Effect of a liberal versus a restrictive pre‐donation blood pressure policy on whole‐blood donor adverse reactions

Abstract

Background and Objectives The role of pre-donation blood pressure (BP) as independent contributor to post-donation vasovagal reactions (VVRs) is still debated. Differences between a liberal (i.e., inclusion of hypotensive donors) and a restrictive policy (i.e., not accepting hypotensive donors) should be investigated. This study aims to investigate the consequences of a liberal policy in development of VVRs after whole-blood donations. Materials and MethodsWe compared the incidence of VVRs between 2015 (restrictive policy) and 2016 (liberal policy) and the associated risk factors. We evaluated respectively 22 789 vs. 21 676 blood donations obtained from 18 001 blood donors (12 501 donated in both years). ResultsComparing the results we obtained between 2015 and 2016, donations showed an overlap of the cohorts. Two hundred fifteen VVRs (incidence rate 0Á48%) were observed, 104 (0Á46%) of which in 2015, and 111 (0Á51%) in 2016. A preliminary univariate analysis showed that donors with systolic BP <110 mm Hg had a two-fold risk of VVRs compared to normotensive donors (VVR/donation rate of 0Á99% vs. 0Á46%; P = 0Á001). The subsequent multivariable logistic regression model showed that VVRs were highly associated with weight, site of collection, age and number of donations, excluding a role for systolic and diastolic BP.Conclusion A liberal pre-donation BP policy seems to be safe for blood donors. Our analysis confirms that older donors with higher body-weight who already had donated blood are unlikely to experience VVRs.

Implementation of measures to reduce vasovagal reactions: Donor participation and results

“…Several small studies, mainly in younger first‐time donors, have demonstrated a correlation between donor fear and the likelihood of a reaction 8,9 . Providing individuals with pre‐donation materials aimed at fear and explaining specific coping strategies may increase intention to donate and enhance donor confidence.…”

“…These include deferral of donors thought to be at higher risk of reactions, such as younger donors with an estimated blood volume (EBV) below 3.5 L, donors with a low or high heart rate, and donors with a high BP (typically over 180 systolic and/or 90 diastolic) or low BP (typically below 90 systolic and/or 50 diastolic) 2,3,6,7 . Donor information about adverse reactions and how to avoid them can be tailored to reduce the “fear factor” and increase confidence in novice donors 8,9 . Salt and fluid loading before and after donation, and applied muscle tension (AMT) during donation attempt to increase intravascular volume and improve cerebral blood flow 4,5,10 .…”

Development and validation of a nomogram for predicting the risk of vasovagal reactions after plasma donation

“…Previous studies suggest that age is a predictor of VVRs 1,25,26 . With a tendency to have less donation experience, younger donors may be more prone to tension and fear during the collection process.…”

“…Previous studies suggest that age is a predictor of VVRs. 1,25,26 With a tendency to have less donation experience, younger donors may be more prone to tension and fear during the collection process. On the other hand, the peripheral pressure receptors of younger donors are more sensitive than those of older donors.…”

Optimierung der Depotführung für Erythrozytenkonzentrate in Krankenhäusern

“…Die freiwillige unentgeltliche Blutspende erfolgte mit dem Ziel, dem Transfusionsempfänger zu helfen. Sie birgt für den Blutspender ein Risiko von 1,4 bis 7 %, eine moderate, 0,1 [17] bis 0,5 % [18], eine schwere Kreislaufreaktion zu erleiden [19,20]. Daraus folgt, dass der Verfall nicht nur in den Blutdepots, sondern auch bei dem Hersteller zu berücksichtigen ist, was auch der volkswirtschaftlich korrekte Ansatz ist.…”