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. 2021 Mar;116(3):336-341.
doi: 10.1111/vox.12983. Epub 2020 Oct 26.

Endoscopies, blood-borne viruses and blood donors: time to move on from precaution

Veronica C Hoad  1 , George Serhan  1 , Clive R Seed  1 , Philip Kiely  1 , Iain B Gosbell  1   2
Affiliations

Endoscopies, blood-borne viruses and blood donors: time to move on from precaution

Veronica C Hoad et al. Vox Sang. 2021 Mar.

Abstract

Background and objectives: Based on the Council of Europe directive which dictates regulatory requirements in Australia, blood donors are currently deferred from donating for 4 months after an endoscopic procedure if either polyps were removed or a biopsy sample was taken. We aimed to assess the incidence of blood-borne viruses (BBVs) (HIV, hepatitis B and C) in blood donors who donated after an endoscopic procedure and evaluate the risk to blood safety through risk modelling.

Materials and methods: Donors from 1/1/2013 to 31/12/2017 with an endoscopy deferral on their blood donor file with pre- and post-BBV testing were analysed to determine an incidence of BBVs using standard methods. The standard blood donor cohort was used as a comparator group. Using the incidence of endoscopies and BBV risk, the total residual risk estimate of allowing donors to return postendoscopy without restriction was calculated.

Results: The incidence of a BBV postendoscopy in this large cohort of 16,283 where testing has been confirmed postendoscopy was zero (95% CI 0-0·000105). The upper confidence interval of the zero events is 10·5 per 100 000 donations. Total positive donations from 2017 repeat donors were 1·87 per 100 000 (95% CI 0·0000117-0·0000277). Sensitivity analysis demonstrated that the residual risk remained negligible under realistic worst-case scenarios.

Conclusion: A BBV endoscopy deferral is not required for blood safety in Australia. The presented data has enabled us to submit a request for an exemption to our regulator, which has been approved and the policy change subsequently implemented by Lifeblood on 4/4/2020.

Keywords: blood safety risk; endoscopy; infection.

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References

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