Audit of a paediatric directed donation programme

Objective: A paediatric directed donation programme (DDP) was instituted by Women's and Children's Health in conjunction with the Australian Red Cross Blood Service, Melbourne, Victoria, Australia, in response to public demand following a case of transfusion-transmitted HIV. This audit assesses the first 18 months of the programme. Methods: Retrospective analysis, from February 2000 to July 2001, examining the number of units of blood requested, donated, and transfused, as well as the use of allogeneic (non-directed) blood. Results: The DDP received 125 referrals. Most (78%) were for elective surgery. Of the 89 eligible children, 76% (68) had blood donated for them by an ABO/Rhesus-compatible parent, 81% of whom were first-time blood-donors. No donor tested positive for infectious markers. In total, 221 units of blood were requested and 116 units were collected. Non-collection was mainly a result of parent-child ABO incompatibility or medical ineligibility of the proposed donor. Of the children for whom blood was collected, 28 (41%) received no transfusion and eight (12%) received non-directed components in addition to DDP blood; thus, 32 (47%) received solely the blood from their directed donor. Of the units collected, 53 (46%) were transfused and 63 (54%) were discarded. Conclusions: While the paediatric DDP serves a community need, the programme has a high wastage rate, is time-consuming, labour-intensive and an expensive alternative when compared with the provision of non-directed volunteer blood. In continuing the programme, appropriateness of referral needs to be refined to reduce wastage rates.