Causes and Factors Associated with Blood Donor Deferrals in National Blood Centre

Abstract

Blood donor deferral is a critical aspect of ensuring donor and patient transfusion safety. This study aimed to evaluate the causes and factors associated with blood donor deferrals in the National Blood Centre, Malaysia. A retrospective cross-sectional study was conducted on 1,103 whole blood donors who experienced deferral from the 1st of January 2018 to the 31st of December 2020. Data were extracted from donor deferral reports and the Blood Bank Information System. Simple and multiple logistic analyses were used for statistical analysis, and a p-value of < 0.05 was considered significant. Out of 732,756 registered blood donors, 167,855 (22.9%) were deferred during the study period. Among the 1,103 deferrals analysed for this study, 1,053 (95.5%) were temporary deferrals, while 50 (4.5%) were permanent deferrals. Notably, a majority of temporarily deferred donors were female (698, 66.3%), whereas 38 (76%) of permanently deferred donors were male. The most common reason for temporary deferral was low haemoglobin levels (551, 52.3%), followed by high blood pressure (459, 12.3%). Medical illnesses accounted for most permanent deferrals (19, 36%), with high-risk behaviours being the second most common cause (15, 30%). After adjusting for confounding factors, female donors showed a significantly higher risk of deferral (adjusted odds ratio [OR] = 5.220, 95% confidence interval [CI] 2.657–10.25, p < 0.001), as did regular donors (adjusted OR = 6.470, 95% CI 1.929–21.70, p = 0.002). The study highlights that female and regular donors are more likely to face deferral. Enhancing blood donor education, awareness, and pre- and post-donation support are crucial steps in reducing deferrals and preserving the donor pool.