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Transfusion. 2020 Mar;60(3):544-552. doi: 10.1111/trf.15676. Epub 2020 Feb 8.

Variations in hemoglobin measurement and eligibility criteria across blood donation services are associated with differing low-hemoglobin deferral rates: a BEST Collaborative study.

Author information

1
Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.
2
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
3
Medical Services and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.
4
Vitalant, Scottsdale, Arizona.
5
Physician Services, Innovative Blood Centers, St. Paul, Minnesota.
6
Medical Affairs and Innovation, Héma-Québec, Quebec City, Canada.
7
Safety Vigilance Department, Technical Department, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan.
8
New Zealand Blood Service, Auckland, New Zealand.
9
Australian Red Cross Blood Service, Adelaide, South Australia, Australia.
10
Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland.
11
Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
12
Blood Centre and Laboratory Medicine, Innlandet Hospital, Lillehammer, Oppland, Norway.
13
Finnish Red Cross Blood Service, Helsinki, Finland.
14
Blood Assurance, Inc, Chattanooga, Tennessee.
15
Stanford Blood Center, Stanford, California.
16
Shepeard Community Blood Center, Augusta, Georgia.
17
Red Cross Flanders, Ghent, East Flanders, Belgium.
18
Établissement Français du Sang, Paris, Île-de-France, France.
19
Centro Vasco de Transfusion y Tejidos Humanos, Galdakao, Biscay, Spain.
20
Division of Transfusion Medicine, Mayo Clinic, Rochester, New York.
21
National Institutes of Health Clinical Center, Bethesda, Maryland.
22
Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong SAR, China.
23
Welsh Blood Service, Wales, United Kingdom.
24
Community Blood Center of the Carolinas, Charlotte, North Carolina.
25
Carter BloodCare, Bedford, Texas.
26
Hospital Sirio Libanes Blood Bank, São Paulo, Brazil.
27
LifeShare Blood Centers, Shreveport, Louisiana.
28
German Red Cross, Springe, Lower Saxony, Germany.
29
Michigan Blood, Saginaw, Michigan.
30
American Red Cross, Washington D.C., Washington.
31
Military University Hospital Prague, Czech Republic, Prague, Bohemia.
32
Health Sciences Authority Blood Services Group, Singapore, Singapore.

Abstract

BACKGROUND:

Determination of blood donor hemoglobin (Hb) levels is a pre-requisite to ensure donor safety and blood product quality. We aimed to identify Hb measurement practices across blood donation services and to what extent differences associate with low-Hb deferral rates.

METHODS:

An online survey was performed among Biomedical Excellence for Safer Transfusion (BEST) Collaborative members, extended with published data. Multivariable negative-binomial regression models were built to estimate adjusted associations of minimum donation intervals, Hb cut-offs (high, ≥13.5 g/dL in men or ≥ 12.5 g/dL in women, vs. lower values), iron monitoring (yes/no), providing or prescribing iron supplementation (yes/no), post-versus pre-donation Hb measurement and geographical location (Asian vs. rest), with low-Hb deferral rates.

RESULTS:

Data were included from 38 blood services. Low-Hb deferral rates varied from 0.11% to 8.81% among men and 0.84% to 31.85% among women. Services with longer minimum donation intervals had significantly lower deferral rates among both women (rate ratio, RR 0.53, 95%CI 0.33-0.84) and men (RR 0.53, 95%CI 0.31-0.90). In women, iron supplementation was associated with lower Hb deferral rates (RR 0.47, 95%CI 0.23-0.94). Finally, being located in Asia was associated with higher low-Hb deferral rates; RR 9.10 (95%CI 3.89-21.27) for women and 6.76 (95%CI 2.45-18.68) for men.

CONCLUSION:

Differences in Hb measurement and eligibility criteria, particularly longer donation intervals and iron supplementation in women, are associated with variations in low-Hb deferral rates. These insights could help improve both blood donation service efficiency and donor care.

PMID:
32034925
DOI:
10.1111/trf.15676

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