Background and Objectives
Since 25 May 2010, all donors at our blood centre who tested false‐positive for HIV, HBV, HCV or syphilis are eligible for re‐entry after further testing. Donors who have a ...second false‐positive screening test, either during qualification for or after re‐entry, are deferred for life. This study reports on factors associated with the occurrence of such deferrals.
Materials and Methods
Rates of second false‐positive results were compared by year of deferral, transmissible disease marker, gender, age, donor status (new or repeat) and testing platform (same or different) both at qualification for re‐entry and afterwards. Chi‐square tests were used to compare proportions. Cox regression was used for multivariate analyses.
Results
Participation rates in the re‐entry programme were 42·1%: 25·6% failed to qualify for re‐entry different platform: 2·7%; same platform: 42·9% (P < 0·0001). After re‐entry, rates of deferral for second false‐positive results were 8·4% after 3 years different platform: 1·8%; same platform: 21·4% (P < 0·0001). Deferral rates were higher for HIV and HCV than for HBV at qualification when tested on the same platform. The risk, when analysed by multivariate analyses, of a second deferral for a false‐positive result, both at qualification and 3 years after re‐entry, was lower for donors deferred on a different platform; this risk was higher for HIV, HCV and syphilis than for HBV and for new donors if tested on the same platform.
Conclusion
Re‐entry is more often successful when donors are tested on a testing platform different from the one on which they obtained their first false‐positive result.
BACKGROUND: There is strong evidence that locally secreted cytokines control the implantation process and can cause implantation failure. Uterine flushing fluids were analysed to determine their ...concentrations of leukaemia inhibitory factor (LIF) and tumour necrosis factor (TNF). METHODS AND RESULTS: We began by flushing the uterine cavities of 33 infertile patients on day 26 of two consecutive cycles. The concentrations of LIF (by enzyme-linked immunosorbent assay) and TNF (by bioassay) were significantly correlated during these cycles (r = 0.762, P = 0.0001 and r = 0.822, P = 0.001 respectively) and hence reliable. Then, after a reference flushing of 30 infertile patients, we followed the outcome of their first consecutive cycle of ovarian stimulation, which preceded either IVF or intrauterine insemination. A total of 10 patients became pregnant. The median concentration of LIF was 0 pg/ml (range: 0–177) and of TNF was 0 U/ml (range: 0–6.17) among those who became pregnant, and 203 pg/ml (range: 0–1620) and 2.14 U/ml (range: 0–16) respectively among those who did not. The LIF concentration was significantly lower in the pregnant group (P = 0.0013). CONCLUSION: A low concentration of LIF in the uterine flushing fluid at day 26 was predictive of subsequent implantation. Use of this procedure should increase the number of IVF attempts yielding successful pregnancies and also lead to corrective therapies.
Canada now allows donations from men who had sex with men (MSM) if their last sexual contact with a man was more than 5 years ago. We modelled the impact of this policy on supply and safety. ...Approximately 4500 new donors will be added and assuming compliance to the new policy remains unchanged, the worst‐case scenario predicts the introduction of one HIV‐contaminated unit in the inventory every 1072 years. This change will entail negligible additional HIV risk to recipients. A five‐year deferral will also protect recipients against the theoretical concern that MSM may represent a group at higher risk of sexually transmitted, emerging blood borne pathogens.
The highlights of the recent Canadian consensus conference on pathogen inactivation are summarized. Also, a brief summary of steps taken to date in order to implement these technologies is presented.
Background and Objectives
Being notified of a false‐positive infectious disease marker result can cause psychological distress in blood donors. A new notification process, informing donors of the ...possibility of re‐entry, was compared with the previous one in which donors were indefinitely deferred to evaluate the mitigating effect on donors' psychological distress levels.
Materials and Methods
Two groups of donors, ‘deferred donors’ (DD) and ‘donors eligible for re‐entry’ (DER), completed a questionnaire involving 5‐point scales. Levels of psychological distress, attitude towards blood donation, desire to donate blood in the future and perception of notification process quality were assessed.
Results
Attitudes towards blood donation (P = 0·0276) (DD: 3·94 ± 0·11 vs. DER 4·21 ± 0·09) and perceived quality of communication (P = 0·0108) (DD: 2·72 ± 0·12 vs. DER 3·08 ± 0·10) were significantly improved with the new notification process. No significant difference was found between groups in psychological distress levels or desire to donate blood in the future.
Conclusion
Informing donors of the possibility of re‐entry appears to contribute to maintaining a positive predisposition towards future blood donation. It does not, however, appear to alleviate the distress felt after being notified of a false‐positive infectious disease marker result, nor does it increase willingness to give blood again in the future.
Many jurisdictions still do not accept blood donations from men who had sex with men (MSM). Those who defend the status quo argue that a less stringent policy would unduly increase the risk to ...recipients. In an effort to address this dilemma, investigators have tried to project the impact of having less stringent deferral policies on HIV transmission risk, using mathematical models that rely on empirical data. Under certain assumptions, these models predicted very small but definite increases in risk if MSM were allowed to donate after a temporary deferral period. However, the predicted increase in the number of transfusion‐transmitted infections would be so small as to remain imperceptible in reality. Models also predict a sizeable increase in the number of HIV‐positive donors who would present to donate, an outcome that should be more readily observable. When applied to the Australian experience, where a one‐year deferral policy for MSM was implemented, most models would have predicted significant increases in the prevalence of HIV in male donors. The actual rate of HIV among Australian male donors remained very low and unchanged, suggesting that these models were overly pessimistic. It will be interesting to validate this finding in other countries that implemented a time‐based deferral. The Australian experience, if confirmed in other countries, would suggest that a time‐based deferral for MSM poses an even lower risk than what the models predict.
This study examined the prevalence of three human herpesviruses (HHV), namely HHV‐4 (Epstein–Barr virus/EBV), HHV‐6b and HHV‐7 in leucoreduced blood products obtained from the Sainte‐Justine Hospital ...blood bank. A total of 100 specimens, including 34 red blood cell concentrates, 33 platelet bags and 33 plasma units, were collected and screened by a sensitive PCR assay using virus‐specific primers. Positive units were then retested by quantitative PCR. Of the 100 specimens, one platelet unit tested positive for EBV.
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