BACKGROUND AND OBJECTIVES:Platelet concentrates (PCs) are difficult to manage because of their short shelf-life and variable clinical demand. The aim of this study was to evaluate the impact of a modified platelet inventory management strategy at a Regional Blood Donation and Treatment Center on product utilization and expiration-related losses. MATERIALS AND METHODS:This retrospective observational study analyzed platelet inventory management from 2015 to 2025, focusing on changes introduced in 2024. The strategy included an Excel-based decision-support tool incorporating current inventory, predefined target stock levels, ABO distribution, and the use of group AB platelets as universal products. Apheresis platelet collection was also reorganized to improve supply flexibility. RESULTS:Between 2015 and 2025, the number of transfused PCs increased from 8306 to 13,971 units/year (p < 0.001), while the outdate rate decreased from 1.86% to 0.04% (p = 0.0009). After 2023, apheresis platelets accounted for over 40% of issued products, and the mean use of group AB platelets increased from approximately 7% to over 12%. The mean age of transfused platelets increased from 2.38 ± 1.19 days in 2015-2023 to 2.62 ± 1.33 days in 2024-2025. CONCLUSION:Implementation of an integrated platelet inventory management strategy improved inventory utilization, substantially reduced expiration-related losses, and maintained supply despite increasing clinical demand. Simple decision-support tools combined with organizational changes may provide a practical approach to platelet inventory optimization in regional blood centers.
BACKGROUND AND OBJECTIVES:Sexual activity-based blood donation restrictions aim to reduce incident transfusion-transmissible infections (TTIs) but are not required for source plasma because of additional pathogen reduction. On 13 July 2025, Australian Red Cross Lifeblood introduced a plasma pathway (PP) allowing previously ineligible individuals to donate source plasma irrespective of recent sexual activity or human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) use. This study describes donor demographics and donation prevalence of tested TTIs from the program's first 6 months. Separately, associated PP changes facilitated a contemporary TTI prevalence estimate among transgender donors during this period. MATERIALS AND METHODS:Descriptive demographics and TTI results were extracted from identified cohort donors from 13 July 2025 to 13 January 2026. TTI prevalence (per 10,000 plasma donations) was estimated by detected TTIs divided by the total number of donations. RESULTS:The PP supported 6673 donations from 7832 attendances by 3465 donors over 6 months. Zero (upper 95% confidence limit 6.94 per 10,000 donations) cases of HIV, hepatitis B virus or hepatitis C virus were detected. New donors constituted 40% of PP donors. Donations were predominantly from men reporting sex with men without (48%) or with PrEP use (30%). No TTIs (0, upper 95% confidence limit 25.76 per 10,000 donations) were detected from transgender donors during this period. CONCLUSION:TTI prevalence was lower than predicted. The PP demonstrates an inclusive way to limit restrictions on sexual activity and PrEP use without changing the safety profile. Other blood services should consider its introduction.
BACKGROUND AND OBJECTIVES:To investigate the hierarchical structure of blood donation motivation based on self-determination theory (SDT), specifically examining the associations between six regulatory styles-spanning the spectrum from amotivation to intrinsic motivation-and overall donor motivation. MATERIALS AND METHODS:A nationwide cross-sectional study across 31 Iranian provinces enrolled 7187 potential donors (92.4% response rate). Motivation was assessed using the 24-item Self-Regulation of Blood Donation Scale. Multivariable linear mixed-effects models, adjusted for demographic and behavioral confounders, were used for statistical analysis. Bonferroni-corrected pairwise comparisons elucidated the hierarchy, and multiple imputation addressed missing data. RESULTS:Adjusted mean scores differed significantly across all six regulatory styles (all pairwise p < 0.001). Scores increased progressively across the SDT continuum, from amotivation (adjusted mean = 1.58) to intrinsic motivation (adjusted mean = 4.43). Intrinsic motivation had the highest adjusted score, followed by integrated, identified, introjected, and external regulation. The difference between intrinsic motivation and amotivation was 2.865 points (95% confidence interval [CI]: 2.826-2.904). Adjustment for demographic and donation-related characteristics produced minimal changes in the estimated differences. Sensitivity analyses using multiple imputation yielded comparable results. CONCLUSION:Iranian blood donors demonstrated a clear motivational hierarchy consistent with the SDT continuum, with the highest scores observed for intrinsic and other autonomous forms of motivation. These findings support the utility of SDT for characterizing blood donation motivation in Iran and suggest that donor retention strategies may benefit from approaches that support autonomy and the internalization of personally and socially meaningful reasons for donation.
BACKGROUND AND OBJECTIVES:Non-invasive prenatal testing (NIPT) for fetal RHD genotyping is widely used to guide anti-D prophylaxis, but discrepancies between predicted fetal RhD status and postnatal serological typing can occur due to variant RHD alleles. This study aimed to confirm and characterize a suspected novel exon 4 deletion in RHD using multiple molecular methods and to assess inheritance. MATERIALS AND METHODS:NIPT predicted an RhD-positive fetus in an RhD-negative pregnant woman, whereas postnatal serology showed an RhD-negative phenotype. Molecular analysis of RHD was performed using the RBC-Ready Gene CDE kit (Inno-Train, Kronberg, Germany), targeted next-generation sequencing (NGS) and Sanger sequencing in the family and in an unrelated RhD-negative woman. RESULTS:Targeted NGS identified a single-nucleotide deletion in the RHD gene (c.540del), predicted to result in a frameshift and premature termination (p.Leu181CysfsTer48). Sanger sequencing confirmed the variant in the newborn and demonstrated paternal inheritance, with the father heterozygous for the deletion. The same variant was also identified in an unrelated RhD-negative woman of Swedish origin; notably, the newborn's father was also of Swedish origin. CONCLUSION:This case illustrates a limitation of current NIPT approaches, which detect RHD sequences but not gene functionality. Molecular follow-up is crucial in cases of discordant RhD typing.
BACKGROUND AND OBJECTIVES:Blood donation services are vital to healthcare delivery, ensuring the continuous availability of safe and adequate blood products, particularly during periods of disruption and crisis. Disruptive events such as pandemics, mass-casualty incidents, (natural) disasters, pandemics, armed conflicts and blood shortages can affect donor availability, logistics, workforce capacity, communication and operational continuity. This study systematically identifies and synthesizes lessons learned from crises affecting blood donation and translates them into a structured framework of operational practices. MATERIALS AND METHODS:A systematic literature review between 2010 and 2025 was conducted using four databases. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 142 included publications were analysed using qualitative content analysis with MAXQDA and organized using an analytical framework adapted from the International Society of Blood Transfusion (ISBT) COVID-19 Operational Recommendations Framework. RESULTS:The analysis identified six overarching dimensions of operational practice in blood donation services: collaboration, coordination and standards; blood supply chain design and management; resource management; disaster preparedness and risk management; communication; and operations. Three overarching operational practice themes emerged: coordinated governance and communication, operational continuity and organizational resilience. CONCLUSION:Crises affecting blood donation services generate transferable lessons for maintaining safe and reliable blood supply operations under disruptive conditions. This review provides a structured synthesis of cross-crisis operational practices and offers an evidence-based foundation for blood services.
BACKGROUND AND OBJECTIVES:Hepatitis E virus (HEV) is a recognized transfusion-transmissible pathogen with significant impact in immunocompromised recipients. Data from Southeast Asia are limited, and the epidemiology of HEV in Muslim-majority populations with low pork consumption remains poorly characterized. This study aimed to determine anti-HEV immunoglobulin G (IgG) and immunoglobulin M (IgM) seroprevalence and associated demographic, dietary, environmental, zoonotic and knowledge-related factors among Malaysian blood donors. MATERIALS AND METHODS:A prospective cross-sectional study was conducted among 500 consecutive blood donors at the Universiti Malaya Medical Centre. Anti-HEV IgG and IgM were measured using enzyme-linked immunosorbent assay. A structured questionnaire assessed demographic, dietary, environmental and zoonotic exposures. Univariate and multivariable logistic regression identified predictors of anti-HEV IgG seropositivity. RESULTS:Anti-HEV IgG seroprevalence was 2.8% (14/500), and IgM positivity was 0.6% (3/500). IgG seropositivity increased with age but showed no association with dietary exposures, including pork consumption. Knowledge of HEV was low, with a median score of 1 out of 12. Multivariable analysis identified freshwater recreational exposure (adjusted odds ratio [aOR] 20.04; p = 0.017) and direct rodent contact (aOR 13.36; p = 0.030) as factors associated with anti-HEV IgG seropositivity; however, these findings were based on small numbers of exposed individuals and should be interpreted cautiously. CONCLUSION:HEV seroprevalence in Malaysian blood donors was low, indicating a limited burden of previous HEV infection. The observed epidemiological profile suggests that environmental and zoonotic exposures may be associated with HEV seropositivity, although these findings require cautious interpretation. These findings provide baseline data for continued surveillance and future evaluation of transfusion-transmitted HEV risk in Malaysia.
BACKGROUND AND OBJECTIVES:Trans blood donors may be at higher risk of vasovagal reactions (VVRs) if their estimated blood volume is calculated without considering their sex assigned at birth. Yet no studies have addressed this research question. We assessed the rates of VVRs among trans and cisgender blood donors. MATERIALS AND METHODS:This was a cross-sectional study of whole blood donors in Québec, Canada (11 August 2016-25 August 2021). Trans donors were identified if they self-reported their gender transition or following an interview triggered by affirmative answers to questions on recent physician consultations and medication use. The odds of VVR were modelled using logistic regression analyses, adjusting for donor age and status. RESULTS:Overall, 377,980 donors were included and made 1,799,509 donations: 29 were trans men (mean age ± standard deviation [SD] = 28.6 ± 9.1), 173,464 were cisgender men (mean age ± SD = 42.5 ± 16.2), 13 were trans women (mean age ± SD = 33.7 ± 9.7) and 204,474 were cisgender women (mean age ± SD = 38.7 ± 15.4). There was no statistically significant difference in the odds of VVR (any severity) between trans and cisgender men (odds ratio [OR] [95% confidence interval, CI] = 1.71 [0.88-3.32]) or between trans and cisgender women (OR [95% CI] = 1.33 [0.40-4.40]). CONCLUSION:In this study, the risk of VVR was similar among trans and cisgender blood donors.
BACKGROUND AND OBJECTIVES:Maintaining safe and adequate blood supply in low- and middle-income countries requires understanding factors influencing donor return intentions. Nigeria faces chronic blood shortages, yet evidence on determinants of return intention among blood donors in tertiary hospitals remains limited. This study assessed donor motivation, satisfaction and intention to return among blood donors at Lagos University Teaching Hospital (LUTH) and identified factors independently associated with post-donation intention. MATERIALS AND METHODS:A descriptive cross-sectional study was conducted among 1589 consecutive donors using a structured interviewer-administered questionnaire adapted from validated instruments. Motivation, satisfaction and intention to return were measured using Likert-scale items. Participants retrospectively reported pre-donation intention and current post-donation intention immediately after donation. Descriptive statistics, chi-square tests, McNemar's test, subgroup analyses and binary logistic regression were performed. RESULTS:Most donors were family-replacement (70.5%) and male (91.8%), with a mean age of 30.9 years. Motivation was high (84%), driven primarily by altruism, personal choice and perceived health benefits. Satisfaction was also high (mean 4.59 ± 0.64). Intention to return increased significantly after donation (56.1%-64.2%, p < 0.001). Motivation (odds ratio [OR] = 7.32, p < 0.001) and pre-donation intention (OR = 0.014, p < 0.001) were independently associated with post-donation intention, whereas satisfaction was not significant after adjustment. Family replacement and voluntary non-remunerated donors differed significantly in motivation, satisfaction and post-donation intention. CONCLUSION:Blood donors at LUTH demonstrated high motivation and satisfaction. Donation experience strengthened intention to return. Differences between donor types highlight the need for donor-specific retention strategies in replacement-dominated blood systems.
BACKGROUND AND OBJECTIVES:Syphilis is caused by the bacterial spirochete Treponema pallidum and can be transmitted through blood transfusion. However, there have been less than 10 documented transfusion-transmitted cases since World War II. Global data comparing population-level syphilis trends with blood donor reactivity and screening practices are limited. This study aimed to compare syphilis screening practices worldwide and to explore the value of universal donor screening. MATERIALS AND METHODS:A cross-sectional international survey was conducted among blood transfusion professionals. Participants reported data collected between 2018 and 2024 on syphilis prevalence, blood donor screening algorithms and reactivity rates, deferral policies and blood safety interventions. Descriptive analyses were performed by year and geographic region. RESULTS:Thirty-nine participants from 26 countries across five continents answered the survey. Universal donor screening was reported by 35 of 36 institutions providing policy data, with treponemal assays representing the predominant screening approach. Substantial variation was observed in confirmatory testing, donor deferral criteria and donor re-entry policies. Reactivity rates varied markedly across centres and were higher among first-time donors compared to repeat donors. Institutions with higher syphilis rates generally reported higher donor reactivity. Routine leukoreduction was reported by 66.7% of institutions, while pathogen reduction technologies were routinely used by 36.1%. Most centres apply indefinite donor deferral and have not considered removing screening. CONCLUSION:Syphilis screening and donor management practices vary across blood services worldwide despite widespread implementation of universal screening. Local epidemiology, testing strategies and donor eligibility policies contribute to observed differences in donor reactivity and surveillance practices.
BACKGROUND AND OBJECTIVES:Repeated blood donations deplete 200-250 mg of iron per donation. While biochemical consequences on iron stores are well documented, the role of circulating microRNAs (miRNAs) in maintaining iron homeostasis remains poorly characterized. This study investigated whether repeated blood donation alters iron metabolism-related miRNA expression. MATERIALS AND METHODS:A cross-sectional study compared 42 male participants: 21 repeat donors (donating three to four times annually; mean total donations: 15) and 21 first-time donors. Plasma iron metabolism markers (ferritin, hepcidin, ferroportin, transferrin, soluble transferrin receptor 1 [sTfR1], soluble transferrin receptor 2 [sTfR2], unsaturated iron-binding capacity [UIBC]) were quantified using enzyme-linked immunosorbent assay (ELISA) and chemiluminescence methods. Expression of 13 miRNAs was analysed by quantitative reverse transcriptase polymerase chain reaction, normalized to U6 and quantified using the 2-ΔΔCt method. RESULTS:Repeat donors exhibited significantly lower ferritin (median: 26.8 vs. 72.2 ng/mL; p < 0.001), elevated red cell distribution width coefficient of variation (RDW-CV) (13.86% vs. 13.07%; p < 0.001) and reduced mean corpuscular haemoglobin concentration (MCHC) (33.80 vs. 34.23 g/dL; p = 0.009) while maintaining normal haemoglobin. No significant differences were observed in any miRNA after multiple-testing correction. However, miR-130a showed a marginal decrease (fold change: 0.389; p = 0.0564; Cohen's d = 0.514), while miR-200b and miR-485-3p demonstrated non-significant upward trends. Correlation analysis revealed distinct patterns between groups in iron regulatory protein relationships. CONCLUSION:Repeated blood donations demonstrate 'compensated iron depletion'. No significant differences were detected in the 13 selected iron-homeostasis-related miRNAs after multiple-testing correction. Within the limits of this small, male-only study evaluating a single miRNA panel, these findings indicate no detectable alteration, while underscoring the importance of ferritin monitoring; broader molecular pathways were not assessed, and given the limited statistical power, a Type II error cannot be excluded.
BACKGROUND AND OBJECTIVES:India has one of the world's highest burdens of thalassaemia, with 10,000-15,000 births annually and a carrier prevalence of 3%-4%. Services for prevention and comprehensive care remain fragmented, especially in rural regions. To address gaps in provider knowledge and practice, Extension for Community Healthcare Outcomes (ECHO) India, in collaboration with the Post Graduate Institute of Child Health and state partners, launched a virtual tele-mentoring programme in Maharashtra, Madhya Pradesh and West Bengal. MATERIALS AND METHODS:We conducted a mixed-methods evaluation using a convergent parallel design. Data included pre- and post-training knowledge assessments, post-session feedback surveys and hub reflection meetings. A logical model and Moore's framework guided outcome assessment across participation, satisfaction, knowledge, competence and reported changes in practice. RESULTS:Following a national training-of-trainers workshop in April 2023, state hubs were established and peer-reviewed modules developed. From October 2023 to March 2025, 73 ECHO sessions were conducted across the three state hubs, with curricula tailored to different participant groups (eight modules for medical officers and six for paediatricians). Paediatricians showed a mean knowledge gain of 15.8% (p < 0.001) and medical officers 11.4% (p = 0.001). Over 70% rated sessions highly relevant, and over 90% intended to apply learning. Reported behaviour changes included improved interpretation of complete blood counts, more systematic referral and promotion of antenatal screening. CONCLUSION:This first multicentre evaluation demonstrates that ECHO tele-mentoring strengthens thalassaemia care in India, improving provider competence and catalysing systemic and policy-level change. The model is scalable for integration into primary health systems across low- and middle-income countries.
BACKGROUND AND OBJECTIVES:In Denmark, increasing demand for plasma-derived medicinal products has made plasma self-sufficiency based on voluntary, non-remunerated donation a political priority. This report describes recent developments in plasma collection, with a focus on the Central Denmark Region. MATERIALS AND METHODS:Plasma capacity was expanded progressively over time through dedicated units, increased staffing and donor-focused initiatives in the Central Denmark Region, particularly in 2024. National and regional donation trends were described for 2016-2025. Donor characteristics and donation frequency were summarized for the Central Denmark Region. Plasma self-sufficiency was calculated assuming an immunoglobulin yield of 5 g/kg plasma. RESULTS:From 2016 to 2025, national plasma donations increased by 167% reaching 161,438 donations in 2025, corresponding to 65% self-sufficiency. In the same period, plasma donations in the Central Denmark Region increased more than threefold to 41,268 corresponding to 70% self-sufficiency. CONCLUSION:Plasma collection can be substantially expanded within a voluntary, non-remunerated system. In the Central Denmark Region, dedicated infrastructure and targeted recruitment and retention were associated with a more than threefold increase in donations and 70% self-sufficiency, achieved through a single plasma centre in a region with 1.4 million inhabitants. The opening of four additional small facilities (November 2025-April 2026) supports projected full self-sufficiency within 1-2 years.
BACKGROUND AND OBJECTIVES:As blood collection agencies (BCAs) seek to increase donor diversity, making changes to eligibility criteria to enable more people to donate is an important consideration. BCAs in Canada have a permanent deferral from whole blood and platelet donation for anyone with a history of malaria, a barrier to donation for many in African, Caribbean and Black (ACB) communities. If a malaria nucleic acid test (NAT) is implemented in donor screening, malaria-related deferral criteria could be eased. This study explored the public's views on potential changes to malaria deferral criteria. MATERIALS AND METHODS:A mixed-methods community-based study was conducted in Canada. This paper reports results from the qualitative component (n = 26). Topics explored in semi-structured interviews included experiences with donation, awareness and knowledge of deferral criteria, cognitive interview questions and potential responses to receiving a positive test result for malaria. RESULTS:Participants understood blood donor screening processes as a shared responsibility of both BCAs and donors for ensuring blood safety. Participants had a literal interpretation of donor screening questions assessed, and most would feel comfortable answering the questions in a blood donation context. If malaria NAT is implemented and they were to receive a positive test result, participants shared they would respond with concern, fear and uncertainty. CONCLUSION:If BCAs work to implement a malaria NAT and ease deferral criteria, this must be communicated clearly and effectively to the public and donors, with particular focus on communities impacted. BCAs should work with community partners to communicate these changes.
Abstract Background and Objectives This descriptive retrospective study evaluated the content, completeness and usability of information available in the Human Pluripotent Stem Cell Registry (hPSCreg®), including registered cell lines, research projects, clinical studies, donor characteristics and regulatory information. Materials and Methods We analysed data registered in hPSCreg® from January 2008 to December 2021. We analysed the data regarding cell lines, research projects, clinical studies, diseases, countries and legal issues. Results There were 7538 total cell lines registered in the hPSCreg®. The most common derivation and generation countries were the United Kingdom, the United States, Germany and China. There were 3139 (46.5%) cell lines labelled as readily obtainable for a third party; few (7.2%) were labelled as available for commercial use. The most common diseases of the donor were Parkinson's disease, Alzheimer's disease and diabetes mellitus. Complete characterization data were available for the minority of the cell lines. The most common sponsor of research projects registered in the hPSCreg® was the European Union's Seventh Framework Programme (FP7). There were 97 registered clinical trials in the hPSCreg®. Challenges identified were incomplete user‐entered information, entry of non‐standardized information about diseases and continuing verification of the evolving legal status of embryonic stem cell (ESC) research per country. Conclusion The hPSCreg® represents an important international resource for stem cell research; however, this evaluation identified substantial variation in data completeness and standardization across registry fields. Future development should focus on improving the completeness of key metadata, standardization of terminology and systematic monitoring of registry data quality.
BACKGROUND AND OBJECTIVES:In 2020, Brazil implemented individual donor assessment (IDA), expanding eligibility to include individuals previously deferred, such as men who have sex with men (MSM). We assessed human immunodeficiency virus (HIV) incidence and correlates of incident infection among blood donors following this policy change. MATERIALS AND METHODS:We analysed donation data from five Brazilian blood centres from 2020 to 2024. Routine HIV screening included fourth-generation antigen/antibody (Ag/Ab) assays and nucleic acid testing (NAT). Additional testing (limiting antigen [LAg] avidity, viral load) was used to identify recent infections. Incidence was estimated separately for first-time donors (FTD) and repeat donors (RD), and multivariable Poisson regression was used to assess correlates of incident infection. RESULTS:Among 1.66 million screened donations, 2598 (0.16%) were HIV-reactive on routine screening. Residual serum was available for 74% (n = 1927), and following additional testing, 98 were classified as recent HIV infections. HIV incidence was higher among FTD (20.9/100,000 person-years) than RD (18.3/100,000). Higher incidence was observed among male and younger donors as well as those identifying as Black or multiracial (Pardo). Incidence varied between blood centres, with overall incidence stable across the study period. No increase in the residual risk (RR) of HIV transfusion-transmission was observed. CONCLUSION:Our findings indicate that the adoption of IDA in Brazil did not change blood safety. HIV incidence remained stable, with varying HIV infection patterns reflecting known disparities in the epidemiology of HIV in Brazil.
BACKGROUND AND OBJECTIVES:Umbilical cord blood (UCB) as a source for red blood cell (RBC) transfusions is a promising alternative to adult RBC transfusions in extremely preterm neonates, as UCB contains predominantly fetal haemoglobin (HbF). A limitation to clinical use is the low and variable yield of UCB collections. This study aimed to assess UCB collection volume and feasibility across three techniques in uncomplicated term pregnancies. MATERIALS AND METHODS:We conducted a prospective observational study in two centres in The Netherlands. We compared the volume of UCB units collected from uncomplicated term deliveries using three different techniques: in utero, ex utero with a funnel and ex utero with a plateau. A minimum target volume of 70 mL was deemed adequate for further processing. RESULTS:Of 606 collection attempts, 570 (94%) were successful. The median UCB volume was 65 mL (interquartile range, IQR 49-84), with 242 (42.5%) collections ≥70 mL. Volumes differed significantly between the three techniques, with the ex utero plateau technique yielding the highest median volume (70 mL, IQR 55-88), followed by in utero (56 mL, IQR 45-71) and the funnel technique (36 mL, IQR 30-51) (p < 0.001). UCB volume correlated with birth weight (p < 0.001), but not with gestational age or sex. Volumes obtained with the plateau technique increased over time, suggesting a learning-curve effect. CONCLUSION:Collected UCB volume was highest using the ex utero plateau technique and was associated with birth weight and operator experience. The observed learning curve underscores the importance of dedicated teams to maximize UCB collection efficiency for future transfusion use.
