Donor hemovigilance: Delayed vasovagal reaction with injury in a blood donor

Sir,

We report a case of delayed vasovagal reaction in a 19-year-old male blood donor of severe grade and definite imputability as per the classification of working group on complications related to blood donation (International Society of Blood Transfusion working party on Hemovigilance and European Hemovigilance Network, 2008) in a blood donor qualifying the blood donor selection criteria as per the standard operating procedure of our department based on the Drugs and Cosmetics Act of India. The blood donor was brought back to the donation venue 1½ h post blood donation by his colleagues. The donor was found to be responsive and reported that he was sitting in the garden adjoining hostel and consequent upon standing in order to walk to his room, experienced light headedness, profuse sweating and then fainted. On examination, the pulse rate was 62/min, regular and blood pressure of 110/68 mm of Hg. There was no h/o of projectile vomiting, no nystagmus. The left thumb was swollen and painful, which is consistent with a post blood donation delayed vasovagal loss of consciousness, followed by fall. Closed reduction with k-wire fixation of base of distal phalanx was done after X-ray [Figure 1]. Donor was asymptomatic; the nail bed showed early new nail recovery on follow-up. The donor hemovigilance arm of a national hemovigilance system should be based on standardized reporting formats and review initiatives being implemented to reduce adverse reactions. Reporting, monitoring and evaluation of blood donor reactions and the outcome of interventions could help generate evidence for formulating strategies that could have an impact to decrease adverse donor reactions in order to retain willingness to donate blood.[1]

Figure 1.

Pre and post K-wiring of left distal phalaynx