Evaluating blood donation safety for donors with sickle cell trait

Finding compatible blood donors for patients from minority racial and ethnic populations can be challenging due to differences in blood group antigen frequencies with the existing donor pool. Individuals with sickle cell trait (SCTrait) are allowed to donate in some countries, but in the Netherlands, carriers are currently not permitted to donate. This study estimates the incidence of adverse events among SCTrait donors compared with non-SCTrait donors, to inform potential policy decisions.

A retrospective study was performed at Sanquin, including whole-blood (WB) and plasma donors, from 2012 to 2024. Adverse events related to donation were compared between SCTrait donors (identified retrospectively) and a control group of non-SCTrait donors. Donor complications included systemic events, such as vasovagal reactions (VVRs), and venipuncture-related complications.

A total of 259 donations from 47 SCTrait donors and 2590 donations from 1371 non-SCTrait donors were analysed. The overall rate of donor complications was low in both groups, with no differences observed between SCTrait and non-SCTrait donors. VVR rates were 2.4% versus 2.7% in WB donations and 2.2% versus 1.0% in plasma donations for SCTrait versus non-SCTrait donors, respectively (p > 0.05). Separation issues, like filter squirting in the plasma collection set, occurred in 10.0% of plasma donations from SCTrait donors versus 0.5% in non-SCTrait donors (p < 0.001).

The low incidence of adverse events among SCTrait donors suggests that blood donation is safe in this group. However, filter-related issues do occur more frequently, and thus remain a point of concern.