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


Journal

Vox sanguinis
ISSN: 1423-0410
Titre abrégé: Vox Sang
Pays: England
ID NLM: 0413606

Informations de publication

Date de publication:
May 2019
Historique:
received: 13 09 2018
revised: 18 01 2019
accepted: 19 02 2019
pubmed: 19 3 2019
medline: 23 7 2019
entrez: 19 3 2019
Statut: ppublish

Résumé

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. We 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). Comparing the results we obtained between 2015 and 2016, donations showed an overlap of the cohorts. Two hundred fifteen VVRs (incidence rate 0·48%) were observed, 104 (0·46%) of which in 2015, and 111 (0·51%) 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 0·99% vs. 0·46%; P = 0·001). 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. 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.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
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 METHODS METHODS
We 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).
RESULTS RESULTS
Comparing the results we obtained between 2015 and 2016, donations showed an overlap of the cohorts. Two hundred fifteen VVRs (incidence rate 0·48%) were observed, 104 (0·46%) of which in 2015, and 111 (0·51%) 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 0·99% vs. 0·46%; P = 0·001). 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 CONCLUSIONS
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.

Identifiants

pubmed: 30883806
doi: 10.1111/vox.12772
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

317-324

Informations de copyright

© 2019 International Society of Blood Transfusion.

Auteurs

Ugo Salvadori (U)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Marco Sandri (M)

DMS StatLab, University of Brescia, Brescia, Italy.

Roberto Cemin (R)

Department of Cardiology, Central Hospital of Bolzano, Bolzano, Italy.

Ahmad Al-Khaffaf (A)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Massimo Daves (M)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Francesco Maniscalco (F)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Rudolf Hueber (R)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Christina Troi (C)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Astrid Griessmair (A)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Franz Ploner (F)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Karl Egger (K)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Gottfried Kuehebacher (G)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Ivo Gentilini (I)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

Cinzia Vecchiato (C)

Department of Immunohaematology and Transfusion, Central Hospital of Bolzano, Bolzano, Italy.

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