Background and objectivesBlood donation is very crucial for continuous supply of blood in blood banks for the appropriate patient management. This study was conducted to obtain information from replacement blood donors regarding barriers for voluntary blood donation, and for this, we assessed the effectiveness of personal communication strategy to convert them into voluntary blood donors.Materials and methodsProspective longitudinal interventional study with personal communication strategy as intervention, conducted on in‐house replacement blood donors, who never donated voluntarily, and to convert them into future voluntary blood donors. Enrolled blood donors were randomized into the case and the control arms, and a questionnaire regarding barrier for voluntary blood donation was administered. Personal communication strategy was applied in the case arm, and no intervention was done in the control arm. Six months after the enrolment, donors were contacted telephonically and the history of repeat donation in the last 3 months was asked.ResultsOf the selected 769 donors, 381 and 388 donors were randomized into the case and the control arms, respectively. Lack of awareness about voluntary blood donation, lack of time and convenience were the most common reasons for not donating blood voluntarily. In the post‐motivational period, 23·35% and 3·35% of the blood donors in the case and the control arms, respectively, donated blood voluntarily.ConclusionThis study revealed the factors for not donating blood voluntarily. We believe that our results can be used to convert the existing replacement donors into voluntary donors by applying the personal communication strategy, and future study can be planned, combined with some other effective tools to bring the maximum desired results.
Background and objectivesThe Cameroon National Blood Transfusion Programme (NBTP) has set national standards and recommendations for HIV testing in blood banks, which involves the use of two highly sensitive 99·5% and specific 99·5% fourth‐generation enzyme immunoassays (EIA). The present study aimed at investigating HIV strategies, algorithms and assays currently used in Cameroonian blood banks, after which their level of compliance to blood safety recommendations would be assessed.Materials and methodsA cross‐sectional descriptive study was conducted in 18 blood banks located in the ten regions of Cameroon during the year 2018. Data were collected through in‐person interview of blood bank heads, on the HIV testing practice. The information provided from the questionnaire‐based interview was crosschecked and completed through the exploitation of blood bank records.ResultsThis study showed that 12/18 blood banks had Hospital Blood Transfusion Hemovigelance Committee, while guidelines were available in 15/18 centres. According to testing algorithms, 22·2% used one RDT, 27·8% used two RDTs, 33·3% used one RDT combined with Ag/A EIA or CLIA (chemiluminescent immunoassay) and 16·7% used two RDT combined with Ag/Ab EIA/CLIA. Concerning testing kits, a total of 13 different kits were found among which 69·2% were WHO‐prequalified. A good level of compliance with the NBTP guideline was observed in 1/18.ConclusionThis study revealed a diversity of practice in HIV screening for blood transfusion in Cameroon. As fewer blood banks meet the required standards, these findings should serve as the footprint for the National Blood Transfusion Programme in implementing corrective actions nationwide.
Blood donors of African descent are essential for the availability of specific antigen-negative blood, yet past recruitment strategies yielded limited successes. The aim was to systematically develop an intervention to recruit African blood donors in the Netherlands, following the Intervention Mapping (IM) protocol. Based on the previous needs-assessment (Step 1), change objectives (Step 2) and practical strategies (Step 3) were developed, and further determined through eight interviews and two focus groups with blood bank staff and experts. The strategies were then translated into a magazine article pilot-experiment ( n = 16) as part of the programme production (Step 4). The magazine appraisal and intention-change were studied of the target group and compared with a previously published magazine article and a control group in an online survey. Important factors in the needs-assessment related to donation awareness and knowledge and were also rated by staff and experts as most relevant and feasible determinants. The finalized objectives and strategies consisted of awareness raising and understanding how and where to donate blood. In the magazine pilot, the look and feel of the previously published article was higher valued, but the newly developed article’s content was higher rated. Reading the magazine articles increased donation intention as compared to the pre-test and reference, but the increase did not differ between the articles. IM helped to define intervention objectives and strategies and gave valuable insights in how to implement (step 5) and evaluate (step 6) a donor recruitment intervention.
A 58‐day‐old female infant reported with complaints of fever, difficult breathing, loose stool, vomiting and refusal to feed for 4 days. Laboratory work showed anaemia, leucocytosis with elevated neutrophils and thrombocytopenia along with high C‐reactive protein and D‐dimer with bilateral patchy infiltrate on X‐ray and positivity for COVID‐19. Her blood culture was also positive for Gram‐negative bacilli (acinetobacter lwoffii). Along with antibiotics, she was given 50 ml convalescent plasma. She was off oxygen within 2 days and showed improvement in lung lesions, and RT‐PCR was negative by day 7 and discharged by day 10 of transfusion.
Data on the frequencies of RBC antigens and their variants in the Arab world are limited. Thus, determining the antigenic profile of the United Arab Emirates (UAE) population by serologic and molecular methods is significant to enhance operational efficiency in donor centres and transfusion services.
The blood donation environment includes a variety of disgust‐related stimuli that may influence attitudes among new and prospective donors. To explore the causal role of disgust in the context of attitudes towards blood donation, we experimentally induced feelings of disgust (vs. fear, moral elevation or control). We hypothesized that for people who are generally sensitive to their bodily sensations, disgust would lead to more negative implicit attitudes towards blood donation than other emotions.
Background and aimsIn order to determine actual concentration of clinically significant IgG antibodies, there is a need to inactivate IgM antibodies, which can be performed by DTT or heat. The aim of the present study was to compare the effect of DTT treatment and heat inactivation (HI) on ABO isoagglutinin titres performed by column agglutination technology (CAT) and conventional tube technique (CTT).Materials and methodsThis was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group donors were included. Serum from each donor was treated with DTT, and heat and tests were performed by CTT and CAT before and after treatment.ResultsA total of 2005 donors were included. 401 (20%) samples had inter‐observer variation by CTT, and 69 (3·4%) had inter‐observer variation by CAT. Median anti‐A and anti‐B titre results were higher with CAT as compared to CTT. Median anti‐A and anti‐B IgG titre results showed a one‐ to twofold difference between CTT and CAT with higher titres reported by CAT. Median IgM titres decreased two‐ to threefold after DTT treatment, whereas onefold decrease was confirmed after HI. Concordance was found to be poor. However, correlation was found to be strong.ConclusionThere is overestimation of ABO IgG antibody titres and hence, estimation of ABO IgG titres after inactivation of IgM antibodies is strongly recommended. DTT treatment was found to be superior to HI in terms of efficiency in elimination of IgM activity.
Antibody titration by the manual method has certain limitations. The aim of this study was to compare the manual conventional test tube technique (CTT) with semi-automated, column agglutination technique (CAT) and fully automated haemagglutination/solid-phase red cell adherence (HA/SPRCA) technology in measuring antibody titres of anti-A and anti-B isoagglutinins of blood group O blood donors. The median IgM and IgG antibody titres with 1+, 2+ and 3+ end-points were determined for each technology, and the agreement and correlation between results of the 3 technologies were evaluated. This was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group blood donors, who donated blood at the Department of Transfusion Medicine at a tertiary healthcare centre, were included in the study. All samples were consecutively tested by CTT, CAT and HA/SPRCA, and the results were recorded and compared. A total of 2005 donors were included. Inter-observer variation was observed in 295 (14.71%) samples by the CTT and in 51 (2.54%) by the CAT. There was 43.4% and 40.3% agreement of anti-A IgM and IgG titres between CAT (2+ strength) and CTT (1+ strength), respectively. The agreement for anti-B IgM and IgG titres between CAT (2+ strength) and CTT (1+ strength) was 43.6% and 32%, respectively. While a strong correlation was found between CTT (1+ strength) and CAT (1+, 2+ strengths) for both IgM and IgG measurements of anti-A and anti-B isoagglutinins, the correlation between CTT (1+ strength) and HA/SPRCA (1+, 2+ strengths) was found to be weak. The median IgM titres for anti-A and anti-B were lower than the median IgG titres. The antibody titration levels were higher with CAT than with CTT, and those of HA/SPRCA were lower than those of CTT. Transfusion services need to decide which method would provide higher benefit to their patient population.
Background and ObjectivesThere is limited evidence regarding the advantage of transfusing extended phenotype‐matched (EPM) packed red blood cells (PRBCs) to prevent alloimmunization in haemato‐oncology patients. This randomized control trial aimed to determine the alloimmunization in haemato‐oncology patients transfused with PRBCs which are EPM for Rh (C, E, c, e) and Kell (K) antigens (group I) versus those receiving standard compatible PRBCs (group II).Materials and MethodsPatients having a negative antibody screen (ABS), direct antiglobulin test (DAT) and autologous control (AC) were randomly allocated to either group I or II (n = 50 each). A follow‐up (FU) testing post‐transfusion was conducted for haemoglobin (Hb), ABS and DAT at 1 week, 1 month and 3 months. ABS was conducted using fully automated immunohaematology analyser, while DAT, compatibility testing and extended phenotyping were conducted manually using column agglutination technique.ResultsThere was no significant difference between the two groups with respect to mean (±SD) Hb at initial enrolment (group I, 5·06 ± 1·29 g/dl and group II, 5·41 ± 1·37 g/dl; P = 0·179), age (40 ± 17·3 years v/s 42·2 ± 17·2 years; P = 0·523), gender (P = 0·835) and diagnosis (P = 0·06). All patients in group I and II had negative ABS, DAT and AC at all three FUs. Group II patients were transfused more PRBCs (372 v/s 187, P = 0·000), while the mean Hb increment between successive FU was significant in both the groups (P = 0·003).ConclusionIt appears that there is no added benefit of providing EPM PRBCs in haemato‐oncology patients, as none developed RBC alloantibodies.
AbstractBackground and objectivesThe identification of factors leading to high or low return rates among volunteer blood donors is increasingly important to maintain sufficient blood supply. A particular focus on young donors is an essential component of blood bank donor retention strategy. By means of large databases, our aim was to predict the donation frequency pattern of young donors using a random forest model, to potentially improve donor retention and increase donation frequency.Materials and methodsRandom forests are an ensemble learning method for classification and regression designed to produce accurate predictions that do not overfit the data. They consist of a large number of independent decision trees that operate as an ensemble and classify data into groups in a sequential manner, using time‐specific cut‐offs to differentiate groups into branches. Since a large number of trees are grown, prediction of donation behaviour in young donors will be made with limited generalization errors.ResultsThe final dataset analysed was composed of 81 986 donors aged 18–24 at the last donation. The model correctly predicts more than 91% of the donation frequencies, with an overall error rate of 8·16% and specific error rates of 4·6% and 12·3% for ‘unreturned donor’ and ‘returned donor’ groups, respectively. The best predictive variables used in the model appear to be the number of contacts used by the marketing department, the donors’ age, the number of adverse effects during donation, the donors’ status and the ethnicity.ConclusionOur results provide relevant information for interpreting donor behaviour and could contribute to the improvement of initiatives by blood services to increase donation return rate.
Background and aimsTo determine actual concentration of clinically significant IgG antibodies, there is need to inactivate IgM antibodies. Aim of this study was to study effect of dithiothreitol (DTT) on ABO isoagglutinin titres performed by column agglutination technology (CAT) and conventional tube technique (CTT) and to compare results obtained by DTT treatment.Materials and methodsThis was a prospective, observational study conducted from October 2019 to March 2020. All consecutive A, B and O group donors were included. All samples were consecutively tested by CTT and CAT, before and after DTT treatment (pCTT, pCAT).ResultsA total of 300 donors were included, 100 each from group A, B and O. IgG titres were found to be more than IgM titres. For group O, IgG titre results were higher for both anti‐A and anti‐B compared with group A and B. Reduction in IgG titres was observed with DTT. With the use of DTT, one log reduction in group O IgG titres was observed and three log reduction in group A/B IgG titres was observed. When comparing anti‐A and anti‐B IgG results for group O individuals, results of CTT and pCAT were not found to be significant. IgG measurement of anti‐A and anti‐B of group O individuals showed strong to very strong correlation between CTT and CAT, before and after DTT treatment.ConclusionThere is significant difference between antibody titres estimated using DTT‐treated and DTT‐untreated plasma. Use of DTT for ABO isoagglutinin titre estimation is recommended.
The exciting advancement in cell therapies in both cancer and regenerative medicine provides alternative therapeutic opportunities for patients with advanced diseases who have exhausted all treatment options. However, with the emergence of new technologies and innovations this also brings about “unproven” cell‐ and tissue‐based interventions that have not been fully evaluated in clinical trials. Such interventions have resulted in injuries and deaths in patients. Collectively, these practices increase the potential for patient exploitation and harm through the imposition of medical and financial risks. Recognizing this worrying situation, in April 2020, European Medicine Agency (EMA), committee for Advances Therapies advised patients and the general public to be cautious unproven cell‐based therapies. Likewise, the Food and Drug Administration (FDA) has posted information about products marketed as stem cells, mesenchymal stromal cells (MSCs) or other regenerative medicine products, including the conditions for which they are approved, and which products are not approved. Though both EMA and FDA recognize the promise of cell‐based therapies for treating patients with serious diseases, both concur that well‐designed clinical trials and regulatory oversight are necessary to ensure safety, efficacy and quality of the therapies. In this review, I will mention proven cell therapies in the haematopoietic stem cell transplant setting and in the form of chimeric antigen receptor (CAR) T‐cell therapies and briefly mention how these therapies have evolved over time, the learning curve and scientific progress in these therapies. I will then mention briefly about MSCs and focus on both the proven and unproven aspects of MSC.
Donor eligibility assessment and subsequent return after deferral are key in maintaining an adequate and safe blood supply. Eligibility criteria should be reviewed regularly to ensure regional relevance and impact on donor deferral and return. Large‐scale studies investigating donor deferral and return in Africa are currently lacking.
Background and ObjectivesThis paper sets out the case that fairness and reciprocity are critical to donor recruitment and warm glow is central to donor retention.Materials and MethodsNarrative review.ResultsI show that blood donors, compared to non‐donors, are more sensitive to violations of fairness. I argue that interventions that tap into reciprocity and fairness (e.g. voluntary reciprocal altruism) and the inequality in health between donors and recipients are likely to be effective in recruiting new donors. Once recruited, donors with greater experienced warm glow will remain as donors and those with weaker warm glow will relapse: a self‐selection mechanism. I argue that warm glow messages can, therefore, be used to enhance retention rates in new donors with lower levels of warm glow. I also show how research on emotions (prosocial emotions and emotional trajectories), sexual selection and trust offers new and exciting avenues for donor recruitment.ConclusionWarm glow is central to retaining blood donors and fairness and reciprocity to recruiting them.
There are limited published data on association of results from commercial serological anti‐SARS‐CoV‐2 IgG antibody CLIA (chemiluminescent immunoassay) assays with neutralizing antibodies. This study was undertaken with an objective to correlate sample‐to‐cut‐off (S/Co) ratio of CLIA antibody tests with inhibition activity, which may then serve as a valuable guide for labelling plasma as COVID convalescent plasma (CCP) for therapy and assessing vaccine efficacy.
ISBT Science SeriesVolume 16, Issue 2 p. 128-131 Editorial Understanding, predicting and influencing blood donation: an introduction to the special issue on donor behaviour Tanya E. Davison, Corresponding Author tdavison@redcrossblood.org.au tanya.davison@monash.edu Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, VIC, AustraliaSearch for more papers by this author Tanya E. Davison, Corresponding Author tdavison@redcrossblood.org.au tanya.davison@monash.edu Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, VIC, AustraliaSearch for more papers by this author First published: 26 May 2021 https://doi.org/10.1111/voxs.12637Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume16, Issue2Special Issue: Donor BehaviourMay 2021Pages 128-131 RelatedInformation
Background and Objectives:The COVID-19 pandemic has spread across 87 million people with more than 1·8 million deaths in the world. As there is no definite treatment modality, the use of convalescent plasma has become increasingly popular worldwide. This study aimed to identify an appropriate strategy of donor recruitment and to evaluate the appropriateness of pre-set plasma donation guidelines.Material and Methods:In this prospective study conducted from May to September 2020, the donors were recruited under the following two circumstances: Group I, patients in the post-COVID-19 follow-up in the clinic, and Group II, patients recovered from COVID-19 recruited through mass and electronic media. A pre-set donor selection criteria and laboratory investigation was designed according to national and international guidelines. Approximately 500 ml of COVID-19 convalescent plasma (CCP) was collected from recovered individuals in each group by two different cell separators. The overall donor's attendance rate, deferral rate, adverse events and donor compliance was analysed and compared between the two groups.Results:There was a significant difference in attendance in relation to registration between the groups (P < 0·0001). Donor deferral was significantly higher in group II compared with group I. The single most frequent cause of donor deferral was low antibody index (P = 0·0001). The total donor adverse event rate in CCP donation was significantly lower compared with routine plateletpheresis procedures. The donor's compliance to blood centre's protocol was satisfactory in both the groups.Conclusion:Recruitment of patients in the post-COVID-19 follow-up in the clinic was more effective than the general recruitment through mass and electronic media for convalescence plasma donation in a resource-constrained blood centre.
As a result of the objectives related to patient safety established in the Basque Country, and the need to increase safety and transfusion efficiency, a Basque transfusion network has been created whose strengths are the availability and interconnection of information systems covering all phases of a single and common blood process for all centres in the region. All relevant information is generated, disseminated, shared and recorded in an automated manner. The information includes donor and patient health records, transfusion requirements and transfusion history, data and process traceability, among others. This compact network of information is having a significant impact on almost all phases of the transfusion process, being the most relevant: Safety in donor selection; clinical and biological shared information for all hospital; safety in the identification of patients, samples and blood components; complete real‐time traceability; increased quality of the decision to transfuse and decrease unnecessary transfusions; decreased number of adverse effects, component administration errors and near miss related to blood component transfusion; or optimization of training programmes, as it is a standardized activity for all staff involved on blood transfusion. It is also assumed that PBM programmes will be able to improve their efficiency by having high‐quality data.
Background and objectivesWith greater numbers of Australians living longer with healthier lives, older adults could make a greater contribution to whole‐blood and plasma donor panels. Understanding the experiences and attitudes of middle‐aged to older Australians towards blood donation may provide opportunities to develop strategies to engage, recruit and retain older donors.MethodsSemi‐structured interviews were conducted with 34 donors aged 50 and over with diversity of donation experiences and age at which they first donated. The interviews focussed on becoming and remaining a donor, donating in later life and intentions to continue donating.ResultsFor some older people, being a blood donor is an important social role associated with a sense of themselves as healthy, knowledgeable and able to make a valuable contribution to the community. The majority of participants believed that age should not be a barrier to continued donation and that eligibility should be based on health and not age.ConclusionOlder donors intend to continue to donate for as long as they are eligible or until they perceive themselves ineligible. Recommendations are provided for strategies to engage with older donors.
BackgroundCompliance with accepted quality standards guarantees safe and effective blood transfusion in patients. Introduction of well‐defined quality systems in the Caribbean has however remained a big challenge.MethodsThe Red Cross Blood Bank Foundation on the island of Curaçao selected the EU GMP/GPG standards as the national blood programme quality standard. A stepwise quality improvement programme was designed in collaboration with Sanquin Consulting Services. The external audit results were used for formulating a yearly quality improvement plan. The main challenges and key success factors of the progress made over a 10‐year span are presented according to WHO key blood quality elements.ResultsThe quality improvement programme showed the importance of legislation based on a voluntary non‐remunerated blood donor programme. A clearly defined national blood bank organizational structure with appropriate job descriptions, required competencies and appointment at the start of a dedicated quality manager were key basic elements. The focus of the yearly audits varied from technical issues, progress evaluation to emerging infectious diseases with special attention for the small‐scale blood bank environment. Use of EuBIS documents greatly facilitated the required GAP analyses. Introduction of automatization for TTI testing and PRT strongly improved the provision of safe blood products. Effective communication and collaboration should be included as key elements for a safe national blood programme.ConclusionMaking use of a stepwise quality improvement programme, based on collaboration, compliance with international quality standards, provision of sufficient safe blood on the island of Curaçao, could be achieved in a sustainable manner.
