Blood donation in times of crisis: Early insight into the impact of COVID-19 on blood donors and their motivation to donate across European countries.

BACKGROUND: In this survey, we aimed to provide early insight into the impact of COVID-19 on blood donors and their motivation to donate during the crisis. STUDY DESIGN AND METHODS: We asked representative samples in 7 European countries (Denmark, France, Germany, Italy, Portugal, the Netherlands and the UK) about their blood donation activity and motivation to donate using an online survey. We analysed donor turnout during the COVID-19 period descriptively and using logistic regression. RESULTS: Of the 7122 people that responded to the survey, 1205 (16·9%) blood donors were identified, with 33·8% donating during the first 4-5 months of the COVID-19 period. We observed that around half of donors donated less than normal. The vast majority of donors that did donate made a special effort to do so in response to COVID-19. The majority of donors were also not aware of their blood being tested for COVID-19 antibodies. Although the perceived risk of infection among all respondents whilst donating blood was relatively low, those who anticipated a high risk of infection were much less likely to donate (OR = 0·540; P-value = 0·006). Furthermore, those that were adherent to COVID guidelines were also less likely to donate (OR = 0·583; P-value = 0·000). DISCUSSION: We suggest that blood collection services consider specialist campaigns that focus on the altruistic motivation of donors during the crisis and that they continue to communicate the additional safety measures in place with the aim of reducing the fear of infection whilst donating blood.

The impact of temporary deferrals on future blood donation behavior across the donor life cycle.

BACKGROUND: Donor retention is essential for blood banks because acquiring new donors is more expensive than retaining existing ones. Previous studies show that the temporary deferral of donors negatively impacts future donation likelihood. In this study, we analyze the impact of temporary deferrals on future donation behavior while correcting for potential endogeneity, depending on the level of donor experience and number of previous deferrals. STUDY DESIGN AND METHOD: We use data from more than 123,000 whole blood donors of the Austrian Red Cross over a period of 5.5 years. We estimate logit models to analyze how a deferral affects future donation behavior while controlling for potential selection biases because donors are not deferred randomly. We control for gender, blood type, years since first donation, and number of previous donations and deferrals. We analyze the direct deferral effect, its interaction with donor experience, and the number of previous deferrals. RESULTS: Our results confirm that temporary deferrals hurt future donation behavior. This effect varies with donor experience and the number of previous deferrals. The effect is weaker with a higher number of previous donations and is stronger with a higher number of previous deferrals. The results suggest that donors learn to cope with deferrals the more they donate. However, the negative effect of deferrals amplifies over time, and each additional deferral decreases donation likelihood. CONCLUSION: Blood banks that seek to overcome the negative effect of deferrals should be aware that this effect varies with donor experience and with the number of previous deferrals. Our results suggest that blood banks should focus on early-stage donors who are deferred because the negative deferral effect is stronger for more experienced donors. At the same time, blood banks should be careful with donor groups who have experienced deferrals in the past because every additional deferral demotivates future donation behavior. Overall, researchers should be careful to correct for endogeneity because our results suggest that ignoring these effects could lead to substantial underestimation of the negative deferral effect.

Blood donation and donors: insights from a large German teaching hospital (2008-2017).

BACKGROUND AND OBJECTIVES: The availability of blood and blood products is crucial for the provision of high-quality hospital services. We analyse changes in whole blood donations, donors and their behaviour over 9 years at a large German teaching hospital. MATERIALS AND METHODS: A descriptive analysis using data from over 34 000 donors and 265 000 donations from a large university hospital's blood centre was conducted using data from July 2008 to December 2017. The analysis focussed on (a) whole blood donations and (b) donor characteristics and how they changed over time. We categorized donors into four categories according to their donation activity (First-Time, Highly Active, Active and Reactivated). RESULTS: We observed falling donations over time and that donors donated less frequently. Consequently, we show a downward trend in the number of Highly Active donors, whilst First-Time donors remained stable. We also provide evidence that donors donated well below their capacity and that the blood type of donors appeared to be in line with the wider German donor population. Lastly, we show a sharp drop in the return rates of First-Time donors over time. CONCLUSION: We recommend that Highly Active donors and former Highly Active donors are more carefully considered when planning donor engagement strategies and effort made in (at the very least) maintaining their donation activity. Our results in the context of the literature highlight the need for further research into the changing attitudes towards blood donation and prosocial activities.

ATTIRE: Albumin To prevenT Infection in chronic liveR failurE: study protocol for an interventional randomised controlled trial.

INTRODUCTION: Circulating prostaglandin E2 levels are elevated in acutely decompensated cirrhosis and have been shown to contribute to immune suppression. Albumin binds to and inactivates this immune-suppressive lipid mediator. Human albumin solution (HAS) could thus be repurposed as an immune-restorative drug in these patients.This is a phase III randomised controlled trial (RCT) to verify whether targeting a serum albumin level of ≥35 g/L in hospitalised patients with decompensated cirrhosis using repeated intravenous infusions of 20% HAS will reduce incidence of infection, renal dysfunction and mortality for the treatment period (maximum 14 days or discharge if <14 days) compared with standard medical care. METHODS AND ANALYSIS: Albumin To prevenT Infection in chronic liveR failurE stage 2 is a multicentre, open-label, interventional RCT. Patients with decompensated cirrhosis admitted to the hospital with a serum albumin of <30 g/L are eligible, subject to exclusion criteria. Patients randomised to intravenous HAS will have this administered, according to serum albumin levels, for up to 14 days or discharge. The infusion protocol aims to increase serum albumin to near-normal levels.The composite primary endpoint is: new infection, renal dysfunction or mortality within the trial treatment period. Secondary endpoints include mortality at up to 6 months, incidence of other organ failures, cost-effectiveness and quality of life outcomes and time to liver transplant. The trial will recruit 866 patients at more than 30 sites across the UK. ETHICSANDDISSEMINATION: Research ethics approval was given by the London-Brent research ethics committee (ref: 15/LO/0104). The clinical trials authorisation was issued by the medicines and healthcare products regulatory agency (ref: 20363/0350/001-0001). The trial is registered with the European Medicines Agency (EudraCT 2014-002300-24) and has been adopted by the National Institute for Health Research (ISRCTN 14174793). This manuscript refers to version 6.0 of the protocol. Results will be disseminated through peer-reviewed journals and international conferences. Recruitment of the first participant occurred on 25 January 2016.