Prevalence of posterior subcapsular cataracts in volunteer cytapheresis donors

BACKGROUND: Granulocyte donors routinely receive dexamethasone orally before donation. Steroids may increase the risk of posterior subcapsular cataract (PSC) formation. STUDY DESIGN AND METHODS: We recruited 100 granulocyte donors (four or more granulocyte donations; any number of platelet [PLT] donations) and 100 age‐ and sex‐matched PLT donors (zero to three granulocyte donations, any number of PLT donations) to examine the risk of PSC. PSC was assessed by a masked ophthalmologist and reading center lens photograph gradings or medical record documentation of PSC as the reason for cataract extraction. RESULTS: Fourteen eyes of 10 granulocyte donors and five eyes of four PLT donors had PSCs (odds ratio [OR], 2.82; 95% confidence interval [CI], 0.83‐9.61; p = 0.10). Risk of PSC increased with number of granulocyte donations: compared to zero to three donations (4.0%), the risk for four to nine, 10 to 19, and 20 or more donations was 8.6% (OR, 2.25; 95% CI, 0.31‐13.99; p = 0.30), 9.5% (OR, 2.53; 95% CI, 0.44‐14.20; p = 0.21), and 13.0% (OR, 3.60; 95% CI, 0.48‐22.81; p = 0.11), respectively (p = 0.06 for trend). CONCLUSION: We did not demonstrate a statistically significant increased risk of PSC associated with granulocyte donation. However, although this makes a large risk unlikely, we cannot rule out a small to moderate risk and there is biologic plausibility that the steroid administration associated with granulocyte donation could be associated with PSC formation. Transfusion medicine professionals should advise granulocyte apheresis donors to maintain an appropriate frequency of eye examinations.     

Hepatitis B e antigen in volunteer and paid blood donors

Sera from 200 volunteer donors and 200 paid blood donors, all positive for hepatitis B surface antigen (HBsAg), were tested for the presence of hepatitis B e antigen (HBeAg).HBeAg was detected in 31 HBsAg- positive paid donors (15%), and in 11 HBsAg-positive volunteer donors (5%) by agar gel diffusion. The presence of HBsAg was associated with higher titers of HBsAg. No significant difference was found in the prevalence of antibody to HBeAg (anti-HBe) in the two donor groups. Rheumatoid factor was not associated with the presence or absence of HBeAg or anti-HBe, indicating that HBeAg is probably not an anti-IgG. These data support the epidemiological evidence that paid blood donors appear to be more likely than volunteer donors to transmit hepatitis B virus infection to recipients of their blood.     

Racial and ethnic composition of volunteer cord blood donors: comparison with volunteer unrelated marrow donors

BACKGROUND: Umbilical cord blood is an alternative peripheral blood progenitor cell source for patients who need transplantation. A presumed advantage of cord blood is the ability to increase minority recruitment. STUDY DESIGN AND METHODS: The racial composition of five member cord blood banks of the National Marrow Donor Program (NMDP) was compared, representing 9020 cord blood donors with NMDP marrow donors from comparable geographic areas, representing 417,676 donors. Cord blood and marrow donors self-reported racial designations on questionnaires. Donor statistics were compared with baseline racial data of deliveries from participating hospitals for cord blood donors and with geographic census data for marrow donors. RESULTS: The California, Florida, and Massachusetts cord blood banks recruited a lower percentage of minorities than the corresponding marrow donor centers. In New York and Colorado, minority recruitment was equivalent. In California, Florida, Massachusetts, and New York, the cord blood banks recruited a lower percentage of minorities than those delivering at the respective hospitals. The cord blood banks in California, Colorado, Florida, and Massachusetts recruited a lower percentage of minorities compared with delivery data than the corresponding marrow donor centers compared with census population (p < 0.001). In New York, the percentages were similar. CONCLUSION: The problem of insufficient minority recruitment of cord blood has not yet been solved. Better strategies are needed to recruit minority donors.     

Relative safety of first‐time volunteer and replacement donors in West Africa

BACKGROUND: A significantly higher level of safety between nonremunerated volunteer and replacement donor blood is assumed. This is supported by global data without stratifying between genuine replacement and paid donors, for first‐time or repeat volunteer, or according to age. STUDY DESIGN AND METHODS: In 2008, first‐time volunteer and replacement donors were identified, and confirmed human immunodeficiency virus antibody (anti‐HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus antibody (anti‐HCV)‐positive screening results were collated. Data were analyzed according to age and sex between the two types of donors. RESULTS: In 6640 first‐time volunteer and 4360 replacement donors, the prevalence of anti‐HIV and HBsAg (1.03 and 13.8% vs. 1.1 and 14.9%, respectively) was not significantly different. Anti‐HIV prevalence was higher in replacement donors less than age 20 than in first‐time volunteers; the difference was not significant. HBsAg and anti‐HIV confirmed‐positive prevalence was significantly higher in first‐time volunteer donors over age 20. CONCLUSION: In Kumasi, Ghana, viral safety of replacement and first‐time volunteer donors was similar, constituting a single population of donors. Safety increment is provided by repeat donation applicable to either group, through different approaches. A blood unit from replacement donor costs half or less than that from a volunteer donor; similar studies conducted elsewhere in sub‐Saharan Africa may lead to changes in current strategies.     

The relative safety of automated two-unit red blood cell procedures and manual whole-blood collection in young donors

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.     

Adverse effects in blood donors after whole-blood donation: a study of 1000 blood donors interviewed 3 weeks after whole-blood donation

BACKGROUND: There are no reports in the transfusion medicine literature that describe adverse reactions and donor arm injuries after whole-blood donation based on solicited information. STUDY DESIGN AND METHODS: The present study solicited adverse reaction and donor arm injury information from 1000 randomly selected whole-blood donors approximately 3 weeks after the whole-blood donation. Two 16-gauge phlebotomy needles in use were also compared. RESULTS: Thirty-six percent of the donors had one or more adverse effects (AEs). The most common systemic AEs were fatigue (7.8%), vasovagal symptoms (5.3%), and nausea and vomiting (1.1%). The most common arm findings were bruise (22.7%), arm soreness (10.0%), and hematoma (1.7%). Men were half as likely as women to have an AE (23% AE vs. 48% AE, p < 0.0001). Repeat blood donors had fewer AEs than first-time blood donors (36% AE vs. 47% AE, p < 0.007), and African-American donors had numbers of AEs similar to those of Caucasian donors (31% AE vs. 38% AE, p = 0.30). The two phlebotomy needles did not differ in causing blood donor AEs. CONCLUSION: AEs after donation and complaints may be more common than previously thought. The postdonation interview is a good tool for defining the blood donor's experience. It can also be used to evaluate and potentially improve blood donor safety and comfort.     

In vitro study of immunologic changes in long-term cytapheresis donors.

Several in vitro measurements of immune function were examined retrospectively in a population of active long-term cytapheresis donors (group I; n = 50) and the results were compared to age- and sex-matched controls (group II; n = 50) who had donated only whole blood. In group I, significantly different mean absolute lymphocyte counts (P = .0025), total T-cells (P = .0026) and T-helper cells (P less than .0001), and helper-to-suppressor ratios (P = .0279) were present. No differences were noted between the two groups for peripheral blood mean B-cell count, T-suppressor numbers, lymphocyte responsiveness to mitogens or alloantigen, and serum immunoglobulin level. The reduced mean absolute lymphocyte count in group I was due to the reduction in T-helper cell numbers and accounted for the imbalance in the helper-to-suppressor ratio. These disturbances are currently unexplained and, while no clinical consequences have so far become evident, there is a need to continuously monitor the immunologic status of cytapheresis donors. It is also important to determine whether reversal of the defects occurs and, if so, over what time interval.     

Collection of erythroid progenitor cells by cytapheresis of peripheral blood of normal donors

Human peripheral blood may be an alternative to bone marrow as a source of cells for hemopoietic engraftment. The ability to collect large numbers of circulating granulocyte-macrophage progenitors provides support for this contention. In the present study of cells from normal granulocyte donors, the cell concentrates obtained by cytapheresis were shown to contain even greater numbers of primitive erythroid precursors (153-956 [median 647] per 10(6) mononuclear cells) than would be predicted from the peripheral blood mononuclear cell counts. Moreover, the number of primitive erythroid precursors harvested correlated significantly with the number of granulocyte-macrophage progenitors obtained and with the total lymphocyte collection. These observations further substantiate the validity of transplanting peripheral blood as hemopoietic tissue.     

Voluntary whole-blood donors, and compensated platelet donors and plasma donors: motivation to donate, altruism and aggression.

BACKGROUND AND OBJECTIVES: To establish if voluntary whole-blood donors and compensated platelet donors and plasma donors may differ in their motivation to donate, altruism, aggression and autoaggression. MATERIAL AND METHODS: Whole-blood (n=51), platelet (n=52) and plasma donors (n=48) completed a battery of validated questionnaires while waiting to donate. Bivariate and multivariate analyses of variance and t-tests were performed to detect differences between groups as noted. RESULTS: Altruism (mean=40.2) was slightly higher in whole-blood donors than in platelet (mean=38.3) and plasma donors (mean=39.1) (p=0.07). Blood donors (mean=2.8) scored lower in the spontaneous aggression measure than platelet (mean=4.1) and plasma donors (mean=4.4) (p=0.01). Plasma donors (mean=4.9) had higher auto-aggression than whole-blood donors and platelet donors (mean for both groups=3.4) (p=0.01). Differences between the three groups were mediated by sociodemographic variables (MANCOVA). Whole-blood donors donated to help others, platelet and plasma donors mostly to receive the compensation. However, those platelet and plasma donors, who would continue to donate without compensation were similar in altruism and aggression to whole-blood donors. CONCLUSION: While most platelet donors and plasma donors were motivated by the compensation, those who stated that they would continue to donate without compensation had altruism and aggression scores similar to voluntary whole-blood donors.     

Platelet function in whole-blood donors is impaired: the effects of painkillers

BACKGROUND: Aspirin (ASA) or non-aspirin-like nonsteroidal anti-inflammatory drugs (NSAIDs) influence platelet (PLT) function by inhibiting cyclooxygenase enzymes. In this study, the aim was to address the use of ASA or NSAIDs before donation and the effect on PLT function. STUDY DESIGN AND METHODS: Donors were asked questions about recent use of ASA or NSAIDs. Furthermore, PLT function was evaluated by measurement of the closure time (CT) in a PLT function analyzer (PFA-100, Dade Behring) and by aggregometry (response to ADP or arachidonic acid [AA]). RESULTS: Of 100 questioned donors, 22 percent had used ASA (n = 4), NSAIDs (n = 6), or paracetamol (n = 12) before donation. Upon assessment of the PLT function in the PFA-100, 27 donors showed values of greater than 180 seconds, indicative of impaired PLT function. Of these, only 7 had used pain killers before donation. Furthermore, 15 of 22 users had normal CTs. Aggregation after stimulation with AA was absent in 33 PLT-rich samples. Again only 8 had reported use of ASA (3), NSAIDs (1), or paracetamol (4). Of the 22 users, 14 had normal AA aggregation responses. All donor samples showed ADP-induced aggregation, indicating PLT integrity. There was no difference between the group of donors who reported the intake of ASA or NSAIDs and the group of donors who did not with respect to the tested PLT function assays. CONCLUSION: It is concluded that there is a considerable group of donors that use PLT-influencing medication before donation. A relation between the reported use and impaired PLT function in blood donors could not be established, however. Impaired PLT function as tested may have other causes than intake of ASA or NSAIDs.     

浅谈无偿献血志愿者的多重角色

目的探索无偿献血志愿者志愿服务过程中诠释的多重角色。方法根据无偿献血志愿服务工作中志愿者所提供的服务探析其角色定位。结果无偿献血志愿者在志愿服务过程中诠释了献血者、宣传者、招募者、服务者、监督者、协调者、调解者等多重角色,满足献血者个性化的需求,提高献血者满意度与忠诚度。结论发挥无偿献血志愿者多重角色优势,使无偿献血工作更具特色和亲和力,推动其持续、稳定、健康发展。     

A highly specialized and motivated volunteer population: platelet donors

The plateletpheresis program of the M.D. Anderson Hospital was established in 1963. Approximately 20,000 units of platelet concentrates are produced per year. Credit for the nonreplacement fee generates the greatest number of donors. No organized recruitment campaign exists. Each donor becomes a recruiter for the program. Also involved in donor recruitment are all laboratory personnel, as well as Donor Room exployees.     

Seasonal influences on hemoglobin levels and deferral rates in whole-blood and plasma donors

BACKGROUND: Indications exist that deferral rates in blood donors are highest in summer. However, a detailed quantitative analysis is not available. The association between Hb values, deferral rates, and daily temperatures was investigated in a large data set of blood donors. STUDY DESIGN AND METHODS: The study population consisted of both plasma and whole-blood donors from the southeast region of the Netherlands. Individual Hb levels and other examination data between January 2002 and December 2004 were extracted from the donor file. Data on daily maximum temperatures were related to Hb levels and Hb deferrals. Results are reported separately for plasma and whole-blood donors as well as for men and women. RESULTS: Data were available from 106,398 whole blood donors and 6983 plasma donors, resulting in data of more than 600,000 examinations. Hb levels decreased with increasing daily temperature. Highest deferral rates were observed in summer months, which were consistent over the several groups and over the three years. The highest Hb deferral of 11.1 percent was observed for female whole-blood donors on days with a maximum temperature of 25 degrees and above. In all four donor categories a gradual increase with temperature was observed with 1.7-2.2 times higher deferral rates on hot days (> or = 25 degrees C) compared to cold days (<5 degrees C). CONCLUSION: A clear seasonal pattern in Hb levels and in the percentage of Hb deferrals was observed. The observed seasonal effect could not be explained by differences in donor characteristics. Our observations might have practical implications for donor management.     

献血400ml后献血者血液学指标观察

目的了解献血400ml后献血者相关血液学指标恢复情况。方法选择年龄、体格检查及献血前血液检验指标均符合我国现行法规要求的各种年龄的自愿无偿献血者123名,每人采血400ml,在献血后24h、7d、1个月和3个月时各采集血样1次,观察其白细胞、红细胞、血红蛋白、红细胞比积、血小板、血浆总蛋白、白蛋白和血清铁的动态变化与恢复情况。结果献血者献血400ml后,其白细胞、血小板、血浆总蛋白和白蛋白水平,同献血前比较变化无统计学意义(P>0.05);献血400ml后,其红细胞、血红蛋白、红细胞比积和血清铁在3个月内均可恢复到献血前水平。结论无论男女,只要符合我国现行规定的年龄与健康标准,每人每次献血400ml,且间隔3个月献1次血是安全的。