Paying for blood donations: still a risk?

Area of Science:

• Transfusion Medicine
• Infectious Disease Epidemiology
• Public Health

Background:

• The relevance of historical findings on increased infectious disease risk in paid blood donors is debated.
• Previous studies suggested higher infectious disease marker rates among paid donors, but trends over time are unclear.

Purpose of the Study:

• To assess whether the elevated risk of infectious disease markers in paid blood donors has changed over time.
• To evaluate the ongoing implications of donor selection on blood safety.

Main Methods:

• A meta-analysis of comparative studies published between 1968 and 2001 was conducted.
• Log-linear regression analysis was used to analyze relative risk estimates for infectious disease markers in paid versus unpaid donors from 28 datasets.

Main Results:

• Most studies, including recent ones, reported higher infectious disease marker rates in paid donors.
• Statistical analysis revealed no significant decrease in the risk difference between paid and unpaid donors over time (P = 0.128).
• Paid donors remain more likely to donate during the infectious "window period" and carry higher risks for labile blood components.

Conclusions:

• Paid blood donors continue to exhibit higher rates of infectious disease markers, indicating an ongoing risk.
• While plasma derivative processing may mitigate risks for plasma products, vigilance is needed for emerging infectious agents.
• Blood establishments should implement ongoing surveillance and report donor infectious disease marker data to authorities.