Venous sample is superior to repeated skin‐prick testing in blood donor haemoglobin second‐line screening

Bäckman, Sari; Valkeajärvi, Anne; Korkalainen, Piia; Arvas, Mikko; Castrén, Johanna

doi:10.1111/vox.12920

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…Many studies in the past have focussed on the accuracy of the Hb measurement. 5,12,14,17 And the measurement accuracy definitely plays an important role in the risk of ineligible donors donating. Obviously, the more accurate the measurement performed, the lower the risk of ineligible donors donating, and the lower the risk of deferring eligible donors.…”

Section: Discussionmentioning

confidence: 99%

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Why the majority of on‐site repeat donor deferrals are completely unwarranted…

Janssen

2022

Transfusion

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Background: On-site deferral for low hemoglobin (Hb) is common in most countries and deferral rates commonly vary between 1% and 20%. Blood banks continuously strive to reduce deferral rates as these imply an immediate loss of products, a waste of materials, a waste of staff and donor time, and potential loss of donors. Despite many efforts, the main cause of donor deferral-the variability in hemoglobin measurement outcomes-remains largely unaddressed.Study Design and Methods: Repeated hemoglobin measurements obtained at donor intake were used to estimate the variability in measurement outcomes (measurement variability). This information is incorporated in a new algorithm for donor deferral where the mean hemoglobin level of a donor is used to determine both donor eligibility and the deviance of individual measurement outcomes. The algorithm was tested on a cohort of new Dutch donors that started between 2012 and 2022 to evaluate its impact on the donor deferral rate. Results: Historical data from 439,376 new donors with a deferral rate of 5.3% were analyzed by applying the new donor deferral algorithm. It was found that 92% of all deferrals were unnecessary as Hb levels were within the range of expected measurement variability. Contrarily, it appeared that 460 donors (0.10%) made 704 donations (0.06%) whilst not complying with donor eligibility criteria.Discussion: Not accounting for measurement variability can be shown to not only result in unnecessary on-site deferrals but also results in donations by donors that can be shown not to comply with the legally required minimum Hb levels.donor deferral, donor risk management, hemoglobin measurement variability | INTRODUCTIONDonor screening and deferral to guarantee the safety of blood donors have been a topic of research and debate ever since the first reporting of negative side effects of blood donation. 1,2 In the Netherlands, as in most countries, pre-donation testing is applied before each donation, and donors with Hb levels below a set Hb threshold are temporarily deferred. European law prescribes a minimum weight for a donor of 50 kg, and minimum

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Section: Discussionmentioning

confidence: 99%

“…Many studies in the past have focussed on the accuracy of the Hb measurement 5,12,14,17 . And the measurement accuracy definitely plays an important role in the risk of ineligible donors donating.…”

Section: Discussionmentioning

confidence: 99%

Why the majority of on‐site repeat donor deferrals are completely unwarranted…

Janssen

2022

Transfusion

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“…Capillary skin-prick Hb measurement point of care (POC) before each donation. If the Hb is below threshold, venous sample is taken and Hb measured by POC device at donation site [19].…”

Section: Finlandmentioning

confidence: 99%

An international comparison of haemoglobin deferral prediction models for blood banking

et al. 2023

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Background and Objectives Blood banks use a haemoglobin (Hb) threshold before blood donation to minimize donors' risk of anaemia. Hb prediction models may guide decisions on which donors to invite, and should ideally also be generally applicable, thus in different countries and settings. In this paper, we compare the outcome of various prediction models in different settings and highlight differences and similarities. Materials and Methods Donation data of repeat donors from the past 5 years of Australia, Belgium, Finland, the Netherlands and South Africa were used to fit five identical prediction models: logistic regression, random forest, support vector machine, linear mixed model and dynamic linear mixed model. Only donors with five or more donation attempts were included to ensure having informative data from all donors. Analyses were performed for men and women separately and outcomes compared. Results Within countries and overall, different models perform similarly well. However, there are substantial differences in model performance between countries, and there is a positive association between the deferral rate in a country and the ability to predict donor deferral. Nonetheless, the importance of predictor variables across countries is similar and is highest for the previous Hb level. Conclusion The limited impact of model architecture and country indicates that all models show similar relationships between the predictor variables and donor deferral. Donor deferral is found to be better predictable in countries with high deferral rates. Therefore, such countries may benefit more from deferral prediction models than those with low deferral rates.

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“…There is, however, substantial variation across national blood services in methods of haemoglobin measurement 4,5 . This has resulted in part because the timing of blood sampling and sample material for assessing blood donors is not defined by legislation, and partly because there is little evidence about the comparative performance of different rapid measurement methods 6‐11 …”

Section: Introductionmentioning

confidence: 99%

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study

Bell

Sweeting

Ramond

et al. 2020

Transfusion Medicine

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Objective To compare four haemoglobin measurement methods in whole blood donors. Background To safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant's (NHSBT) customary method have been capillary gravimetry (copper sulphate), followed by venous spectrophotometry (HemoCue) for donors failing gravimetry. However, NHSBT's customary method results in 10% of donors being inappropriately bled (ie, with haemoglobin values below the regulatory threshold). Methods We compared the following four methods in 21 840 blood donors (aged ≥18 years) recruited from 10 NHSBT centres in England, with the Sysmex XN‐2000 haematology analyser, the reference standard: (1) NHSBT's customary method; (2) “post donation” approach, that is, estimating current haemoglobin concentration from that measured by a haematology analyser at a donor's most recent prior donation; (3) “portable haemoglobinometry” (using capillary HemoCue); (4) non‐invasive spectrometry (using MBR Haemospect or Orsense NMB200). We assessed sensitivity; specificity; proportion who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference. Results Compared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect) to 79.0% (portable haemoglobinometry) in men, and from 19.0% (MBR Haemospect) to 82.8% (portable haemoglobinometry) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect) to 99.9% (NHSBT's customary method) in men, and from 74.1% (Orsense NMB200) to 99.8% (NHSBT's customary method) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for portable haemoglobinometry to 18.9% in women for MBR Haemospect. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for NHSBT's customary method to 20.3% in women for OrSense. Most donors preferred non‐invasive spectrometry. Conclusion In the largest study reporting head‐to‐head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of NHSBT's customary method with portable haemoglobinometry.

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Venous sample is superior to repeated skin‐prick testing in blood donor haemoglobin second‐line screening

Cited by 6 publications

References 26 publications

Why the majority of on‐site repeat donor deferrals are completely unwarranted…

Why the majority of on‐site repeat donor deferrals are completely unwarranted…

An international comparison of haemoglobin deferral prediction models for blood banking

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study

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