From Screening to Safety: Addressing Donor Deferral Practices for a Safer Blood Supply

For ensuring blood safety, potential blood donors undergo comprehensive eligibility screening, comprising a review of their medical history and a physical examination. The commonly utilized testing platform, ELISA may not identify infections occurring within the "window period". Thus, donor screening and the acknowledgement of common causes of donor deferral in a particular region becomes imperative. The present study determines the common reasons for donor deferral and the possible measures to increase blood safety as well as deferred donor recall rate. Donor deferral record of one year consisting of 8650 donors was accessed and analysed. The deferred donors were classified into 5 categories (from1 to 5) based on (1) preliminary information about donor, (2) medical history, (3) surgical history, (4) physical examination and (5) high risk of TTI transmission. The overall deferral rate was 17.9% while category-wise deferral rate across categories 1 to 5 were 7.03%, 19.54%, 6.64%, 49.93%, and 16.83% respectively with maximum donors deferred on physical examination. The most common cause of deferral was low hemoglobin (26.45%) followed by high blood pressure (12.13%), alcohol consumption (7.03%) and presence of active infection (5.29%). Identifying the pattern of donor deferral serves as a crucial tool for ensuring blood safety and guiding regional or national policy formulation for donor selection and safety. By categorizing deferral reasons, it becomes easier to target specific areas for improvement and focus efforts on retaining a motivated pool of blood donors.