Changes in minimum hemoglobin and interdonation interval: impact on donor hemoglobin and donation frequency

Abstract

BACKGROUND To reduce donor iron deficiency in whole blood donors, we changed our hemoglobin (Hb) cutoff in males and interdonation interval in females. STUDY DESIGN AND METHODS A change in messaging to females in fall 2016 was followed by changing the interdonation interval from 56 to 84 days in the appointment booking system (December 2016) and actual donation criterion (March 2017). The minimum Hb for males increased from 125 g/L to 130 g/L (March 2017). We evaluated Hb levels and deferral rates, donor presentations with a Hb level below 120 g/L, donation frequency, and donor base size before and after these changes. RESULTS The Hb deferral rate decreased in females from 13.0% to 9.5%, increased in males from 1.2% to 2.1%, and decreased overall from 6.8% to 5.4% (all p < 0.001). Mean Hb increased from 135.0 g/L to 136.2 g/L in females and from 149.9 g/L to 150.6 g/L in males (both p < 0.0001). The percentage of presentations with Hb below 120 g/L decreased by 27% in males and females (p < 0.001). Annual donation frequency decreased by 12% in females and 4% in males; the donor base was expanded by 5.8%. CONCLUSIONS Many positive impacts were seen for female donors, including a shift in the Hb distribution curve to the right, and a large reduction in Hb deferrals. For males, there was an increase in Hb deferrals and a small increase in mean Hb. Changes were related to both reduced donation frequency and a shift in composition of the donor base.

Longer-term efficiency and safety of increasing the frequency of whole blood donation (INTERVAL): extension study of a randomised trial of 20 757 blood donors

“…Our results support the recent changes in the Canadian Blood Services that have increased the minimum inter-donation interval in women to reduce iron deficiency and deferrals for low haemoglobin. 24 Third, given the decrease in haemoglobin concentrations we observed over a longer period, it is essential for blood services to protect the health of donors by adopting appropriate screening methods to test donors' eligibility to donate whole blood. 25 To evaluate the relative merits of different screening methods in the context of NHSBT, the COMPARE study (ISRCTN90871183) aims to provide a systematic, within-person comparison of different methods to measure haemoglobin concentrations in whole blood donors to inform approaches for routine eligibility checks in England, UK.…”

“…In the extension study reported here, donors nearing completion of their 2-year participation in the main trial were invited by email to continue donating blood at their allocated inter-donation intervals beyond the 2-year period initially agreed (appendix p [22][23][24]. Participants were assigned to active (ie, more intensive) or routine reminders for donation appointments.…”

“…The active reminder system (as used in the main trial) consisted of a uniform three-step reminder process of email, text message, and telephone call to encourage donation attendance, with a particular focus on donors missing appointments. The routine reminders followed the standard NHSBT protocol, which was less intense (appendix p [22][23][24].…”

Donor Deferral Due to Low Hemoglobin—An Updated Systematic Review

“…A US study [41] found that, after increasing the minimum inter-donation interval from eight to twelve weeks, the LHD rate was reduced from 12.5% to 10.2% (p<0.0001). A Canadian study [42] also found that after raising its minimum donation interval from 56 to 84 days, deferral rates fell from 13% to 9.5%.…”

“…Two studies [41,42] reported the effect of minimum inter-donation interval on LHDs. A US study [41] found that, after increasing the minimum inter-donation interval from eight to twelve weeks, the LHD rate was reduced from 12.5% to 10.2% (p<0.0001).…”