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

Abstract

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.

Clinical and epidemiological profile of blood donors with positive serology for viral hepatitis in southern Brazil

“…More subtle rewards include offers of free tests, such as those for high blood pressure, cholesterol, glucose etc, which are beyond the mandatory donation screening for hemoglobin concentration and infection markers. The arguments against encouraging these donations include inadvertent recruitment of individuals with a lifestyle that puts blood recipients at higher risk, but some providers feel unable to sustain a sufficient blood supply without such encouragement 30,31 . Pereira et al 32 showed that replacement donors present 2.5-fold higher seropositivity for HBV, HCV and HIV than volunteer donors.…”

Serum hepcidin as a diagnostic test of iron deficiency in premenopausal female blood donors

“…13 Thus, donors are a good population in which to evaluate novel tests of iron deficiency. In a population of healthy female blood donors we evaluated the diagnostic properties of hepcidin concentration as a test of iron deficiency.…”

Anonymizing datasets with demographics and diagnosis codes in the presence of utility constraints

“…Similarly, increasing the dataset size, resulted in lower UL scores, as shown in Figure 11d. This is because larger datasets contain combinations of diagnosis codes which appear in more records 3 . Thus, the anonymization of these datasets can be performed with lower information loss.…”

“…Healthcare data are essential for performing large-scale, low-cost analyses [18], which range from Genome-Wide Association Studies (GWAS) to predictive modeling [9,32] and have the potential to improve medical research and practice. For instance, the study in [14] used more than 350,000 records of the Scandinavian Donations and Transfusions database, along with the donors' and the recipients' health records, to answer whether blood transfusions transmit cancer, and it had a substantial impact on public health policies regarding restrictions placed on blood donors [3,13]. Another study [75] used an EHR database of over 300,000 records, to learn meaningful comorbidities, which are associated with different stages of Chronic Obstructive Pulmonary Disease (COPD).…”