ABSTRACT
Background: Safe blood transfusion services play a key role in healthcare. This stems from blood donors who are aware and motivated for the voluntary blood donation process. Prospective blood donors are screened as per the regulatory guidelines and current clinical criteria based on evidence. National blood policy of India encourages to launch extensive awareness programmes for donor information, education, motivation, recruitment, and retention to ensure adequate availability of safe blood. Despite best efforts, many of the donors walking into a blood center or donation drive get deferred due to several reasons. A demographic detailing along with the categorization of the deferral reasons enable the blood center to develop innovative tools of intervention for a target population to spread awareness regarding blood donation. Aims: Assessment of demographic distribution and associated deferral pattern for the prospective donor population walking into our center. Methods: This retrospective study was conducted in an institutebased blood center, which started operations in September 2021. The duration of the study was September 2021 through February 2022. The details of the prospective donors who walked into our center with an intent to donate were retrieved from the blood center information management system. The reasons along with the type of deferral and demographic details of the donors were collated for evaluation. Effects of COVID-19 pandemic and vaccination drives on the donor deferral were also recorded to assess the variations in the supply pattern and onward inventory management. The statistical analysis was done by using Excel (Office 365 version, Microsoft, USA). Results: A total of 1714 donors walked into our center with an intent to donate blood during the study period. Out of which, 1367 (79.75%) donors donated either whole blood or did apheresis, and 347 (20.25%) were rejected due to assorted reasons. Among the rejected donors, 77 donors were voluntary and 270 were replacement donors. Three-hundred nineteen deferred donors were males and 28 were females. The mean age distribution of the deferred donors was 31.9 ± 8.5 years (Median 30 years, Range: 16-63 years). Among all deferrals, a total of 337 were temporary deferrals and 10 were permanent deferrals (eight were suspected cases of transmissible infection associated risks and two were because of medical reasons). Of all the deferrals, 46 (13.6%) donors did not complete 3 months since the last donation, 19 (5.6%) were absent, 47 (13.9%) were deferred due to COVID vaccination within 14 days, 23 (6.8%) were due to low haemoglobin content, 125 (37.1%) were due to medical reasons such as infections or medications, 57 (16.9%) due to miscellaneous causes like menstrual cycle, alcohol intake, feeling unwell or lack of sleep, 18 (5.3%) were due to surgical reasons, and 2 (0.6%) were underaged. Summary/Conclusions: Deferral of prospective donors can have a detrimental psychological effect on the donor causing a permanent attrition from the probable future donor pool. A temporarily deferred donor due to medical, surgical, low haemoglobin content or vaccinations, if properly counselled, motivated, educated regarding voluntary blood donation, can be accepted for blood donation after the completion of the deferral period. A comprehensive multipronged approach by a multi-disciplinary team will help promotion of voluntary healthy safe blood donations and lesser deferrals.
ABSTRACT
Background: Blood transfusion services are of paramount importance in cancer care. Streamlined and judicious usage of this scarce resource against the higher demand is one of the greatest challenges. Continuous monitoring of the utilization pattern of the blood components paves the way for better picturization of the transfusion practices and formulating strategies for implementation of better patient blood management. National blood policy of India encourages appropriate clinical use of blood components. An oncology care facility poses an additional challenge of random variation in demands against a low supply. This warrants a more stringent monitoring of the blood component utilization pattern according to the patient profiles, indications for transfusions and onward therapeutic benefits. Aims: Evaluation of pattern of blood component utilization in a blood storage center catering to oncology only. Methods: This retrospective study was conducted in a blood storage center of an oncology-only center. Time frame of the study was June 2019 through August 2021. The procurement of components from the mother blood center, onward issue details to different wards for transfusion of all blood components [Packed red blood cells units (PRBC), Fresh frozen plasma units (FFP), Platelet units (PLT)], and discard of components with reference to their respective causes were recorded. Effects of COVID-19 pandemic on the utilization pattern was also recorded to assess the variations in the utilization pattern. The statistical analysis was done by using Microsoft Excel (Office 365 version, Microsoft, USA). Results: A total of 4599 component units were procured which is comprised of 2196 (47.75%) PRBC, 2012 (43.75%) PLTs and 391 (8.5%) FFPs. A total of 3624 of 4599 units (78.8%) were requested during the study period which is comprised of 2076 of 2196 PRBCs (94.5% utilization), 1189 of 2012 PLTs (59.1% utilization) and 359 of 391 FFPs (91.8% utilization). A total of 652 of 4599 units were received back which is comprised of 76 of 2196 PRBCs (3.5%), 565 of 2012 PLTs (28.1%) and 11 of 391 FFPs (2.8%). Majority of the blood components 1553 of 3624 (42.85%) were issued to patients admitted under medical oncology comprised of 924 of 2076 (44.5%) PRBCs, 533 of 1189 (44.8%) PLTs and 96 of 359 (26.75%) FFPs followed by to onco-emergency and patients admitted under surgical oncology. COVID surge led to curtailment of oncology care as the facility catered to the COVID patients with 310 PRBCs (14.9%), 408 RDPs (34.31%) and 102 FFPs (28.4%). A total of 271 units (5.9%) were discarded during this time which is comprised of only 4 of 2196 PRBCs (0.18%) due to failure in cold chain maintenance, 254 of 2012 PLTs (12.6%) and 13 of 391 FFPs (3.32%) due to breakage of units or receive back from wards beyond 30 min. Summary/Conclusions: Blood utilization patterns change with the patient profiles, level of organization in an oncology center. This storage center data presented here is a preliminary step for planning and maintaining a balance between demand, supply, and wastage. Although the utilization rate of PRBCs and FFPs were >90%, the same for the PLTs was <60%. This is attributed to planning errors and unpredictable demand to supply. The proportions of wastage were <5% for PRBCs and FFPs but was >12% for RDPs due to logistic issues, expirations, and non-compliance to good clinical practices. A comprehensive approach by a multi-disciplinary team will help streamline the judicious usage of the blood components at our center.