Post-donation telephonic interview: A tool for active follow-up of voluntary whole blood donors for analysis of frequency and predisposing factors of adverse reactions

Abstract

Background: Blood donation by healthy volunteers assures the availability of blood components for transfusion. Blood donation is well tolerated by most of the donors; however a few may experience adverse reactions. Reactions which occur at donation site are documented while those which occur after the donor has left the donation site may go unnoticed and thus are unreported. Hence, post-donation follow-up is important to get information about these adverse reactions. Aim(s): To analyze frequency and type of adverse donor reactions and its correlation with contributory factors if any To add to the donor hemovigilance data for better understanding of the adverse donor reactions through analyzing data with other blood centers. To develop a predictive model for the donors with a goal to define target groups to recommend best practices to improve donor care and safety. Method(s): This was a prospective observational study of 1,000 voluntary whole blood (WB) donors who consented to participate in it. Donors were contacted by the telephonic interview on two occasions; first after 24 h of donation and second after 2 weeks of donation. Donors were asked structured questionnaire, and information was documented according to gender, age, weight, place of donation, donation status and occupation. Statistical analysis was done by SPSS (Statistical Package for the Social Sciences) software. Result(s): Of the 1,000 voluntary WB donors, 926 responded to phone calls on both the occasions. Of these 926, 79 (8.5%) donors experienced adverse reactions. All these donors experienced reactions within 24 h of donation while none experienced reactions beyond 24 h to 2 weeks. Of the 79 donors, 26 (3!3%) reactions occurred at the donation site while 53 (67%) reactions occurred after donor left the donation site. Total of 94% onsite reactions was vasovagal reaction (VVR) while 57% offsite reactions were hematoma. Of the 79 donors, 60% experienced VVR and 40% experienced hematoma including 2 donors experiencing both. VVR was higher in low weight donors, female donors and the first time donors (P < 0.05). Of the 49 VVR, 76% were mild, 18% were moderate and 6% were severe. Of the 49 donors with VVR, 27% donors complained of fear and anxiety of donation and all these were first time donors, 18% gave the history of inadequate water/fluid intake while in 55% donors, no associated factors were reported. Of the 32 hematoma reactions, 94% occurred at offsite while 6% occurred at onsite. Majority of hematoma took more than 7 days to recover. Summary/Conclusions: Post donation interview proves to be an effective tool to acquire information about adverse donor reactions. Follow-up after 24 hours was helpful as all the reactions had occurred within this time period and donor recall of the reactions was better, which would otherwise have gone unreported. All these donors were advised for its management. This can also be used as a valuable tool for donor hemovigilance which is presently not mandatory in India. This will help in improving donor safety and satisfaction and will have a positive impact on national blood supply by improving donor return rate.