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Re-entry of donors deferred for false-reactive screening tests in Canada: 10 years post implementation
Chinchin Wang1, Steven J Drews2,3, Mark Bigham4
1Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.
Insights
Canadian Blood Services
Area of Science:
- Blood Transfusion Medicine
- Infectious Disease Screening
- Donor Management
Background:
- Canadian Blood Services established a donor re-entry program in 2014.
- Donors with false-reactive or indeterminate screening results can re-enter after 6 months.
- The program aims to re-engage deferred donors if they test negative for infectious markers.
Purpose of the Study:
- Evaluate the impact of the re-entry program on donor return and retention.
- Assess factors associated with reactive results during re-entry testing.
- Analyze the effectiveness of the re-entry program in maintaining blood supply.
Main Methods:
- Retrospective analysis of 8094 donors deferred for hepatitis B virus (HBV), human immunodeficiency virus (HIV), and hepatitis C virus (HCV) from 2014 to 2025.
- Characterization of donors by sex, age, donation status, and infection marker.
- Logistic regression used to identify predictors of reactive re-entry test results.
Main Results:
- 17.3% of eligible donors returned to donate; 35.5% participated in re-entry testing.
- Repeat and older donors showed higher participation rates.
- Among tested donors, 59.2% were negative, with most continuing to donate; 13.1% had false-reactive results upon return, more common in first-time donors.
Conclusions:
- The donor re-entry program successfully improved donor retention and increased the blood supply.
- Reminder notifications could potentially enhance participation rates in the re-entry program.
- The program demonstrates a viable strategy for re-integrating deferred donors.
Background And Objectives:
Canadian Blood Services implemented a re-entry programme in 2014. Donors deferred because of false-reactive or indeterminate screening tests can provide a specimen for re-entry testing 6 months after their initial test, and resume donating if they test negative for all infectious markers. We evaluated the impact of the programme on donor return and retention, and assessed factors associated with reactive results upon re-entry testing.
Materials And Methods:
Using extracted data from our donor database, we followed up donors who tested false-reactive for hepatitis B virus (HBV), human immunodeficiency virus (HIV) and hepatitis C virus (HCV), from the implementation of the programme on 3 February 2014 until 30 June 2025 (n = 8094). We characterized the donors reaching each step of the programme by sex, age, donation status and infection marker. We employed logistic regression to identify important predictors of obtaining reactive results upon re-entry testing.
Results:
Overall, 17.3% of donors eligible for re-entry testing successfully returned and donated. Re-entry testing participation rates were 35.5%, with repeat and older donors more likely to participate. Among re-entry tested donors, 59.2% tested negative. Most donors continued to donate for multiple years upon re-entry. Upon return, 13.1% tested false reactive on a subsequent donation. False-reactives upon re-entry testing were more likely for first-time donors and less likely when a different assay was employed than for the initially false-reactive.
Conclusion:
The implementation of a donor re-entry programme has resulted in donor retention and increases in the blood supply. Sending reminder notifications to eligible donors could increase participation.
