Search

Background and Objectives: The process of selecting blood donors is crucial for keeping the health of donors and ensuring the safety of the blood supply. However, it may create unpleasant feeling in those who are deferred. In this study, we aim to explore the return rates of Iranian deferred donors in comparison with eligible donors., Materials and Methods: The study included all whole blood donors referred between March 2017 and March 2018, who experienced temporary deferral for any reason. Donors who successfully donated blood during this period were also part of the study. Participants were followed up until their next donation attempt, spanning 4.8 years after initial inclusion. Then odds of return and median return time for both deferred and eligible donors were calculated., Results: From 993,824 volunteers, 733,153 (73.77%) were eligible and 192,332 (19.35%) temporary deferred. The return rate in the eligible and deferred donors was 74.77% vs. 51.77%, respectively (OR:2.78; 99%CI: 2.71-2.81). Odds of return among deferred regular (OR = 7.02, 99%CI:6.64-7.42), men (OR: 2.57, 99%CI:2.45-2.69), and over 45 years (OR: 1.15, 99% CI: 1.09-1.20), was higher than first-time, women, and younger donors. The median return time for eligible and deferred donors was 315 (99%CI: 313-316) and 1,467(99%CI: 1,412-1,524) days, respectively., Conclusion: This study revealed the negative effect of deferral on the return rate, that led to a 23% reduction in the return of deferred donors. Avoiding unnecessary deferral through adherence to the standard operating procedure of donor selection and effective counselling which clarifies the purpose of deferral and encourages them to return after the deferral period ends are recommended., (Copyright © 2024 Société française de transfusion sanguine (SFTS). Published by Elsevier Masson SAS. All rights reserved.)

Background: Eliminating high-risk individuals has a special role in ensuring blood safety. Due to epidemiological, demographic, and even cultural changes in each country, this process should be continuously evaluated and reviewed, if necessary. Objectives: This study aimed to evaluate the impact of the current donor selection procedure on blood safety in Iran. Methods: A total of 2,525 high-risk deferred donors who were referred between 2018 and 2019 were evaluated regarding hepatitis B surface antigen, hepatitis C virus antibody, and human immunodeficiency virus antigen and antibody. All repeatedly reactive samples were evaluated by confirmatory tests. Characteristics' parameters, donor status, and TTI marker rates of the participants and 1,315,871 eligible donors in the indicated period obtained from the national database on blood donors, were compared. Data were analyzed using SPSS version 24.0. Results: The prevalence of HBV, HCV, and HIV in 100,000 deferred donors was 1148, 515, and 119, respectively. This prevalence was 26, 28, and 33-times higher than the eligible donors, respectively. Unlike HBV, its prevalence among males was almost twice that of females among the deferred group. In the eligible group, females had a higher prevalence for HBV and HCV as compared to males. The HCV and HBV (6.7 and 4.3-fold) among deferred first-time donors had a significantly higher prevalence compared with the eligible first-time donors (P-value< 001). Notably, the higher was the education degree, the lower was the prevalence of infection in both groups. Conclusions: Current deferral criteria and donor selection procedure in Iran are an opportunity to eliminate high-risk individuals from the blood donation. [ABSTRACT FROM AUTHOR]

Background and Objectives Considering the importance of donor selection process in blood safety, this study aimed at comparison of frequency of intravenous drug use (IDU) among accepted HCV positive blood donors in different regions of Iran. Materials and Methods This cross sectional-analytical study was conducted on serologically confirmed HCV positive blood donors who referred to blood transfusion centers for counseling all over the country during November 2015 to May 2017. All provinces were classified in three regions. IDU status and demographic specification of participants were analyzed using questionnaires. Chi square, fisher exact and ANOVA with STATA software version 13 were used for statistical analysis. Results Participants, according to the number of provinces, sample size and geographical proximity to three areas were classified including 76 from North; 105 from West-South and 90 from East- Center individuals with the mean ages of 37.73 ± 8.27, 38.83 ± 8.80 and 36.86 ± 8.63 and history of IDU of 37 (48.68%), 45 (42.86%) and 41 (45.56%), respectively. No significant differences between different regions of the country were found in the frequency of IDU voluntary blood donors with hepatitis C, age, gender, education status, marriage status (p > 0.05). Conclusions Approximately half of the voluntary blood donors with hepatitis C were IDUs. The frequency of IDU was similar among donors from different regions of Iran. Considering the fact that studied donors were found eligible in donor selection and donated the blood, though rejected during the screening phase, conducting research on the issue can increase the quality of blood donor selection and blood safety. [ABSTRACT FROM AUTHOR]

Background and Objectives Iranian Blood Transfusion Organization, to maintain the health of blood donors and recipients, defines the eligibility criteria for conducting blood donation process without which blood donors are deferred. Previous studies have shown the necessity of deferral criteria for blood safety. This study showed that deferral of these volunteers has improved the health of blood donors; it has been determined based on the frequency of both positive confirmatory screening test results in blood donors on their return and temporary deferral rates especially due to high risk behaviors. Materials and Methods The study was cross-sectional descriptive. Data collection was performed based on all the data of blood donation volunteers included in the NEGAREH software. The data were then analyzed by Chi-square and Excel software. Results Out of 6,877,627 volunteers during 2012-2014, 1,416,791 volunteers were deferred from blood donation. The prevalence of infectious markers in blood donors was 0.19% (10354 donations); the prevalence was 0.018% in 2,784,593 donations of donors on return (493 donors); and for 460,559 donations of deferrals it was 0.209% (975 donors). The prevalence of infectious markers for donations on return was 0.225% (211 donations) for risky behaviors and 0.205% (764 donations) for the other deferred donors. Conclusions It has been shown that the prevalence rate of the confirmed screening test results for Transfusion Transmitted Infections especially HBSAg is higher in repeat and regular donors once temporalily deferred (particularly for high risk behaviors) and returned for donation than those without the deferral record; it shows their deferral has been effective in improving blood safety. [ABSTRACT FROM AUTHOR]

Background and Objectives The blood transfusion organization of Iran, based on international requirements, for the protection of blood donors and recipients, has established some criteria for the selection of donors. This manner inevitably rejects a number of donors from blood donations. This process leads to the promotion of blood safety, but at the same time it loses some donors and reduces the likelihood of a donor's return. This study intends to determine the rate of return of blood donors who have temporarily rejected from blood donation and to compare it with the rate of return of donors without any previous blood donation. Materials and Methods This study is a cross-sectional descriptive and data collection is performed based on the entire blood donation data registered in the donor information program of the IBTO. The data were analyzed by Excel & 2 test. Results A temporary rejection for blood donation in donors during the period from 2012 to the end of 2014 has reduced their return compared with those who did not have any rejection from 61.9% to 43.6%. For those who have been rejected from blood donations due to high-risk behaviors (421428 donated), the return rate was slightly down to 27.4% (115550 donors). Conclusions The result of this study showed that the rate of return of rejected donors was 1.5 times less than the return rate of accepted donors, and this difference was much lower for donors who were rejected due to high-risk behaviors: 1.8 times less. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the results of transplantation from living unrelated donors (LURD) versus living related donors (LRD) with a long term follow-up of 25-30 years.Materials and Methods: From 1984 to 2015, a total of3716 kidney transplantations (411 LRDs and 3305 LURDs) were enrolled to the study. Long-term survival of grafts and patients as well as the association between relation state and patients or grafts surveillance were the outcomes.Results: A total of 3716 live donor kidney transplants (LRD, n = 411; LURD, n = 3305) were carried out over this period. The mean age of donors was 28 ± 54 years in the LURD group and 34.4 ± 11.7 years in LRD (P < . 001), while the mean age of the recipients was 35.6 ± 15.6 years and 27.6 ± 10.1 years for the two groups, respectively. Donor age was the only statistically significant predictor of graft survival rate (hazard ratio = 1.021, 95% confidence interval: 1.012-1.031). Between 1984 and 2015, patient survival and graft survival improved significantly also patient survival and graft survival was similar in LURDs compared with LRDs.Conclusion: It seems that the outcome of LURD and LRD is comparable in terms of patient and graft survival. Therefore, transplants from LURDs may be proposed as an acceptable management for patients with end stage renal disease. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Donor selection is a critical process to identify high risk volunteers and defer them from donating blood. Despite viral screening test on all donated blood, one cannot rely on screening tests alone to ensure a safe blood supply. Monitoring and assessment of the deferral procedure is of utmost importance to balance blood availability and safety. This study compares the prevalence of HIV, HCV, and HBV markers between deferred donors and accepted blood donors in order to evaluate the effectiveness of the current donor selection process in Iran. Materials and methods: This study was carried out on deferred blood donors throughout the country. A blood sample was collected from participants and tested for three viral markers: HbsAg, anti-HCV, and anti-HIV. Repeatedly reactive samples were retested with a confirmatory screening assay. The prevalence of viral markers among deferred donors was compared with national statistical data on blood donors. Results: The prevalence of HIV, Hepatitis B, and Hepatitis C was 120 (CI 95%; 90–150), 1280 (CI 95%; 1170–1390), and 580 (CI 95%; 510–650) in 100,000 deferred donors respectively. A significant increase exists in the prevalence of HBV (1.7 times), HIV (24 times) and HCV (15 times) in deferred donors as compared to accepted blood donors. Discussion: The effectiveness of donor selection in identifying high risk individuals is obvious upon comparing the prevalence of selected viral infections in deferred donors with those accepted for blood donation. This study showed the role and necessity of donor selection criteria. [Copyright &y& Elsevier]

• This study analyzed the COVID-19 deferrals of blood volunteers during the COVID-19 outbreak in Iran. • The blood donations dropped to 26.09 % in Iran at 2020. • The blood shortage was due to reduction in the number of voluntary blood donors. With the outbreak of the coronavirus disease in 2019, called COVID-19, Iranian Blood Transfusion Organization (IBTO) implemented the new deferrals. This study analyzed the COVID-19 deferrals of blood volunteers and compared the demographics, deferrals, and the donor status during the COVID-19 outbreak in 2019. Data were collected from the integrated blood donor database between Feb-Apr 2019 and 2020. Deferral reasons of COVID-19 were categorized as: those who have symptoms or live with a symptomatic family member, have direct exposure with a confirmed case, have travelled from the outbreak affected areas, and have fully recovered from confirmed COVID-19. The z-test analysis was used, and 95 % confidence intervals were calculated to compare the sample proportions. The blood donations dropped to 26.09 % in 2020. The percent change of first-time blood donors, female donors, and donors within the age group of 45−54 years old was significantly greater in 2020 than the same time frame in 2019 (p < 0.05). The results showed that 0.58 % of volunteers were deferred from blood donation to avoid transmission of SARS-CoV-2. The rate of COVID-19 deferrals in all types except travelling to affected areas has increased in the second 30-day of the study (p < 0.05). The blood shortage that occurred during the COVID-19 outbreak was not due to increased deferral for COVID-19, but it was mostly due to a decrease in the number of volunteers who referred to BTCs. [ABSTRACT FROM AUTHOR]

Call back as a procedure to report post donation symptoms or illness by donors has been established since 2009 in Iranian Blood Transfusion Organization (IBTO). During the first phase of COVID-19 outbreak, all blood donors were requested to report any respiratory infection symptoms after donation. The study investigated the callback data of COVID-19 in Tehran Blood Center during the first 3 months of the outbreak in Iran. The purpose of this study was to estimate the frequency of post donation COVID-19 related call back reports and determine its implications for blood donors and patients. A telephone interview was conducted with donors who had reported COVID-19 symptoms. Some questions were asked to evaluate donor's health at the time of blood donation. The donors categorized into three groups: laboratory-confirmed, suspected, and COVID-19 irrelevant based on their answers. In cases that the blood component obtained from a laboratory-confirmed donor had been released, the hospital was notified and asked to follow up the recipient for COVID-19. The results showed 30 donors (0.08 %) had callback related to COVID-19 and 76.63 % of the obtained component was disposed. The results also showed that only one donor had a laboratory-confirmed result with the RBC unit processed from her whole blood released for transfusion. The RBC unit recipient did not show any signs or symptoms of infection during a 46-day follow-up. Concluded that callback system was effective to remove most of the components obtained from the donors who reported to be COVID-19 suspected or confirmed. Moreover, the result did not support virus transmission through blood transfusion., (Copyright © 2021. Published by Elsevier Ltd.)

Objectives: Although transplant teams understand the effects of donor characteristics on liver transplant outcomes, few studies have investigated the quality of livers obtained from poisoned donors. The aim of this study was to compare livers procured from poisoned donors with a matched control group., Materials and Methods: Liver transplant outcomes from poisoned donors and from donors with trauma-induced death (as the control group) were compared using data of an Organ Procurement Unit from 2000 to 2013. Procured livers were evaluated via histology findings before transplant. Recipient characteristics were assessed in both groups, and immediate and medium-term (up to 5 years after transplant) survival rates were compared with the use of Kaplan-Meier analyses and log-rank tests., Results: Over a 13-year organ donation program, 1485 livers from brain dead patients were donated. Among them, 115 poisoned donors were evaluated for liver grafts; of these, 74 successful liver transplants were performed. In the poisoned donors, the incidence of reversed cardiac arrest was 54.1%. Likewise, acute kidney injury was detected in 14.9% of the patients, and 16.2% needed urgent dialysis either for clearance of the toxic agents or for treatment of acute kidney injury. No significant differences were observed in 1- to 5-year survival rates, and log-rank test also showed a significance level of 0.83., Conclusions: Proper case selection strategies can be implemented to expand the donor pool, including use of poisoned donors. Hence, poisoning is not a contra-indication for a referral, which could lead to decreased mortality for patients requiring a liver transplant.

Objectives: This study sought to investigate discarded organs at the Shiraz University of Medical Sciences, Shiraz, Iran., Materials and Methods: We performed a retrospective analysis of Shiraz Transplant Center database regarding discarded organ during May 2010 and December 2013. Our study investigated 80 unused liver donors' characteristics. The data included age, sex, cause of discard, cause of brain death, hypotension during hospitalization of donors, and result of liver biopsy., Results: Among 780 grafts, 80 livers (10.25%), between May 2010 and December 2013, were unsuitable for transplant. Among the donors whose livers were discarded, 36 were women (45%) and 44 were men (55%) (mean age, 43.7 ± 14 years; range, 1-67 y). The most common causes of brain death were cerebrovascular accidents 27 (33.8%), trauma 27 (33.8%), aneurysm, and subarachnoid hemorrhage 13 (16.3%). The most common cause of unused organ were fatty liver 50 (62.5%) and necrosis 25 (31%) (steatosis more than 40%)., Conclusions: Old age, cerebrovascular accidents, and severe steatosis ≥ 40 were the most common associated factors in organ discard in this study.

Objectives: This study sought to evaluate graft outcome of kidneys from deceased-donor pediatric donors in adult recipients, and compare it with outcomes of kidney transplants from adult donors., Materials and Methods: This historical cohort study involved 2 groups. Group 1 included 23 first kidney adult recipients who received their first renal transplant from pediatric deceased-donor donors. Group 2 consisted of 33 first renal transplant adult recipients with kidneys coming from adult deceased donors. The Kaplan-Meier method was used to generate graft survival and patient survival curves. The log-rank test was done to compare differences between survival outcomes., Results: Graft survival rates at 1 and 5 years were 96% and 85% in group 1, and 91% and 85% in group 2. No significant difference existed in graft survival rates between the groups. Patient survival rates at 1 and 5 years in group 1 were 94% and 94% compared with 91% and 91% for group 2. No significant difference existed in graft survival rates between the groups., Conclusions: This study demonstrates that with our experience, improvement in surgical technique and immunosuppressive therapy, pediatric deceased-donor kidneys may be considered as an alternate option for adult recipients. Renal transplants from pediatric donors into adult recipients is associated with good graft and patient survival outcomes.

Background: Recruiting and retaining blood donors is of utmost importance, especially since there is no alternative for human blood. This article describes different aspects of blood donation to evaluate recruitment activities., Study Design and Methods: Data were obtained from annual reports made by the Statistical Committee of the Iranian Blood Transfusion Organization and the national database., Results: The trend in yearly blood donations has significantly increased from 1,183,630 blood units in 1998 to 1,735,008 by the end of 2007. During this period the overall growth rate was 59.8% (p < 0.005). Yearly blood donation in the northwest region of the country was 13 per 1000 in contrast to 39 per 1000 in the central region. There was a significant decrease in the number of donations during the months of April, September, and January whereas in May, August, and the religious month of Muharram a significant increase was noted. Voluntary donations increased from 77% in 1998 to 100% by the end of 2007., Conclusion: Continuous donor recruitment efforts in Iran have resulted in a significant increase in blood donation rates during the past decade as well as achieving 100% voluntary, nonremunerated blood donors. Nevertheless some provinces will have to put more effort into donor recruitment and retention so as to ensure self sufficiency in their blood supply. Educating blood donors and the public about the continuous need for a sufficient blood supply in every community is equally important and times where supply exceeds demand should be avoided at the most.

Assessment of the quality of donor selection and safety of the blood supply can be estimated by monitoring the prevalence of the serologic markers of infectious disease in screening tests. In the present study, changes in rates of hepatitis B virus (HBV) infection are studied in the period 1998-2007 in Iranian Blood Transfusion Organization (IBTO). Prevalence of serological marker of HBV infection [hepatitis B surface antigen (HBsAg)] was evaluated in blood donations in Iran as well as for Fars province representing a low prevalence, and Sistan-Baluchestan (S&B) province as a high prevalence region throughout 1998-2007. For assessing frequency of infection, the prevalence of HBsAg per 100 000 donations and 95% confidential intervals (95% CIs) is calculated. P value is estimated by chi(2) test. A total of 14 599 783 donations were collected during 10 years. The overall HBsAg prevalence rates declined from a 1.79% (1789/100 000 donations) in 1998 to 0.41% (409/100 000 donations) in 2007 in Iran. In Fars province, HBsAg prevalence decreased from 0.89% in 92 999 donations in 1998 to 0.34% in 148 014 donations in 2007 and in S&B province, the rate of HBsAg has gone down from 3.74% in 44 036 donations in 1998 to 1.15% in 56 057 donations in 2007. The frequency of HBV infection entering the blood supply has decreased over this period as a result of improvement in donor recruitment and selection, usage of software in transfusion services and possibly decreasing HBV infection prevalence in general population.