Removing upper age restrictions for returning donors and increasing the new donor upper age: Novel adverse event findings using a comprehensive donor vigilance system in Australia.

IF 1.8 4区医学 Q3 HEMATOLOGY Vox Sanguinis Pub Date : 2024-11-25 DOI:10.1111/vox.13776

Joanna Speedy, Gabrielle Josling, Veronica C Hoad

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Abstract

Background and objectives: In July 2019, Australia removed the upper age limit for returning donors (previously 80 years) and increased the upper age for new donors from 70 to 75 years. This study assessed the safety of our new policy for our newly eligible upper age donors (NEUADs).

Materials and methods: For the period, 14 July 2019 to 30 June 2023, the relative risk (RR) of individual adverse events in NEUADs was compared with younger cohorts.

Results: There were 4529 NEUADs who made 8000 donations. The overall rates of vasovagal reactions (VVRs) were significantly lower in the NEUAD cohort. However, compared with younger donors; returning NEUADs had a significantly higher rate of loss of consciousness (RR 2.62; 95% confidence interval [CI]: 1.41-4.86) and new NEUADs had a significantly higher rate of offsite VVRs (RR 1.60; 95% CI: 1.08-2.37). Both new and returning NEUADs had significantly higher rates of VVR requiring outside medical care (RR 2.48; 95% CI: 1.28-4.79 and RR 4.45; 95% CI: 2.00-9.91 respectively).

Conclusion: Our findings support historical findings that overall VVR rates decline with age but suggest a higher risk of more serious VVRs.

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取消回国捐献者的年龄上限限制，提高新捐献者的年龄上限：澳大利亚利用全面的捐献者警戒系统发现的新的不良事件。

背景和目标：2019 年 7 月，澳大利亚取消了返回捐献者的年龄上限（之前为 80 岁），并将新捐献者的年龄上限从 70 岁提高到 75 岁。本研究评估了新政策对符合条件的高龄捐献者（NEUADs）的安全性：在2019年7月14日至2023年6月30日期间，比较了NEUADs与年轻组群中个别不良事件的相对风险（RR）：结果：共有 4529 名 NEUADs 进行了 8000 次捐赠。东北大学捐赠者队列中血管迷走反应（VVR）的总体发生率明显较低。然而，与年轻的捐献者相比，返回的 NEUAD 发生意识丧失的比例明显更高（RR 2.62；95% 置信区间 [CI]：1.41-4.86），而新的 NEUAD 发生异地 VVR 的比例明显更高（RR 1.60；95% 置信区间：1.08-2.37）。结论：我们的研究结果支持了以往的研究结果，即在所有非住院医护人员中，需要接受外部医疗护理的 VVR 发生率最高（分别为 RR 2.48；95% CI：1.28-4.79 和 RR 4.45；95% CI：2.00-9.91）：我们的研究结果支持历史研究结果，即随着年龄的增长，VVR 的总体发生率会下降，但发生更严重 VVR 的风险更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

期刊介绍： Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.