (first-time, experienced); phlebotomist's reaction rating; and phlebotomy procedure (WB, 2RBC) were collected for the initial donation by each donor. Dates of any donation attempts in the 12 months starting from the donor's first eligible date after the initial donation were also collected. RESULTS: On average, WB donors were less likely to react and more likely to donate again and returned more quickly to donate than 2RBC donors, even after accounting for differential delays in eligibility. Reactions decreased the likelihood of repeat donation among all first-time donors regardless of initial phlebotomy procedure. Among experienced donors, however, reactions depressed retention of WB donors by 27.6 percent, whereas reactions lowered retention of 2RBC donors by just 3.6 percent. CONCLUSION: Although 2RBC donors were more likely to react, first-time 2RBC donors were no more affected by reactions than first-time WB donors. Experienced WB donors suffered a larger drop in retention as a function of reactions, in fact, than did experienced donors who gave 2RBC donations. Potential reasons for this data pattern require further investigation.  相似文献   

5.
BACKGROUND: Automated red blood cell (RBC) apheresis offers the advantage of collecting 2 units of RBCs (2RBC) from one donation, but may expose donors to procedure-related risks. This study evaluated the relative safety of 2RBC compared to whole-blood (WB) donation with a focus on young donors.
STUDY DESIGN AND METHODS: Adverse reactions recorded at the collection site or requiring outside medical care were compared after 4,348,686 WB and 206,570 2RBC donations in 26 regional blood centers.
RESULTS: 2RBC donors were more likely than WB donors to be male (91.6% vs. 50.3%) and repeat donors (84.0% vs. 81.0%). The overall complication rate was higher for 2RBC than WB collections (627.9 vs. 435.1 per 10,000; odds ratio [OR], 1.44; 95% confidence interval [CI], 1.41-1.47), but more than 96% of all reactions were minor in severity. For donors younger than 20 years, adverse events were equally or less common after 2RBC than after WB donation, but were more common after 2RBC for donors 20 years or older. The rate of major systemic complications was significantly lower for 2RBC than WB donations in all age groups (10.2 vs. 14.3 per 10,000 collections; OR, 0.71; 95% CI, 0.62-0.82). Overall, the need for outside medical care was similar for 2RBC and WB collections (3.4 vs. 4.2 per 10,000 donations, respectively), but significantly less likely after 2RBC donation for donors less than 20 years old (3.8 vs. 7.0. per 10,000 donations; OR, 0.53; 95% CI, 0.32-0.89).
CONCLUSION: 2RBC collection procedures, as currently performed in the American Red Cross, are associated with fewer immediate adverse reactions in young donors and have a comparable safety profile in older donors. These data support the collection of 2RBC from young donors.  相似文献   

6.
BACKGROUND: Iron deficiency is a frequent side effect of whole blood (WB) donation. In contrast, less red blood cell loss and therefore less iron loss results from plateletpheresis. STUDY DESIGN AND METHODS: WB donors presenting a decrease in either hemoglobin (Hb) or ferritin levels were offered to switch to plateletpheresis with or without iron supplementation. We analyzed the effect of this intervention on deferral rates for an insufficient Hb level in 168 donors. Further, we assessed how this intervention affected Hb and ferritin levels, anemia occurrence, and platelet (PLT) concentrate yields in the donors who presented at least four successive times for thrombapheresis. RESULTS: Switching WB donors to repetitive plateletpheresis procedures resulted in an increase of median Hb (+12 g/L, p < 0.001) and ferritin (+15.5 ng/mL, p = 0.002) values. Anemia and deferral rates were reduced by 23% (p = 0.004) and 13% (p < 0.001). Between high‐ and low‐frequency apheresis donors, no significant differences in Hb and ferritin levels were found. Similarly, discrepancies in Hb and ferritin values between donors that adopted iron supplementation and those who did not were insignificant. The median PLT concentrate yield was 5.43 × 1011 PLTs. CONCLUSION: Switching iron‐deficient WB donors to plateletpheresis was an effective intervention that permitted us to correct low Hb and ferritin levels while retaining donors in our pool.  相似文献   

7.
BackgroundHigh-intensity donation is a risk factor for iron deficiency in blood donors. Interdonation intervals for whole blood (WB) donation and double unit red blood cell apheresis (2RBC) vary among countries. We retrospectively evaluated the course of haemoglobin (Hb) and ferritin values in men regularly donating WB 4 times a year or 2RBC twice a year (i.e., maximal frequency) over a period of 48 months.MethodsData of male donors with 16 WB or 8 2RBC consecutive donations were analysed. The minimum Hb levels for WB donation and 2RBC apheresis (collection of 360 mL RBC) were 135 and 140 g/L, respectively. There was no lower limit set for ferritin, and no iron was substituted.ResultsWe identified 294 WB (mean age 53 years, SD 11) and 151 2RBC donors (mean age 48 years, SD 9) who donated at a mean interval of 97 (SD 18) and 201 days (SD 32), respectively, between January 1, 2008, and December 31, 2013. At baseline, Hb and ferritin values were lower in WB donors compared to 2RBC donors, with a mean Hb of 153 g/L (SD 13) versus 159 g/L (SD 8) and a mean ferritin of 44 μg/L (SD 52) versus 73 μg/L (SD 56; p < 0.001 for both parameters), respectively. Ferritin was below 15 μg/L in 40 WB (14%) and in 4 (3%) 2RBC donors. In WB donors, the mean Hb levels at baseline versus last donation showed no significant difference (153 vs. 152 g/L, p = 0.068), whereas the mean ferritin levels decreased significantly (44 vs. 35 μg/L, p < 0.001). The 2RBC donor group displayed a statistically different decrease in both the mean Hb levels (158 vs. 157 g/L; p < 0.05) and the mean ferritin levels (73 vs. 66 μg/L; p = 0.052). The lowest Hb was measured at the 11th WB donation (152 g/L; p < 0.05) and at the 4th 2RBC apheresis (157 g/L; p < 0.05). There was no deferral due to low Hb at any time. The lowest ferritin was shown at the 4th WB (37 μg/L) and at the 3rd 2RBC donation (60 μg/L), respectively. At the last visit, ferritin was below 15 μg/L in 23 WB donors (8%) and in 2 2RBC donors (1%).ConclusionsHigh-intensity male donors with an interdonation interval of 12 weeks for WB donation and 24 weeks for 2RBC apheresis maintain acceptable Hb levels and, after an initial decline, stable ferritin levels despite ongoing blood donation.  相似文献   

8.
Recipients of untested blood from donors who at a subsequent donation were positive for HIV antibody by enzyme immunoassay (EIA) were evaluated, whether the result on Western blot (WB) assay was negative (EIA+/WB-) or positive (EIA+/WB+). For 109 EIA+/WB- donors, 78 recipients were tested for HIV antibody, and 3 (4%) were positive. Two of the three anti-HIV-positive recipients had clotting disorders, and the other had been massively transfused; in each of these three cases, subsequent test data exonerated the EIA+/WB- donor. For 101 current EIA+/WB+ donors, 35 recipients were tested for HIV antibody, and 13 (37%) were positive. For donors subsequently found to be EIA+/WB+, the rate of isolation of HIV was the same whether the recipients were anti-HIV-positive or anti-HIV-negative (each, 5/6). While recipients of blood from donors subsequently found to be EIA+/WB+ were at substantial risk for HIV infection, regardless of the donor's subsequent HIV culture result, risk of HIV infection was not demonstrated for recipients of blood from donors later found to be EIA+/WB-.  相似文献   

9.
10.
Donation reactions among autologous donors   总被引:2,自引:0,他引:2  
Studies of risk factors associated with reactions among autologous blood donors have been limited. Therefore, 2091 autologous and 4737 homologous donations were examined. Donors at greatest risk for reaction were autologous donors who had reactions at first donation; among 45 who made repeat donations for the same surgery, 17 (38%) had repeat reactions. The group least likely to experience reactions were the autologous donors greater than or equal to 66 years old; they experienced a 1.9 greater than or equal to percent (6/310) incidence of reactions. More reactions were seen in both autologous and homologous donors in the categories of first-time donor, female gender, decreasing age, and lower weight. Multiple logistic regression analysis showed that all of these variables were independent predictors of donor reaction, with first-time donation (odds ratio, 2.4) and female gender (odds ratio, 1.9) being the strongest predictors of reaction. Donor room personnel should be alerted that autologous donors who react at first donation are very likely to react at subsequent donations. Contrary to common concern, elderly autologous donors are least likely to have reactions.  相似文献   

11.
BACKGROUND: Adverse reactions after whole blood donation reduce the likelihood of a subsequent donation. Still, many donors return to give blood even after experiencing a reaction. Consequently, we evaluated the risk of recurrent syncope among returning donors. STUDY DESIGN AND METHODS: Allogeneic whole blood donors in 2009 who had vasovagal‐type reactions including syncope were evaluated for return donation within 12 months and subsequent reactions, based on donation status (novice [first‐time] or active [repeat]) or age at index donation. RESULTS: Syncope after a first whole blood donation significantly reduced the frequency of return donation (18%), compared to either presyncopal symptoms (27%; p < 0.0001) or no reaction (35%; p < 0.0001). Among novice donors who returned to donate, syncope was more likely among donors who had any reaction (0.8%) or syncope (3.5%) at their first donation, compared to donors who had no reaction (0.3%; p < 0.0001). Syncope at a first donation identified only 2% (19 of 1062) of syncopal reactions among returning donors. For active, repeat donors who experienced syncope in 2009, a history of prior reactions had no effect on the likelihood of return donation or recurrent syncope. CONCLUSION: Donation experience strongly influences the likelihood of return donation and the risk of subsequent reactions, but a prior reaction after whole blood donation does not reliably predict recurrent syncope among returning donors.  相似文献   

12.
A confidential self-administered questionnaire was given to all donors prior to blood donation (n = 95,917). The questionnaire describes acquired immunodeficiency syndrome (AIDS) high-risk groups and requires the donor to designate his blood for either laboratory purposes or for transfusion. Six-hundred and twenty-seven people (0.65%; 78% men) designated their blood for laboratory purposes. In addition to routine enzyme-linked immunoassay (EIA) screening for human immunodeficiency virus (HIV) antibody, all units from the latter group of donors were tested by Western blot (WB) irrespective of the EIA result. An equal number of donor units was selected from those designating their blood for transfusion (age, sex and clinic matched) and these too were tested by WB irrespective of the EIA result. We found that donors designating their blood for laboratory purposes had a 10 times (vs transfusion-designated controls) to 100 times (vs general donor population) greater exposure to HIV. In the laboratory-designated group, an EIA negative donor was WB positive, yielding an estimated EIA false-negative rate of 16 per million. A confidential questionnaire, as described, is a valuable adjunct in ascertaining high-risk blood donors.  相似文献   

13.
目的对抗-HCV反应性献血者进行随访以分析反应性献血者的归队途径。方法随机对上海地区52名抗-HCV单试剂反应性献血者献血间隔6个月后随访,使用4种采供血机构常用的抗-HCV ELISA试剂检测,对于抗-HCV反应性标本使用重组免疫印迹试验确证,同时使用罗氏cobas Taqscreen MPX核酸检测试剂(NAT)单人份检测;3~6个月后进行第2次随访,开展相同实验。结果 2次随访研究发现,52名献血者中,39名(75%)献血者4种抗-HCV试剂检测结果均为阴性,13名(25%)献血者4种抗-HCV试剂至少有1种试剂检测结果为反应性,与原抗-HCV试剂检测结果相同,且S/CO数值保持基本一致,13名抗-HCV反应性献血者中有1名免疫印迹检测结果为阳性;52名献血者NAT结果均为阴性。结论献血者抗-HCV单试剂反应性,经过至少6个月间隔,使用包含原抗-HCV在内的2种试剂检测结果阴性,同时NAT检测阴性者可恢复献血权利。  相似文献   

14.
BACKGROUND: In Brazil, most donations come from repeat donors, but there are little data on return behavior of donors. STUDY DESIGN AND METHODS: Donors who made at least one whole blood donation in 2007 were followed for 2 years using a large multicenter research database. Donation frequency, interdonation intervals, and their association with donor demographics, status, and type of donation were examined among three large blood centers in Brazil, two in the southeast and one in the northeast. RESULTS: In 2007, of 306,770 allogeneic donations, 38.9% came from 95,127 first‐time donors and 61.1% from 149,664 repeat donors. Through December 31, 2009, a total of 28.1% of first‐time donors and 56.5% of repeat donors had donated again. Overall, the median interdonation interval was approximately 6 months. Among men it was 182 and 171 days for first‐time and repeat donors, and among women, 212 and 200 days. Predictors of return behavior among first‐time donors were male sex (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.13‐1.20), community donation (OR, 2.26; 95% CI, 2.20‐2.33), and age 24 years or less (OR, 0.62‐0.89 for donors ≥25 years). Among repeat donors predictors were male sex (OR, 1.35; 95% CI, 1.32‐1.39), age 35 years or more (OR, 1.08‐1.18 vs. ≤24 years), and community donation (OR, 2.39; 95% CI, 2.33‐2.44). Differences in return by geographic region were evident with higher return rates in the northeast of Brazil. CONCLUSION: These data highlight the need to develop improved communication strategies for first‐time and replacement donors to convert them into repeat community donors.  相似文献   

15.
BACKGROUND: The demographics, deferrable risk behaviors, and the prevalence and incidence of viral infections of apheresis (PH) and whole-blood (WB) donors were compared, to characterize these two populations and to evaluate the relative safety of PH and WB donors in terms of transfusion-transmitted viral infections. STUDY DESIGN AND METHODS: A comparison was made of 36,119 PH donors (> or = 1 PH donation) and 1.38 million WB donors (> or = 1 WB donation) in terms of demographics and the prevalence (/100,000 donors) and incidence (/100,000 person-years) of viral infections, by using data collected at five United States blood collection centers between 1991 and 1994. Deferrable risk behaviors were defined as those risk behaviors that would have resulted in donor deferral, had they been reported. The prevalence of deferrable risk behaviors was estimated by using data collected through an anonymous mail survey. RESULTS: PH donors were older and more likely than repeat (2+ donations) WB donors to be female, white, and United States-born and to have a higher degree of education (p < or = 0.001). The prevalence of any viral infection was 50 percent higher in WB donors than in PH donors (p = 0.04), whereas the incidence of HIV, human T-lymphotropic virus, and hepatitis B surface antigen was nonsignificantly higher in WB donors. The prevalence of deferrable risk behaviors did not differ in the two groups. CONCLUSION: Further studies will be needed to evaluate whether the difference in the prevalence of viral infections observed in this study can be explained by demographic characteristics and patterns of donation frequency.  相似文献   

16.
Blood products are critical to health systems and donations by voluntary nonremunerated donors are recommended. Worldwide, however, only around 5% of those eligible to donate do so and around half of those never return to donate again. This review focuses on what deters first-time donors, what predicts their retention, and what interventions may promote retention of this group. A comprehensive search of relevant databases identified 9 studies investigating motives and deterrents of first-time donors, 14 studies investigating predictors for first-time donors (13 whole blood [WB] and 2 plasmapheresis), and 15 studies (in 14 published articles) detailing interventions conducted on first-time donors. Drawing on an established blood donation taxonomy, studies were classified by 2 independent raters. Interventions were also classified into traditional, behavioral, or social science interventions. With only 2 eligible studies among first-time plasmapheresis donors, analyses focused on WB donors. First-time WB donors reported benevolent and collectivistic motivations, as well as personal benefits to commence WB donation. Self-reported deterrents have typically not been examined. Intention predicted first-time donor retention with intention determined by attitudes and a sense of (perceived behavioral) control. However, anxiety, adverse events, and deferrals all deterred retention. Traditional interventions, such as reminders and incentives, are widespread yet had only a small effect on return of first-time donors. Although behavioral science interventions such as fluid loading are effective, the strongest effect for the return of first-time donors was found when individual psychological support was provided. The purpose of this analysis was to identify the factors associated with the commencement and continuation of first WB donations. The current review revealed that self-reported motivators are typically not effective, and most successful predictive factors identified have not been translated into interventions. Future work would do well to identify, manage, and meet donors' expectations along with developing more individualized donation experiences. Blood donor research should delineate donor career stages; addressing first-time donor retention will support stable panels for blood collection agencies.  相似文献   

17.
BACKGROUND: A pilot study was conducted to evaluate the impact of a single autologous blood donation on the presence or absence of myocardial ischemic episodes in patients with coronary artery disease. STUDY DESIGN AND METHODS: Fifty patients scheduled for elective coronary artery bypass grafting underwent two 24-hour periods of ambulatory electrocardiogram monitoring, one before and one after their first autologous blood donation. The presence or absence and the number, duration, and integral area of episodes of ST segment depression for each 24-hour monitoring period were determined. RESULTS: Forty-two patients had legible electrocardiogram recordings for both monitoring periods. Of these, 36 patients (86%) had at least one episode of ST segment depression during any monitoring period. The number of patients who had at least one episode of ST segment depression before donation was not significantly different from the number of those who had at least one episode after donation (31 and 33 patients, respectively; p = 0.73). CONCLUSION: Donating a unit of blood had no demonstrable effect on the presence or absence of myocardial ischemic episodes in this sample of 42 autologous blood donors with coronary artery disease. The results of this study should be validated in further trials.  相似文献   

18.
BACKGROUND: There are few reports about thrombopoietic responses in whole blood (WB) and platelet-pheresis donors. This study compares the thrombopoietic responses of such donors and their platelet values. STUDY DESIGN AND METHODS: The effect of WB donation or selective platelet loss (plateletpheresis) was evaluated prospectively. WB and platelet donor samples before donation and for 7 days thereafter were assessed for platelet count, mean platelet volume, and platelet reticulocytes. RESULTS: Reticulated platelets appeared in the circulation of plateletpheresis donors by 24 hours. The proportion of reticulated platelets was highest on Day 2, and above-normal levels of reticulated platelets persisted until Day 7. The mean platelet volume was high on Days 2 and 3, which corresponded with the appearance of reticulated platelets. After plateletpheresis, platelet counts were higher than could be accounted for by new platelets, which suggested the release of sequestered platelets. WB donors manifested no changes in platelet counts but had a peak of circulating platelet reticulocytes 2 days after the donation. CONCLUSION: The thrombopoietic peak in WB and plateletpheresis donors occurs 2 days after donation, and the response level is related to the amount of platelets lost. The impact of platelet loss on the number of circulating platelets is modulated by the release of platelets from the spleen.  相似文献   

19.
This Australian study monitored the effects of monthly plasmapheresis on donor serum IgG and IgM levels in 127 new and 124 established plasma donors who donated 1014 units over a five-month period. Of the 251 donors, 3% had reduced total serum protein (TSP) levels, 7% had low IgG levels and 12% had low IgM levels prior to donation on at least one occasion over the study period. Statistical analysis showed that the TSP, IgG and IgM levels of new donors who had donated plasma on less than 10 occasions were no more likely to fall below normal than those of old donors. However, new and old donors whose IgG or IgM levels fell below normal at any time during the study had significantly lower levels of the relevant parameter on entry to the study. Followed longitudinally, IgG and IgM levels in old and new donors tended to fall, although levels fluctuated throughout the study. Statistical analysis failed to show any correlation between TSP levels and IgG or IgM levels. These parameters did not correlate significantly with the number of previous plasmaphereses, donor weight, volume collected or history of infection. This study highlighted the need for regular, specific quantitation of IgG and IgM levels as well as TSP in regular plasmapheresis donors. The frequency of testing is yet to be determined, in view of the high materials and labour costs of such a programme.  相似文献   

20.
BACKGROUND: In China recruitment and retention of sufficient numbers of safe blood donors continues to be a challenge. Understanding who donates blood, particularly those who donate larger (>200 mL) whole blood (WB) units, will help blood centers to target more effective recruitment and retention strategies. STUDY DESIGN AND METHODS: Demographic characteristics of 226,489 allogeneic WB donors from January to December 2008 at five geographically and ethnically diverse, urban blood centers were analyzed. RESULTS: The typical Chinese WB donor can be characterized as first‐time volunteer (67.9%), male (56.9%), less than 45 years old (93.8%), and Han ethnicity (86.1%). Most donors had some college or below educational level (77.5%), donated at a mobile collection site (97.6%), and donated 300‐ or 400‐mL units (76.0%). Differences in WB volume donations and donor demographics exist among the five centers. CONCLUSION: In China compared to the United States, donations are made by younger donors and donors give infrequently and make smaller WB donations. To help ensure supply adequacy, continued efforts are needed to have donors give larger volumes of WB in China.  相似文献   

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