Eligibility of blood donors with thalassaemia trait, sickle cell trait or glucose-6-phosphate-dehydrogenase deficiency in Italy: Results of a national survey and practical guidance.

Thalassaemia trait (ThalT), glucose-6-phosphate dehydrogenase (G6PD) deficiency and sickle cell trait (SCT) are prevalent inherited red blood cell disorders among blood donors in Italy, particularly in southern and insular regions, and among donors of non-European origin. Despite their frequency, harmonized national guidance on eligibility of carriers for blood and apheresis donation has been lacking, resulting in heterogeneous practices across Italian transfusion centres. Between 17 January and 16 February 2024, the Italian National Blood Centre distributed a structured questionnaire to 276 transfusion services across the Italian transfusion network. The survey investigated current practices in donor identification, eligibility assessment and blood component utilization for donors with ThalT, G6PD deficiency and SCT. A total of 110 responses (40% response rate) were collected and analysed. ThalT donors were active in 88% of responding centres; 86 centres (78%) considered individuals with ThalT eligible for whole blood donation, 88 (80%) for plasma apheresis and 40 (36%) for platelet apheresis. G6PD-deficient donors were accepted for whole blood donation in only 19% of centres and for plasma apheresis in 44%. SCT donors were accepted for whole blood in 10% of centres and for plasma apheresis in only 17%. Significant heterogeneity in identification strategies and utilization criteria was observed across all three conditions. Italian practices are more restrictive than World Health Organization (WHO) and European Directorate for the Quality of Medicines and HealthCare (EDQM) recommendations. Harmonization with international guidelines and targeted haemovigilance monitoring are warranted.