ORIGINAL ARTICLE

Pre-donation Deferral of
ISSN No 2230-7885
CODEN JPBSCT

Blood Donors in Tertiary Care NLM Title

DOI
J Pharm Biomed Sci
http://dx.doi.org/10.20936/jpbms/160271

Hospital Attached to Medical Preeti B Agrawal*,

College in Southern Rajasthan Divyesh Goswami,
Sajjan S Surana,
Sujanani Shashi
ABSTRACT
Department of Pathology, Pacific Medical
Purpose  The primary objective of this study is to record and document the current rate College and Hospital, Udaipur Rajasthan,
and reason for donor deferral in our tertiary care hospital in Southern Rajasthan. India
Method  A retrospective study of donors was carried out from the donor records in the  Address reprint requests to:
blood bank of a tertiary hospital during period of April 2014 to April 2016. Detailed informa- *Dr Preeti B Agrawal, 174/A,
tion of the donor deferral was recorded from deferral register. We used statistical method P Road, Bhupalpura, Udaipur 313001,
to detect the rate and reason for donor deferral. Rajasthan, India
Result and Conclusion Every blood bank should analyze the reasons of deferral E-mail: preetibagrawal79@gmail.com
amongst blood donors and utilize this analysis for addressing the issue and ameliorating  Article citation: Agrawal PB, Goswami
the cause of deferral if possible. D, Surana SS, Shashi S. Pre-donation
deferral of blood donors in tertiary care
KEYWORDS  blood donor, deferred donor, NACO, SBTC, Pre-donation deferral
hospital attached to medical college in
Southern Rajasthan. J Pharm Biomed Sci
2016;06(07):460–463.
Available at www.jpbms.info
INTRODUCTION
Statement of originality of work: The
Blood transfusion is a life-saving procedure in many situations, especially manuscript has been read and approved by all
in trauma cases. Therefore, the importance of availability of blood and its the authors, the requirements for authorship have
allied products in an emergency situation cannot be emphasized. Safe and been met, and that each author believes that the
adequate supply of blood and products is a major public health issue faced glob- manuscript represents honest and original work.
ally. According to National AIDS control organization’s statistics, the annual Source of funding: None.
rate of blood donation is about 7.4 million units against the requirement of Competing interest / Conflict of interest: The
10 million units in India1. author(s) have no competing interests for financial
Blood donors are deferred for various reasons. The rate and reasons of support, publication of this research, patents
deferral differs from region to region and center to center. A voluntary donor and royalties through this collaborative research.
All authors were equally involved in discussed
is one who donates without any rewards or compulsion where as a replace-
research work. There is no financial conflict with
ment donor is one who donates blood upon request of specific patient or the subject matter discussed in the manuscript.
patient’s family which intended to be used specifically for treatment of
Disclaimer: Any views expressed in this paper
that patient1. Individuals disqualified from donating blood are known as are those of the authors and do not reflect the
“deferred” donors. To protect blood donors and recipients, stringent donor official policy or position of the Department of
screening criteria are necessary. Defense.
Blood donor deferral is a painful and sad experience for the blood
donor as well as the blood bank unit screening the donor2. Nodal agencies
like the National AIDS Control Organization (NACO) and the State Blood
Transfusion Councils (SBTCs) do not actively collect data on donor defer-
rals. Their formats for data collection are more inclined toward “quan-
tity” of supply and deferrals due solely to infectious marker positivity in
donated units. As a result, most of the efforts at government, community,
and individual level are focused at recruiting more and more new donors
while ignoring the retention and re-entry of those recruited but deferred
due to various causes. This can be achieved by analyzing the reason of these
deferrals amongst blood donors, addressing the issue and ameliorating the
cause if possible3.
Most of the previous studies carried out concentrated mainly on blood
groups and transfusion-transmitted diseases, however, very few studies are
published regarding the preblood donation deferral. The primary objective
of this study was to record and document the current rate and reasons for
donor deferral in our tertiary care hospital in Southern Rajasthan.

Copyright © 2016

Received Date: 08 May 2016 – Accepted Date: 18 June 2016 – Published Online: 28 July 2016
 Pre-donation deferral of blood donors in tertiary care hospital attached to medical
MATERIALS AND METHODS
A retrospective study of donors carried out from the
donor records in the blood bank of a tertiary care hos-
pital during the period of April 2014 to April 2016.
Each donor was selected by a medical officer based on
detailed medical history and brief physical examination
of donors with regard to hemoglobin, blood pressure,
temperature, and pulse rate and regularity.
The criteria laid down by the Director of General
Health Services and Drug controller of India were fol-
lowed. Hemoglobin level of 12.5 gm/dl, Weight not less
than 45 kg, Age limit between 18 and 60, systolic BP
100–180, and diastolic 50–100 were preset standards.
Detailed information on the donor deferral includ-
ing the cause of deferral was recorded from deferral reg-
ister. We used statistical method to detect the rate and
reason for donor deferral.
RESULTS
Total 1835 people donated blood during the study
period, of whom 1681 were males and 154 were females.
88 donors were deferred by medical officer based on
detailed medical history and brief physical examination
of donors with regard to hemoglobin, blood pressure,
temperature, and pulse regularity and rate. Out of 88
deferred donors, 64 were males and 24 were females.
Percentage of deferral among the total number of reg-
istered males and females were (3.80%) and (15.58%),
respectively. Demographic profile of blood donors is
shown in Table 1.
In our study, 61.68% were replacement donors and
38.31% were voluntary donors as shown in Table 2. As
per records, the reasons of deferral are many as listed
but they are broadly classified as permanent and tem-
porary deferral. There were 65(73.8%) temporary and
23(26.2%) permanent deferral among total 88 deferred
donors as shown in Table 3.
Low hemoglobin was the most common cause
of temporary deferral 37(56.92%) followed by low
  Table 1    Demographic profile of blood donors.
No. of No. of % of deferrals
registered deferred of total
donors donors registration
Male 1681 64 3.80
Female 154 24 15.58
Total 1835 88 4.79
  Table 2   Donor distribution based on type of blood
donation (Replacement and Voluntary).
No. of donors % of total donors (1835)
Replacement 1132 61.68
Voluntary 615 33.51
J Pharm Biomed Sci | Vol. 06 No. 07 | 460–463
461
weight 5(7.69%), low blood pressure 5(7.69) as shown
in Table 4. Whereas out of 23 permanent deferred
cases, the leading cause is hypertension 19(82.60%)
followed by jaundice 2(8.69%), consumption of anti
thyroid drugs 1(4.35%) and stomach ulcer 1(4.35%)
as shown in Table 5.
One of the major causes of deferral among both males
and females was anemia as shown in Table 4. The total
number of deferral due to anemia in male and female is
almost same but the number of deferral due to hyperten-
sion was almost eight times in male compared to females
(Table 6). The majority of male and female donors were
in age group 18–30 years as shown in Table 7.
DISCUSSION
Blood donor deferral is a painful and sad experience
for blood donation centers that screen the donors2.
This also leaves the person with negative feeling about
themselves as well as the blood banking system. But
there are definite advantages of eliminating donors
with possible risk of disease because despite the avail-
ability of sensitive screening tests to detect HIV infec-
tion, blood donors can be infected but test negative if
they have been infected for a period of 6 weeks or less4.
Deferring donors also protects the donors from pos-
sible adverse reactions and avoid consequent negative
impact on the donor motivation.
The rate of deferral differs from region to region
and sometimes in the same region and one centre to
another2. The total number of 1835 donors who came
forward for donation, of which 88 cases (4.79%) were
deferred due to various reasons. Many studies reported
different rate of deferrals (Table 8).
Most of the donors 1681 were males (91.60%)
women accounted for only (8.39%) of the donors. The
female donor population was very low in many stud-
ies. (John et al.1–4.92%, Krishna et al.2–1.55%, Krishna
et al.3–5.98%, Sunder P et al.4–11.27%, Sareen R et al.8–­
8.39%, Choudhary et al.9–8.68%, Girish et al.13–2.66%).
Our study also showed low-donor population of females
(8.39%). This is due to fear, lack of awareness, phys-
iological reasons, ignorance and lack of motivation in
females.
In our study, replacement was the major reason for
donation (61.68%). This may be because our blood bank
did not have permission for outdoor voluntary donation
camp during the study period.
The majority of the donors (73.8% n = 65) were
deferred for temporary reasons, and smaller subset
  Table 3   Distribution of temporary and permanent
deferrals.
No. of deferrals % of total deferrals
Temporary 65 73.86
Permanent 23 26.13
 462 Preeti B Agrawal

  Table 4    Causes of temporary deferrals and their proportion.

Causes Male Female Total % of temporary deferral % of total deferral
Low hemoglobin 20 17 37 56.92 42.04
Medication 1 1 2 3.07 2.27
Fever 2 0 2 3.07 2.27
Alcohol 2 0 2 3.07 2.27
Menstruation 0 1 1 1.53 1.13
Malaria 2 0 2 3.07 2.27
Vaccination 1 0 1 1.53 1.13
Dental procedure 1 0 1 1.53 1.13
Bleeding piles 2 0 2 3.07 2.27
Tattoo 3 0 3 4.61 3.40
Under age 1 0 1 1.53 1.13
Low weight 3 2 5 7.69 5.68
Low blood pressure 5 0 5 7.69 5.68
Skin allergy 1 0 1 1.53 1.13

  Table 5    Causes of permanent deferrals and their proportions.

Causes Male Female Total % of permanent deferral % of total deferral
Hypertension 17 2 19 82.60 21.59
Antithyroid drugs 1 0 1 4.35 1.13
Stomoch ulcer 1 0 1 4.35 1.13
Jaundice 2 0 2 8.69 2.27

  Table 6   Blood pressure and hemoglobin level   Table 7    Age distribution of deferred donors.
distribution among donors. Age Male Female Total Statistical indices
Male Female Total Statistical 18–30 34 19 53
(1681) (154) (1835) indices Chi-square (χ2)
30–40 16 1 17 value-9.70
Deferred cases 40–50 13 2 15 DF-3
due to high 17 2 19 Significance level
blood pressure 50–60 1 2 3
P value 0.021
Donors with Chi-square Total 64 24 88
normal blood 1664 152 1861 (χ2) value
pressure -10.457 goes undetected and could be an incidental finding
with DF-2 while screening, at the same time, it could be due to fear
Deferred cases Significance of phlebotomy, stress, fear of sight of blood, apprehen-
due to low 20 17 37 level P value sion and fear of donation etc. It is a growing epidemic
hemoglobin 0.005 in our country.
Donors
with normal 1661 137 1698
hemoglobin CONCLUSION
The majority donors are deferred due to temporary
(26.2% n = 23) were deferred permanently. The lead- reason (73.8%). To increase the pool of donors, we
ing cause of deferral in total deferral was low hemo- should educate donors about the cause and time period
globin (42.04%). It is also a major cause of temporary of deferral. They must be motivated and counseled to
deferral both in male (30.76% n = 20) and female help them to overcome the problem before next visit,
(26.15% n = 17). This indicates poor nutritional status thus we could reduce huge percentage of temporary
among people living in Southern Rajasthan. deferral. Similarly before voluntary blood donation
Among the causes of permanent deferral, hyper- camp we can educate donors about common causes
tension is the most common cause (82.60%) (Table 9). of deferral like age limit, weight, smoking and alcohol
However, it is the second most common cause of defer- abstinence, menstruation, breast feeding women etc. to
ral among total deferral (21.59%). Hypertension often reduce number of deferral.

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 Pre-donation deferral of blood donors in tertiary care hospital attached to medical 463

  Table 8    Deferral rate in various studies. REFERENCES

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