Perspectives of paid whole and plasma donation
V Kretschmer1, M Weippert-Kretschmer, J Slonka
1Institute of Transfusion Medicine and Haemostaseology, University Hospital Marburg, Germany. kretschv@mailer.uni-marburg.de
Insights
In Germany, paid blood donors provide a safe and reliable blood supply, despite international rejection of donor payment. Ending compensation could cause critical shortages, necessitating objective discussion of all safety-improving measures.
Area of Science:
- Transfusion Medicine
- Public Health Policy
- Hematology
Background:
- International organizations like WHO and Red Cross oppose paid blood donation.
- Germany permits financial compensation for blood and plasma donation.
- Blood supply safety and donor demographics in Germany are under scrutiny.
Purpose of the Study:
- To analyze the safety and reliability of paid blood donors in Germany.
- To compare seroconversion rates between paid and unpaid blood donors.
- To assess the impact of eliminating donor compensation on blood supply.
Main Methods:
- Analysis of transfusion-transmitted infection markers in German donors.
- Detailed examination of a paid donor cohort at a university blood service.
- Comparison of seroconversion rates between paid (university) and unpaid (Red Cross) donors.
- Survey of paid donors regarding willingness to donate if compensation ceases.
Main Results:
- Low frequency of transfusion-transmitted infection markers in German donors.
- Paid donors at the university blood service form a stable, reliable cohort.
- Unpaid Red Cross donors exhibited a significantly higher seroconversion rate (16x) than paid donors.
- 77% of paid donors would stop donating if compensation ended, risking acute shortages.
Conclusions:
- Paid blood donation in Germany contributes to a safe and stable blood supply.
- Eliminating donor compensation poses a significant risk of blood shortages.
- Objective discussion of all measures, including financial compensation, is crucial for ensuring a safe blood supply.
Abstract:
Although payment of blood donors is rejected by the WHO, the FDA, the EU, and the Red Cross (RC), in Germany, monetary compensation of expenses is permitted not only for plasmapheresis but also for whole blood donation. The structure and organisation of the institutions ensuring the blood supply in Germany and the pertaining aspects of blood safety will be discussed. Data reported to the health authorities show that the frequency of transfusion-transmitted infection markers in the German donor population is low and that only very few infections have been transmitted through blood. This is underlined by a detailed analysis of the paid donor population of a small university blood service (UBS). The analysis documents a very stable and reliable cohort of predominantly repeat donors. Unpaid RC donors of blood units transfused to patients at the university hospital of Marburg showed a sixteen-times higher sero-conversion rate than those of the UBS (p < 0.0001). However, in a survey, 77% of the paid donors denied continuation of blood donation in the event of payment being stopped. Therefore non-remuneration would result in acute blood supply shortages. Since increased blood shortages are to be expected anyway in the near future, all measures improving the supply of safe blood, including monetary compensation, should be objectively discussed without prejudice.
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