JOURNAL - Blood donor selection and deferral pattern as an important tool for blood safety in a tertiary care hospital.

1. Blood donor selection and deferral
pattern as an important tool for blood
safety in a tertiary care hospital
Authors: Manisha Shrivastava, Nehal Shah, Seema Navaid, Kalpana
Agarwal, and Gourav Sharma
Department of Transfusion Medicine, Bhopal Memorial Hospital and
Research Centre, Bhopal, Madhya Pradesh.
Presenter: Dr Sowmya Srinivas

2. INTRODUCTION
• In Blood banking, blood safety has received a major attention from the point
of view of transfusion-transmitted infections.
• For ensuring blood safety, blood donor selection criteria and deferral criteria
acts as an important, effective and economical tool.
• The process of donor selection is based on criteria of subjecting them to-
- Questionnaire
- Physical examination
- Hemoglobin estimation

3. • Only those who meet all the requirements qualify as blood donors.
• Also there is a need to defer the blood donors to protect the recipients from
getting TTIs.
• The criteria for blood donor selection and deferral in India are provided by
the Drugs and Cosmetic Act 1940 supplemented by the Standards for Blood
Banks and Blood Transfusion Services.

4. • The process involves legal, ethical, political, and psychological considerations.
• It also influences donor demographics and leads to specific deferral patterns.

5. AIM OF THE STUDY
• To evaluate and analyze the blood donor deferral pattern and its causes
among blood donors in a tertiary care hospital blood bank.
• Also to review its influence on policy for recruitment and retention of blood
donors.

6. SETTINGS AND DESIGN
• Hospital based blood bank.
• Retrospective analysis for a period of 13years.(2001-2013)

7. METHODOLOGY
• SUBJECTS: Potential donors presenting themselves at the hospital blood
bank and deferred due to temporary or permanent donor deferral criteria.
• DURATION: 2001 to 2013
• For the collection of whole blood, the standard operating procedure(SOP)
followed.

8. Since its retrospective, Deferral record available was analyzed
Donors – subjected to questionnaire
Haemoglobin estimation
Physical Examination
After which donors were deferred
Reasons for deferral were classified under categories-
1) Replacement-Voluntary blood donors
2) Gender – based (male - female)
3) Various age groups

9. • Donors were categorised into four categories for analysis based on reasons
for deferral-
1) Category 1 – Whose own health might be affected by donating blood.
2) Category 2 – Risk of transmitting TTIs.
3) Category 3 - Donors with a condition where transmissibility by blood is
unknown or with diseases/condition not suitable for blood donation.
4) Category 4 – Sensitive physical and social considerations.

10. RESULTS
• The deferral rates according to the categories of the deferred donors and the
reason for deferral were evaluated.
• A total of 53,480 blood donors were registered for blood donation during
the study period.
• The analysis is as follows-

11. RESULTS
Donor deferral according to four categories of blood donors

12. Donor deferral according to age and occupation

13. CAUSES OF TEMPORARY DONOR DEFERRAL

15. CAUSES OF PERMANENT DONOR DEFERRAL

16. *Typhoid, lung disease/tuberculosis, epilepsy/psychiatric problem, diabetes, heart disease, cancer, endocrine diseases,
and kidney disease.
**Menstrual problems, alcohol, underage, high-risk group, overage, H/o previous blood donation reaction, and dog
bite/vaccination

17. DISCUSSION
• Donor deferral criteria will be different in specific geographic areas.
• It is important to bring back the donors deferred due to temporary causes of
deferral .
• Low Haemoglobin level is the most important cause of deferral in most
studies and in this study too.
• Hence combining anaemia prevention and treatment in donor recruitment
could help regain the donors and develop a healthy blood donor pool.

18. • According to a study conducted in our Blood bank (JSS Hospital Blood
Bank, Mysore) by Bobati. et al., the most common reason for deferral was
low Hb levels accounting to 25.3%, highest in female population.
• The other leading causes in order of frequency were alcohol consumption
within 72 h, hypertension and elevated Hb levels accounting to 158 (21%),
106 (14%), and 47 (6%), respectively, seen exclusively in males.

20. • A structured questionnaire is an important prerequisite for safe donor
recruitment and if carried out as a uniform policy may even affect the
prevalence data as donors with transfusion transmitted infections.
• Hence the deferral pattern need to be assessed in different regions for
- recommending revisions in donor selection criteria.
- planning strategies for re-entry of donors deferred temporarily.

21. • Hence raising general awareness for blood donation and encouraging related
donors to become regular donors may help increase the number of voluntary
donations.
• The analysis of the pattern of deferral and interventions to bring back
deferred donors when possible could be a strategy for long-term retention
of motivated blood donors.

22. TAKE HOME MESSAGE
• A standardised questionnaire for donor selection in a specific area is
important after analysing the causes of donor deferral.
• It reduces the prevalence data of donors with TTIs even before the donation
of blood.
• The value of determining donor deferral pattern is in calling back donors
deferred due to temporary reasons and can help retain pool of motivated
blood donors.

23. STRENGTHS OF THE STUDY
• A large sample size is taken and the study is analysed based on the data of 13
years.
• A standardized questionnaire is followed for donor selection – minimises
TTIs.
• The donors are categorised based on the deferral criteria and reasons for
deferral for better understanding.

24. WEAKNESS OF THE STUDY
• It’s a retrospective study. The data is retrieved from the deferral records –
chances of bias during data entry and data collection.
• The deferral records so obtained from the study cannot be generalised since
the study is undergone in a specific geographic area.

25. REFERENCES
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Press; 2008. pp. 153–7.
• 4. Drugs and Cosmetic Act. [Last accessed on 2015 Sep 05]. Available from:
http://www.cdsco.nic.in/writereaddata/DrugsandCosmeticAct.pdf .
• 5. Standards For Blood Banks & Blood Transfusion Services, National AIDS Control
Organisation, Ministry of Health and Family Welfare, Government of India, New Delhi.
2007.

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27. -THANK YOU