Results of the first 9 months of testing for anti-HIV antibodies in blood donors in France

An inquiry conducted in all the French blood transfusion centres from the 1st of July, 1985 to the 31st of March, 1986 in respect of blood donations confirmed to be positive for anti-HIV antibodies has given the following results: prevalence of 0.59 per thousand (1661/2,809,744); significant difference between first-time and regular blood donors (2.04% and 0.39% respectively); predominance of males (85%); 65% are less than 30 years old; the main risk factors are homosexuality (49%) and the use of I.V. drugs (28%).     

Analysis of factors related to ELISA-HBsAg negative and HBV DNA positive blood donors

This report analyzed factors relating to ELISA-HBsAg and Hepatitis B virus (HBV) DNA in blood donors. To provide a reference for an accurate screening model for HBV infection in donated blood, we collected rel-evant information from 124 blood donors testing ELISA-HBsAg negative and HBV DNA positive in 2017, including ELISA-HBsAg Max s/co, gender, age, residence, education level, blood donation record and alanine aminotransferase(ALT) value. Meanwhile, 99 blood donors with the results ELISA-HBsAg negative and HBV DNA negative were randomly selected as control. Univariate logistic analysis was conducted for possible correlation factors, then multivariate logistic regression analysis was performed for statistically significant observation indicators. The results showed that the Ct value of HBV DNA mixed test in the observation group donor was higher than that of HBV DNA single test (P<0.05). If one of the two ELISA-HBsAg s/co values was within the range of 0.259 to 0.304, the chance of HBV DNA positive was increased. Univariate logistic regression analysis showed that ELISA-HBsAg Max s/co, gender, age, blood donation history and ALT value were all risk factors in the observation group. Multivariate logistic regression analysis showed that ELISA-HBsAg Max s/co, (OR=5352.448, P<0.05), age (OR= 4.527, P<0.05) and blood donation history (OR=0.441) were risk factors. The study concluded that ELISA-HBsAg Max s/co, age and number of blood donations are risk factors for ELISA-HBsAg negative and HBV DNA positive blood donors, women or donors under 26 years of age had the lowest risk.     

Donor Exclusion in the National Blood Service Tissue Services Living Bone Donor Programme

National Blood Service (NBS) Tissue Services (TS) operates living donor and deceased donor tissue banking programmes. The living bone donor programme operates in collaboration with 91 orthopaedic departments across the country and collects bone donations, in the form of surgically removed femoral heads (FHs), from over 5000 patients per annum undergoing total hip replacement. Bone donated via the living programme constitutes approximately 55% of the total bone donated to NBS. Non-NBS tissue banks, primarily in hospital orthopaedic departments, also bank donated bone for the UK. A survey of information received from 16 collaborating orthopaedic centres, between April 2003 and August 2004, identified 709 excluded donors. The total number of donations banked from these sites was 1538. Donations can be excluded before collection if there are contraindications noted in a potential donor’s medical history before their operation. Donors may also be excluded after collection of the FH, for instance because of reactive microbiology tests for blood borne viruses, or if the donation storage conditions or related documentation have not met stringent quality requirements. In this survey, bone or joint conditions were the major reasons for excluding potential donors before donation (154 of 709 exclusions, 22%), followed by a current or a past history of malignancy (139 of 709 exclusions, 20%). Local staffing and operational difficulties sometimes resulted in potential donors being missed, or specific reasons for exclusion not being reported (117 exclusions). These out numbered exclusions due to patient refusal (80 exclusions). A small number (< 5) appear to have been excluded erroneously. There was considerable local variation in the reasons given for exclusion and certainly under-reporting. A survey of donations discarded after collection in the same period highlighted that 43% were donor related; 110 of 370 did not provide a follow-up blood sample. More than 30% were due to delays in forwarding blood samples to the microbiological laboratory for testing, resulting in deterioration of the sample quality. Training to ensure that standards are complied with and a firm evidence base for exclusion criteria, applied uniformly, will help focus donor identification efforts on individuals meeting rational criteria so that fewer potential donations are lost.     

Prevalence of antibodies to human T cell leukaemia/lymphoma virus in blood donors in north London.

OBJECTIVES--To determine the prevalence of antibodies to the human T cell leukaemia/lymphoma viruses (HTLV-I and HTLV-II) in blood donors in north London in order to assess the economic impact and the logistic effects that routine screening would have on the blood supply. DESIGN--All donations collected by the north London blood transfusion centre between January 1991 and June 1991 were screened for antibodies to HTLV-I and HTLV-II by modified, improved Fujirebio gel particle agglutination test. Positive samples were titrated and retested as necessary. SUBJECTS--96,720 unpaid volunteers, who gave 105,730 consecutive donations of blood and plasma. SETTING--North London blood transfusion centre. MAIN OUTCOME MEASURE--Observed numbers of donors confirmed to be seropositive for HTLV by reference laboratories. RESULTS--Of 2622 (2.5%) initially reactive samples, 414 (0.4% of all samples) gave a titre of > or = 1 in 16 on the modified agglutination test. Thirty five of the 414 serum samples yielded positive results on one of two enzyme linked immunosorbent assays (ELISA (Cambridge Biotech and Abbot)), and none of these results were confirmed by either reference laboratory. Five samples yielded positive results on both ELISAs and all five of these were confirmed to contain antibodies to HTLV. One of the five contained antibodies to HTLV-II and the others antibodies to HTLV-I. Four seropositive donors were white women whose only risk factor for infection was sexual contact. The fifth (positive for antibodies to HTLV-II) was an Anglo-Caribbean man who admitted to previous misuse of intravenous drugs. CONCLUSION--The prevalence of antibodies to HTLV in blood donors in north London was one in 19,344 (0.005%). Up to 100 donors a year might be identified in the United Kingdom as being infected with HTLV, although prevalence in different regions may vary considerably.     

Fostering repeat donations in Ghana

IntroductionMost African countries are challenged in recruiting and retaining voluntary blood donors by cost and other complexities and in establishing and implementing national blood policies. The availability of replacement donors who are a cheaper source of blood has not enhanced repeat voluntary donor initiatives.MethodsAn overview of activities for recruiting and retaining voluntary blood donors was carried out. Donor records from mobile sessions were reviewed from 2002 to 2008.Results and discussionA total of 71,701 blood donations; 45,515 (63.5%) being voluntary donations with 11,680 (25%) repeat donations were collected during the study period. Donations from schools and colleges contributed a steady 60% of total voluntary whilst radio station blood drives increased contribution from 10 to 27%. Though Muslim population is less than 20%, blood collection was above the 30-donation cost-effectiveness threshold with a repeat donation trend reaching 60%. In contrast Christian worshippers provided <25 unit/session and 30% repeat donations. Repeat donation trends amongst school donors and radio blood drives were 20% and 70% respectively.ConclusionRepeat donations rates have been variable amongst different blood donor groups in Kumasi, Ghana. The impact of community leaders in propagating altruism cannot be overemphasized. Programs aiming at motivating replacement donors to be repeat donors should be developed and assessed.     

Description and evaluation of a canine volunteer blood donor program

Human volunteer blood donor programs are commonplace, but the concept of nonhuman animal blood banking is relatively new. Few studies exist regarding efficacy, donor screening, and safety for volunteer companion animals. This retrospective study evaluated a nonprofit, community-based canine volunteer donor program using community blood drives. Of 98 potential donors, 14 were ineligible to donate, including 4 who tested seropositive for blood-borne pathogens. Of 84 donors, 45 were Dog Erythrocyte Antigen (DEA) 1.1 positive and 39 were DEA1.1 negative. Donations totaling 143 included 29 repeat donors (35%). No serious adverse events occurred. Minor adverse events included acute donor reaction (2.8%), hematoma (4.2%), rebleeding (2.1%), and skin irritation (0.7%). Adverse event rates were comparable to data for human blood donations. A substantial fraction of donors donated multiple times, suggesting that volunteer donors and their guardians perceived the donation process to be safe and effective. This article discusses the issue of donor consent and use of the term volunteer. This study indicates that nonprofit, community-based canine volunteer donor programs for animal blood banks can be successful while maintaining high safety standards and ethical treatment of volunteers.     

Description and Evaluation of a Canine Volunteer Blood Donor Program

Human volunteer blood donor programs are commonplace, but the concept of nonhuman animal blood banking is relatively new. Few studies exist regarding efficacy, donor screening, and safety for volunteer companion animals. This retrospective study evaluated a nonprofit, community-based canine volunteer donor program using community blood drives. Of 98 potential donors, 14 were ineligible to donate, including 4 who tested seropositive for blood-borne pathogens. Of 84 donors, 45 were Dog Erythrocyte Antigen (DEA) 1.1 positive and 39 were DEA1.1 negative. Donations totaling 143 included 29 repeat donors (35%). No serious adverse events occurred. Minor adverse events included acute donor reaction (2.8%), hematoma (4.2%), rebleeding (2.1%), and skin irritation (0.7%). Adverse event rates were comparable to data for human blood donations. A substantial fraction of donors donated multiple times, suggesting that volunteer donors and their guardians perceived the donation process to be safe and effective. This article discusses the issue of donor consent and use of the term volunteer. This study indicates that nonprofit, community-based canine volunteer donor programs for animal blood banks can be successful while maintaining high safety standards and ethical treatment of volunteers.     

Nucleic acid testing (NAT) in high prevalence–low resource settings

Blood screening by NAT for major transfusion transmitted viral infections (TTIs) was originally intended to complement serology for detection of infected donations. Reports from developed countries showed limited marginal value to NAT blood screening in improving blood safety. Reports on NAT results from Europe indicated yield of 1:0.6 million donations for HBV, <1:M for HCV and HIV-1-related to low prevalence of TTI. In contrast, prevalence of TTI in resource-limited countries is almost always high. As a result, more incident cases can be expected among first-time blood donors. Most reports of NAT blood donation screening in these countries showed NAT confirmed yield as high as 1/2800 for HBV and 1/3100 blood donations for HCV as reported from Thailand and Egypt, respectively. The issues for low resource countries are mostly the high cost of NAT but also the requirements of staff qualification, adequate facilities, reagent procurement and maintenance of delicate equipment. Alternatives to commercial NAT are the use of combos antigen-antibody for HIV and HCV, anti-HBc for HBV and in-house NAT. Most of these alternatives have been reported but very few comparisons are available. Once yield data is available, models for estimation of feasibility and cost-effectiveness are proposed to help decision-making.     

Iron stores in female blood donors evaluated by serum ferritin

Iron stores were evaluated by serum ferritin determinations in 948 menstruating and 141 non-menstruating female blood donors. Blood donation was associated with a decrease in ferritin. First-time donors (n = 163) had a geometric mean ferritin of 24 micrograms/l and multiple-time donors a value of 19 micrograms/l (p less than 0.01). In the donating population 31.5% had ferritin values less than 15 micrograms/l (i.e. depleted iron stores). Menstruating donors had lower mean serum ferritin than non-menstruating donors (p less than 0.001), and a higher frequency of ferritin values less than 15 micrograms/l (p less than 0.05). There was no relationship between ferritin levels and the number of pregnancies. The frequency of donations was more predictive of ferritin levels than the number of donations. Mean ferritin displayed a moderate fall up to the 2nd donation, and was hereafter relatively constant, whereas an increase in donation frequency was accompanied by a significant decrease in ferritin. Female donors, especially when phlebotomised greater than or equal to 3 times per year, should have their iron status checked at appropriate intervals by measurement of serum ferritin and should be advised regular iron supplementation.     

Seroprevalence and Incidence of hepatitis E in Blood Donors in Upper Austria

Background

In recent years various studies showed, that hepatitis E virus (HEV) is a growing public health problem in many developed countries. Therefore, HEV infections might bear a transmission risk by blood transfusions. The clinical relevance still requires further investigations. The aim of this study was to provide an overview of acute HEV infections in Upper Austrian blood donors as well as a risk estimation of this transfusion-related infection.

Methods and Findings

A total of 58,915 blood donors were tested for HEV RNA using a commercial HEV RT-PCR Kit. 7 of these donors (0.01%) were PCR-positive with normal laboratory parameters in absence of clinical signs of hepatitis. Viral load determined by quantitative real-time PCR showed a HEV nucleic acid concentration of 2,217 293,635 IU/ml. At follow-up testing (2–11 weeks after donation) all blood donors had negative HEV RNA results. Additionally, genotyping was performed by amplification and sequencing of the ORF1 or ORF2 region of the HEV genome. All HEV RNA positive donor samples revealed a genotype 3 isolate. For the antibody screening, anti-HEV IgM and IgG were detected by ELISA. Follow up serological testing revealed that no donor was seropositive for HEV IgM or IgG antibodies at time of donation. Moreover, we verified the prevalence of anti-HEV IgG in 1,203 of the HEV RNA negative tested blood donors. Overall 13.55% showed positive results for anti-HEV IgG.

Conclusions

In the presented study, we investigated HEV infections in blood donations of Upper Austria over 1 year. We concluded that 1 out of 8,416 blood donations is HEV RNA positive. Seroprevalence of anti HEV IgG results in an age-related increase of 13.55%. Therefore, based on this data, we recommend HEV-PCR screening to prevent transmission of hepatitis E virus by transfusion.     

Regional transfusion centre preoperative autologous blood donation programme: the first two years.

OBJECTIVE--To assess the efficacy of a regional autologous blood donation programme. DESIGN--Clinical and laboratory data were collected and stored prospectively. Transfusion data were collected retrospectively from hospital blood bank records. SETTING--Northern Region Blood Transfusion Service and 14 hospitals within the Northern Regional Health Authority. SUBJECTS--505 patients referred for autologous blood donation before elective surgery. MAIN OUTCOME MEASURES--Patient eligibility, adverse events from donation, autologous blood units provided, and autologous and allogeneic blood units transfused within 10 days of operation. RESULTS--Of 505 patients referred, 354 donated at least one unit. 78 of 151 referred patients who did not donate were excluded at the autologous clinic, mostly because of anaemia or ischaemic heart disease. In 73 cases the patient, general practitioner, or hospital consultant decided against donation. 363 autologous procedures were undertaken. In 213 (59%) cases all requested units were provided. The most common reasons for incomplete provision were late referral or anaemia. Adverse events accompanied 24 of 928 donations (2.6%). Transfusion data were obtained for 357 of the 363 procedures. 281 donors were transfused; autologous blood only was given to 225, autologous and allogeneic blood was given to 52, and allogeneic blood only was given to four. 648 of 902 (72%) units of autologous blood were transfused. Complete provision of requested autologous units was followed by allogeneic transfusion in 12 of 208 procedures (5.8%). Incomplete provision was followed by allogeneic transfusion in 44 of 149 procedures (30%). CONCLUSIONS--This study shows the feasibility of a regional autologous transfusion programme. Autologous donors only infrequently received allogeneic transfusion. Patients should be appropriately selected and referred early.     

Prevalence and Trend of Major Transfusion-Transmissible Infections among Blood Donors in Western China, 2005 through 2010

BackgroundThe prevalence of transfusion-transmissible infections (TTIs) in blood donations is important for evaluating blood safety and potential risks to the population. This study investigated the prevalence of TTIs among blood donors in Western China and suggested measures for policy-makers.MethodsThe screening results of 66,311 donations between 2005 and 2010 from a central blood center in Western China were analyzed. The prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections were expressed in percentages for the entire study group as well as groups by demographic characteristics and donation frequency, with differences analyzed using Fisher''s exact or Chi-square test. Logistic regression was performed to identify the influencing factors of the detected results.Results1,769 (2.67%, 95% CI 2.55–2.79%) of the donated blood had serological evidence of infection with at least one pathogen and 44 (0.07%, 95% CI 0.05–0.09%) showed evidence of multiple infections. The seroprevalence of HBV, HCV, HIV, and syphilis infections was 0.87% (95% CI 0.80–0.94%), 0.86% (95% CI 0.79–0.93%), 0.31% (95% CI 0.26–0.35%), and 0.70% (95% CI 0.64–0.76%) respectively. Trend analysis for the prevalence of TTIs showed a significant increase from 2.44% to 3.71% (χ² = 100.72, p = 0.00) over this 6-year period. The positive rates for TTIs varied along demographic lines. The top three risk factors in test-positive donors were identified as age, education level and donation frequency. The older age group and lower educated group were linked to a higher prevalence of TTIs. A decreasing prevalence was associated with an increasing frequency of blood donations (χ2 = 562.78, p = 0.00).ConclusionsHepatitis B and C were found most, and often in conjunction with syphilis. These were the primary threats to blood safety. The high positivity rate and the increasing prevalence of TTIs among blood donors in Western China call for further actions.     

Demography and blood donation trends in Saudi Arabia: A nationwide retrospective,cross-sectional study

BackgroundBlood product supply and utilization are understudied in Saudi Arabia. This study evaluates the trends in Saudi blood banks readiness, donors’ demography, and blood product utilization and wastage.Study design and methodsA retrospective, cross-sectional study of records obtained from the Ministry of Health (MOH) was initiated to report trends and statistics on annual whole blood donors and blood product utility from 2010 to 2020. Data collected in 2020 was further characterized for donors’ demographics, laboratory readiness, and staffing.ResultsThe average number of annual blood donors over the last decade (2010–2020) was 325,847.3 ± 43,160. The forecasted blood donation and dispatch trends suggest a significant increase in blood demand (R² = 0.7582) over annual donation rates (R² = 0.2356). In 2020, 342,460 nationwide blood donations were registered in governmental donation centers and females constituted a mere 2.5 %. Approximately 60 % of whole blood donation was voluntary, 36% was compensatory, and 4% was part of driving license renewal. The highest blood donation rate per 1,000 inhabitants was observed in Taif (69.8) and Alqonfoda (45.0). Eastern directory and Madinah had the most successful donation campaigns attracting 53% and 50% of total annual donations, respectively. Notably, Tabouk, Hai’l, and Albaha had the highest blood product wastage medians.ConclusionBlood donation rates and impetus, staffing ratios, and laboratory readiness and wastage varied among the various directories. Laboratory managers and medical directors need to increase efforts to refine current guidelines in order to comply with the transformation plan of the health sector.     

Autologous versus allogeneic transfusion: patients' perceptions and experiences

BACKGROUND: Preoperative autologous donation is one way to decrease a patient''s exposure to allogeneic blood transfusion. This study was designed to determine patients'' perceptions about the autologous blood donation process and their experiences with transfusion. METHODS: To assess patient perception, a questionnaire was administered a few days before surgery to patients undergoing elective cardiac and orthopedic surgery in a Canadian teaching hospital. All patients attending the preoperative autologous donation clinic during a 10-month period were eligible. A convenience sample of patients undergoing the same types of surgery who had not predonated blood were selected from preadmission clinics. Patient charts were reviewed retrospectively to assess actual transfusion practice in all cases. RESULTS: A total of 80 patients underwent cardiac surgery (40 autologous donors, 40 nondonors) and 73 underwent orthopedic surgery (38 autologous donors, 35 nondonors). Of the autologous donors, 75 (96%) attended all scheduled donation appointments, 73 (93%) said that they were "very likely" or "likely" to predonate again, and 75 (96%) said that they would recommend autologous donation to others. There was little difference in preoperative symptoms between the autologous donors and the nondonors, although the former were more likely than the latter to report that their overall health had remained the same during the month before surgery (30 [75%] v. 21 [52%] for the cardiac surgery patients and 30 [79%] v. 18 [51%] for the orthopedic surgery patients). When the autologous donors were asked what they felt their chances would have been of receiving at least one allogeneic blood transfusion had they not predonated, the median response was 80%. When they were asked what their chances were after predonating their own blood, the median response was 0%. The autologous donors were significantly less likely to receive allogeneic blood transfusions (6 [15%] for cardiac surgery and 3 [8%] for orthopedic surgery) than were the nondonors (14 [35%] for cardiac surgery and 16 [46%] for orthopaedic surgery). They were, however, more likely to receive any transfusion (autologous or allogeneic) than were the nondonors (25 [63%] v. 14 [35%] for cardiac surgery and 31 [81%] v. 16 [46%] for orthopedic surgery). INTERPRETATION: Patients who underwent preoperative autologous blood donation were positive about the experience and did not report more symptoms than patients who did not donate blood preoperatively. Autologous donors overestimated their chances of receiving allogeneic blood transfusions had they not predonated and underestimated their chances after they had predonated. They were less likely to receive allogeneic transfusions, but more likely to receive any type of transfusion, than were patients who did not predonate.     

Oxytocin Increases the Influence of Public Service Advertisements

This paper presents a neurophysiologic model of effective public service advertisements (PSAs) and reports two experiments that test the model. In Experiment 1, we show that after watching 16 PSAs participants who received oxytocin, compared to those given a placebo, donated to 57% more causes, donated 56% more money, and reported 17% greater concern for those in the ads. In Experiment 2, we measured adrenocorticotropin hormone (ACTH) and oxytocin levels in blood before and after participants watched a PSA. As predicted by the model, donations occurred when participants had increases in both ACTH and oxytocin. Our results indicate that PSAs with social content that cause OT release will be more effective than those that do not. Our results also explain why some individuals do not respond to PSAs.     

Risk of HIV infection from blood transfusion in Montreal

OBJECTIVES: To determine the incidence (including associated donor characteristics and time trends) of HIV infection among repeat blood donors and to estimate the risk of HIV transmission from blood transfusion in Montreal and in Canada as a whole. DESIGN: Retrospective cohort analysis. SETTING: Montreal Centre Blood Transfusion Service. PARTICIPANTS: People who donated blood at least twice after Nov. 1, 1985, and at least once from Apr. 1, 1989, to Mar. 31, 1993. INTERVENTION: Blood was screened for HIV by enzyme-linked immunosorbent assay and results were confirmed by Western blot analysis. OUTCOME MEASURES: Incidence density (the incidence rate per person-time) of HIV infection among repeat blood donors by sex, age group and region of residence, and incidence density and risk among first-time donors and for Canada as whole. RESULTS: There were 200,196 eligible donors and 432,631 person-years (PY) of observation. From 1989 to 1993, there were 18 HIV seroconversions among repeat donors. The crude incidence density was 3.3 per 100,000 PY (95% confidence interval [CI] 1.8 to 5.4 per 100,000 PY); it was 4.9 per 100,000 PY among men and 0.61 per 100,000 PY among women. Age-specific incidence per 100,000 PY was 2.5 among those 12-29 years of age, 5.1 among those 30-49, 2.9 among those 40-49, and 1.4 among those 50 and older. Based on an estimated mean "window period" (from when a donor''s blood is capable of transmitting HIV until detectable antibody appears) of 25 days, the current risk of HIV infection from repeat donors in the window period is estimated at 1 in 440,000. Inclusion of blood units from first-time donors produces an overall risk of 1 in 390,000 (95% CI 1 in 250,000 to 655,000). The estimated risk per blood unit in Canada as a whole is 1 in 913000 (95% CI 1 in 507,000 to 2,050,000). CONCLUSIONS: This "sentinel" population of repeat blood donors is subject to important trends in HIV spread. Therefore, estimating the incidence density of HIV infection in repeat donors provides insight into the epidemiologic characteristics of HIV infection at minimal expense. As a result of measures to improve blood safety, including HIV testing, the incidence of HIV infection among blood donors in Canada is low and the risk of HIV transmission from transfusion is extremely small, although not zero.     

How special is a 'special' interval: modeling departure from length-biased sampling in renewal processes

Length-biased sampling occurs in renewal processes when the probability that an interval is selected is proportional to the length of the interval. This can occur when intervals are selected because they contain an event that is independent of the renewal process and occurs with constant hazard. For example, if the times between donations for repeat blood donors are independent and identically distributed, and if the donor seroconverts to HIV (develops antibodies that indicate infection with human immunodeficiency virus), then the interval between the last HIV seronegative and first HIV seropositive test is expected to be longer than that donor's previous time intervals between donations. We develop hypothesis tests to determine if the relationship between the typical and length-biased intervals is as expected, or if there is departure from length-biased sampling. We further develop a regression method to determine if there are covariates that explain the departure from length-biased sampling. Our approach is motivated by the question of whether there is evidence that repeat blood donors who develop antibodies to HIV or other viral infections change their donation pattern in some way because of seroconversion.     

Challenges in the Testing of Non-Heart-Beating Cadavers for Viral Markers: Implications for the Safety of Tissue Donors

Natural changes that occur in blood and tissue after death may result in false positive results in antigen and antibody detection tests performed to identify markers of viral infection in potential tissue donors. Such tissue, which might otherwise be acceptable for therapeutic purposes, would not meet current standards for safe tissue banking. This is especially important in the context of insufficiency in the tissue supply. In this study, a series of blood samples collected during routine post-mortem examination was assayed using a range of commercially available kits for the detection of HBsAg, anti-HCV and anti-HIV 1 + 2 antibody/antigen. Results of tests on 104 samples collected from 97 individuals indicate that some kits result in a higher number of initial reactive samples than others. Approximately 40% of samples were reactive in one or more HBsAg assay, less than 10% in at least one anti-HIV kit and only 1 sample at low level on an anti-HCV kit. Liver or lymph node samples from individuals whose serum sample gave reactive results in antigen/antibody assays were tested for viral nucleic acid in the corresponding nucleic acid amplification test. Only one individual’s sample was confirmed to test positive for HBsAg in a confirmatory neutralisation test and by nucleic acid amplification technology, and a second individual whose serum was scored reactive for anti-HCV, but negative for HBsAg, had a liver sample which was HBV DNA positive and HCV RNA negative. The results of the study indicate that antibody/antigen assays are not as specific as NAT using state of the art DNA extraction techniques. Both types of assay complement each other and used together will help assure the safety of tissues for transplantation.     

Confirmation of cadaveric blood sample identity by DNA profiling using Short Tandem Repeat (STR) analysis

Blood samples collected from deceased tissue donors for mandatory transfusion microbiology testing may be taken either at the time of tissue donation, or residual samples may be retrieved from hospital laboratories where they were originally used for ante-mortem tests. In the latter case, sample labelling may not conform to the required standard, which stipulates that three independent identifiers be provided. If no alternative adequately labelled sample is available for testing the donated tissues may have to be discarded, which can adversely affect tissue sufficiency. An alternative method to ensure that the blood sample to be tested is from the intended deceased donor is to confirm the identity of the blood sample by Deoxyribonucleic Nucleic Acid (DNA) Short Tandem Repeats (STR) analysis, then comparing the DNA profile with the DNA from the donated tissues. If the two DNA profiles are identical, probability calculations can demonstrate the chance of the two samples of DNA being from the same or different individuals. The authors have used this approach to salvage deceased tissue donations.