Evaluation of 6 years of confidential unit exclusion at the <scp>B</scp>elgian <scp>R</scp>ed <scp>C</scp>ross <scp>F</scp>landers <scp>B</scp>lood <scp>S</scp>ervice

Vandewalle, Givoani; Baeten, Martine; Bogaerts, Kris; Vandekerckhove, Philippe; Compernolle, Veerle

doi:10.1111/vox.12115

Cited by 6 publications

(12 citation statements)

References 20 publications

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“…Despite this issue, the IBTO has used this system to improve the safety of blood and its components [15,24]. Several studies confirmed that CUE is a relatively costbeneficial system that can significantly improve the safety of blood products [15,25]. In our study, this issue was observed and the CUE option was more commonly used by first-time donors.…”

Section: Discussionmentioning

confidence: 64%

First-Time Blood Donors are Double Edged Swords for Blood Transfusion Centers: a Retrospective Study in Southwest Iran

Niazkar¹,

Dorgalaleh²,

Rad³

2019

Tjh

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Objective: First-time blood donors are the most common group of blood donors. They usually have different motivations for blood donation, some of which provoke the donors to hide risk factors of transfusion-transmissible infections (TTIs). Therefore, detection of TTIs among first-time donors is crucial and can decrease the rate of TTIs among blood recipients. This study aimed to evaluate the prevalence of TTIs among first-time donors in the transfusion center of Kohgiluyeh and Boyer-Ahmad Province (KBTC), Iran. Materials and Methods:This retrospective study was conducted with volunteer blood donors in 2004-2014 in the KBTC. Various data, including sex, confidential unit exclusion (CUE), previous donation history, and the laboratory findings of confirmatory tests, were extracted from blood donor software. Data were analyzed by SPSS using the chi-square test.Results: Among 198,501 blood donors, 52,527 (26.46%) were firsttime donors, while 145,974 donors (73.54%) were repeat and regular donors. Most of the donors (94.5%) were male, while a minority (5.5%) were female. The CUE option was chosen by 2,237 (1.13%) donors. The incidence of hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) was 247 (0.13%) and 134 (0.07%) among the entire study population, respectively. Three donors (0.002%) had confirmed human immunodeficiency virus (HIV), while none of the blood donors were positive for syphilis. Most of the donors with positive HBsAg (95.8%), HCV (86.6%), and HIV (100%) infection were first-time donors. Conclusion:Since TTIs are more common among first-time blood donors than regular and repeat donors, special considerations should be taken into account for this common group of blood donors.Amaç: Kan donörlerinin büyük çoğunluğunu ilk kez kan veren donörler oluşturmaktadır. Bu kişilerin genellikle kan vermek için farklı motivasyonları vardır ve bu da vericilerin transfüzyon ilişkili enfeksiyonları (TTI) saklaması açısından risk oluşturur. Bu nedenle ilk kez verici olanlarda TTI'ları tespit etmek çok önemlidir ve böylece kan alıcılarında TTI'lar azaltılabilir. Bu çalışmada amaç İran'da Kohgiluyeh ve Boyer-Ahmad Bölgesi (KBTC) transfüzyon merkezindeki ilk kez verici olan kan donörlerinde TTI prevelansının araştırılmasıdır. Gereç ve Yöntemler:Bu çalışma, KBTC'de 2004-2014 yılları arasında gönüllü kan vericilerinin dahil edildiği retrospektif bir çalışmadır. Cinsiyet, gizli ünite dışlaması (CUE), daha önceki kan bağışları, ve doğrulama testlerinin laboratuvar bulguları gibi veriler, kan vericileri yazılımından elde edilmiştir. Elde edilen veriler ki-kare testi kullanılarak SPSS ile değerlendirilmiştir. : 198,501 kan vericisinden 52,527'i (%26,46) ilk kez kan veren donörler, 145,974'i ise düzenli olarak kan verenler veya daha önce kan vermis olanlardı (%73,54). Vericilerin çoğu erkekti (%94,5), kadın verciler azınlıktaydı (5,5%). CUE seçeneği 2,237 (%1,13) verici tarafından kullanılmıştı. Bütün çalışma grubunda hepatit B yüzey antijeni (HBsAg) ve hepatit C virüsü (HCV) sıklığı sırasıyla 247 (%0,13) ve 134 (%0,0...

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Section: Discussionmentioning

confidence: 64%

First-Time Blood Donors are Double Edged Swords for Blood Transfusion Centers: a Retrospective Study in Southwest Iran

Niazkar¹,

Dorgalaleh²,

Rad³

2019

Tjh

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“…During the study period, four window period donations detected by HIV‐NAT only were from non‐CUE users indicating a good performance of the Brazilian HIV‐NAT test. Previous studies have shown both low sensitivity and predictive value of CUE to identify window period donations . These non‐CUE users window period HIV cases suggest that the donors might had been concerned in using the CUE‐option and not having their blood tested, overcoming all the blood bank screening barriers in order to donate blood and getting tested.…”

Section: Discussionmentioning

confidence: 96%

“…Studies have shown association of CUE and higher prevalence of serologic markers, however with low sensitivity and positive predictive value to indicate window period of TTI . CUE was discontinued in most US blood centers, while in the recent decade it has been reported in Brazil, Belgium and Canada . The controversy about the utility of CUE usage has increased especially after the implementation of highly sensitive and specific nucleic acid tests (NAT), which reduce, the risk of transmission during the window period .…”

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confidence: 99%

High rate of seromarkers for HIV, HBV and syphilis among blood donors using confidential unit exclusion, before and after HIV‐NAT implementation at a major public blood bank in the Brazilian Amazon

et al. 2018

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BACKGROUND: Confidential unit exclusion (CUE) was introduced in the 1980's as an additional layer to blood safety, before highly specific and sensitive nucleic acid tests (NAT) for HIV were implemented. The utility of CUE-use in settings that have implemented NAT should be evaluated over time. STUDY DESIGN, METHODS: Cross-sectionalretrospective study carried out from June 2010-November 2015, at Manaus Hemocenter (HEMOAM), Amazonas, Brazil that implemented HIV-NAT in 2012. The HIV, HCV, HBV, HTLV, Chagas disease, and syphilis rates were compared among CUE and non-CUE blood donors, before and after HIV-NAT implementation. RESULTS:Among 287,588 donations, 2,154 (0.75%) were associated with CUE, mainly voluntary donations (64.2%), by repeat donors (58.4%) from young (median age = 31 years), males (84.4%), unmarried (63.1%). CUE-users compared to non-CUE donors (n = 285,434) had higher seropositivity rates to HIV (OR = 6.09, 95% CI: 3.68-10.07, p < 0.001), HBV (anti-HBc OR = 1.81 95% CI: 1.24-2.64, p = 0.004; HBsAg OR = 5.68, 95% CI: 1.78-18.07, p = 0.017), and syphilis (OR = 1.78, 95% CI: 1.05-3.04, p = 0.030). Most (97.2%) discarded blood units associated to CUE was seronegative for all pathogens. Most donations (73.4%) were tested by HIV-NAT and showed four window period donations, positive by HIV-NAT only among non-CUE donors. CONCLUSION:A high rate of transfusion transmissible infections/TTIs was observed at HEMOAM especially in CUE-users. CUE-use offered an additional layer of blood safety by its association with anti-HBc/HBsAg and syphilis that are not covered by NAT. For blood banks in highly endemic areas for HIV and TTI, as HEMOAM, the identification of at risk donors, and the orientation to be tested at proper sites remain a great challenge. W orldwide safe blood transfusions have been continuously challenged by both emerging and known transfusion transmissible infections (TTIs). Brazil, the largest and most populous country in Latin America is also the most affected by HIV/AIDS. From 1980From -2017,810 AIDS cases were reported in the country. 1 In the recent decade, the Brazilian Amazon in the North region has shown an uncontrolled AIDS epidemic with growing prevalence and mortality rates. 1 This expansion sharply contrasts with a stable epidemic with decreased prevalence and mortality in its epicenter, located in Southeast Brazil. 1 A recent 21-year historical series from a major public blood bank from Amazonas State, the Hematology and Hemotherapy Foundation of Amazonas State (HEMOAM), described a significant rate of HIV infection in young male donors, suggesting high-risk, test-seeker behavior and potential risk of HIV transmission by blood transfusion. 2 In the isolated geographic context of Amazonas state where there is a high demand for blood transfusions, the control of an expanding AIDS epidemic and the implementation of safe transfusion procedures are both challenging and represent a critical component for the public health network.From the

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“…Most of these have not focused on the quality of CUE processes and only compared the donors opting for CUE and those without CUE regarding the serological markers. [9132122] Nevertheless, comparison of HIV prevalence between CUE and non-CUE donors is difficult due to the very low prevalence rate of HIV among blood donors. [9132122] A previous study showed that the prevalence of HBV, HCV, and HIV was higher among the CUE donors.…”

Section: Discussionmentioning

confidence: 99%

“…[9132122] Nevertheless, comparison of HIV prevalence between CUE and non-CUE donors is difficult due to the very low prevalence rate of HIV among blood donors. [9132122] A previous study showed that the prevalence of HBV, HCV, and HIV was higher among the CUE donors. [23] In another previous study, the prevalence of HIV antibody was 21 folds higher among the blood donors who had opted for CUE compared to those who had not.…”

Section: Discussionmentioning

confidence: 99%

A study on confidential unit exclusion at Shiraz Blood Transfusion Center, Iran

Kasraian

Karimi

2016

Asian J Transfus Sci

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Background:Confidential unit exclusion (CUE) system has been designed to enhance transfusion safety as an extra additive approach.Aims:This study was designed to survey demographic characteristics, prevalence of serologic markers, and reasons of opting CUE.Materials and Methods:The cross-sectional study was performed at Shiraz Blood Transfusion Center (Southern Iran). CUE is used for all individuals who refer for blood donation, and donors can choose their blood not to be used if they have any doubt about their blood suitability for transfusion. The prevalence rate of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) was compared between the blood donors who opted into and out of CUE. Then, the donors were contacted to give another blood sample and the reasons of deferral. Researchers also determined whether their reasons were logical or not. Data were analyzed using comparison of proportions in MedCalc software 7.Results:Out of all the donors, 2365 ones (2.3%) opted for CUE. CUE was more frequent among men, singles, donors with low education levels, between 18 and 25 years old, and with history of previous donation (P < 0.05). The prevalence rate of HCV was higher among the donors who opted for CUE (P < 0.05), but it was not the case regarding HBV and HIV (P>0.05). Furthermore, 91.5% of the donors had opted for CUE by mistake and only 8% had chosen CUE logically.Conclusion:It is necessary to review the process of CUE, make some changes both in procedure and design, and then survey its effectiveness in blood safety.

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Evaluation of 6 years of confidential unit exclusion at the Belgian Red Cross Flanders Blood Service

Cited by 6 publications

References 20 publications

First-Time Blood Donors are Double Edged Swords for Blood Transfusion Centers: a Retrospective Study in Southwest Iran

First-Time Blood Donors are Double Edged Swords for Blood Transfusion Centers: a Retrospective Study in Southwest Iran

High rate of seromarkers for HIV, HBV and syphilis among blood donors using confidential unit exclusion, before and after HIV‐NAT implementation at a major public blood bank in the Brazilian Amazon

A study on confidential unit exclusion at Shiraz Blood Transfusion Center, Iran

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