Pre-donation deferral rates and causes among whole blood and apheresis platelet donors in China: A multi-centre retrospective study (2016-2024).

BACKGROUND AND

OBJECTIVES

Pre-donation deferral can negatively affect donor retention and blood supply sustainability. Comprehensive analysis of national deferral rates and reasons can inform evidence-based adjustments to donor eligibility criteria and improve the specificity of pre-donation screening.

MATERIALS AND

METHODS

Data on deferral rates and the top three deferral causes were collected from 47 blood establishments (BEs) (23 provincial-level, 24 prefectural-level) across China between 2016 and 2024. Deferral reasons were classified into 16 standardized categories. Chi-square and Spearman correlation analyses were performed to examine differences between groups and associations with potential influencing factors.

RESULTS

A total of 42.6 million whole blood (WB) and 5.9 million apheresis platelet (AP) donation attempts were analysed. Overall deferral rates were 11.4% for WB and 14.7% for AP donations, with provincial-level BEs exhibiting higher rates than prefectural-level BEs, for both donation types. The most frequently reported deferral reasons were elevated alanine aminotransferase (ALT) levels, low haemoglobin (Hb), lipaemia and abnormal blood pressure. Deferral rates were positively associated with the proportion of first-time donors and, for WB donors, with the detection rate of hepatitis B surface antigen (HBsAg).

CONCLUSION

Pre-donation deferral remains relatively high in China, with elevated ALT, low Hb, lipaemia and abnormal blood pressure identified as the most frequent causes. These findings highlight the need for evidence-based revisions of eligibility criteria, targeted donor education and strategies to promote repeat donation. Standardizing pre-donation screening practices across BEs may reduce unnecessary deferrals, enhance donor retention and support a more efficient and sustainable blood supply.