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Donors with repeated blood product discards for filtration problems, clots or hemolysis: Causes and follow-up
Niubel Díaz Padilla1, Johanna C Wiersum-Osselton1,2, Shahryar Ghasemi Nezjad1
1Donor Medicine Department, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands.
Insights
Donor blood donations are sometimes rejected, leading to waste and potential health concerns. A new uniform procedure helps identify causes and re-evaluate donors, improving donation quality and safety.
Area of Science:
- Transfusion Medicine
- Blood Banking
- Donor Management
Background:
- Donation rejection is undesirable as it leads to unusable products and may indicate underlying medical issues.
- A uniform procedure was developed to address regional variations in handling rejected donations.
Purpose of the Study:
- To investigate the causes of rejected blood donations and components.
- To assess current policies regarding donor follow-up after product rejection.
- To standardize procedures for managing rejected donations and donor re-evaluation.
Main Methods:
- Data extracted from blood bank information systems for whole blood, plasma, and plateletpheresis donations with rejected components.
- Donors contacted after two successive rejections or a total of three.
- Medical history review and family doctor consultations for donor re-evaluation.
- Survey conducted among blood services regarding policies for discarded products.
Main Results:
- 0.08% of donations (1742/2.2 million) had rejected components, highest in plateletpheresis (1.5%) due to clots.
- No underlying medical causes found for most rejections; 24 whole blood donors deferred for sickle cell trait (SCT).
- Significant variation exists in follow-up policies and SCT donor acceptance among 16 blood banks.
Conclusions:
- Informing donors about repeated rejections prevents donation wastage and aids in identifying causes.
- Donor follow-up is crucial for understanding and addressing reasons for repeated discarded products.
- A significant discrepancy in global blood bank policies for managing rejected donations and donors was observed.
Introduction:
Sanquin donor medicine department is informed when donations or their components are rejected. This can occur isolated or frequently. It is undesirable because the donations cannot be used and there may be an underlying medical cause. Based on regional approaches, a uniform procedure was developed.
Methods:
Information about whole blood, plasma- plateletpheresis donations from which one or more components were rejected for filtration time (>2 h), hemolysis or clots were extracted from blood bank information system. After rejection of two successive components or donations or total ≥3 the donor is contacted. Depending on the medical history and investigation by the family doctor, the donor carrier is re-evaluated. We looked for the causes of the discarded products and performed a survey among blood services regarding polices with discarded products.
Results:
One or more components from 1742 of about 2.2 million successful donations (0.08%) were rejected. The highest percentage of rejection was seen in plateletpheresis (1.5%), all for clots. No underlying medical causes were found. 24 whole blood donors were found to have sickle cell trait (SCT) and were permanently deferred. The policies for follow-up after discarded products or acceptance of SCT donors vary between the 16 blood banks. Six organizations do not follow-up donors and seven accept SCT for blood or plasma donation.
Conclusion:
Informing donors with repeated discarded products avoids the non-use of donations. Causes of repeated discarded products can be found by follow-up of donors. The results of the survey indicate a large discrepancy in policies applied worldwide.
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