PDF(Pubmed)
Abstract：
OBJECTIVE: This study aims at evaluating whether subjective donor deferral (SDD) has the potential for increasing blood transfusion safety.
BACKGROUND: Appropriate donor selection via clinical and serologic screening is necessary to prevent transfusion-transmissible infections (TTIs). One additional strategy adopted by some Brazilian blood transfusion centers (BTCs) is the rejection of a donation by the pre-donation interviewer based on subjective factors.
METHODS: We conducted a STROBE-guided cross-sectional study including 105 005 prospective donors who presented to our BTC between 1 January 2013, and 31 December 2015. Donors were evaluated for age, gender, education level, donation type and history, confidential unit exclusion, SDD, and results of serologic screening for TTIs.
RESULTS: Even after controlling for potential confounding variables, subjectively deferred donors were more likely to have at least one reactive serology in the standard screening (OR: 2.80; 95% CI: 2.13-3.69; P < .001). They also had a higher risk for testing positive for syphilis (OR: 4.47; 95% CI: 3.05-6.55; P < .001), hepatitis B (OR: 5.69; 95% CI: 2.48-13.08; P < .001), and HIV (OR: 6.14; 95% CI: 3.22-11.69; P < .001).
CONCLUSIONS: Routine implementation of SDD in donor selection may be an effective additional measure to avoid TTIs, highlighting the importance of interviewer experience, perspicacity, and face-to-face contact with donors for blood safety assurance.
BACKGROUND: Appropriate donor selection via clinical and serologic screening is necessary to prevent transfusion-transmissible infections (TTIs). One additional strategy adopted by some Brazilian blood transfusion centers (BTCs) is the rejection of a donation by the pre-donation interviewer based on subjective factors.
METHODS: We conducted a STROBE-guided cross-sectional study including 105 005 prospective donors who presented to our BTC between 1 January 2013, and 31 December 2015. Donors were evaluated for age, gender, education level, donation type and history, confidential unit exclusion, SDD, and results of serologic screening for TTIs.
RESULTS: Even after controlling for potential confounding variables, subjectively deferred donors were more likely to have at least one reactive serology in the standard screening (OR: 2.80; 95% CI: 2.13-3.69; P < .001). They also had a higher risk for testing positive for syphilis (OR: 4.47; 95% CI: 3.05-6.55; P < .001), hepatitis B (OR: 5.69; 95% CI: 2.48-13.08; P < .001), and HIV (OR: 6.14; 95% CI: 3.22-11.69; P < .001).
CONCLUSIONS: Routine implementation of SDD in donor selection may be an effective additional measure to avoid TTIs, highlighting the importance of interviewer experience, perspicacity, and face-to-face contact with donors for blood safety assurance.
摘要：
目的：本研究旨在评估主观供者推迟（SDD）是否具有提高输血安全性的潜力。
背景：通过临床和血清学筛查进行适当的供体选择对于预防输血传播性感染（TTI）是必要的。一些巴西输血中心（BTC）采用的另一种策略是捐赠前采访者基于主观因素拒绝捐赠。
方法：我们进行了一项STROBE指导的横断面研究，包括在2013年1月1日至2015年12月31日期间向我们的BTC提交的105005名前瞻性捐赠者。对捐赠者的年龄进行了评估，性别,教育水平,捐赠类型和历史，机密单位排除，SDD,和TTIs的血清学筛查结果。
结果：即使在控制了潜在的混杂变量之后，在标准筛查中,主观推迟的供者更可能出现至少一种反应性血清学(OR:2.80;95%CI:2.13-3.69;P<.001).他们的梅毒检测呈阳性的风险也较高（OR：4.47;95％CI：3.05-6.55;P<.001），乙型肝炎（OR：5.69;95％CI：2.48-13.08;P<.001），和HIV（OR：6.14；95%CI：3.22-11.69；P<.001）。
结论：在供体选择中常规实施SDD可能是避免TTI的有效附加措施，强调面试官经验的重要性，perspeccity,并与献血者面对面接触，以保证血液安全。
背景：通过临床和血清学筛查进行适当的供体选择对于预防输血传播性感染（TTI）是必要的。一些巴西输血中心（BTC）采用的另一种策略是捐赠前采访者基于主观因素拒绝捐赠。
方法：我们进行了一项STROBE指导的横断面研究，包括在2013年1月1日至2015年12月31日期间向我们的BTC提交的105005名前瞻性捐赠者。对捐赠者的年龄进行了评估，性别,教育水平,捐赠类型和历史，机密单位排除，SDD,和TTIs的血清学筛查结果。
结果：即使在控制了潜在的混杂变量之后，在标准筛查中,主观推迟的供者更可能出现至少一种反应性血清学(OR:2.80;95%CI:2.13-3.69;P<.001).他们的梅毒检测呈阳性的风险也较高（OR：4.47;95％CI：3.05-6.55;P<.001），乙型肝炎（OR：5.69;95％CI：2.48-13.08;P<.001），和HIV（OR：6.14；95%CI：3.22-11.69；P<.001）。
结论：在供体选择中常规实施SDD可能是避免TTI的有效附加措施，强调面试官经验的重要性，perspeccity,并与献血者面对面接触，以保证血液安全。
