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      An Original Approach to Evaluating the Quality of Blood Donor Selection: Checking Donor Questionnaires and Analyzing Donor Deferral Rate

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          Abstract

          Blood donor selection is a cornerstone for blood transfusion safety, designed to safeguard the health of both donors and recipients. In the Service du Sang, Belgian Red Cross, French and German-speaking part of Belgium (SFS), health professionals (HPs) are allowed to interview donors on their own after formal qualification. This qualification is afterward evaluated by means of two complementary quality indicators: monitoring of donor health questionnaires (DHQs) and analysis of donor deferral rate. The study aims to evaluate the degree to which both quality indicators may be useful and appropriate tools to evaluate the quality of blood donor selection. An analysis performed on 2016 data showed that noncompliance detected by means of DHQ monitoring seems to be more frequent in HPs who conduct a low number of interviews compared to all HPs as a group (5.67 vs. 3.23%; p < 0.001). Deferral rates are also higher in HPs with a lower activity compared to HPs who interview more donors (14.80 vs. 13.00%, p < 0.001). Furthermore, statistically differences are observed between the type of blood donation venue in terms of the global deferral rate (for instance fixed site vs. schools: 11.9 vs. 19.5%; p < 0.001), and specific reasons for deferral (such as sexual risk behavior and travel in at-risk areas, the differences being highly significant between each category of blood donation venue; p < 0.001). Providing the HPs with feedback on these findings was an opportunity to draw their attention to some aspects of the selection process in order to improve it.

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          The consequences of temporary deferral on future whole blood donation.

          The consequences of temporary deferral are not well understood. This study sought to investigate blood donor return after deferral expiration. A retrospective cohort analysis of allogeneic whole-blood donation was conducted. All deferred donors and a random sample of eligible donors were identified from the year 2000, with subsequent blood center visits through December 2005 captured. Stratified results are reported as the percentage returning, rates of return, and time to return. Measures of statistical association and Cox regression modeling are reported. For first-time (FT) donors, 25 percent of temporarily deferred donors returned during the 5-year follow-up period compared to 47 percent of eligible donors (p < 0.0001); for repeat donors, 81 and 86 percent of deferred and eligible donors returned, respectively (p < 0.0001). Depending on the deferral category, 14 to 31 percent of FT and 58 to 90 percent of repeat donors returned. Rates (per year) of successful donation during the follow-up period were 0.09 for index-deferred FT donors, 0.28 for eligible FT donors, 1.0 for deferred repeat donors, and 1.45 for eligible repeat donors. Multivariate modeling indicated that in addition to deferral, age, sex, race, and education were associated with return in both FT and repeat donors. The effects of deferral were more pronounced than expected, affecting both FT and repeat donors. For FT donors, the type and duration of deferral, while important, were not as relevant as hypothesized because so few returned, suggesting the need to develop appropriate interventions to recapture those donors likely to be eligible.
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            Donor return after temporary deferral.

            The consequences of temporary predonation deferral are unsatisfactorily understood. Studies have found that deferral negatively impacts future donor return. However, the applicability of these findings across centers has not been established. Using a cohort design, presenting donors with a temporary deferral in 2006 to 2008 in one of six categories (low hematocrit [Hct], blood pressure or pulse, feeling unwell, malaria travel, tattoos or piercing and related exposures, or could not wait or second thoughts) were passively followed for up to a 3-year period for the time to first return after deferral expiration at six US blood centers. Time-to-event methods were used to assess return. We also analyzed which donor characteristics were associated with return using multivariable logistic regression. Of 3.9 million donor presentations, 505,623 resulted in deferral in the six categories. Low Hct was the most common deferral, had the shortest median time to return (time in days when 50% of deferred donors had returned), and had the largest cumulative proportion of donors returning. Deferrals of shorter duration had better return. Longer-term deferrals (up to 1 year in length) had the lowest cumulative return proportion, which did not exceed 50%. Return was associated with previously identified factors such as repeat donor status, older age, and higher educational attainment regardless of the type of deferral. In addition, return was associated with having been born in the United States and donation at fixed sites. The category of temporary deferral influences the likelihood of future return, but the demographic and donation factors associated with return are largely consistent regardless of the deferral. © 2010 American Association of Blood Banks.
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              Understanding noncompliance with selective donor deferral criteria for high-risk behaviors in Australian blood donors.

              Using a predonation screening questionnaire, potential blood donors are screened for medical or behavioral factors associated with an increased risk for transfusion-transmissible infection. After disclosure of these risks, potential donors are deferred from donating. Understanding the degree of failure to disclose full and truthful information (termed noncompliance) is important to determine and minimize residual risk. This study estimates the prevalence of, and likely reasons for, noncompliance among Australian donors with the deferrals for injecting drug use, sex with an injecting drug user, male-to-male sex, sex worker activity or contact, and sex with a partner from a high-HIV-prevalence country.
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                Author and article information

                Contributors
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                21 March 2018
                2018
                : 5
                : 74
                Affiliations
                [1] 1Service du Sang, Belgian Red-Cross , Suarlée, Belgium
                Author notes

                Edited by: Meral Beksac, Ankara University, Turkey

                Reviewed by: Wei Li, Marshall University, United States; Pinar Yurdakul, TOBB University of Economics and Technology, Turkey; Pervin Topçuoğlu, Ankara University Medical School, Turkey

                *Correspondence: Philippe Gillet, philippe.gillet@ 123456croix-rouge.be

                Specialty section: This article was submitted to Hematology, a section of the journal Frontiers in Medicine

                Article
                10.3389/fmed.2018.00074
                5871657
                90bb6491-b8f8-4cc9-be3e-482208adf987
                Copyright © 2018 Gillet and Neijens.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 December 2017
                : 06 March 2018
                Page count
                Figures: 0, Tables: 5, Equations: 0, References: 20, Pages: 8, Words: 5953
                Categories
                Medicine
                Original Research

                blood donor selection,transfusion safety,evaluation,donor health questionnaire,donor deferral rate

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