Infectious disease markers in autologous and directed donations

Autologous collections are strongly advocated by the New South Wales Red Cross Blood Transfusion Service (BTS) and have increased more than sevenfold since 1988. Directed donations, although not promoted, have also increased during this time. The prevalence of infectious disease markers (HIV, hepatitis C, hepatitis B and syphilis) in donations collected by the BTS from different donor groups including overall volunteer homologous, first-time volunteer homologous, autologous and directed were evaluated over a 42-month period. Donations from first-time volunteer homologous donors had the highest prevalence of hepatitis B and C. Autologous donations had a significantly higher prevalence of hepatitis B, hepatitis C and syphilis compared with overall volunteer homologous donations. The percentage of directed donations testing positive for either hepatitis B or C was higher than overall volunteer homologous donations, but not statistically significant. This study demonstrates that donations from first-time donors are the least safe, that the crossover of autologous blood into the volunteer homologous pool decreases the safety of that pool and suggests that directed donations may not be as safe as volunteer homologous donations and cannot be generally advocated at this time.