Temporary deferral and donor return

Deferral from donation is usually for conditions that make the donor only temporarily unable to give. Based on questionnaires given to 1247 donors with subsequent follow-up of their donation records for 6 months, permanent psychological effects of deferral are suggested. Only one of 36 deferred first-time donors (2.8%) compared with 27.3 percent of those who were not deferred returned for a second donation during the next 6 months. Among most first-time donors, temporary deferral may be interpreted psychologically as providing a permanent excuse for not donating.     

The impact of temporary deferral due to low hemoglobin: future return,time to return,and frequency of subsequent donation

BACKGROUND: This study investigated the effects of a 6‐month deferral due to low hemoglobin (Hb) on the subsequent donation patterns of Australian whole blood donors. STUDY DESIGN AND METHODS: The study was a retrospective cohort study of the donation patterns of all whole blood donors deferred for low Hb during a 2‐month period compared with donors who were not deferred. Donations 3 years after eligibility to give blood were recorded. Analysis of proportion returning, time to return, and frequency of donation was performed using logistic regression, survival analysis, and negative binomial regression. RESULTS: Among first‐time donors, 20.9% of low Hb–deferred donors returned during the follow‐up period versus 69.9% of those not deferred. Among repeat donors, 64.0% of deferred donors returned versus 91.0% of those not deferred. Temporary deferral delayed time to first return (p < 0.001), reduced frequency of donation (2.4 donations per donor before deferral compared to 1.1 per donor in first year of follow‐up), and increased the likelihood of dropping out in later years of follow‐up. However, if a donor returned promptly once eligible and gave more donations in the first year, the negative impact on future donation patterns was diminished. High frequency of attendance before deferral was the strongest predictor of time to return and future donation frequency. CONCLUSION: Deferral for low Hb had a strong effect on first‐time and repeat donors. This study highlights the influence of strong donation habits on return after deferral and the importance of encouraging donors to return promptly once eligible.     

The consequences of temporary deferral on future whole blood donation

BACKGROUND: The consequences of temporary deferral are not well understood. This study sought to investigate blood donor return after deferral expiration. STUDY DESIGN AND METHODS: A retrospective cohort analysis of allogeneic whole-blood donation was conducted. All deferred donors and a random sample of eligible donors were identified from the year 2000, with subsequent blood center visits through December 2005 captured. Stratified results are reported as the percentage returning, rates of return, and time to return. Measures of statistical association and Cox regression modeling are reported. RESULTS: For first-time (FT) donors, 25 percent of temporarily deferred donors returned during the 5-year follow-up period compared to 47 percent of eligible donors (p < 0.0001); for repeat donors, 81 and 86 percent of deferred and eligible donors returned, respectively (p < 0.0001). Depending on the deferral category, 14 to 31 percent of FT and 58 to 90 percent of repeat donors returned. Rates (per year) of successful donation during the follow-up period were 0.09 for index-deferred FT donors, 0.28 for eligible FT donors, 1.0 for deferred repeat donors, and 1.45 for eligible repeat donors. Multivariate modeling indicated that in addition to deferral, age, sex, race, and education were associated with return in both FT and repeat donors. CONCLUSION: The effects of deferral were more pronounced than expected, affecting both FT and repeat donors. For FT donors, the type and duration of deferral, while important, were not as relevant as hypothesized because so few returned, suggesting the need to develop appropriate interventions to recapture those donors likely to be eligible.     

The effect of short-term, temporary deferral on future blood donation

BACKGROUND: Most blood donor deferrals are temporary and short-term. The effect of short-term, temporary deferral (STTD) on blood donor return rates and subsequent blood donations is an important issue. STUDY DESIGN AND METHODS: Donors given STTDs during the first 3 months of 1993 were computer-matched with nondeferred donors on the basis of age, sex, and donation date. Computer records were evaluated during the next 4.25 years (4/93-6/97) to determine donor return rates and subsequent blood donations. RESULTS: The most common reasons STTD were low hemoglobin (46%), colds and/or sore throats (19%), and elevated temperature (10%). Nondeferred donors were 29 percent more likely than donors with STTD to return over the next 4.25 years (80% vs. 62%), and nondeferred donors donated 81 percent more whole blood units (13,798 vs. 7,615) over the same period. CONCLUSION: The study showed that STTD have a very negative impact on blood donor return rates and subsequent blood donations. Actions to alleviate these negative effects are indicated.     

Donor understanding and attitudes about current and potential deferral criteria for high-risk sexual behavior

BACKGROUND: Few donor criteria are as contentious as the deferral of men who have had sex with men (MSM). We performed an anonymous donor survey to determine attitudes toward current screening and the feasibility and acceptability of adoption of alternate donor criteria for MSM. STUDY DESIGN AND METHODS: Donors who had successfully donated to Canadian Blood Services were randomly mailed an anonymous questionnaire several weeks after donation; there were 40,000 donors sampled, evenly split between first‐time and repeat donors. RESULTS: The response rate was 45.5%. The vast majority of donors found the current screening questions and clinic environment acceptable. Attention to clinic educational materials was poor. A total of 53% felt that the MSM criteria should be changed; many were supportive of criteria based on specific behaviors rather than a period of abstinence. Gender‐neutral questions such as number of sexual partners would result in deferral of large numbers of donors. CONCLUSION: Many donors would support a change in MSM deferral policy. Implementation of strategies based on donor attention to additional material would be challenging. Universal use of simple gender‐neutral questions would result in very high donor loss and are therefore not an acceptable option. The acceptability and feasibility of various screening approaches should be explored further with both donors and advocacy groups.     

Donor deferral and resulting donor loss at the American Red Cross Blood Services, 2001 through 2006

BACKGROUND: A large number of blood donors are deferred each year and many of the temporarily deferred donors do not return to donate blood. This study analyzed actual deferral and return donation data from the American Red Cross to further assess the impact of donor deferral on donor availability. STUDY DESIGN AND METHODS: Voluntary blood donors who presented between 2001 and 2006 were included in this study. Deferred donors were classified into three groups according to their history of presentation during the prior 2 years: Group 1 with no prior donation or deferral, Group 2 with prior donation but no deferral, and Group 3 with prior deferral. Temporarily deferred donors in Groups 1 and 2 who did not return during the next 3 years were considered lost donors. All indefinitely deferred donors were lost donors. RESULTS: A mean of 12.8 percent of a total of 47,814,370 donor presentations between 2001 and 2006 resulted in a deferral. While majority of the deferrals were related to donor safety reasons, deferrals for recipient safety reasons accounted for 22.6 percent of deferrals or 2.9 percent of total presentations. Temporary and indefinite deferrals for recipient safety‐related reasons collectively caused an estimated loss of 647,828 donors during the 6 years. An additional 1,042,743 donors were lost due to deferrals for donor safety‐related reasons during the same period. CONCLUSIONS: The results on donor loss after deferral call attention to the impact of donor deferrals on donor availability and the need to monitor and assess the necessity and effectiveness of such deferrals.     

Donor neutrophil function after plateletpheresis

BACKGROUND: Neutrophils are important mediators of inflammation and may be activated by foreign surfaces in apheresis systems. Because most of the WBCs are returned to the donor, it was investigated whether artificial activation leads to altered donor neutrophil function. STUDY DESIGN AND METHODS: Three apheresis systems (Amicus, Autopheresis-C, and CS-3000; all: Baxter Fenwal) were investigated. Preapheresis and postapheresis blood samples were drawn from 10 volunteer donors, with all three apheresis systems used in random order for each donor. Changes in neutrophil phagocytic ability, oxidative burst, and expression of L-selectin and CD11b were measured by flow cytometry, and plasma concentrations of myeloperoxidase and lactoferrin were measured by EIA. Complement activation was evaluated by quantification of C3bc and the terminal complement complex by EIA. RESULTS: Neutrophil expression of L-selectin increased after apheresis (p = 0.02), and the production of oxygen radicals was reduced (p = 0.01). This effect was possibly a result of priming. Complement was not activated. There were no significant differences in neutrophil function after apheresis with any of the three apheresis systems. CONCLUSIONS: Neutrophil function was altered after apheresis, although to a very small extent, and contact between neutrophils and the foreign surface in the apheresis systems is found to be a biotolerant procedure.     

Donor Deferral Rates after the Implementation of a New German Blood Donor Questionnaire

Background

The implementation of a new national German blood donor questionnaire was proposed to improve donor and recipient safety.

Methods

We compared deferral/exclusion rates of whole blood donors before (May 2010, n = 64,735) and after (May 2011, n = 71,687) the implementation of a new blood donor questionnaire. Considering seasonal variations, analysis was performed with respect to collection site (mobile vs. fixed), sex, donor status (first-time vs. repeat), age, and the frequencies of sexual risk behavior and other reasons for deferral.

Results

We observed a statistically significant increase (p < 0.001) of the overall deferral/exclusion rate from 6.2 to 8.1%, irrespective of type of collection site (fixed: from 6.0 to 8.5%; mobile: from 6.2 to 8.0%), sex (females: from 7.5 to 9.9%; males: from 5.1 to 6.6%), donor status (first-time donors: from 19.7 to 24.7%; repeat donors: from 4.6 to 6.3%) or age (18–29 years: from 9.1 to 11.7%; 60–71 years: from 5.1 to 6.6%). Confidential self-exclusion increased from 0.08 to 0.14% (p < 0.001). Besides risk behavior, various medical reasons could be identified that explain this increase.

Conclusions

The new blood donor questionnaire resulted in an increased deferral/exclusion of all donor groups. Thus the impact on future blood supply must be considered carefully, and long-term studies and investigation of donor acceptance will be needed.     

活体肝移植的术后护理

活体肝移植是90年代初刚刚兴起的一项治疗终末期肝脏疾病的新方法,具有供肝来源广泛,适合我国未建立“脑死亡法”的国情;由于经过认真的术前准备,且供肝冷保存时间短,所获取的供肝质量高;由于有血缘关系,故移植术后免疫排斥发生率     

Low hemoglobin deferral in blood donors

Low hemoglobin deferral occurs in about 10% of attempted whole blood donations and commonly is a consequence of iron deficiency anemia. Pre-menopausal women often have iron deficiency anemia caused by menstruation and pregnancy and have low hemoglobin deferral on their first donation attempt. Frequent donors also develop iron deficiency and iron deficiency anemia because blood donation removes a large amount of iron from the donor and the 56-day minimum inter-donation interval for donors in the United States is not sufficient for recovery of hemoglobin and iron stores. Other causes for low hemoglobin deferral range from a medically insignificant deferral of a woman with hemoglobin between 12.0 and 12.4 g/dL, which is within the normal reference range but below the 12.5 g/dL needed to donate blood, to anemia caused by an unrecognized malignancy in a “healthy” individual attempting to donate blood. The diverse causes of anemia in blood donors make it difficult to provide accurate information to donors about the cause of their low hemoglobin deferral and complicate implementation of programs to prevent them by blood collecting agencies. This article reviews how hemoglobin is measured and the demographics and causes of low hemoglobin deferral in blood donors. It provides recommendations for how blood collection agencies can provide donors with accurate information about the cause of their deferral and discusses programs that can be implemented to decrease these deferrals in regular donors.     

活体肝移植的术后护理

活体肝移植是90年代初刚刚兴起的一项治疗终末期肝脏疾病的新方法,具有供肝来源广泛,适合我国未建立"脑死亡法"的国情;由于经过认真的术前准备,且供肝冷保存时间短,所获取的供肝质量高;由于有血缘关系,故移植术后免疫排斥发生率低;免疫抑制剂用量相对小、费用低等优点.     

Factors affecting return to work after hand injury

The study of 61 hand-injured subjects suggested that it is more than surgical and technical excellence that facilitates the return-to-work status among the hand-injured wage earners. Financial need, level of activities of daily living, and participation in occupational therapy were found to be directly related to return-to-work status. Additional findings indicated no difference between the rate of return to work for those whose injuries affected their dominant hand over those who had nondominant hand injuries. The amount of medical care needed and whether it was delivered as an outpatient or an inpatient were not associated with the return to work. The hand-injured subjects' relevant medical history, participation in occupational therapy, capacity in activities of daily living, desire and ability to return to work, and financial support were quantified through chart audit and interview. Occupational development was measured by using the Moorhead Occupational Work History.     

献血者服用中药后延期献血期限设定的探讨

目的　探讨服用过中药的献血者须延期献血的时间。方法　采用药动学方法。有致敏、致畸作用的药物推迟时间从最后一次服药算起为tmax+2 0×t1 / 2 ,无致敏、致畸作用的药物为tmax+7×t1 / 2 。有其它特殊药理作用的药物根据具体情况而定。结果　探讨了 2 2种中药、中成药的安全间隔时间。结论　服用过中药的献血者一般应推迟献血的时间 ,从而有效排除中药对血液质量的影响