Comprehensive Serology-Based Assessment of Transfusion-Transmissible Infections and Evaluation of Blood Donor Screening Practices for Transfusion Safety: A Three-Year Multicenter Research

Abstract

Transfusion-transmissible infections (TTIs) remain a serious and persistent concern in modern transfusion medicine. Despite remarkable advances in donor screening and testing technology, the goal of completely risk-free blood transfusion still feels distant. This study was conducted across multiple accredited blood centers in the Madinah region between 2020 and 2022 to evaluate both the prevalence of TTIs and the effectiveness of current screening practices. A total of 104,538 blood donations were reviewed. Initial serological reactivity was identified in 1.01% of samples, and confirmed positivity accounted for 0.39%. Hepatitis B virus (HBV) was the most common infection (66.3%), followed by hepatitis C virus (15.9%), syphilis (13.2%), human immunodeficiency virus (HIV) (3.1%), and HTLV (1.4%). All participating centers complied with AABB, CBAHI, and SFDA standards and were active in CAP external quality programs. In most cases, turnaround time did not exceed 24 hours. Overall, the unit rejection rate was 4%. These results demonstrate that integrated accreditation and quality systems can ensure consistent safety in donor screening and sustain low infection rates over time. Still, maintaining such achievements require continuous monitoring and professional commitment from laboratory teams.