Background and Objectives: Counseling and notification of reactive blood donors play an important part in maintaining the chain of safe blood. The process of notification involves informing donors about the status of their reactivity against five major and mandatory transfusion-transmitted infections (TTIs). Such notification and timely follow-up till the donor reaches the referred place help in reducing the burden of TTI in society, thereby improving blood safety. The aim of this study is to highlight the importance of prompt donor notification, referral, and follow-up. Materials and Methods: This was a retrospective cross-sectional study carried out at a stand-alone blood center from January 2019 to October 2021. A total of 36,162 donations were screened for the five mandatory TTIs-HIV (I and II), hepatitis C virus (HCV), hepatitis B virus (HBV), syphilis, and malaria. All reactive results were retested with a duplicate tube sample and a bag sample to confirm the reactivity. Donors were notified regarding the serostatus by phone and called for reporting at our blood center, and referred to Integrated Testing & Counseling Centre (ICTC) or any other referral center. Results: A total of 212 (0.58%) out of 36162 donors were tested reactive during the study period. Out of them, 40.56% (n = 86) were hepatitis B virus reactive, 21.7% (n = 46) were HIV (I and II) reactive, 20.7% (n = 44) were HCV reactive, and remaining 17.1% (n = 36) were syphilis reactive. All the donors were informed. Out of them, 71.69% (n = 152) responded to the communication and 52.83% (n = 112) personally visited the blood center or respective ICTC for further evaluation. Conclusion: Even after laying strict criteria for predonation screening and counseling, few donors do conceal their high-risk behavior or even their serostatus and continue to donate blood, leading to the wastage of resources. Thorough follow-up of seroreactive donors helps in improving blood safety and also improves their quality of life by the commencement of timely treatment.

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