Insight into Donor Deferral Pattern Based on Peripheral Blood Counts: An Experience from Southern Pakistan

Introduction:

American association of blood banking (AABB) recommends screening of all potential donors by a copper sulphate technique, but this method has chances of false acceptance as well as false deferral. Additionally others valuable blood parameters remain undetermined. Yet this is practically applicable in developed countries with low prevalence of anemia and community infections. In Pakistan anemia's secondary to nutritional deficiency or infectious diseases are much common. It makes the application of this crude method questionable. With this background we determined the whole peripheral blood counts by automated hematology analyzers in all prospective blood donors.

This is to provide the pre-donation deferral rate of the healthy blood donors based on peripheral blood counts. The basic knowledge about frequency, types and severity of anemia among donors will help to plan a strategy to promote donor recruitment and overall national health.

Methods:

Prospective records of all the reported donors were collected from January-2014 to December-2015 at Liaquat National Hospital, Karachi.

Results:

Overall 36954 potential donors reported to the blood bank, out of which 33853 were selected and 3101 were deferred, which makes the deferral rate of 8.39%. Of total, 264 (0.71%) donors were excluded based on history whereas 174 (0.47%) donors were excluded due to examination findings while majority [n=2663 (7.20%)] of donor were deferred based on complete blood counts.

Based on peripheral blood counts; anemia (91.8%) represents the major cause of deferral, followed by raised total leukocytic count (3.7%) and polycythemia (3.3%) respectively and thrombocytopenia (1.0%) was the least potential cause. Microcytic-hypochromic anemia was found in 58.5% donors followed by normocytic and macrocytic anemias in 38.9% and 2.4% respectively. Mild anemia was seen in 78.2% followed by moderate and severe anemias in 20.5% and 1.18% respectively.

Conclusion:

In view of frequently anemic donors in the present study, it is strongly recommended to have a full blood counts rather to rely on semi-quantitative methods which led to acceptance of anemic donors.

High prevalence of anemia among Pakistani blood donors signifies deteriorating health status not only in donor population but also in general population as well. Astonishingly high TLC (sub clinical infections) turned out as second important cause of deferral. This situation recalls for strenuous efforts to overcome as it entails that we will likely to face more dearth of donors in future.