Informing Blood Donor Safety and Blood Supply Management in the United States: Factors Affecting Donor Time-To Return After Low Hemoglobin Deferral
Author(s)
Wanjin Li, MSc1, Marjorie Bravo, MD2, Brian Custer, PhD3, Ralph Vassallo, MD2, William Alton Russell, PhD1;
1McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada, 2Vitalant, Vitalant Medical Affairs, Scottsdale, AZ, USA, 3Vitalant, Vitalant Research Institute, San Francisco, CA, USA
1McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada, 2Vitalant, Vitalant Medical Affairs, Scottsdale, AZ, USA, 3Vitalant, Vitalant Research Institute, San Francisco, CA, USA
Presentation Documents
OBJECTIVES: Blood establishments defer donors with low hemoglobin to protect donors’ health, but deferral periods vary globally. This study aimed to identify factors affecting donor time-to-return after being deferred for low Hb.
METHODS: We analyzed whole blood donors deferred for low hemoglobin (fingerstick hemoglobin < 12.5 g/dL (female) or 13.0 g/dL (male)) from 2017-2022 in the U.S., where donors are deferred for only one day. We developed Cox proportional hazard models to examine the relationship between post-deferral time-to-return within one year of deferral and donor baseline characteristics, including baseline Hb, sex, age, race/ethnicity, education, donor experience, and donation history (red blood cells lost and previous deferral).
RESULTS: The analysis included 178,751 deferred donors. Time-to-return after deferral was significantly faster for donors who were male (median time-to-return: 116 days), White (160 days), had post-secondary education (165 days), were active repeat donors (115 days), and had a history of previous low hemoglobin deferral (63 days). Baseline hemoglobin near the eligibility threshold and greater red blood cell loss in the prior year were also associated with faster returns. For donors returning <3 months after a hemoglobin deferral, 6% of males and 28% of females experienced a repeat deferral. Among female donors, repeat deferral was more likely if the original hemoglobin was < 11.0 g/dL (44% re-deferred) compared to 11.0-12.4 g/dL (24% re-deferred).
CONCLUSIONS: Donor return status and time-to-return differed based on prior donation history, baseline Hb, and socio-demographics. Considering these factors in low hemoglobin deferral policies could improve donor management. Future research assessing the association between post-deferral time-to-return and the risk of repeat hemoglobin deferrals, while accounting for these factors, could inform policies aimed at reducing repeat deferrals without compromising donor retention.
METHODS: We analyzed whole blood donors deferred for low hemoglobin (fingerstick hemoglobin < 12.5 g/dL (female) or 13.0 g/dL (male)) from 2017-2022 in the U.S., where donors are deferred for only one day. We developed Cox proportional hazard models to examine the relationship between post-deferral time-to-return within one year of deferral and donor baseline characteristics, including baseline Hb, sex, age, race/ethnicity, education, donor experience, and donation history (red blood cells lost and previous deferral).
RESULTS: The analysis included 178,751 deferred donors. Time-to-return after deferral was significantly faster for donors who were male (median time-to-return: 116 days), White (160 days), had post-secondary education (165 days), were active repeat donors (115 days), and had a history of previous low hemoglobin deferral (63 days). Baseline hemoglobin near the eligibility threshold and greater red blood cell loss in the prior year were also associated with faster returns. For donors returning <3 months after a hemoglobin deferral, 6% of males and 28% of females experienced a repeat deferral. Among female donors, repeat deferral was more likely if the original hemoglobin was < 11.0 g/dL (44% re-deferred) compared to 11.0-12.4 g/dL (24% re-deferred).
CONCLUSIONS: Donor return status and time-to-return differed based on prior donation history, baseline Hb, and socio-demographics. Considering these factors in low hemoglobin deferral policies could improve donor management. Future research assessing the association between post-deferral time-to-return and the risk of repeat hemoglobin deferrals, while accounting for these factors, could inform policies aimed at reducing repeat deferrals without compromising donor retention.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH116
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)