The research in this dissertation aims to optimise blood donation processes in the framework of the Dutch national blood bank Sanquin. The primary health risk for blood donors is iron deficiency,... Show moreThe research in this dissertation aims to optimise blood donation processes in the framework of the Dutch national blood bank Sanquin. The primary health risk for blood donors is iron deficiency, which is evaluated based on donors' hemoglobin and ferritin levels. If either of these levels are inadequate, donors are deferred from donation. Deferral due to low hemoglobin levels occurs on-site, meaning that donors have already traveled to the blood bank and then have to return home without donating, which is demotivating for the donor and inefficient for the blood bank. A large part of this dissertation therefore has the objective to develop a prediction model for donors' hemoglobin levels, based on historical measurements and donor characteristics.The prediction model that was developed reduces the deferral rate by approximately 60\% (from 3\% to 1\% for women, and from 1\% to 0.4\% for men), showing the potential of using data to enhance blood bank policy efficiency. Additionally, the model predictions were made explainable, providing the blood bank with insights into why specific predictions are made. These insights increase our understanding of the relationships between donor characteristics and hemoglobin levels. If this prediction model would be implemented in practice, the explanations could also be shared with the donor to help them understand why they are (not) invited to donate, which could also contribute to donor satisfaction and retention.In a collaborative effort with blood banks in Australia, Belgium, Finland and South Africa, the same prediction model was applied on data from each blood bank. Despite differences in blood bank policies and donor demographics, the models found similar associations with the predictor variables in all countries. Differences in performance could mostly be attributed to differences in deferral rates, with blood banks with higher deferral rates obtaining higher model accuracy.Beyond hemoglobin prediction models, additional research questions are explored. One study aims to identify determinants of ferritin levels in donors through repeated measurements, and linking these to environmental variables. Another study involves modeling the pharmacokinetics of antibodies in COVID-19 recovered donors, and finding relationships between patient characteristics, symptoms, and antibody levels over time.In summary, the research in this dissertation shows the potential within the wealth of data collected by blood banks. The proposed data-driven donation strategies not only decrease deferral rates but also increase donor retention and understanding. This comprehensive approach allows Sanquin to provide more personalised feedback to donors regarding their iron status, ultimately optimising the blood donation process and contributing to the overall efficacy of blood banking systems. Show less
Hemovigilance is the systematic monitoring of adverse reactions and incidents in the transfusion chain in order to make recommendations for safety improvement. EU member states must have a... Show moreHemovigilance is the systematic monitoring of adverse reactions and incidents in the transfusion chain in order to make recommendations for safety improvement. EU member states must have a reporting system for serious adverse reactions or events which might have an effect on quality or safety of blood components. The thesis presents an analysis of routinely collected data on occurrence of blood donation complications and risk factors. A study of procedural and follow-up data from a cohort of related peripheral blood stem cell donors gave no indication of unacceptable risks. In transfused patients an exploratory case-control study found previously undescribed associations with patient characteristics. Using national hemovigilance data the reduction of the risk of TRALI following implementation of male-only plasma was estimated as 33%. Hospitals with a relatively high rate of reported nonserious transfusion reactions were also more likely to have reported one or more transfusion errors, thus this does not support the notion that they might be safer. Hemovigilance reporting has provided insight in short-term risks in the transfusion chain. Additonal methods should be sought for monitoring long-term risks and for promoting measures to bring about safety improvement. Show less
