Seasonal increase in syphilis screening reactivity rates in whole blood donors, United States, 2011-2023.

BACKGROUND: In December 2021, the U.S. Food and Drug Administration published a letter to clinical laboratory staff and healthcare providers detailing a risk of false Rapid Plasma Reagin (RPR) when using the Bio-Rad Laboratories BioPlex 2200 Syphilis Total & RPR kit in people who had received COVID-19 vaccination; Treponema pallidum particle agglutination assays did not appear to be impacted by this issue. We evaluated reactivity rates of syphilis screening with negative confirmatory testing at our institution by year and seasonality. METHODS: We performed a retrospective study of routine syphilis testing of whole blood (WB) collections at an academic hospital-based donor center in the eastern United States. All WB donations from 2011 to 2023 which demonstrated reactive syphilis screening (Beckman Coulter PK TP Microhemagglutination) with negative confirmatory testing (CAPTIA Syphilis (T. pallidum)-G) were evaluated. Reactivity rates by year and season of donation were compared using unpaired t-tests. RESULTS: A total of 109 WB donations from 86 unique donors who donated from 2011 to 2023 screened reactive for syphilis with negative confirmatory testing. The unconfirmed syphilis reactivity rate increased from 2018 to 2023 (mean: 0.360%) compared to 2011-2017 (mean: 0.071%, p < .05). An autumnal peak in unconfirmed reactives was observed. CONCLUSION: The unconfirmed syphilis reactivity rate among WB donors at our institution increased markedly since 2017 compared to the 7 years prior and doubled from 2020 to 2021. No testing assay changes explain these results. The autumnal peak in unconfirmed reactives suggests a possible environmental trigger such as viral infection or vaccination.

Advancing Understandings of Blood Donation Motivation and Behavior.

In this review, we provide critical analysis of social science research into blood donation motivation and behavior. We first share an understanding of the existing literature and recommendations for future research collectively developed by members of the Working Group on Blood Donors and the Supply: Diversifying while Maintaining the Donor Pool, Donor Selection, and Optimizing Blood Availability and Safety, as part of the National Heart, Lung, and Blood Institute's 2022 State of the Science in Transfusion Medicine symposium. Then, rather than aim for a comprehensive treatment, we review 4 newer manuscripts that exemplify aspects of the group's recommendations and report results from countries where the blood supply is based on voluntary, nonremunerated donations. From the substantial existing literature, we selected: (1) a study that employed motivational interviewing techniques, thematic analysis, and surveys to link donation motivations and barriers reported by diverse young donors in the United States to actual donation behavior over a year of subsequent eligibility; (2) a survey regarding donation motivations and barriers and monetary amounts associated with willingness to participate in whole blood, plasma, or platelet collection; (3) a survey-based assessment of various emotional states reported by donors at 2 time points during donation and the relationship between emotional experience and subsequent vasovagal reactions; and (4) an interpretive discourse analysis of blood collection agency messaging to donors and the public in the beginning of the COVID-19 pandemic. We close by noting several challenges posed by the structure of the United States blood system and the current funding environment to conducting rigorous research and translating findings into practice.

Increased serum pro-B-type natriuretic peptide in hematopoietic progenitor cell donors stimulated with G-CSF.

Hematopoietic stem cells (HPCs) donors mobilized by granulocyte-colony-stimulating factor (G-CSF) can develop various signs and symptoms. proBNP (pro-B-type natriuretic peptide) is a serum marker of heart failure. A donor who developed severe adverse reactions after G-CSF mobilization was found to have high serum proBNP levels. We followed additional donors who received identical mobilization regimen to investigate the prevalence of this phenomenon. Eighteen healthy donors underwent a mobilization regimen of 10 µg/Kg G-CSF daily for 5 days prior to allogeneic HPC collection using Spectra Optia between January 2016 and February 2017 were included in this study. Serum proBNP levels were measured before and after G-CSF stimulation and immediately after apheresis. Apheresis collection parameters and other laboratory results were also reviewed. The majority of donors (86.7%) had post-G-CSF elevation of serum proBNP. Seven of those had elevated proBNP above upper normal range (124 pg/ml). The subgroup of donors with normal proBNP is younger (median age of 37 vs 42 years), with majority being male (90.9% vs 28.6%) and with smaller processed blood volume (2.2 vs 3 × total blood volume). This case series demonstrates an increase of serum proBNP can be common in HPC donors stimulated with 5 days of 10 mcg/kg G-CSF. This is an adverse reaction that has not been described before. The temporary elevation of proBNP in these donors is not associated with ventricular dysfunction of the heart. The risk factors for marked elevation of proBNP post-G-CSF should be further investigated.