Transfusion Medicine is a dynamically evolving field. Recent high-quality research has reshaped the paradigms guiding blood transfusion. As increasing evidence supports the benefit of limiting ...transfusion, guidelines have been developed and disseminated into clinical practice governing optimal transfusion of red cells, platelets, plasma and cryoprecipitate. Concepts ranging from transfusion thresholds to prophylactic use to maximal storage time are addressed in guidelines. Patient blood management programs have developed to implement principles of patient safety through limiting transfusion in clinical practice. Data from National Hemovigilance Surveys showing dramatic declines in blood utilization over the past decade demonstrate the practical uptake of current principles guiding patient safety. In parallel with decreasing use of traditional blood products, the development of new technologies for blood transfusion such as freeze drying and cold storage has accelerated. Approaches to policy decision making to augment blood safety have also changed. Drivers of these changes include a deeper understanding of emerging threats and adverse events based on hemovigilance, and an increasing healthcare system expectation to align blood safety decision making with approaches used in other healthcare disciplines.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Among 397,640 first-time blood donors screened in South Africa during 2012-2015, HIV prevalence was 1.13%, hepatitis B virus prevalence 0.66%, and hepatitis C virus prevalence 0.03%. Findings of note ...were a high HIV prevalence in Mpumalanga Province and the near absence of hepatitis C virus nationwide.
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DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Studies preceding the COVID‐19 pandemic found that slower time‐to‐return was associated with first‐time, deferred, and mobile drive blood donors. How donor return dynamics changed during ...the COVID‐19 pandemic is not well understood.
Methods
We analyzed visits by whole blood donors from 2017 to 2022 in South Africa (SA) and the United States (US) stratified by mobile and fixed environment, first‐time and repeat donor status, and pre‐COVID19 (before March 2020) and intra‐COVID19. We used Kaplan–Meier curves to characterize time‐to‐return, cumulative incidence functions to analyze switching between donation environments, and Cox proportional hazards models to analyze factors influencing time‐to‐return.
Results
Overall time‐to‐return was shorter in SA. Pre‐COVID19, the proportion of donors returning within a year of becoming eligible was lower for deferred donors in both countries regardless of donation environment and deferral type. Intra‐COVID19, the gap between deferred and non‐deferred donors widened in the US but narrowed in SA, where efforts to schedule return visits from deferred donors were intensified, particularly for non‐hemoglobin‐related deferrals. Intra‐COVID19, the proportion of donors returning within a year in SA was higher for deferred first‐time donors (>81%) than for successful first‐time donors (80% at fixed sites; 69% at mobile drives).
Conclusions
The pandemic complicated efforts to recruit new donors and schedule returning visits after completed donations. Concerted efforts to improve time‐to‐return for deferred donors helped mitigate donation loss in SA during the public health emergency.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
BACKGROUND
False‐positive infectious transfusion screening results remain a challenge with continued loss of both donors and blood products. We sought to identify associations between donor ...demographic characteristics (age, race, sex, education, first‐time donor status) and testing false positive for viruses during routine blood donation screening. In addition the study assessed the prevalence of high‐risk behaviors in false‐positive donors.
STUDY DESIGN AND METHODS
Blood Systems, Inc. donors with allogeneic donations between January 1, 2011, and December 31, 2012, were compared in a case‐control study. Those with a false‐positive donation for one of four viruses (human immunodeficiency virus HIV, human T‐lymphotropic virus HTLV, hepatitis B virus HBV, and hepatitis C virus HCV) were included as cases. Those with negative test results were controls. For a subset of cases, infectious risk factors were evaluated.
RESULTS
Black race and Hispanic ethnicity were associated with HCV and HTLV false‐positive results. Male sex and lower education were associated with HCV false positivity, and age 25 to 44 was associated with HTLV false positivity. First‐time donors were more likely to be HCV false positive although less likely to be HBV and HTLV false positive. No significant associations between donor demographics and HIV false positivity were observed. A questionnaire for false‐positive donors showed low levels of high‐risk behaviors.
CONCLUSION
Demographic associations with HCV and HTLV false‐positive results overlap with those of true infection. While true infection is unlikely given current testing algorithms and risk factor evaluation, the findings suggest nonrandom association. Further investigation into biologic mechanisms is warranted.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
BACKGROUND
West Nile virus (WNV) infection is mostly asymptomatic (AS) but 20% of subjects report WNV fever and 1% of patients experience neurologic diseases with higher rates in elderly and ...immunosuppressed persons. With no treatment and no vaccine to prevent the development of symptomatic (S) infections, it is essential to understand prognostic factors influencing S disease outcome. Host genetic background has been linked to the development of WNV neuroinvasive disease. This study investigates the association between the ABO and D blood group status and WNV disease outcome.
STUDY DESIGN AND METHODS
The distribution of blood groups was investigated within a cohort of 374 WNV+ blood donors including 244 AS and 130 S WNV+ blood donors. Logistic regression analyses were used to examine associations between A, B, O, and D blood groups and WNV clinical disease outcome.
RESULTS
S WNV+ donors exhibited increased frequencies of blood group A (S 47.6%, AS 36.8%, p = 0.04; odds ratio OR, 1.56; 95% confidence interval CI, 1.01‐2.40) and D– individuals (S 21.5%, AS 13.1%, p = 0.03; OR, 1.82; 95% CI, 1.04‐3.18).
CONCLUSION
The findings suggest a genetic susceptibility placing blood group A and D– individuals at risk for the development of S disease outcome after WNV infection.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background and Objectives
Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different ...jurisdictions in relation to those rates in the general population and differences in deferral practices.
Materials and Methods
Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody‐positive donations and nucleic acid testing (NAT)‐only‐positive donations was broken down according to first‐time or repeat donor status, along with the relevant denominators.
Results
There is a modest correlation between HIV prevalence among first‐time donors and HIV prevalence in the general population. However, rates of HIV‐positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT‐only‐positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons.
Conclusion
Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Digital polymerase chain reaction (dPCR) is a refinement of the conventional PCR approach to nucleic acid detection and absolute quantification. Digital PCR works by partitioning a sample of DNA or ...cDNA into many individual, parallel PCR reactions. Current quantification methods rely on the assumption that the PCR reactions are always able to detect single target molecules. When the assumption does not hold, the copy numbers will be severely underestimated. We developed a novel dPCR quantification method which determines whether the single copy assumption is violated or not by simultaneously estimating the assay sensitivity and the copy numbers using serial dilution data sets. The implemented method is available as an R package “digitalPCR”.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
BACKGROUND: Historically, minority populations have represented only a small proportion of US blood donors, but recent trends in immigration and potential blood shortages emphasize the need for ...recruitment strategies to increase minority donations.
STUDY DESIGN AND METHODS: Donation data from a network of six US blood centers for 2006 were analyzed. Race/ethnicity, country of birth, and educational attainment data were collected specifically for the study and assessed for their influence on donation behavior. Logistic regression was used to determine independent associations with repeat donors status and annual donation frequency.
RESULTS: A total of 1,288,998 donations from 729,068 donors were studied; most donors had data on race/ethnicity (97.1%) and country of birth (93.1%). The proportion of minority donors differed by blood center, with African American donors (16%) most common at the Southeastern blood center and Asian (12%), Hispanic (13%), and foreign‐born donors (13%) most common at the Northern California blood center. Minority donors and those born in Mexico or Latin America were younger than white donors. Minority and non–US‐born donors were less likely than white and US‐born donors to be repeat donors (odds ratio OR, 0.60‐0.78), and most were less likely to give two or more annual donations (OR, 0.82‐1.11).
CONCLUSION: Minority and Mexico/Latin America–born donors represent a younger and often first‐time donor population compared to white and US‐born donors, but their annual donation frequency was only slightly lower than white and US‐born donors. Increasing the retention and donation frequency of minorities will be important for supplementing the blood supply.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
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