Analysis of causes of unqualification in primary blood screening among voluntary blood donors of apheresis platelets in Chengdu

Objective To analyze the causes of unqualification in primary blood screening among voluntary blood donors of apheresis platelets in Chengdu Blood Center. Methods A total of 36 127 cases of voluntary blood donors who participated in apheresis platelets donation in Chengdu Blood Center from January to December 2017 were selected as study objects. Age of blood donors was (32.4±7.7) years. Male and female blood donors were 26 423 and 9 704 cases, respectively. Before donation of apheresis platelets, about 4 mL of whole blood was taken from the elbow vein of each blood donor, and these whole blood samples were used for the inspection of primary blood screening. Inspection items of primary blood screening included alanine transaminase (ALT) value, platelet count, hematocrit (HCT), white blood cell count (WBC), hemoglobin (Hb) value, chylemia and hepatitis B virus surface antigen (HBsAg) expression. Then, qualification situations for primary blood screening of apheresis platelets donors were assessed according to Technical Operation Procedure for Blood Stations (2015 Edition). Total unqualified rate of primary blood screening in all apheresis platelets donors, and unqualified rates of each inspection item were counted, respectively. Chi-square test was used to compare the unqualified rates of each inspection item of all blood donors, as well as the unqualified rates between the male and female blood donors. The procedures followed in this study were in line with the requirements of the revised Declaration of Helsinki of World Medical Association in 2013. And all blood donors signed Informed Consent of Blood Donors before blood donating. Results ① In this study, among the 36 127 blood donors who participated in apheresis platelets donation in Chengdu Blood Center in 2017, 19 323 cases were unqualified in primary blood screening, and the total unqualified rate of primary blood screening was 53.49%. ② Among the 19 323 cases of apheresis platelets donors who were unqualified in primary blood screening, the unqualified rates of the primary blood screening items from high to low were 15.82% in unqualification of HCT, 15.45% in unqualification of platelet count, 9.72% in unqualification of ALT value, 7.60% in unqualification of WBC, 3.96% in unqualification of chylemia, 0.80% in unqualification of Hb value, and 0.17% in unqualification of HBsAg. Overall comparison of the unqualified rates of each inspection item of primary blood screening, the difference was statistically significant (χ2=12 724.350, P<0.001). The main causes of unqualification in primary blood screening among apheresis platelets donors were decrease of HCT, increase of ALT value, and decrease of platelet count. The proportion of unqualified blood donors with these three causes accounted for 76.63%(14 806/19 323) of the total unqualified blood donors. ③ Among the 19 323 cases of apheresis platelets donors who were unqualified in primary blood screening, the unqualified rate of male blood donors was 40.44% (10 689/26 423), which was lower than 89.01% (8 638/9 704) of female blood donors, and the difference was statistically significant (χ2=6 731.805, P<0.001). Of which, the unqualified rates of ALT value (10.63%) and platelet count (15.96%) of male blood donors were higher than those of 7.23% and 14.04% in female donors, respectively; the unqualified rates of HCT (2.97%), Hb value (0.12%), WBC (7.14%) and chylemia (3.44%) of male blood donors were lower than those of 50.80%, 2.61%, 8.83% and 5.37% in female blood donors, respectively; and all the differences in above inspection items of primary blood screening between male and female blood donors had statistical significance (χ2=77.930, 20.199, 12 194.302, 564.119, 28.879, 81.479; P<0.001). Conclusions The main causes of unqualification in primary blood screening among apheresis platelets donors in Chengdu include decrease of HCT, increase of ALT value, and decrease of platelet count. Unqualification of male blood donors are mainly due to increase of ALT value and decrease of platelet count. The majority unqualification of female blood donors is decrease of HCT. Therefore, according to the causes of unqualification in primary blood screening among different apheresis platelets donation populations, the corresponding intervention recruitment strategy should be taken to improve the qualification rate in primary blood screening among apheresis platelets donors. Key words: Voluntary blood donor; Apheresis platelets; Alanine transaminase; Plantlet count; Hematocrit; Primary blood screening, unqualification; Causes analysis; Recruitment strategy, voluntary blood donors