Prevention of multiple whole blood donations by an individual at the same month through the creation of a national Deferred Donor Registry (DDR).

INTRODUCTION: The Colombian National Institute of Health administers the National Information System of Haemovigilance (SIHEVI-INS). Today, SIHEVI-INS constitutes a national blood donor and recipient database, which contains a national deferred donor registry (DDR), allowing blood banks to take acceptance or rejection decisions of a potential donor in real time. The study aimed to determine the rate of people who have made more than one whole blood donation monthly in Colombia, violating the national guideline of intervals between donations (three months for men and four for women), since DDR implementation. METHODS: We detected the unique personal identification number of people who, in 30 calendar days, made more than one whole blood donation at any of the 83 blood banks set up in Colombia. There were three comparison periods: 01/01/2018-08/31/2019 (launch of SIHEVI-INS and first national feedback); 09/01/2019-12/31/2020 (second feedback) and 01/01/2021-09/30/2022 (massive incorporation of web services). RESULTS: For the first period, blood banks accepted 18.0 donations per 1000 people. There was a rate of 28.8 people/10,000 donations who had donated whole blood twice within 30 days. In the second period, there were 17.0 donations/1000 people and a rate of 2.1 people/10,000 donations (OR:14.0 CI95 %:12.2-16.0). For the last period, there were 18.2 donations/1000 people and a rate of 0.9 individuals/10,000 donations (OR:31.3 CI95 %:26.6-36.9, p < 0.001). CONCLUSION: DDR reduced by 31 times the acceptance of blood donors who made more than one whole blood donation in the same month. It was necessary to provide periodic feedback and promote web service implementation to reduce this risky behavior.

Effect of red blood cell parameters and blood donation interval on ferritin level in apheresis platelet donors with ferritin deficiency / 中国输血杂志

【Objective】 To study the effect of changes in red blood cell parameters and blood donation interval on ferritin level in platelet donors with ferritin deficiency, so as to provide experimental evidence for formulating targeted blood donor care strategies. 【Methods】 100 regular male platelet apheresis donors in April 2020 were selected to test the ferritin and red blood cell parameters. Blood donors were classified according to the annual blood donation numbers: 3~10, 11~15, and 16~24, and the difference of iron deficiency rate among groups was analyzed. They also were classified according to the detection value of ferritin: iron deficiency donors versus SF normal donors, and the changes of Hb, MCV, MCH and MCHC values of them were compared. The iron deficiency donors were stratified by donation time: January to March 2019, April to June 2019, July to September 2019, October to December 2019 and January to April 2020, so as to compare the changes of Hb, MCV and MCH values among each group. The iron deficiency donors, continued the donation afterwards, were divided into interval-extended donors (minimum donation interval of 30 days) and normal ones (minimum donation interval of 14 days), and blood donation from May to December 2020 was intervened and observed. In December 2020, serum ferritin was tested again for iron deficiency donors to analyze the changes in SF between two groups. 【Results】 The incidence of iron deficiency in three groups with different donation frequency was 7.5%, 22.5% and 40.0%, respectively(P0.05), and original 13.89±4.66 vs current 35.92±5.20 in the extended ones(P<0.05). 【Conclusion】 The incidence of iron deficiency in apheresis platelet donors increased as blood donation frequency elevated. The Hb, MCV, MCH and MCHC value of iron deficiency donors decreased while the dispersion of pre-collection Hb, MCV and MCH decreased. MCV and MCH are superior to Hb in early-reflection of metabolism status of red blood cell. It is recommended that iron deficiency donors with Hb less than 130 g/L should reduce the frequency of donation. Extending the donation interval can increase the SF level of iron deficiency donors.Dynamic monitoring of ferritin and related red blood cell parameters should be carried out by blood banks to customize the donation interval.

Information sharing system for donation interval query in Yangtze River Delta / 中国输血杂志

【Objective】 To continuously improve the management of blood donors and ensure blood safety in the Yangtze River Delta(Zhejiang province, Jiangsu province, Anhui province and Shanghai city). 【Methods】 The information sharing system for donation interval query in the Yangtze River Delta was established in July 2020 to provide data and technical support to block blood donors who should not redonate due to insufficient intervals. 【Results】 Blood stations in the Yangtze River Delta unified the information sharing standard, developed the query service and realized the information sharing of donation interval query. 【Conclusion】 The establishment of this system could reduce the risk of blood donation from eligible donos with insufficient donation interval, and further improve the management of blood donors and blood safety in the Yangtze River Delta.

Ferritin measurement IN Donors-Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND'EM): study protocol for a stepped wedge cluster randomised trial.

BACKGROUND: Blood donors are at risk for reduced iron stores, because of which donor iron monitoring received increased attention in the last decade. Despite the importance for donor health, international consensus on an appropriate policy for iron monitoring is lacking. Therefore, we conduct a trial to evaluate to what extent ferritin-guided donation intervals are effective in increasing haemoglobin and ferritin levels, decreasing low-haemoglobin deferral, increasing donor return and improving the health of whole blood donors in the Netherlands. METHODS: Sanquin Blood Bank is implementing ferritin-guided donation intervals to prevent donors from increasing iron loss at repeated donations. Using a stepped wedge cluster randomised trial approach, the design involves a random crossover of 29 clusters of blood collection centres from the existing policy without ferritin measurements to a ferritin-guided donation interval policy. This new policy includes ferritin measurements for all new donors and at every 5th whole blood donation, extending donation intervals to 6 months if ferritin is 15-≤ 30 ng/mL and to 12 months if ferritin is < 15 ng/mL. We measure ferritin levels of whole blood donors from stored plasma samples and collect haemoglobin levels and information on low-haemoglobin deferral and donor return from the donor database before, during and after the implementation period. We measure donor health during and after the implementation period using questionnaires, assessing physical and mental wellbeing and iron deficiency- and donation-related symptoms. We use multilevel analyses to investigate differences in ferritin and haemoglobin levels, low-haemoglobin deferral rates, donor return and donor health from whole blood donors, between blood collection centres that have versus those that have not yet implemented the ferritin-guided donation interval policy. DISCUSSION: This stepped wedge cluster randomised trial will provide insight into the effectiveness of ferritin-guided donation intervals in lowering iron deficiency, decreasing donor deferrals due to low haemoglobin and improving donor health. We will evaluate a policy that is implemented nationwide in a real-life setting. Our study is therefore not limited to a small experimental setting and the results will guide policymakers seeking an appropriate policy for iron monitoring. TRIAL REGISTRATION: The Dutch trial registry NTR6738 . Registered on 29 September 2017. Retrospectively registered.

Impact of risk-dependent interventions on low haemoglobin deferral rates in whole blood donors.

BACKGROUND: Blood donors with a relatively low haemoglobin (Hb) level at their previous donation attempt have an increased risk of Hb deferral at the subsequent donation attempt. The aim of this study was to investigate whether the interventions prolongation of donation interval and/or a dietary advice decrease the Hb deferral rate. METHODS: 11 897 whole blood donors with Hb levels from below to 0·2 mmol/l above the cut-off level for donation received either no intervention, a prolongation of the donation interval to six or twelve months, a dietary advice, or both. Deferral rates for low Hb levels at the subsequent donation attempt were compared in the different intervention groups. Additionally, the effects of the interventions on Hb deferral risk and donor return for a subsequent donation attempt were analysed using generalized estimating equations. RESULTS: The Hb deferral rate was substantially lower in the group that received a prolongation of the donation interval to six months than in the Control Group (12·9% vs. 6·3% in men and 20·4% vs. 13·4% in women). However, the additional benefit of twelve over 6-month interval prolongation was small, and no benefit of a dietary advice showed up. On the other hand, receiving a dietary advice increased the likelihood of donor return for a subsequent donation attempt. CONCLUSION: Implementation of a protocol for the prolongation of donation intervals to six months for donors with Hb levels from below to slightly above the cut-off level for donation may reduce the deferral rate for low Hb levels while keeping donor lapse at a minimum.