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Evaluation of the confidential unit exclusion on Iranian blood donors: An 11-year experience
Mohammad Reza Ameli1, Seyed Hossein Hosseini2, Fariba Rad3
1Iranian Blood Transfusion Organization Research Center, South Khorasan Blood Transfusion Service, Birjand University of Medical Sciences, Birjand, Iran.
Insights
Confidential unit exclusion (CUE) did not improve blood safety by identifying donors with transfusion-transmissible infections (TTIs). This blood safety measure showed low effectiveness and is recommended for discontinuation.
Area of Science:
- Blood Transfusion Safety
- Public Health
- Epidemiology
Background:
- Confidential unit exclusion (CUE) allows blood donors to exclude their donations, but its effectiveness in enhancing blood supply safety is debated.
- The Food and Drug Administration recommended CUE as a safety measure for blood donations.
Purpose of the Study:
- To evaluate the benefit of CUE in identifying donors at risk for transfusion-transmissible infections (TTIs).
- To assess the impact of CUE on overall blood safety within a specific population.
Main Methods:
- A cross-sectional and retrospective study was conducted at the South Khorasan Blood Transfusion Center.
- Data from 2006-2016 on CUE usage and confirmed TTI markers were analyzed.
- Statistical analysis was performed using SPSS software.
Main Results:
- Out of 165,267 donations, 493 (0.3%) donors used the CUE option, predominantly first-time donors, men, those with less schooling, and younger donors (18-24 years).
- Donations from CUE donors did not exhibit higher infection rates.
- CUE demonstrated low sensitivity (0.6%) and low positive predictive value (0.6%) for detecting TTI markers.
Conclusions:
- The study found no evidence that CUE provides a safety advantage to the blood supply.
- Based on the findings, the discontinuation of the CUE procedure is recommended.
Background:
Confidential unit exclusion (CUE) was recommended by the Food and Drug Administration to permit blood donors confidentially exclude their donation for transfusion. However, its effectiveness as a safety measure to the blood supply is debated.
Aims:
We, therefore, evaluated its benefit in identifying donors at risk of transmitting transfusion-transmissible infections (TTIs) and increasing blood safety in our population.
Settings And Design:
This was a cross-sectional and retrospective study. The study was performed at the South Khorasan Blood Transfusion Center.
Materials And Methods:
In this descriptive and retrospective study, data of CUE use and data of confirmed positive TTI markers were analyzed for the study period 2006-2016.
Statistical Analysis:
Data were analyzed using SPSS software version 16.
Results:
Out of 165,267 donations, the CUE option was selected by 493 (0.3%) donors, most frequently by first-time blood donors, by men, by donors with <12 years schooling, and by 18-24-year-old donors. The data revealed that donations from CUE donors had no higher infection rates. Moreover, CUE showed low sensitivity (0.6%) and low positive predictive value (0.6%) in detecting TTI markers.
Conclusion:
The data do not provide any indication of a safety advantage from CUE; thus, we recommend that the procedure of CUE can be discontinued.
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