<p>Blood Donor Deferral Analysis in Relation to the Screening Process: A Single-Center Study from Southern India with Emphasis on High Hemoglobin Prevalence</p>

Abstract

Donor deferral results in loss of potential, motivated blood donors, and thereby, availability of blood for needy patients. This study analyses the frequency and reasons for donor deferral, including high hemoglobin deferral, which is underreported in India. Methods: Retrospective analysis of the deferral record of whole blood donors from January 2014 to December 2018 was performed with respect to the pre-donation screening process at our center. Accordingly, the deferrals are categorized as stage1-evaluation of Donor History Questionnaire (DHQ), stage 2-medical examination, stage 3-hemoglobin (Hb) check using copper sulfate method or a gradually implemented quantitative hemoglobin analyzer, and stage 4-before phlebotomy. Donor demographic details, donation frequency, and deferral reasons were noted. Descriptive statistical analysis was performed using SPSS version 20 (IBM, USA). Results: Of 99,680 pre-donation screenings, 10.6% was deferred. The highest deferral (56.02%) was at stage 3 (based on hemoglobin level) contributed by low (52.45%) and high (3.75%) hemoglobin deferrals against cutoff of 12.5 to 18 g/dl. High Hb was noted only in male donors when screened by hemoglobin analyzer. Further, a steady fall in low hemoglobin but a rise in high hemoglobin deferral rate owing to the gradual implementation of hemoglobin analyzer over the study period was noted. The deferrals in stage 1, 2, and 4 were 29.64%, 13.97%, and 0.36%, respectively. Overall, the deferral rate was higher in females (49.88%), and in first-time (13.63%), and 18 to 25 yrs age-group (4.25%) donors for low Hb, underweight, and tattooing/ear piercing. Conclusion: Insights on donor deferral reasons promote proactive measures towards donor recruitment and retention. Further, donor hemoglobin screening by quantitative method, if followed uniformly by all blood centers across the country, will help identify the true prevalence of high hemoglobin in Indian blood donors and ensures donor safety.

Phenotype, Allele and Genotype Frequency of ABO and Rhesus D Blood Groups of Blood Donors at the North Gondar District Blood Bank, Northwest Ethiopia

“…Studies revealed that deferral significantly increased as age increased due to abnormal blood pressure. 19,20 In the current finding, most of the donors (82.1%) were males. This was comparable with other studies conducted in Madagascar 17 and India.…”

“…Studies showed that females were more defer than males 19,30,31 due to being more anemic compared to males. 19,20 World Health Organization and other international and national organizations advised that blood donations must be voluntary and unpaid. This ensures the availability of a constant and safe blood supply.…”

“…Studies revealed that deferral significantly increased as age increased due to abnormal blood pressure. 19 , 20 …”

“…Indeed, other studies supported males and females had no significant difference in blood donation practice. 20 , 28 , 29 The other reason might be due to the high deferral rate in females. Studies showed that females were more defer than males 19 , 30 , 31 due to being more anemic compared to males.…”

COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care blood center in southern Karnataka, India

“… 20 , 21 , 22 , 23 The common deferral reasons identified in a previous study conducted at our center include the hemoglobin-based deferral followed by high blood pressure. 24 However, in the pandemic year post-lockdown phase, a minimal proportion (5.4%) of the deferral was due to the COVID-19 risk. This is probably due to the inclusion of regular blood donors, rather than first-time donors, who are well informed on the blood donation eligibility criteria and, thus, opted for self-deferral.…”