Low donor Hb is the most common reason for deferral of blood donors, according to Dr. Rajesh B Sawant, Head of the Transfusion Medicine Department at Kokilaben Dhirubhai Ambani Hospital & Medical Research Centre in Mumbai, India. As one of the largest blood banks in Mumbai with an average of 1,000 donors per month, preventing unnecessary donor deferrals due to inaccurate Hb results is essential for the recruitment and retention of eligible donors.
Concerned about the lack of standardization and quality control for the Copper-Sufate (CuSO4) method they had been using to screen donors, the hospital decided to switch to a modern point-of-care (POC) technology.
Dr Sawant wanted a proven, safe, fast and reliable point-of-care testing system. Key criteria for selecting a reliable POCT system was repeatability of results, objective reading, ease to operate and high-quality results. The HemoCue system was selected for its ability to provide his team with fast and reliable results, accuracy, ease of use and safer disposals.
The donors also feel more confident when they can see their actual hemoglobin (Hb) values on the HemoCue display. It is actual figures and not only a yes or no.
With quantified numeric results the technicians and medical staff can take confident decisions without risk for observer bias. The counselling service to the donors have also been extended with recommendations of nutrition improvements or further investigations if Hb values are out of range. The system is easy to use in donation camps without risk of external environmental effects on the quality of result.
To compare performance of the HemoCue method (Hb 201) and CuSO4, Dr Sawant performed a study on 2,000 blood donors deferred with the CuSO4 method. Dr Sawant investigated if retesting deferred donors with the HemoCue method would help lower deferral rates. With this retesting policy, approximately 20% of the deferred donors could be retrieved. He also found that the sensitivity, specificity, PPV and NPV of the HemoCue method was far better than the CuSO4 method with both capillary and venous samples.
Dr Sawant explains, “Considering the vast amount of donations needed in India, every unnecessary deferral of donors should be avoided. One has to remember that even a small percentage of false acceptance or deferrals represent a large number of individuals.”
Dr Sawant continues, “For cost-constrained centers implementing the retesting policy using HemoCue method can improve the total number of eligible donors. Furthermore, studies on deferred donors indicate that previously deferred donors are less willing to return. We must also take other dimensions in consideration, e.g. costs for marketing activities to regain donors and loss of credibility”.
Dr Sawant concludes that the overall benefit of using a quality controlled, safe and accurate system has been an increase in the number of accepted donors, decrease in false deferral rates, and also an increase in the long term donor pool. The HemoCue system has definitely had a positive impact on the donor screening process in the Kokilaben blood bank where today all donors are tested with the HemoCue system.