Donors with repeated blood product discards for filtration problems, clots or hemolysis: Causes and follow-up

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.