The risks of low hemoglobin deferral in a large retrospective cohort of plasmapheresis donors and the influence factors of return for a subsequent donation in China

Abstract

Background According to the Technical Operation Procedures for Plasmapheresis Collection Station (2019) in China, plasmapheresis donors with low hemoglobin (Hb) levels (men <12.0 g/dL; women <11.0 g/dL) were deferred for at least 2 weeks. The purpose of this retrospective study was to survey the demographic characteristics of plasmapheresis donors with low Hb deferral (LHD) and identify at-risk LHD donors, so as to enhance donor safety and improve donation service management. Methods From 2018 to 2020, a multi-center study involving plasmapheresis donors from 18 plasmapheresis centers in three provinces (Sichuan, Yunnan and Hunan) of China was conducted. Donor demographics (age, sex) and donation information (date of donation, first-time donors vs. repeat donors, the number of lifetime donations, the number of donations in the last 12 months, and whether the LHD donor returned for a subsequent donation) were collected. The Cochran-Mantel-Haenszel method was used to explore the risk factors for LHD while adjusting for the different provinces. Logistic regression analysis was used to investigate the factors influencing the return for a subsequent donation after LHD. Results A total of 497,039 plasmapheresis donors were included. Female donors’ LHD rate was 0.15% on average, while male donors’ LHD rate was 0.01%. Female donors aged 41–50 years old (OR: 2.276, 95% CI [1.333–3.887], p = 0.002) were more likely to experience LHD temporarily than those aged 18–30 years old. For female donors, compared with donations in the winter, they had a higher risk for LHD in the summer (OR: 2.217, 95% CI [1.670–2.943], p < 0.001), spring (OR: 2.402, 95% CI [1.806–3.196], p < 0.001), and fall (OR: 2.002, 95% CI [1.500–2.673], p < 0.001). Among the LHD donors, those who had donated more frequently in the past were more likely to return for a subsequent donation (p = 0.012). Conclusions Female donors were at a higher risk of LHD, particularly between the ages of 41 and 50. A clear seasonal pattern in the rate of LHD was observed. In the winter, the risk of LHD was the lowest; thus, it was advised to recruit plasmapheresis donors throughout the winter and to make the required adjustments for recruitment measures during other seasons. The number of previous donations was correlated with the return rate after LHD. Our observations could have practical implications for plasmapheresis donor management.

Risk prediction of iron deficiency for plasmapheresis donors in China: Development and validation of a prediction model

“…However, the impact of this limitation on the results might be insignificant. According to our previous research in China [31], the proportion of temporary deferral due to low Hb deferral (LHD) is tiny (female donors' LHD rate: 0.15%; male donors' LHD rate: 0.01%), so the potential relationship between plasmapheresis donation intensity and Hb would not determine the result. Second, background information such as educational background, annual household income, meat intake level, smoking history In conclusion, under the current standard of plasmapheresis donation in China, a higher frequency of donation may lead to a reduction in SF level and increase the risk of ID among women.…”