[Donor exclusions, discarded blood and transfusion unsuited blood conserves of 2,13 million potential blood donors 1991 to 1994].

Unlabelled: German authorities plan to legislate transfusion safety. We report on the efficacy of donor selection, unit pre-release testing, quality assurance and look-back efforts (LBE): Among 2,127,102 visits by 503,971 donors are 8.7% first-time donors. 96% of repeaters present our donor ID-card. We defer 5.6% repeat and 18.2% first-time donors, mostly for their own safety. 0.5% of the donors suffer a reaction. 94,000 units (4.7%) are not released due to confidential self-exclusion (1.1%), quality and safety concerns (1.7%), and positive screening tests (1.9%). Only 5.2% positive infectious disease screening tests were confirmed. HIV-prevalence of first-time donors is 0.002%; the HIV seroconversion rate for second-time donors is 0.003%. All other seroconversion rates for HBV, HCV, HIV and lues at subsequent donations are 0.001%. 23 donor-related LBE did not reveal a single HIV-infected recipient. In 106 recipient-related LBE involving 868 donors, we found 5 seroconverted donors (1 HBV, 3 HCV, 1 HIV).

Conclusions: Our repeat donors present proper ID. Strict donor selection criteria result in many rejections. Donor reactions are rare. High demands on blood safety and quality result in many discards. In our hands, confidential unit exclusion does not add safety. The HIV prevalence of first-time and repeat donors is equally low. Donor seroconversions are rare. LBE rarely identify infected donors or recipients. Our current high transfusion safety is unlikely to be improved through legislative measures.