Evaluation of the confidential unit exclusion on Iranian blood donors: An 11-year experience

BACKGROUND: Confidential unit exclusion (CUE) was recommended by the Food and Drug Administration to permit blood donors confidentially exclude their donation for transfusion. However, its effectiveness as a safety measure to the blood supply is debated. AIMS: We, therefore, evaluated its benefit in identifying donors at risk of transmitting transfusion-transmissible infections (TTIs) and increasing blood safety in our population. SETTINGS AND DESIGN: This was a cross-sectional and retrospective study. The study was performed at the South Khorasan Blood Transfusion Center. MATERIALS AND METHODS: In this descriptive and retrospective study, data of CUE use and data of confirmed positive TTI markers were analyzed for the study period 2006–2016. STATISTICAL ANALYSIS: Data were analyzed using SPSS software version 16. RESULTS: Out of 165,267 donations, the CUE option was selected by 493 (0.3%) donors, most frequently by first-time blood donors, by men, by donors with <12 years schooling, and by 18–24-year-old donors. The data revealed that donations from CUE donors had no higher infection rates. Moreover, CUE showed low sensitivity (0.6%) and low positive predictive value (0.6%) in detecting TTI markers. CONCLUSION: The data do not provide any indication of a safety advantage from CUE; thus, we recommend that the procedure of CUE can be discontinued.