{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T18:43:37Z","timestamp":1786214617068,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Confidential Unit Exclusion (CUE) was introduced when earlier\u2010generation assays had lower sensitivity and longer infectious window periods for transfusion\u2010transmitted infections. Improvements in serological and molecular testing have raised questions about its contemporary utility. This study evaluated the use and predictive performance of CUE at S\u00e3o Jo\u00e3o Local Health Unit Blood Bank, Porto \u2013 Portugal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective descriptive study assessed all donations with CUE between January 1, 1999 and August 5, 2025. Donor demographics, CUE outcomes, and laboratory results were retrieved. Confirmed reactive serological and nucleic acid testing (NAT) findings were reviewed. The main analytical focus was on findings suggestive of possible window\u2010period infection after a CUE\u2010excluded donation. Sensitivity, specificity, and positive predictive value (PPV) were calculated; associations between CUE status and reactivity were assessed with Fisher's exact test and odds ratios (OR) with 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 533,227 donations, 2289 (0.429%) underwent CUE self\u2010exclusion. Twenty\u2010four (1.05%) showed initially reactive markers at the time of the CUE\u2010excluded donation or during follow\u2010up, but none were confirmed as findings suggestive of window\u2010period infections. CUE demonstrated a sensitivity of 0%, specificity of 0.7%, and PPV of 0%. In the 2009\u20132025 cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009344,666), no reactive results occurred in the CUE group, whereas 149 (0.043%) occurred in the non\u2010CUE group. No significant association was found between CUE and reactivity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.388; OR\u2009=\u20092.045; 95% CI 0.286\u201314.627).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this retrospective single\u2010center cohort, CUE showed no measurable diagnostic or predictive value beyond routine screening and identifying possible window\u2010period infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70271","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T10:44:03Z","timestamp":1778928243000},"page":"1475-1479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Confidential unit exclusion (cue): Impact on transfusion safety"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8785-6319","authenticated-orcid":false,"given":"Rita","family":"Queir\u00f3s Pereira","sequence":"first","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Braga","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Lima Basto","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Carneiro\u2010Le\u00e3o","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Nobre Fernandes","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department S\u00e3o Jo\u00e3o Local Health Unit  Porto Portugal"},{"name":"Department of Community Medicine, Health Information and Decision University of Porto Faculty of Medicine  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Memorandum to blood establishments: Additional recommendations for reducing further the number of units of blood and plasma donated for transfusion or for further manufacture by persons at increased risk of HTLV\u2010III\/LAV infection","author":"U.S. Food and Drug Administration (FDA)","year":"1986"},{"key":"e_1_2_10_3_1","volume-title":"Standards for blood banks and transfusion services","author":"American Association of Blood Banks (AABB)","year":"1986"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000496749"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/JCSR.JCSR_97_19"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07279-5"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.20344\/amp.190"},{"key":"e_1_2_10_8_1","volume-title":"Memorandum to blood establishments: Revised recommendations for the prevention of human immunodeficiency virus (HIV) transmission by blood and blood products","author":"U.S. Food and Drug Administration (FDA)","year":"1992"},{"key":"e_1_2_10_9_1","volume-title":"Guide to the preparation, use and quality Assurance of Blood Components","author":"European Directorate for the Quality of Medicines & HealthCare (EDQM)","year":"2025"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12115"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/ajts.AJTS_152_18"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2009.01236.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5581\/1516-8484.20110052"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2024.47.211.39015"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1267080"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.424"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70271","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70271","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70271","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T18:29:10Z","timestamp":1786213750000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/trf.70271"],"URL":"https:\/\/doi.org\/10.1111\/trf.70271","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,16]]},"assertion":[{"value":"2025-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}