Kandasamy Dhivya, Shastry Shamee, Chenna Deepika, Mohan Ganesh
Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Blood Med. 2020 Sep 28;11:327-334. doi: 10.2147/JBM.S265461. eCollection 2020.
Donor deferral results in loss of potential, motivated blood donors, and thereby, availability of blood for needy patients. This study analyses the frequency and reasons for donor deferral, including high hemoglobin deferral, which is underreported in India.
Retrospective analysis of the deferral record of whole blood donors from January 2014 to December 2018 was performed with respect to the pre-donation screening process at our center. Accordingly, the deferrals are categorized as stage1 - evaluation of Donor History Questionnaire (DHQ), stage 2 - medical examination, stage 3 - hemoglobin (Hb) check using copper sulfate method or a gradually implemented quantitative hemoglobin analyzer, and stage 4 - before phlebotomy. Donor demographic details, donation frequency, and deferral reasons were noted. Descriptive statistical analysis was performed using SPSS version 20 (IBM, USA).
Of 99,680 pre-donation screenings, 10.6% was deferred. The highest deferral (56.02%) was at stage 3 (based on hemoglobin level) contributed by low (52.45%) and high (3.75%) hemoglobin deferrals against cut-off of 12.5 to 18 g/dl. High Hb was noted only in male donors when screened by hemoglobin analyzer. Further, a steady fall in low hemoglobin but a rise in high hemoglobin deferral rate owing to the gradual implementation of hemoglobin analyzer over the study period was noted. The deferrals in stage 1, 2, and 4 were 29.64%, 13.97%, and 0.36%, respectively. Overall, the deferral rate was higher in females (49.88%), and in first-time (13.63%), and 18 to 25 yrs age-group (4.25%) donors for low Hb, underweight, and tattooing/ear piercing.
Insights on donor deferral reasons promote proactive measures towards donor recruitment and retention. Further, donor hemoglobin screening by quantitative method, if followed uniformly by all blood centers across the country, will help identify the true prevalence of high hemoglobin in Indian blood donors and ensures donor safety.
献血者延期导致有献血意愿的潜在献血者流失，进而影响有需要的患者的用血供应。本研究分析了献血者延期的频率及原因，包括血红蛋白过高导致的延期，这在印度的报告中较少提及。
对2014年1月至2018年12月期间全血献血者的延期记录进行回顾性分析，分析内容涉及本中心的献血前筛查流程。据此，延期被分为四个阶段：阶段1 - 献血者病史问卷（DHQ）评估；阶段2 - 体格检查；阶段3 - 使用硫酸铜法或逐步采用的定量血红蛋白分析仪进行血红蛋白（Hb）检测；阶段4 - 采血前。记录了献血者的人口统计学细节、献血频率及延期原因。使用SPSS 20版软件（美国IBM公司）进行描述性统计分析。
在99,680次献血前筛查中，10.6%的献血者被延期。延期率最高的是阶段3（基于血红蛋白水平），占56.02%，其中血红蛋白过低（52.45%）和过高（3.75%）导致的延期占比最大，血红蛋白水平临界值为12.5至18 g/dl。使用血红蛋白分析仪筛查时，仅在男性献血者中发现了血红蛋白过高的情况。此外，在研究期间，由于逐步采用血红蛋白分析仪，血红蛋白过低导致的延期呈稳步下降趋势，但血红蛋白过高导致的延期率呈上升趋势。阶段1、2和4的延期率分别为29.64%、13.97%和0.36%。总体而言，女性（49.88%）、首次献血者（13.63%）以及18至25岁年龄组（4.25%）的献血者因血红蛋白过低、体重过轻以及纹身/穿孔而导致的延期率较高。
对献血者延期原因的深入了解有助于采取积极措施招募和留住献血者。此外，如果全国所有血站统一采用定量方法进行献血者血红蛋白筛查，将有助于确定印度献血者中血红蛋白过高的真实患病率，并确保献血者安全。
