Volume 44, October 2004 TRANSFUSION 1417 Blackwell Science, LtdOxford, UKTRFTransfusion0041-11322004 American Association of Blood BanksOctober 2004441014171426Original Article QUANTIFYING DONOR AND DONATION LOSSCUSTER ET AL. ABBREVIATIONS: BCP = Blood Centers of the Pacific; REDS = Retrovirus Epidemiology Donor Study. From the Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, Washington; the Blood Systems Research Institute, San Francisco, California; the Blood Centers of the Pacific, San Francisco, California; and the Department of Laboratory Medicine, University of California, San Francisco, c/o BSRI, San Francisco, California. Address reprint requests to: Brian Custer, Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118-4417; e-mail: bcuster@bloodsystems.org. This work was supported by an unrestricted grant from Blood Systems Foundation (Scottsdale, AZ), and data collection was partially supported by the NHLBI Retrovirus Epidemiology Donor Study (REDS). Received for publication May 3, 2004; revision received June 1, 2004, and accepted June 1, 2004. TRANSFUSION 2004;44:1417-1426. BLOOD DONORS AND BLOOD COLLECTION Quantifying losses to the donated blood supply due to donor deferral and miscollection Brian Custer, Eric S. Johnson, Sean D. Sullivan, Tom K. Hazlet, Scott D. Ramsey, Nora V. Hirschler, Edward L. Murphy, and Michael P. Busch BACKGROUND: Donors are deferred for multiple reasons. Losses related to disease marker rates are well established. Donor and donation losses for other reasons, however, have not been extensively quantified. STUDY DESIGN AND METHODS: To quantify these losses, three data sets from the Blood Centers of the Pacific were combined, permitting detailed analysis of year 2000 allogeneic whole-blood donations. RESULTS: During 2000, 13.6 percent of 116,165 per- sons who presented for donation were deferred at pre- sentation. Short-term deferral accounted for 68.5 percent (hematocrit was most common at 60%); long-term defer- ral accounted for 21 percent (travel to a malarial area and tattoo or other nonintravenous drug use needle exposure were most common at 59 and 29%, respectively); and multiple-year or permanent deferral accounted for 10.5 percent (UK travel [variant Creutzfeldt-Jakob dis- ease] risk and emigration from a malarial area were most common at 38 and 11%, respectively). Disease-marker- reactive donations represented 0.9 percent of donor out- comes. The prevalence of deferral and also miscollection (under- and overweight units) varied by age, sex, and first- time versus repeat donor status. Overall, miscollection led to a loss of 3.8 percent of 100,141 collections, ranging from 1.9 percent in repeat male donors 40 to 54 years of age to 10.7 percent in first-time female donors 16 to 24 years of age. CONCLUSION: Loss of units from both first-time and repeat donors due to temporary deferral and loss of units from miscollection are more common events than losses due to disease marker testing. Some of these losses may be avoidable and could increase the blood supply without having to recruit new donors. he voluntary-donor blood supply is dependent on the willingness of individuals to donate. Additional safety initiatives have been imple- mented to reduce the risk of communicable diseases, particularly those that cannot be detected though standard blood marker testing, such as variant Creutzfeldt-Jakob disease. As the number of initiatives has grown, concerns have been raised about their impact on the quantity of blood in the nation’s supply, the size of the population of potential donors, and the implications of temporary donor deferral. Presenting for donation does not mean a donor is eligible to donate or that an eligible donor will provide blood that can be released for transfu- sion. Both donor eligibility assessment and blood unit testing contribute to the safety of the supply. Presenting donors are deferred for multiple reasons related to safety for the donor and potential threats to the safety of the supply. Regardless of the reason, these predonation defer- rals lead to a diminished eligible donor pool, even though the demand for blood has not decreased. 1 To our knowledge, no one has reported on the loss of donors and donations from the time a prospective donor T