Blood-donor eligibility in Belgian Red Cross’ Blood Service: from systematic reviews to impact on policy level

Article type
Authors
De Buck E1, Borra V2, Van Remoortel H2, Compernolle V3, Vandekerckhove P4
1Centre for Evidence-Based Practice Belgian Red Cross; Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven
2Centre for Evidence-Based Practice Belgian Red Cross
3Blood Service Belgian Red Cross; Faculty of Medicine and Health Sciences, Ghent University
4Belgian Red Cross; Faculty of Medicine and Health Sciences, Ghent University; Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven
Abstract
Background: The Belgian Red Cross Blood Service wants to support its blood donor eligibility criteria with solid evidence from systematic reviews (SRs), to guarantee donor and recipient safety, and a sufficient blood supply. However, current blood donor eligibility criteria are often determined at a legal level, and it is a challenge to use SRs to influence policy.

Objectives: To provide an overview of SRs conducted by the Belgian Red Cross’ Centre for Evidence-Based Practice to support blood donor eligibility criteria; and, to provide information on a success story where a SR resulted in an amendment, to be implemented in our Blood Service in the near future.
Methods: (1) SRs were developed according to the Cochrane method and published in peer-reviewed journals. An overview will be provided on the conclusions of the SRs and their implications for our blood donor selection criteria; and, (2) an example will be given of the steps taken going from a SR (published in 2012) to an amendment of the law (in 2016) for a particular group of potential blood donors.
Results: A total of 79 studies was identified in 6 different SRs. SRs supporting blood donor’s safety included: blood donors with hypotension (n=10 studies), (former) epilepsy patients as blood donors (n=3), and blood donation by sportsmen (n=18). SRs aimed at the recipients’ safety included: hemochromatosis (n=6), men who have sex with men (n=14), and endoscopy (n=28) as risk factors for blood donation. The majority of the studies were observational. In the SR on hemochromatosis (hereditary iron overload) no evidence was found showing that patients undergoing regular bloodletting would present a risk for the blood supply, when compared with healthy donors. Our systematic review was used to inform the Belgian Senate on a proposed amendment, allowing stable hemochromatosis patients to donate blood. In January 2016 the amendment was finally approved. As a next step implementation decrees need to be formulated and implementation at our Blood Service will be started.
Conclusions: SRs can inform governments to develop evidence-based policies ensuring donor and recipient safety and a qualitative blood supply.