Original Research Article Deferral of blood donors in a blood bank of a tertiary care centre: A retrospective study Rakesh A Hazari1, Reetesh Kumar Gujar2*, Deepika Kirar3 1Professor and HOD,2Assistant Professor, 3PG, Department of Pathology, People’s Medical College and Research Centre Bhopal, Madhya Pradesh, INDIA. Email: [email protected] Abstract Blood safety is a major issue all over the world in transfusion medicine. For this, donor selection is necessary in addition to the screenings of blood bags for infectious diseases. Deferrals lead to loss of precious blood/ components available for transfusion. For preventing this, we should be having knowledge of causes of deferral and their frequency. In this study, causes of donor deferral were evaluated retrospectively from January 2014 to December 2016 in the blood bank of Peoples college of medical sciences and research centre Bhopal (India). In this study temporary deferral was more common than permanent deferral. Most common cause in permanent deferral was HBsAg positivity. Causes among temporary deferral were anaemia (Hb<12.5 gm%), alcohol in last 72 hr, weight <45 kg, age <18 years, patients on antibiotic, previous donation in last 3 month, typhoid in last 1 year, dog bite etc. Key Words: Deferral, Blood donation, Donor. *Address for Correspondence: Dr. Reetesh Kumar Gujar, Assistant Professor, Department of Pathology, People’s Medical College and Research Centre Bhopal, Madhya Pradesh, INDIA. Email: [email protected] Received Date: 02/01/2018 Revised Date: 31/01/2018 Accepted Date: 14/02/2018 DOI: https://doi.org/10.26611/105524 million units1. According to World Health Organization Access this article online (WHO) figures, over 81 million units of blood are collected annually worldwide but only 39% are collected Quick Response Code: Website: in developing countries which have 82% of the world’s 2 www.medpulse.in population . A blood bank and trained and skilled staff plays a principal role in assuring the supply of safe blood as and when required. This is achieved by having donor 3 deferral criteria and stringent screening of collected Accessed Date: blood for possible Transfusion Transmissible Infections 20 February 2018 (TTIs)4. The donor screening process has four major aspects i.e. a) registration, consent of donor, demographic information. b) Medical history. c) Physical examination. INTRODUCTION d) Laboratory tests. The aim of our study is to know the In current clinical practice, a blood or blood component causes of the permanent and temporary deferral and their transfusion can be a vital, life-saving procedure. For this frequency. This retrospective study was conducted in the we need proper supply of safe blood/component from blood bank of Peoples medical college and R.C. Bhopal screened healthy donor. The donor should be in a good Madhya Pradesh (India) from July 2014 to December health in order to avoid any untoward effect to donor or 2016. recipient. Deferral of donor leads to loss of valuable blood or blood component obtainable for transfusion. To avoid unnecessary deferral we should be having skills and MATERIALS AND METHODS knowledge of causes of deferral and their prevalence. The This retrospective study included all the donors reporting National AIDS Control Organization’s (NACO) statistics for blood donation in the blood bank of Peoples medical show that the annual rate of blood donation in India is college and R.C. Bhopal Madhya Pradesh (India) from about 7.4 million units, against the requirement of 10 July 2014 to December 2016. The donors were evaluated on the basis of clinical history, physical examination, How to cite this article: Rakesh A Hazari, Reetesh Kumar Gujar, Deepika Kirar. Deferral of blood donors in a blood bank of a tertiary care centre: A retrospective study. MedPulse International Journal of Pathology. February 2018; 5(2): 49-51. https://www.medpulse.in/Pathology/ MedPulse International Journal of Pathology, Print ISSN: 2550-7605, Volume 5, Issue 2, February 2018 pp 49-51 blood pressure, temperature and Hb estimation. NACO RESULT guidelines were used for deferral of blood donors. Data In our study we found, out of total 7305 persons came for was collected from the records maintained by the blood blood donation, 6504 were men and 801 were women. bank. Hemoglobin was measured by Haemometer (Sahli Among total registration, 1383 were deferred (Table 1), plano paralal). Blood samples of these donors were out of which 1327 were temporary and 56 were screened for a) HBsAg by Erba Lisa SEN HBsAg ELISA permanent. Deferral in men was 736 and in women it was Test kit, SD BIOLINE Rapid test and b) anti HCV by 647(Table 3). The temporary deferral was more as Erba Lisa HCV Gen3(v2) ELISA,SD BIOLINE Rapid compare to permanent deferral (Table 2). The most test c) anti-HIV by Erba Lisa HIV Gen4 ELISA, SD common cause of temporary deferral in our study was BIOLINE Rapid test d) Malaria by SD Malaria Ag Pf/Pan anemia followed by alcohol intake in last 72 hrs, followed and e) syphilis by ASPEN Rapid test strip a solid phase by donor on medication (Table 4). Amongst permanent immunochromatographic assay for the qualitative deferral most common cause was found history of HBsAg detection of antibodies of all isotypes (IgG, IgM,) against positive followed by history of HCV and HIV 1/2 and Treponema pallidum antigen. heart disease (Table 5). Table 1: Demographic profile of the donors No. of registrations No. of deferrals % deferrals of total registration Men 6504 736 10.0% Women 801 647 8.80% Total 7305 1383 18.8% Table 2: Frequency of temporary and permanent deferrals No. of deferrals % of total deferrals % of deferral total registration Temporary 1327 96.0% 18.1% Permanent 56 4.0% 0.7% Total no. of deferrals 1383 100% 18.8% Table 3: Frequency of deferrals among men and women donors No. of donations No. of deferrals % of deferrals among Men/Women donors Men 6504 736 11.3% Women 801 647 80.7% Table 4: Causes of temporary deferrals with their relative proportion % %total Causes Number temporary deferrals deferrals Anaemia (Hb<12.5%) 618 46.6% 44.68% Alcohol in last 72 hrs 248 18.68% 17.93% On antibiotic/aspirin for last 3 days 152 11.45% 11.00% Pregnant/lactating female/menstruation 40 3.01% 2.90% Malaria in last 3 month 37 2.78% 2.67% Weight <45 kg 30 2.26% 2.17% Hypertension 30 2.26% 2.20% Tattoo/ear piercing in last 1 year 25 1.88% 1.81% Allergy 25 1.88% 1.81% Jaundice last 1 year 22 1.65% 1.59% Dental extraction/surgery in last 6 month 22 1.65% 1.60% Typhoid in last 1 year 18 1.35% 1.30% H/O tuberculosis with no ATT intake/incomplete treatment 18 1.35% 1.30% Dog or cat bite/rabies vaccination in last 1 year 18 1.35% 1.30% Diabetes on insulin 11 0.82% 0.80% Previous donation in last 3 month 05 0.37% 0.36% Upper respiratory tract infection 04 0.30% 0.29% Age <18 years 02 0.15% 0.14% Syphilis for 1 year 02 0.15% 0.14% TOTAL 1327 100% 96% MedPulse International Journal of Pathology, Print ISSN: 2550-7605, Volume 5, Issue 2, February 2018 Page 50 Rakesh A Hazari, Reetesh Kumar Gujar, Deepika Kirar Table 5: Causes of permanent deferrals with their relative proportion Causes Number % Permanent deferrals % Total deferrals HBV positive 19 33.92% 1.37% HCV positive 07 12.5% 0.50% HIV-1,2 positive 07 12.5% 0.50% Heart disease 07 12.5% 0.50% Age>60 years 04 7.14% 0.28% Asthma 04 7.14% 0.28% Epilepsy 04 7.14% 0.28% Leprosy 04 7.14% 0.28% TOTAL 56 100% 04% DISCUSSION REFERENCE Total of 7305 donors who came forward for blood 1. Department of AIDS Control Ministry of Health and donation, of which about 1383 cases (18.8%) were Family Welfare Government of India Annual report deferred due to various reasons. Study done by 2008- 2009: 27. 5 2. Baxi A (2008) Misconceptions over blood donation Chaudhary et al had reported a similar deferral rate causing shortage in India. (16.4%). Some studies have even had a lower deferral 3. Newman B (2001) Blood donor suitability and allogeneic 6 rate of (5.20%) by Unnikrishnan et al , (6%) by Sundar et whole blood donation. Transfus Med Rev 15: 234-244. al7, and (5.6%) by Rabeya et al8. Study has even a higher 4. Bahadur S, Jain S, Goel RK, Pahuja S, Jain M (2009) deferral rate of (35.6%) by Charles et al9. The major Analysis of blood donor deferral characteristics in Delhi, reasons for deferral vary reflecting disparity in India. Southeast Asian J Trop Med Public Health 40: 1087-1091. socioeconomic status. The deferral rate differs from 5. Chaudhary RK, Gupta D, Gupta RK. Analysis of donor- region to region and center to center. These varied deferral pattern in a voluntary blood donor population. differences in the rate could be due to different donor Transfus Med 1995; 5:209–12. selection criteria. Those who were deferred were 6. Unnikrishnan B, Rao P, Kumar N,Ganti S, Prasad R, categorized into temporary constituting 96% and Amarnath A, Reshmi B, Kaur V,Kesharwani P, Seetha permanent 4.0%. A similar rate has been found in study M, Nautiyal A, Goel P, Aggarwal A.Profile of blood donors and reasons for deferral in coastal South India. by Arslan et al with temporary (90%) and permanent 10 AMJ 2011; 4 (7): 379-385. (10%) deferrals . The leading cause among temporary 7.