Improved safety for young whole blood donors with new selection criteria for total estimated blood volume

Abstract

The safety initiative with new selection criteria for EBV led to decreased complications among donors 16 to 18 years old, such that the risk for 16-year-olds was no longer different from that observed for 19-year-olds in the analysis stratified by age, sex, and donation status.

Management of Young Blood Donors

“…Male first-time donors who drank all of the water also showed an 18% difference when compared with male first-time donors who did not drink the water (4.6% vs. 5.5%; OR 0.82, 95% CI 0.62-1.09), but it did not reach a statistical difference. That male first-time donors do benefit from drinking 16 oz of water is consistent with the decrease in vasovagal reactions rates in all ARC male, high-school, first-time donors in 2008 [20], in the study by Tomasulo et al [19] that showed a 21% reduction in men with EBVs greater than 3.5 l, and in data from 8,894 high-school donors in 2004 and 2005 [51]. …”

“…The ARC and the Blood System Institute (BSI) therefore use the variables of weight, height, and sex to determine the most accurate EBV in younger blood donors. Younger blood donors with EBVs below 3.5 l are deferred in both systems, and this decreased the vasovagal reaction rates [19,20] and delayed vasovagal reaction rate [19]. More than 99% of the young donors eliminated for an EBV less than 3.5 l are women [19,25].…”

“…Many studies have studied or reviewed risk factors for vasovagal reactions, and the reader is referred to those studies for an extensive discussion on risk factors [12,13,14]. Youth is the main risk factor for a vasovagal reaction [14,15,16,17,18,19,20,21]. Body size, as measured by estimated blood volume (EBV) calculations and less well by body mass index or weight, is the second most important risk factor, and first-time donation history is also a significant risk factor [14,16].…”

“…Two studies from two large organizations evaluated the interventions of donor selection (≥ 3.5 l EBV required), 16-oz (473 ml) water fluid preloading within 30 min of the phlebotomy, and muscle tension in young whole-blood donors [19,20]. The ARC study compared 754,000 and 711,000 whole-blood donations from 16- to 18-year-old donors in the 2008 and 2009 school years, respectively, to a baseline of 2.02 million donors of the same age from 2005-2007 [20].…”

“…The ARC study compared 754,000 and 711,000 whole-blood donations from 16- to 18-year-old donors in the 2008 and 2009 school years, respectively, to a baseline of 2.02 million donors of the same age from 2005-2007 [20]. Several actions were taken in the 2008 school year (new pre-donation materials for high school students and their parents, standard work guidance for staffing levels, elimination of the view of the venipuncture area from the waiting area, encouraging each donor to drink 16 oz (473 ml) of water before phlebotomy and to perform leg lifting as a form of muscle tension), and in the 2009 school year, 16- to 18-year-old donors had to have an EBV of at least 3.5 l to donate.…”