EVALUATION OF THE CONFIDENTIAL UNIT EXCLUSION PROGRAM IN YAZD BLOOD TRANSFUSION CENTER, IRAN

Background and aims: The confidential unit exclusion (CUE) program was implemented inYazd blood transfusion center in 2004. Some people do not give information about their highrisk behavior in their counseling interview before donating blood while they might be in thewindow period of transfusion transmitted infections (TTI). CUE program was designed andintroduced to the blood services as an option by which high risk donors could confidentiallyexclude their donated blood from being used for transfusion. The aim of this study was toevaluate TTI prevalence in CUE+ donations in comparison to CUE- donations.Methods: Data on transfusion-transmitted disease markers (HBs Ag, HCV Ab, and HIV Ab)were extracted from a database of voluntary blood donations from 2004 through 2010 atYazd Blood Transfusion Center. The prevalence of CUE+ markers was compared with CUEdonations.Results: There were 255932 donations during the seven years of study and the CUE+ ‘do notuse my blood’ option was chosen in 1172 (0•5%) donations. The prevalence of HBs antigen,HCV and HIV antibodies in CUE+ donations were 1.27, 0.42 and 0 percent, respectively.The prevalence of these markers in CUE- donations were 0.26, 0.09 and 0.002 percent. In thisstudy, there were four HIV antibody positive donors but all of these donors indicated thattheir blood was safe for transfusion. Overall 1.7% of CUE+ donations had at least onepositive marker in comparison to 0.36% of CUE- donations. Both the sensitivity (2.5%) andthe positive predictive value of the CUE for the markers (2%) were very low. 97.8% of TTIpositivedonors had chosen ‘use my blood’ (CUE-) while only 2.2% had selected CUE+.Conclusion: Considering very low sensitivity and PPV of CUE in this study, it is necessary tore-evaluate the efficacy of CUE program in Iranian blood transfusion organization.