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Background: Complications of donation reduce donor return. Younger and less experienced donors are more likely to experience vasovagal-type reactions (VVR). A water drink of approximately 500 mL shortly before donation may reduce VVR, but the effect of a smaller volume of water has not been investigated.Study Design and Methods: A placebo-controlled comparative study was conducted among donors < 30 years who attended for a 1st-4th whole blood (WB) donation. Collection centers were assigned to offer one of three interventions: 500 mL water drink, 330 mL water drink, or a placebo intervention consisting of pre-donation arm exercise. Within 7 days after attending, participants received an electronic questionnaire about possible symptoms during and after donation. In additional centers, control donors were recruited, who only received standard care and were also sent the questionnaire. Self-reported VVR and other complications were evaluated in all groups.Results: Out of 8,300 participating donors, 6,921 (83%) returned the questionnaire. Overall, 18.5% of responding donors reported moderate or worse VVR symptoms. In 2nd-4th time donors, both water volumes decreased the odds of a VVR compared to standard care controls (OR500ml 0.75, 95% CI 0.59-0.94; OR330ml 0.73, 0.58-0.91; adjusted combined OR 0.77, 0.64-0.94). There was no effect in new donors or the placebo group compared to controls.Conclusion: In young donors making their 2nd-4th WB donation, drinking water was associated with 23% fewer VVR with no difference between 330 and 500 mL. This decrease was not found in the placebo group. The findings support advocating drinking water for the prevention of VVR. [ABSTRACT FROM AUTHOR]

Background In the Netherlands, universal antibody to hepatitis B core antigen (anti- HBc) donor screening was introduced in July 2011 to intercept potentially infectious donations slipping through hepatitis B surface antigen ( HBsAg) and hepatitis B virus ( HBV) DNA minipool screening ( HBV DNA MP6). Study Design and Methods The yield and donor loss were evaluated after the first 2 years of universal anti- HBc donor screening. A total of 382,173 donors were tested for anti- HBc and, if positive, for antibody to HBsAg (anti- HBs). Anti- HBc-reactive donors with anti- HBs of less than 200 IU/ L were deferred, but repeat donors were allowed retesting after 6 months if anti- HBs was less than 10 IU/ mL. Anti- HBc false positivity was estimated using the crude anti- HBc signal, family name-based ethnicity scoring, and donor follow-up. Results Anti- HBc screening identified 13 confirmed or potential HBsAg- and HBV DNA MP6-negative recent HBV infections. In addition, 820 anti- HBc-reactive donors with low anti- HBs titers (<200 IU/ mL), potentially harboring occult HBV infection ( OBI), were identified and deferred. Overall, 1583 (0.41%) donors were deferred: 1178 (0.31%) during first-time anti- HBc screening, 361 (0.09%) anti- HBc seroconverters, and 44 (0.01%) donors with waning anti- HBs titers. Only 188 of 1583 (12%) deferred donors could be reentered upon retesting. Estimated anti- HBc false positivity was 16%, but varied greatly among anti- HBc-reactive donors with and without anti- HBs (8% vs. 62%). Conclusion Anti- HBc testing has improved the safety of the Dutch blood supply but its exact yield remains difficult to determine, due to the complexity of confirming anti- HBc reactivity and OBI. In a low-endemic country, donor loss associated with anti- HBc screening is sustainable, but adds to the already considerable list of donor exclusions. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, blood donor screening for hepatitis B virus (HBV) consists of HBsAg screening since the 1970s, HBV DNA minipool testing (MP-NAT) since 2008, and anti-HBc screening since 2011. Anti-HBc reactivity causes deferral only if anti-HBs titers are <200 IU/mL, or when anti-HBc was acquired during follow-up., Study Design and Methods: Over 5.5 million donations from 582,459 Dutch donors were screened for HBV DNA, HBsAg, anti-HBc, and, if anti-HBc positive, also for anti-HBs. The added value, expressed as the yield of (potentially) infectious and/or recent HBV infections versus unnecessary donor loss, was evaluated for each of the three HBV screening tests., Results: HBV donor screening identified 89 HBV-infected donors with at least two reactive HBV markers (MP-NAT, HBsAg and/or anti-HBc). Single HBV-marker yield was: 5 MP-NAT-only, 0 HBsAg-only, and 20 anti-HBc-only donors. In addition, anti-HBc screening yielded 1,067 potentially infectious donors at risk for occult HBV infection (OBI). In total, 4,126 (0.71%) donors were anti-HBc-reactive at first-time screening, and 1,098 (0.19%) seroconverted during follow-up. Anti-HBc-related donor loss was limited to 2,627 (0.45%) donors using anti-HBs titers and two-strike programs. Donor loss due to MP-NAT and HBsAg screening was extremely low: 0 and 128 donors, respectively., Conclusion: HBV donor screening could be limited to MP-NAT and anti-HBc screening. MP-NAT and anti-HBc improved blood safety by intercepting infectious donations from donors with recent infection or OBI, while HBsAg did not. Unnecessary donor loss related to anti-HBc screening is substantial but does not endanger the continuity of the blood supply., (© 2021 AABB.)