PATTERNS AND PREDICTORS OF PRE- AND POST-DONATION DEFERRAL IN BRAZIL: A MULTICENTER STUDY OF EIGHT MILLION PRESENTATIONS (2007 TO 2024)
7 affiliations
- 1Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- 2Vitalant Research Institute, United States;
- 3Fundação Hemominas, Belo Horizonte, Brazil
- 4Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil
- 5Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil
- 6Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
- 7Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro, Brazil
Abstract
Background: Clinical and laboratory screening are critical for maintaining donor safety and ensuring the quality of blood components. In Brazil, while legislation establishes eligibility criteria, screening implementation differs among blood centers. Objectives: This study aims to evaluate the patterns and predictors of clinical pre-donation deferral and post-donation laboratory deferral at five major Brazilian blood centers between 2007 and 2024. Material and methods: We analyzed adult (≥18 years) donor presentations from five REDS Brazil blood centers: Fundação Pró-Sangue (FPS), Hemominas, Hemope, Hemorio, and Hemoam. Two stages were evaluated: pre-donation deferral (ineligible during clinical/behavioral screening) and post-donation deferral (collected units deferred for reactive syphilis, HBV, HCV, HIV, HTLV, or Chagas disease). Center-specific codes were mapped to 15 harmonized categories: low hemoglobin/hematocrit, blood pressure or pulse, weight, feeling unwell or signs of infection, malaria-related deferral, donor withdrawal, medical diagnoses and conditions, medications and vaccinations, higher-risk behaviors or exposures, needle exposure/tattooing/piercings, vCJD or European travel, medical or dental procedures, pregnancy/childbirth/lactation, infectious disease–related deferral, and other reasons. Predictors of deferral were estimated using modified Poisson regression adjusted for sex, age, race, education, donor type, and blood center. Results: Among 8,138,751 presentations, 1,739,731 (21.4%) resulted in pre-donation deferral, while 195,610 (3.06%) of the 6,399,020 collected donations were deferred post-donation. Over the study period, pre-donation deferral decreased from 22.4% to 20.2% and post-donation deferral from 3.30% to 2.78%, increasing the proportion of presentations yielding transfusable blood products (from 75.1% to 77.6%). Low hemoglobin/hematocrit accounted for 19.1% of classified pre-donation deferrals, followed by higher-risk behaviors or exposures. Syphilis-related deferrals increased from 36.5% to 47.3%, whereas HBV-related deferrals decreased from 47.6% to 33.0%. Pre-donation deferral was more likely among female donors (adjusted prevalence ratio (aPR) 1.49, 95% CI 1.48–1.50). Post-donation deferral was more likely among first-time donors (aPR 4.55, 95% CI 4.46–4.64), donors with lower educational attainment (aPR 2.28, 95% CI 2.22–2.34), and older donors (aPR 2.09, 95% CI 2.04–2.15). Center-specific differences were observed; Hemoam had the highest pre-donation deferral rate (24.0%), while Hemorio had the highest post-donation deferral rate (4.68%). Discussion: Pre-donation deferral was more common among women, with low hemoglobin representing the leading cause of ineligibility. The increasing contribution of syphilis to post-donation deferrals is consistent with the resurgence of syphilis in Brazil. The higher odds of post-donation deferral among first-time donors is expected. The results reinforce the importance of retaining repeat donors to maximize blood component availability while maintaining blood safety. Conclusion: Distinct predictors of pre- and post-donation deferral provide insights into potential tailored donor subgroup interventions to promote donor health, reduce unnecessary deferrals, and maximize the availability of blood components for transfusion.
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BibTeX
@article{braga2026patterns,
title = {{PATTERNS AND PREDICTORS OF PRE- AND POST-DONATION DEFERRAL IN BRAZIL: A MULTICENTER STUDY OF EIGHT MILLION PRESENTATIONS (2007 TO 2024)}},
author = {Natalia Almeida BRAGA and Renata BUCCHERI and Paulo SUEN and André Rolim BELISÁRIO and Cesar De ALMEIDA-NETO and Allyson Guimarães da COSTA and Édyla MORAES and Luiz De Melo AMORIM FILHO and Ester Cerdeira SABINO and Brian CUSTER},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.107106},
url = {https://doi.org/10.1016/j.htct.2026.107106},
note = {CC BY},
}
RIS
TY - JOUR
TI - PATTERNS AND PREDICTORS OF PRE- AND POST-DONATION DEFERRAL IN BRAZIL: A MULTICENTER STUDY OF EIGHT MILLION PRESENTATIONS (2007 TO 2024)
AU - Natalia Almeida BRAGA
AU - Renata BUCCHERI
AU - Paulo SUEN
AU - André Rolim BELISÁRIO
AU - Cesar De ALMEIDA-NETO
AU - Allyson Guimarães da COSTA
AU - Édyla MORAES
AU - Luiz De Melo AMORIM FILHO
AU - Ester Cerdeira SABINO
AU - Brian CUSTER
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.107106
UR - https://doi.org/10.1016/j.htct.2026.107106
AB - Background: Clinical and laboratory screening are critical for maintaining donor safety and ensuring the quality of blood components. In Brazil, while legislation establishes eligibility criteria, screening implementation differs among blood centers. Objectives: This study aims to evaluate the patterns and predictors of clinical pre-donation deferral and post-donation laboratory deferral at five major Brazilian blood centers between 2007 and 2024. Material and methods: We analyzed adult (≥18 years) donor presentations from five REDS Brazil blood centers: Fundação Pró-Sangue (FPS), Hemominas, Hemope, Hemorio, and Hemoam. Two stages were evaluated: pre-donation deferral (ineligible during clinical/behavioral screening) and post-donation deferral (collected units deferred for reactive syphilis, HBV, HCV, HIV, HTLV, or Chagas disease). Center-specific codes were mapped to 15 harmonized categories: low hemoglobin/hematocrit, blood pressure or pulse, weight, feeling unwell or signs of infection, malaria-related deferral, donor withdrawal, medical diagnoses and conditions, medications and vaccinations, higher-risk behaviors or exposures, needle exposure/tattooing/piercings, vCJD or European travel, medical or dental procedures, pregnancy/childbirth/lactation, infectious disease–related deferral, and other reasons. Predictors of deferral were estimated using modified Poisson regression adjusted for sex, age, race, education, donor type, and blood center. Results: Among 8,138,751 presentations, 1,739,731 (21.4%) resulted in pre-donation deferral, while 195,610 (3.06%) of the 6,399,020 collected donations were deferred post-donation. Over the study period, pre-donation deferral decreased from 22.4% to 20.2% and post-donation deferral from 3.30% to 2.78%, increasing the proportion of presentations yielding transfusable blood products (from 75.1% to 77.6%). Low hemoglobin/hematocrit accounted for 19.1% of classified pre-donation deferrals, followed by higher-risk behaviors or exposures. Syphilis-related deferrals increased from 36.5% to 47.3%, whereas HBV-related deferrals decreased from 47.6% to 33.0%. Pre-donation deferral was more likely among female donors (adjusted prevalence ratio (aPR) 1.49, 95% CI 1.48–1.50). Post-donation deferral was more likely among first-time donors (aPR 4.55, 95% CI 4.46–4.64), donors with lower educational attainment (aPR 2.28, 95% CI 2.22–2.34), and older donors (aPR 2.09, 95% CI 2.04–2.15). Center-specific differences were observed; Hemoam had the highest pre-donation deferral rate (24.0%), while Hemorio had the highest post-donation deferral rate (4.68%). Discussion: Pre-donation deferral was more common among women, with low hemoglobin representing the leading cause of ineligibility. The increasing contribution of syphilis to post-donation deferrals is consistent with the resurgence of syphilis in Brazil. The higher odds of post-donation deferral among first-time donors is expected. The results reinforce the importance of retaining repeat donors to maximize blood component availability while maintaining blood safety. Conclusion: Distinct predictors of pre- and post-donation deferral provide insights into potential tailored donor subgroup interventions to promote donor health, reduce unnecessary deferrals, and maximize the availability of blood components for transfusion.
SN - 2531-1379
SN - 2531-1387
ER -