Abstract

Background -  Blood donor deferral has a significant impact on the adequacy of blood supply and donor retention globally. Understanding deferral patterns is crucial for optimizing donation services and ensuring a sustainable blood supply in middle-income countries with established voluntary donation systems. The aim of this study was to analyze the prevalence, temporal trends, and causes of blood donor deferrals across Iran using a comprehensive 6-year national dataset (2016-2021).

Material and methods - We conducted a retrospective analysis of all voluntary blood donation attempts recorded in Iran’s “Negareh” database (2016-2021).
Data included demographics, donation history, deferral status, and provincial variations. Non-parametric tests and chi-square analyses were performed (p<0.05).

Results - Among 12,966,574 donation attempts, 2,161,808 individuals (16.67%) were deferred: 14.37% temporarily and 2.30% permanently. Deferral rates varied significantly by experience: 32.19% for first-time donors, 18.18% for repeat donors, and 8.98% for regular donors (η²=0.24, p<0.001). Female donors had higher deferral rates than males (30.68 vs 14.08%; odds ratio=2.70, p<0.001). Provincial rates ranged from 11.60% to 26.90%, inversely correlating with the Human Development Index (r= -0.67, p<0.001). Primary deferral reasons were high-risk behaviors (27.80%), general health unfitness (21.60%), and donor record issues (16.89%).

Discussion - Iran’s 16.67% deferral rate falls within global ranges but shows potential for optimization. The predominance of temporary deferrals (86.2%) and their association with modifiable factors suggest that targeted interventions could reduce deferrals by 2-3% while maintaining safety. Gender-specific prevention of anemia, enhanced preparation of first-time donor, and province-specific approaches could improve the donor experience and blood supply sustainability.

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Authors

Leila Kasraian Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iranian Blood Transfusion Organization, Shiraz, Iran ORCID

Erfan Sadeghi Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran ORCID

Zahra Khakrah Iranian Blood Transfusion Organization, Shiraz, Iran

Mahtab Farahangiz Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran

Nima Naderi Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ORCID

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