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Variations in hemoglobin measurement and eligibility criteria across blood donation services are associated with differing low-hemoglobin deferral rates: a BEST Collaborative study.

  • Zalpuri, Saurabh
  • Romeijn, Bas
  • Allara, Elias
  • Goldman, Mindy
  • Kamel, Hany
  • Gorlin, Jed
  • Vassallo, Ralph
  • Grégoire, Yves
  • Goto, Naoko
  • Flanagan, Peter
  • Speedy, Joanna
  • Buser, Andreas
  • Kutner, Jose Mauro
  • Magnussen, Karin
  • Castrén, Johanna
  • Culler, Liz
  • Sussmann, Harry
  • Prinsze, Femmeke J
  • Belanger, Kevin
  • Compernolle, Veerle
  • And 17 more
Publication Date
Jan 11, 2020
Apollo - University of Cambridge Repository
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Background: Determination of blood donor hemoglobin (Hb) levels is a pre-requisite to ensure donor safety and blood product quality. We aimed to identify Hb measurement practices across blood donation services and to what extent differences associate with low-Hb deferral rates. Methods: An online survey was performed among Biomedical Excellence for Safer Transfusion (BEST) Collaborative members, extended with published data. Multivariable negative-binomial regression models were built to estimate adjusted associations of minimum donation intervals, Hb cut-offs (high, ≥13.5 g/dL in men or ≥12.5 g/dL in women, versus lower values), iron monitoring (yes/no), providing or prescribing iron supplementation (yes/no), post- versus pre-donation Hb measurement and geographical location (Asian vs rest), with low-Hb deferral rates. Results: Data were included from 38 blood services. Low-Hb deferral rates varied from 0.11% to 8.81% among men and 0.84% to 31.85% among women. Services with longer minimum donation intervals had significantly lower deferral rates among both women (rate ratio, RR 0.53, 95%CI 0.33-0.84) and men (RR 0.53, 95%CI 0.31-0.90). In women, iron supplementation was associated with lower Hb deferral rates (RR 0.47, 95%CI 0.23-0.94). Finally, being located in Asia was associated with higher low-Hb deferral rates; RR 9.10 (95%CI 3.89-21.27) for women and 6.76 (95%CI 2.45-18.68) for men. Conclusion: Differences in Hb measurement and eligibility criteria, particularly longer donation intervals and iron supplementation in women, are associated with variations in low-Hb deferral rates. These insights could help improve both blood donation service efficiency and donor care.

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