Does blood donor history accurately reflect the use of prescription medications? A comparison of donor history and serum toxicologic analysis

Melanson, Stacy E.F.; Stowell, Christopher P.; Flood, James G.; Lewandrowski, Elizabeth Lee; Zak, Rychard J.; Lewandrowski, Kent

doi:10.1111/j.1537-2995.2006.00909.x

Cited by 14 publications

(10 citation statements)

References 31 publications

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“…Although donor selection policies need definition, evidence for allowing donors requiring medical care to keep them healthy can be difficult to obtain. Melanson et al (2006) found, by toxicology screening, that 11% of donors whose donation was uneventful had not reported certain medications. More prescriptions are dispensed annually – in Scotland they rose by 2·9% to 79·5 million between 2005–2006 and 2006–2007, aspirin and ‘statins’ being the most common (Information Services Division, National Services Scotland, 2007).…”

mentioning

confidence: 99%

Evidence‐based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation‐induced iron depletion

Boulton¹

2008

Transfusion Medicine

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Blood Services, which, in the UK, spend over 0.5% of the NHS budget, are generally subject to quality, regulatory, economic and political authority. As only persons in good health should give blood, Services have refined donor selection criteria and aim to base them on evidence; but they also have to balance the number of donations collected with product demand. Applying selection criteria inevitably leads to deferrals, which donors experience very negatively. Compared with successful donors, even temporary deferrals reduce return rates significantly, especially of first attenders. In order to encourage donor return and sustain supplies, selection criteria should be optimal. However, a major tool for managing patients--evidence from randomized controlled trials (RCTs)--cannot apply to donor selection, so criteria have to be defined by alternatives, such as clinical studies, epidemiology and even what experts deem to be pathophysiologically feasible. The recommended volume of blood taken from each donor at each attendance (450 mL, which was based on old studies) was increased because of greater processing losses (buffy-coat derived platelets, leucofiltration etc.). Although faint rates and donation-induced iron depletion are reduced by lowering bleeding volume and bleeding less frequently, other optimizing strategies including iron supplementation have been trialled and could be enhanced by more RCTs. Better but more complex indicators of donor iron status than one-off Hb thresholds are possible. Regulators and decision-makers must encourage more studies. This review does not consider aphaeresis donors of blood components other than red cells in detail, or the prevention of transfusion-transmitted infections.

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confidence: 99%

Evidence‐based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation‐induced iron depletion

Boulton¹

2008

Transfusion Medicine

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“…Intentionally or unintentionally, donors may withhold such information. Several studies reported drugs in donor blood without declaration of medication in the questionnaire, the frequency being between 6 and 11% [1][2][3][4][5]11]. According to our experience, this may partly be due to the donors' knowledge of deferral criteria combined with a strong motivation for donating blood.…”

Section: Practical Approach At the Blood Bank Of The Bavarian Red Crossmentioning

confidence: 93%

“…Use of drugs is widespread among potential blood donors, and due to progressive aging of the population it is to be expected that the number of blood donors on medication will rise [11,[53][54][55][56]. Many of them are on long-term treatment.…”

Section: Practical Approach At the Blood Bank Of The Bavarian Red Crossmentioning

confidence: 99%

“…However, at present no detailed transformation of guideline requirements into instructions for donor assessment can be found in the literature. To our knowledge, most of the blood banks do not defer donors for their medication, except after the use of teratogenic and platelet aggregation-inhibiting drugs [11][12][13][14]. If detailed deferral periods are defined at all, they often are not based on the pharmacokinetics of the specific drug [15].…”

Section: Introductionmentioning

confidence: 99%

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Blood Donors on Medication – an Approach to Minimize Drug Burden for Recipients of Blood Products and to Limit Deferral of Donors

Becker

Stichtenoth

Wichmann

et al. 2009

Transfus Med Hemother

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Background: Blood products derived from donors on medication can contain drugs which might pose a risk for the recipients or influence the quality of the product itself. Material and Methods: To judge the eligibility of blood donors on medication, 4 drug classes have been formed with respect to their pharmacological properties, and blood products have been divided in accordance with their single-donor plasma contents. Results: For drugs with dose-dependent pharmacodynamics, no deferral periods are necessary for donation of blood products containing less than 50 ml single-donor plasma for application to adults. Waiting periods of tmax + 5 t_1/2 were calculated for the other blood products. Teratogenic drugs do not require special considerations (exception: retinoids, thalidomide and lenalidomide, dutasteride or finasteride with waiting periods for all blood products). A deferral period of t_max + 24 t_1/2 is proposed for every blood product from blood donors on genotoxic drugs. Drugs without systemic effects can be neglected. Irreversible inhibitors of platelet function cause a 10-day waiting period if production of platelet concentrates is intended. Conclusion: Donors on medication are allowed to donate blood for blood products containing less than 50 ml plasma of a single donor, like red blood cell concentrates, for the use in adults without deferral periods, except those taking retinoids, thalidomide, lenalidomide, dutasteride, finasteride, or genotoxic drugs.

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“…It will always be a question of 'how honest' the blood donors are when they fill in the questionnaire. In a study checking donor information on drug usage with actual serum values measured in the plasma from the same donors, there was a discrepancy in 11% of the donations [10]. There are indications that computer-based interviews increase the donor elicitation and may reduce errors [11].…”

Section: Donor Selectionmentioning

confidence: 99%

Where will pathogen inactivation have the greatest impact?

Hervig

2007

ISBT Science Series

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Blood safety has always been a major task in transfusion medicine. A strategy to obtain this aim should include donor education, donor selection, and testing of blood donations. Pathogen inactivation adds another level of safety. In the fractionation industry, pathogen inactivation methods are mandatory. Several countries also use pathogen-inactivated plasma -from pools or single donors. Concerning the cellular blood components, there is still no method available for red cell concentrates, whereas methods for platelet concentrates are available in some countries and others are in the pipeline for commercialization. The efficiency of the 'old' methods to increase blood safety and the costs of the methods seem to be major obstacles for the introduction of the systems. There are also concerns on product quality and loss of volume during the inactivation process. As the importance of pathogen inactivation is largest in countries with blood donors who carry infections it is impossible to protect against, either due to high incidence of the infection or due to shortage of tests, cost will be a major question when pathogen inactivation is considered. Pathogen inactivation of red cell concentrates will also be a necessity. When pathogen inactivation methods are available for all blood components, they will have great impact to protect the patients in countries where a high percentage of the population is infected by agents transmissible through blood transfusion, and in all situations to protect against new pathogens and 'old' pathogens that become more virulent. The total risk of contracting infectious diseases through blood transfusion will probably be important when implementation of new methods for pathogen inactivation is considered.

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Does blood donor history accurately reflect the use of prescription medications? A comparison of donor history and serum toxicologic analysis

Cited by 14 publications

References 31 publications

Evidence‐based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation‐induced iron depletion

Evidence‐based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation‐induced iron depletion

Blood Donors on Medication – an Approach to Minimize Drug Burden for Recipients of Blood Products and to Limit Deferral of Donors

Where will pathogen inactivation have the greatest impact?

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