47. Jahreskongress der Deutschen Gesellschaft für Transfusionsmedizin und Immunhämatologie (DGTI), 9.-12. September 2014, Dresden: Abstracts
Transfusion Medicine and Hemotherapy
Abstracts Transfus Med Hemother 2014;41(suppl 1):2-108 Background: Many blood services are currently facing a significant change in the age structure of their blood donor population. This definitively represents a major challenge for a safe future blood supply, thus an optimization of donor recruitment and retention to meet future blood demand is required. It was the aim of this study to analyse medical reasons for deferral with respect to donor age and status (first time FT versus repeat
... RD) and furthermore clarify whether a transient deferral from blood donation results in permanent unwanted donor loss. This would be of great relevance in order to improve donor recruitment strategies and better prevent future shortages in blood supply. Other covariates such as gender, age or collection site (mobile versus fixed) might also be relevant and have already been addressed in previous studies 1-11. Methods: In a pilot-study we investigated FT and RD who were deferred from whole blood donation at least once during the observation period 2009-2011. Return rates within 24 months after deferral were determined and medical reasons for permanent or transient deferral were categorized into 14 different groups (figure 1). Furthermore the following information was generated from the databank of the Red Cross Blood Service Baden-Württemberg -Hessen: donation frequency, gender, age and site of donation (mobile versus fixed). Currently we perform an analysis of return rates with respect to deferral reasons and a multivariate and logistic regression analysis comparing FT and RD accounting for relevant covariates. Results: Between 2009 and 2011 a total of 2.575.490 blood donations including whole blood (2.404.902 = 93,4%) were performed at mobile or fixed collection sites at our Blood Service. Stratifying by year, there was little fluctuation in terms of significant trends. Among whole blood donors 7.8% were FT donors. 163.601 whole-blood donors were predominantly transiently deferred during the observation period. The majority of the deferred FT and RD belonged in the age-groups 18-25, 40-44 and 45-49 years. 15% of the FT and 4% of the RD were permanently excluded from further donation according to current regulations. 'Tattooing, Piercing and acupuncture' and 'Pathological findings in the examination prior to the attempted donation' were significantly associated with gender, both being more frequent among women (2.51 times and 1.39 times, respectively) as well as 'Addiction to drugs or alcohol', 'Risk of infection having being abroad' and 'Interventions like surgery or endoscopy', the latter three being more frequent among men (5.0-times, 1.38-times and 1.28-times). Regarding donor-status 'Tattooing, Piercing and Acupuncture' was more frequent among FT-donors (1.93-times) while deferrals due to 'Medication and Immunization' and 'Risk of infections having been abroad' was found to be higher among RD (1.39-times and 1.79-times). Among these deferred donors also 'Addiction to alcohol or drugs' (2.0-times more frequent among FT-donors) as well as 'Pathological Hb-Screening' and 'Interventions like surgery and endoscopy' (2.64 and 2.61 times-more frequent among repeat donors) was significantly associated (p < 0.0001) with donor-status. In 2009 77.4% of the FT and 28,0% of the RD-donors did not return after transient deferral from blood donation! (see table) . Blood donations within 24 months after transient deferral among FT and RD at the Red-Cross Blood Service Baden-Württemberg -Hessen gGm-bH in 2009. Donor status Donation after deferral No Donation after deferral FT donor 7.840 [22,6%] 26.897 [77,4%] RD donor 49.297 [72,0%] 19.172 [28,0] all 57.137 [55,4] 46.069 [44,6] Conclusion: Our data provide evidence that the frequency of the medical reasons for deferral differ in FT and RD blood donors. Furthermore gender and age are also relevant parameters impacting on deferral reasons. This is particularly relevant since blood donor populations are continuously changing with respect to the demographic change. However the substantial loss of FT-donors but also RD after transient deferral from blood donation indicates either a critical lack of information or motivation among these blood donors. In order to identify specific predictors, a more detailed analysis of the medical deferral reasons and relevant covariates will be required in order to develop specific prevention strategies and retain this valuable donor cohort. Currently more knowledge about donor motivation and behaviour after transient deferral is required to better identify donors with a high likelihood to get lost. A permanent analysis of deferral reasons may help to adjust information campaigns especially Transfus Med Hemother 2014;41(suppl 1):2-108 Abstracts 5 for FT-blood donors, since it will be a growing challenge to meet future blood demand under the impact of the demographic change.