A methods review of the “healthy donor effect” in studies of long‐term health outcomes in blood donors

Rahman, Morshadur; Karki, Surendra; Hayen, Andrew

doi:10.1111/trf.16791

Cited by 2 publications

(2 citation statements)

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“…Multiple methods have been used to address the HDE in various studies. The main strategy is to apply an exposure window or qualification period to potentially mitigate the HDE [10]. It mainly involves using 1 qualification period (ie, all donors must donate for at least 5 or 10 years to be eligible for the study) to adjust for the HDE [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study

Su,

Sun,

et al. 2024

JMIR Public Health Surveill

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Background The World Health Organization emphasizes the importance of completely voluntary blood donation to maintain safe and sustainable blood supplies. However, the benefits of blood donation for donors, such as reducing the risk of disease, remain a topic of debate due to the existence of the healthy donor effect (HDE). This effect arises because of inherent health differences between blood donors and the general population, and it is also considered a methodological issue. Objective This study aims to generate a more detailed health profile of blood donors from a donor cohort study to mitigate and quantify the HDE and properly interpret the association between blood donation and disease outcomes among blood donors. Methods A retrospective cohort study was conducted between January 2012 and December 2018 among donors before their first donation. One-to-one propensity score matching was conducted through a random selection of individuals without any history of blood donation, as reported from their electronic health records. We conducted a Poisson regression between blood donors and non–blood donors before the first donation to estimate the adjusted incidence rate ratio (AIRR) of selected blood donation–related diseases, as defined by 13 categories of International Classification of Diseases, Tenth Revision (ICD-10) codes. Results Of the 0.6 million blood donors, 15,115 had an inpatient record before their first donation, whereas 17,356 non–blood donors had an inpatient record. For the comparison between blood donors and the matched non–blood donors, the HDE (the disease incidence rate ratio between non–blood donors and blood donors) was an AIRR of 1.152 (95% CI 1.127-1.178; P<.001). Among disease categories not recommended for blood donation in China, the strongest HDE was observed in the ICD-10 D50-D89 codes, which pertain to diseases of the blood and blood-forming organs as well as certain disorders involving the immune mechanism (AIRR 3.225, 95% CI 2.402-4.330; P<.001). After age stratification, we found that people who had their first blood donation between 46-55 years old had the strongest HDE (AIRR 1.816, 95% CI 1.707-1.932; P<.001). Both male and female donors had significant HDE (AIRR 1.082, 95% CI 1.05-1.116; P=.003; and AIRR 1.236, 95% CI 1.196-1.277; P<.001, respectively) compared with matched non–blood donors. Conclusions : Our research findings suggest that the HDE is present among blood donors, particularly among female donors and those who first donated blood between the ages of 46 and 55 years. Trial Registration Chinese Clinical Trial Registry ChiCTR2200055983; https://www.chictr.org.cn/showproj.html?proj=51760

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Section: Introductionmentioning

confidence: 99%

“…Currently, there is no evidence to certify the existence of the HDE prior to donation. The major weakness is that the potential HDE is not quantified and is usually estimated by researchers [10].…”

Section: Introductionmentioning

confidence: 99%

Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study

Su,

Sun,

et al. 2024

JMIR Public Health Surveill

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Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study (Preprint)

Su,

Sun,

et al. 2023

Preprint

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BACKGROUND The World Health Organization emphasizes the importance of completely voluntary blood donation to maintain safe and sustainable blood supplies. However, the benefits of blood donation for donors, such as reducing the risk of disease, remain a topic of debate due to the existence of the healthy donor effect (HDE). This effect arises because of inherent health differences between blood donors and the general population, and it is also considered a methodological issue. OBJECTIVE This study aims to generate a more detailed health profile of blood donors from a donor cohort study to mitigate and quantify the HDE and properly interpret the association between blood donation and disease outcomes among blood donors. METHODS A retrospective cohort study was conducted between January 2012 and December 2018 among donors before their first donation. One-to-one propensity score matching was conducted through a random selection of individuals without any history of blood donation, as reported from their electronic health records. We conducted a Poisson regression between blood donors and non–blood donors before the first donation to estimate the adjusted incidence rate ratio (AIRR) of selected blood donation–related diseases, as defined by 13 categories of International Classification of Diseases, Tenth Revision (ICD-10) codes. RESULTS Of the 0.6 million blood donors, 15,115 had an inpatient record before their first donation, whereas 17,356 non–blood donors had an inpatient record. For the comparison between blood donors and the matched non–blood donors, the HDE (the disease incidence rate ratio between non–blood donors and blood donors) was an AIRR of 1.152 (95% CI 1.127-1.178; P<.001). Among disease categories not recommended for blood donation in China, the strongest HDE was observed in the ICD-10 D50-D89 codes, which pertain to diseases of the blood and blood-forming organs as well as certain disorders involving the immune mechanism (AIRR 3.225, 95% CI 2.402-4.330; P<.001). After age stratification, we found that people who had their first blood donation between 46-55 years old had the strongest HDE (AIRR 1.816, 95% CI 1.707-1.932; P<.001). Both male and female donors had significant HDE (AIRR 1.082, 95% CI 1.05-1.116; P=.003; and AIRR 1.236, 95% CI 1.196-1.277; P<.001, respectively) compared with matched non–blood donors. CONCLUSIONS : Our research findings suggest that the HDE is present among blood donors, particularly among female donors and those who first donated blood between the ages of 46 and 55 years. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR2200055983; https://www.chictr.org.cn/showproj.html?proj=51760

show abstract

A methods review of the “healthy donor effect” in studies of long‐term health outcomes in blood donors

Cited by 2 publications

References 36 publications

Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study

Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study

Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study (Preprint)

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