Vasovagal reactions in blood donors during or immediately after blood donation

The aim of the study was to estimate the type, incidence and causes of donor adverse reactions during and after blood donation in a Greek Blood Bank, where medical staff is responsible for donor selection. 12 173 blood donors were studied for adverse reactions. One-hundred and seven (0.87%) donors had a vasovagal reaction during or after blood donation. Donors who gave blood occasionally had a significant greater incidence of reactions compared with volunteer donors (1.15 versus 0.53%) (P < 0.001). There was no significant difference between men and women (0.85 versus 0.95%). First-time donors (1.7 versus 0.68%) and those under 30 years (1.15 versus 0.71%] had a significant greater possibility to have a reaction (P < 0.001). Twenty-two of 107 (20.5%) donors had a syncopal reaction. There was not a causative correlation of haematocrit, haemoglobin, systolic and diastolic blood pressure, pulse rate and weight in women (except weight in men) in developing a reaction. The stressing experience of phlebotomy was the reason for the higher frequency of a reaction. The incidence of reactions in our donors is lower than in other studies, and the possible reason for this is that only physicians are responsible for the selection of donors and trained personnel are careful of them during the donation process.     

Blood donor notification rate in a blood bank in Veracruz,Mexico

Blood banks are primarily responsible for providing safe blood, but they also indirectly act to prevent the spread of infectious diseases by notifying blood donors of positive screening results. The notification process differs between countries and notifications rates are generally low. This study sought to analyze the notification rate of healthy and infection-positive donors who donated blood at CETS-Veracruz. A total of 41790 donors were analyzed, 1585 (3.79%) were positive for one or more of the screened infection markers. Only 4163 (9.96% of the total) were notified about their serology results. Of the positive donors, 157 were contacted by phone call; of them, 91 (57%) returned to the blood bank for their results. The average notification rate for positive donors was only 17.48%. The highest notification rate was for anti-HBc (26.63%), while the lowest was for HBsAg (4.17%). Age significantly influenced the return of donors: Those aged 18–24 and 25–39 years were 4.71 and 1.64 times less likely, respectively, to return for their results compared to the rate for all ages. The advice received in the pre-donation stage about the risks of transfusion-transmitted infections and the relevance of returning for results did not appear to impact donors, since the rate of notification was lower than those reported internationally. These data indicate that CETS-Veracruz should improve donor data registration and communication mechanisms to increase the notification rate, and that donor notification studies should be carried out in other Mexican blood banks to analyze the return rate at the national level.     

Confidential unit exclusion: the North London Blood Transfusion Centre's experience

SUMMARY. A 'Confidential AIDS Questionnaire' has been used at North London Blood Transfusion Centre (NLBTC) donor sessions since July, 1985. The aim of the questionnaire is to encourage self-exclusion by those donors whose behaviour puts them at risk of HIV infection. In a situation where such individuals cannot avoid donating they can indicate, in confidence, that their blood should not be used for transfusion. Since the introduction of this procedure, an average of 10 donors per month, who admitted relevant risk behaviour, have been permanently excluded and a number of prospective donors have excluded themselves when faced with the questionnaire. We have found the questionnaire to be well accepted by donors. It is a useful adjunct to routine donor selection and microbiological testing of donations in our efforts to minimize transfusion-transmitted infection.     

Awareness of blood group and blood donation among medical students

Background

Transfusion of blood-derived products is often used as a life-saving treatment, and being a blood donor should be common, especially among medical professionals. Thus, an awareness of one’s own blood type in medical students should be common. Our aim was to assess if students of the Medical University of Warsaw know their blood type and how many of them are registered blood donors.

Promoting blood donation: a study of the social profile,attitudes, motivation and experience of donors*

Summary. This study investigated how to improve the recruitment of blood donors, their retention as active donors and their response to call-up. A total sample of 9,000 non-donors, lapsed donors and current donors was examined in three programmes to determine the sex, age and social profile of donors; the attitudes of the population to blood donation; the motivating forces prompting people to give blood; the de-motivating forces preventing them; the image of the blood donor in society and the image of the National Blood Transfusion Service (NBTS). The profile of blood donors, with small variations, reflects that of the population. The experience of blood donation is widespread with 27% of the population either current or lapsed donors. The image of both blood donors and the NBTS was found to be very positive. The main force motivating donors is an awareness of patient need complemented by awareness that the need may one-day be personal. NBTS strategy will concentrate on reinforcing the need for blood donors and enhancing the experience of donors at blood donor sessions.     

互助献血与无偿献血血清学标志物对比分析

目的：对互助献血和无偿献血的血清学指标进行分析对比,研究探讨互助献血的风险。方法2006年1月至2012年12月,对符合献血条件的1834例互助献血者以及217323例无偿献血者进行了血液采集和留取 ETDA 抗凝样本,进行 ALT、HBsAg、Anti-HCV、Anti-HIV、梅毒共5个项目的初复检。结果互助献血（8.67％）的总阳性率要高于无偿献血组（6.31％）,但两组的ALT 阳性率差异无统计学意义,互助献血组的HBsAg、Anti-HCV、梅毒均高于无偿献血组。结论无偿献血群体的血清学安全指标优于互助献血组,是血源性传播疾病较低的低危人群,应该是血液供应的主要来源群体;对互助献血采取合理的干预措施后,能确保其安全指数与无偿献血等同,可作为无偿献血的有益补充。     

Transmission of HCV infection by RIBA indeterminate and positive blood units

A retrospective study was carried out on the recipients of 73 units of blood from 53 donors found reactive for anti-HCV. The donors were screened with anti-HCV enzyme-linked immunosorbent assay (ELISA C-100) and reactivity was confirmed with the first generation recombinant immunoblot assay (RIBA I). Fifty-two patients were recipients of blood from donors reacting as RIBA I 'indeterminate' and 21 of blood from RIBA I 'positive' donors. Only three recipients (5.8%) from 'indeterminate' donors were anti-HCV positive indicating that such donors are very seldom infectious. Eleven (52.4%) recipients from 'positive' donors had antibodies to HCV, indicating that not all RIBA-positive donors are necessarily infectious. Pretransfusion samples of the seropositive recipients were unavailable. All samples were analyzed with the first generation ELISA and with either the second-generation ELISA or RIBA (RIBA II) in order to evaluate test sensitivity. RIBA II was more sensitive than RIB I. One RIBA I indeterminate donor was positive by RIBA II. His recipient had antibodies to HCV. Twelve RIBA I indeterminate and three RIBA I positive donors were negative by RIBA II. All their recipients were anti-HCV negative. The second-generation ELISA was also shown to be more sensitive than ELISA C-100. The second-generation ELISA detected six confirmed anti-HCV positive recipients who were negative by ELISA C-100.     

Chronic pain following donor nephrectomy – A study of the incidence,nature and impact of chronic post‐nephrectomy pain

Chronic pain is a consequence of some types of surgery, but its incidence following open donor nephrectomy has never been investigated. We surveyed 123 patients who underwent open donor nephrectomy at our institution over a 10‐year period, to determine the incidence, severity and nature of chronic pain and its effect on quality of life. Of the 81 (66%) responders, 27 (33%) had experienced prolonged pain, and 21 (26%) still had chronic pain related to their surgery. The overall incidence of severe, disabling pain (visual analogue score ≥7) was 12% and of neuropathic pain was 14%. The average loss in quality adjusted life years (QALYs) was 1.053 for chronic pain sufferers, but was 1.851 for those who suffered specifically from neuropathic pain. Only one third of patients with chronic pain were receiving any treatment, and none were receiving neuropathic adjuvants or specialist pain management interventions. We conclude that the incidence of chronic pain following donor nephrectomy is underestimated and therefore under managed. Given the voluntary and altruistic nature of this procedure, and the enormous personal and social benefits which result from successful donor transplantation, those involved with the preparation and post‐operative management should be more aware of, and actively question donors about chronic pain so that diagnosis and appropriate therapy can be commenced as early as possible.     

Feasibility and success of a single-donor red cell program for pediatric elective surgery patients

Although the risks of allogeneic blood transfusions are small, it is wise to limit donor exposure whenever possible. A program has been developed in which one donor provided all red cell (RBC) units for each patient awaiting elective surgery. Patients were mostly children who were ineligible for autologous blood donation. Seventy-three patients and 115 donors (mostly parents) entered the program. Of the 115 donors, 90 (78%) were eligible to participate and 25 (22%) were ineligible; 21 were ineligible because of RBC incompatibility. For each of the 73 patients, one eligible donor was selected to donate all RBC units. Preoperative RBC orders were 1 to 2 units for 41 patients and > or = 3 units for 32 patients. Of the 73 donors, 58 (79%) gave all RBC units ordered; 15 (21%) failed to complete all donations, but only 1 because of anemia (hematocrit < 33% [0.33]). Of 73 patients entered, 46 (63%) underwent transfusion, and 27 (37%) did not. Of 46 patients transfused, 38 (83%) received only single-donor RBCs. Thus, the RBC needs of nearly all pediatric elective surgery patients were provided by a single donor for each patient. Single-donor blood programs should be considered for elective surgery patients who are ineligible for autologous blood donation and who would otherwise be exposed to multiple donors.     

影响公民自愿无偿献血的因素调查分析

目的了解影响公民无偿献血的各种因素以及公民决定献血的重点因素,以制定有针对性的招募策略。方法依照知、信、行(KAP)理论设计调查表,对成都市2385名献血与未献血的公民做现场问卷调查,通过对其无偿献血的知识、态度、行为的研究来做相关分析。结果①对无偿献血的认知:成都地区公民对我国实行无偿献血制度的知晓率较高(87.5%),但对无偿献血常识和危险行为方式总的知晓率较低(分别为29.4%、32.5%),其中献血者(1349名)对无偿献血常识和危险行为方式总的知晓率(分别为33.4%、38.1%)均高于未献血者(1036名)(分别为24.2%、25.1%)(P<0.05);文化程度越低,对献血常识和危险行为的知晓率越低,职业分布以医生的知晓率最高,农民的最低。②了解渠道:献血者通过人际传播的渠道了解的比例高于未献血者(P<0.05)。③献血动机:未献血者、初次献血者和重复献血者愿意献血的主要原因是“献爱心”,但献血动机比较多样,街头献血的行为受各种环境因素的影响;“人道主义”、“同伴招募”和“健康检查”是促使公民初次献血的因素,而影响初次献血的重点因素是“便利和勇气”;再次献血的公民主要是“献爱心、没什么特别原因和享受用血优惠”。④关注信息:未献血者如果打算献血,最希望了解的依次为“献血后是否影响身体”、“是否会感染疾病”、“血液相关知识”、“相关疾病知识”、“献血后优惠”、“献血时间地点”和“其他“。⑤对待献血的态度和行为:认为献血不影响身体的公民占73.5%,献血者(76.3%)的比例高于未献血者(70%)(P<0.05);献血者愿意继续献血的占93.3%,重复献血者(97.1%)高于初次献血者(91.1%)(P<0.05);77.3%的献血者表示“如有危险行为时选择放弃献血”。结论动机、认知、态度、个性及职业与文化程度等自身因素,献血法律法规、献血宣传方式、献血服务过程等环境因素亦都会影响公民献血。献血者招募的策略,首先应研究不同人群对献血不同的需求,采取针对性的措施,促使公民献血;其次,应为献血者提供安全、舒适和方便的服务。     

重庆地区无偿献血者丙肝病毒感染及对献血者招募的影响

近年来，中国的献血者招募模式正在从有偿献血到单位组织献血，进而到完全无偿献血的模式转变。有关真正的无偿献血者中丙型肝炎感染的资料还较少报道。本研究对重庆地区2003年的首次献血者进行丙型肝炎感染及病毒分型的调查，共有13620份血清标本进行ELISA丙型肝炎抗体检测，其中抗体阳性标本再经RT—PCR扩增HCVRNA的核心区／＆区片段进行基因分型。结果发现，HCV抗体阳性率为0．49％（67／13620），其中在40—49岁年龄段的阳性率（0．86％）最高；高学历人群和大城市生活人群的阳性率相对为高。丙肝病毒的基因分型结果显示，在22份基因分型阳性标本中有基因型1b，2a，3a和3b等四种，分别占4（18％）、5（23％）、9（41）和4（18％），以基因型3（包括3a和3b）为流行。结论：重庆地区无偿献血人群中丙型肝炎抗体阳性率较低；由于本地及周边地区静注毒品人群中丙型肝炎感染以基因型3为主，提示可能在献血人群中有静注吸毒者的存在。因此，随着献血模式的转变，在献血者的招募中应注意排除吸毒者这一高危人群。     

Notes on East Anglian blood donors

The record cards of 10,000 donors were examined. Of these, 44.5 per cent were women, and women formed the majority of rhesus (Rh)-negative donors. In addition, 500 donor cards each of male and female donors were examined to obtain information regarding the age of donors when their first donation was given, how many donations were given by each donor, and how long they remained on the panel. The average number of donations per donor was six, given on the average over a four-year period. The age limits for blood donors are 18 to 64 years. Within these limits, only 5 per cent of the population will be blood donors. Responses to a questionnaire indicated three main reasons for not being current blood donors: lack of time, disqualification on health grounds, and lack of information regarding the time and place of blood donor sessions. The study indicates that publicity to recruit donors should be aimed to appeal to both sexes and that the most desirable age range for new donors is from 20 to 45 years of age. If the present policy of not encouraging individuals 60 years of age or older to be donors were changed to limit new donors to individuals less than 54 years old, the number of donations would be initially decreased by only 4.6 per cent. Any advertising campaign should give more information concerning exact places and times of sessions, and should aim to overcome general disinterest in the need for blood donors and the conviction that a personal donation is not really necessary. It might emphasize that giving up at most, an hour every six months is usually possible.     

Retention of "safe" blood donors. The Retrovirus Epidemiology Donor Study

BACKGROUND: There are obvious advantages to increasing donor retention. However, for reasons of blood safety, certain donors may, in fact, be more desirable to retain than others. “Safe” donors are defined as those who provided a blood donation that was negative on all laboratory screening tests and who subsequently reported no behavioral risks in response to an anonymous survey. This study identifies the most important factors affecting the intention of “safe” donors to provide another donation. STUDY DESIGN AND METHODS: An anonymous survey asking about donation history, sexual history, injecting drug use, and recent donation experience was mailed to 50,162 randomly selected allogeneic donors (including directed donors) who gave blood from April through July or from October through December 1993 at one of the five United States blood centers participating in the Retrovirus Epidemiology Donor Study. Before mailing, questionnaires were coded to designate donors with nonreactive laboratory screening tests at their most recent donation. RESULTS: A total of 34,726 donors (69%) responded, with substantially higher response among repeat donors. According to reported intentions only, the vast majority of “safe” donors indicated a high likelihood of donating again within the next 12 months. Only 3.4 percent reported a low likelihood of donating again. A comparison of those likely to return and those unlikely to return reveals significant differences in demographics and in ratings of the donation experience. A higher proportion of those unlikely to return were first-time donors, minority-group donors, and donors with less education. The highest projected loss among “safe” donors was seen for those who gave a fair to poor assessment of their treatment by blood center staff or of their physical well-being during or after donating. CONCLUSION: These data suggest that efforts to improve donors' perceptions of their donation experience, as well as attention to the physical effects of blood donation, may aid in the retention of both repeat and first-time donors.     

Analysis of donor-deferral pattern in a voluntary blood donor population

SUMMARY. A reterospective analysis of records of the deferred donors from 1 October 1992 to 31 December 1993 was performed. Of 14,269 prospective blood donors (13,030 males and 1,239 females), 2,431 (16.4%) donors were disqualified for various reasons: 8-1% of the donors were deferred for non-pathological causes while 91-9% were deferred for medical reasons. The most common cause for non-pathological deferral was volunteers attending below the minimum acceptable age (5-2%). Abnormal findings on physical examination accounted for 57-2% of the deferrals in which low body weight was the most common finding (32-3%) followed by low Hb (18-6%). A past history of jaundice was the leading cause for deferral on medical interview.
Numerous prospective donors are currently being deferred based on empirically derived criteria. By developing strategies to identify and rationalize donor selection criteria, the blood transfusion services should be able to decrease unnecessary deferrals.     

无偿献血者非一针采血成功原因分析及对策

目的 探讨提高采血一针成功率的方法和对策.方法 选择141 745人次的无偿献血者为对象,对其中1 051例非一针采血成功的献血者进行分组比较,分析原因.结果 非一针采血成功者中,因献血不良反应而终止采血的占大多数,比率为75.17%(790/1 051);18～25岁、26～40岁献血年龄组与41～55岁年龄组比较、首次献血与再次献血组比较、不同献血环境比较均有明显差异;此外,与采血者的工作经验与技术也有相关性.结论 预防和减少献血不良反应的发生是提高采血一针穿刺成功率的关键,应加大宣传的力度,普及献血知识,做好心理护理(年轻人和首次献血者更为重要),改善献血环境,提高采血技术,可以有效提高采血一针成功的机率.     

Remuneration for blood donation and attitudes towards blood donation and receipt in Leeds

In a survey of attitudes towards remuneration for blood donation in Leeds, the following questions were completed by 489 adults (N), of whom 89 were regular donors, 105 were lapsed donors and 295 had never donated: 'If you needed blood, would you be content if the donor had been paid: yes/no'. 'If I were paid enough I would be less/equally/more likely to donate blood '. The majority (67.7%) of potential recipients would be content if the donor had been paid. The prospect of remuneration made 16.4% of respondents more likely and 14.5% less likely to donate. As the difference is less than 2% of N, offering remuneration may not lead to a significant increase in the number of donations. A statistical comparison (chi2 = 45, d.f. = 2, P < 0.001) showed associations between the responses 'more likely to donate if paid' and 'content to receive blood from a paid donor', and between the responses 'less likely to donate if paid' and 'not content to receive blood from a paid donor'. Age distributions are presented for the donor status categories and the responses to the main questions. Of 129 people who stated a minimum, nonzero payment that would persuade them to donate, 103 (80%) suggested pound sterling 10 or less.     

Is third party information true? Should blood donors be excluded because of it?

The Welsh Blood Service contacted and attempted to interview 40 donors about whom information from a third party had been received. This information would have excluded the donor from donation if it had been forthcoming from the donor. 57.5% of donors denied the information, but 25% of them accepted that the information was true and were removed from the register. 17.5% of donors did not respond and they were also removed from the register. Interviewing donors, about whom third party information has been received, enables those who have not divulged a risk factor or who do not wish to discuss a risk factor, to be removed from the donor panel. This increases the safety of the blood supply.     

Predicting a donor's likelihood of donating within a preselected time interval

The procurement of some advanced blood components, like quarantined plasma units, depends critically on retesting the donor within a fixed time frame. For health care systems, such as that in Germany, with mandatory retesting of donors before plasma release, the reliable identification of donors who are more likely to return in time has an immense practical implication, because their blood components could be preferably selected for quarantine purposes. The donation histories of about 760 000 donors with 4910 000 donation attempts were analysed. We developed a logistic regression model to calculate a probability of donation, p(Dts-te), within a preselected time frame (ts-te). The donation history was compounded in a score and shown to be very useful for determining p(Dts-te). A logistic regression model was developed with score and donor status as parameters; different regression coefficients applied to first-time-donors (ftd) and to repeat donors (intercept, int, and score factor, scf ). This model allowed us to determine the probability of donation, p(Dts-te), within a preselected time interval, e.g. 6-9 months after an index donation. The p(Dts-te) can be calculated for any donor of blood services. The p(D170-275 days) ranged from about 22% to 86% for any index donation in 1996/97. First-time donors had a p(D170-275 days) of 33% and were more likely to return within the time interval than certain subsets of repeat donors who can be defined by our model. We provided a technical procedure to increase the rate of plasma unit release after quarantine storage and showed the usefulness of our procedure for blood component management, if quarantine storage is required. By applying the model to our current plasma quarantine programme we could retrieve about 30% more units, which would represent about 30 000 units per year, without incurring additional costs. General implications for blood collection, like planning blood drives, were discussed. The whole demand of a health care system for single plasma units may be met by quarantine plasma and their cost-efficiency can be improved.     

Improving health profile of blood donors as a consequence of transfusion safety efforts

BACKGROUND: Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted in improvements. Mortality and cancer incidence among blood donors in Sweden and Denmark was investigated. STUDY DESIGN AND METHODS: All computerized blood bank databases were compiled into one database, which was linked to national population and health data registers. With a retrospective cohort study design, 1,110,329 blood donors were followed for up to 35 years from first computer-registered blood donation to death, emigration, or December 31, 2002. Standardized mortality and incidence ratios expressed relative risk of death and cancer comparing blood donors to the general population. RESULTS: Blood donors had an overall mortality 30 percent lower (99% confidence interval [CI] 29%-31%) and cancer incidence 4 percent lower (99% CI 2%-5%) than the background population. Mortality rates and cancer incidence were lowest for outcomes that are recognized as being related to lifestyle factors such as smoking or to the selection criteria for blood donation. Blood donors recruited in more recent years exhibited a lower relative mortality than those who started earlier. CONCLUSION: Blood donors enjoy better than average health. Explicit and informal requirements for blood donation in Scandinavia, although mostly of a simple nature, have successfully refined the selection of a particularly healthy subpopulation.