As we continue to grapple with periodic platelet shortages across the nation, it's worth revisiting a promising solution that has seemingly faded from the conversation: the compensated donor model.
Having served as the Senior Director of Sales and Customer Service at Secure Transfusion Solutions (STS), an innovative venture-backed startup that pioneered the compensated platelet donor model, I've seen its potential firsthand. Unfortunately, STS closed its doors in 2023 due to funding challenges. However, the data collected during its operations underscored the viability and safety of this model.
In this article, I’ll cover current platelet shortages, share insights from STS's findings, address some frequently asked questions, and provide my perspective on the future viability of this model.
Current Platelet Shortages:
Platelets are essential for preventing bleeding in certain cancer patients, those undergoing surgeries, trauma patients, and other critically ill patients. With a shorter shelf life than other blood components, only 5 to 7 days, the demand for platelets is continuous.
In January, the American Red Cross declared an emergency blood shortage, urging blood and platelet donors to roll up their sleeves to help ensure that patients receive the care they need 1 . Although platelet inventories seem to have improved nationwide as we approach the midpoint of the year, shortages still remain a concern for many blood centers as we head into summer.
One of the most serious challenges facing blood centers nationwide is the aging platelet donor base, a phenomenon which has been well-documented in the industry but has proven to be notoriously difficult to address 2.
How Does the Compensated Blood Donor Model Work?
The compensated donor model involves offering financial incentives to donors, aiming to increase engagement and donation frequency. STS adopted this approach to address the issue of an aging donor pool and the insufficient number of young donors willing to participate in the time-consuming apheresis platelet donation process. By combining a high-quality donor experience with compensation, STS sought to recruit and retain a younger, more diverse donor base through its donor-facing brand, Trusting Heart Blood Center (THBC).
Safety Features:
The STS model relied on two key safety features:
Pathogen Reduction: STS implemented pathogen reduction on all platelets using the Cerus Intercept system. This technology inactivates a broad range of pathogens, including bacteria, viruses, and parasites, potentially reducing the risk of transfusion-transmitted infections 3.
Rigorous Donor Screening: STS performed infectious disease marker testing for every potential new donor on two separate occasions. New donors were required to wait three weeks after the first test before allowing them to donate to minimize any window period risk. Any donor whose donation interval exceeded six months was required to undergo two rounds of testing again before being allowed to reenter the donor pool.
Key Findings from STS:
During the initial 22 months of operations at STS' first paid blood platelet donation center, Trusting Heart Blood Center in Edina, Minnesota, several encouraging trends were observed. Data indicated that the model successfully recruited and retained a younger donor base, with a median donor age of 43 for males and 45 for females, in contrast to the older donor base of other blood collection organizations 4. Additionally, the donor base was majority female (53.3%), while other organizations typically have a majority male donor base 4.
Data also revealed that donor motivations extended beyond monetary compensation. Altruism, personal significance, and understanding the current need for platelets were all significant factors for donors at Trusting Heart Blood Center 4. This suggests that a compensated donor model does not necessarily undermine the altruistic nature of blood donation.
The model showed substantial efficiencies in split rate (the percentage of successful donations resulting in two or more transfusable platelet units), high order fill rates, and predictability in digital donor recruitment, donation frequency, and collection surge capacity, particularly during traditionally challenging holiday periods 4. Finally, the compensated donor model allowed for more rigorous donor selection and retention processes, contributing to these efficiencies.
Frequently Asked Questions:
1. Do federal regulations allow for paid blood donors?
According to the relevant Code of Federal Regulations (Under 21 CFR 606.121(c)(8)(v)), if a donor receives monetary compensation for blood donation, the unit must be labeled with the “paid donor” classification (this applies to units intended for transfusion)5.
2. Will hospitals accept units from paid blood donors?
Yes, the experience of STS shows that they will. During its operations, the company served several academic medical centers as a secondary provider of blood components for transfusion.
3. Does paying blood donors ultimately drive up the cost of collections and subsequently increase cost to hospitals?
Not necessarily. While there are significant costs associated with compensating donors, the increased efficiency and predictability of the compensated donor model can help offset these costs. Additionally, the potential reduction in wastage and improved donor retention may further contribute to cost savings.
4. Can the compensated blood donor model replace the traditional volunteer model?
The STS experience shows that the compensated donor model can help to mitigate blood shortages and augment the conventional volunteer model.
Conclusion:
The compensated blood donor model has shown promise in addressing the ongoing platelet shortages. By offering financial incentives to donors, STS was able to recruit and retain a younger, more diverse donor base, and achieve substantial efficiencies in split rate, high order fill rates, and predictability in donor recruitment, donation frequency, and collection surge capacity. While the compensated model may not replace the traditional volunteer model, it can be a useful way to augment the existing blood collection system and potentially mitigate shortages.
References:
1. American Red Cross. (2024). National Blood Crisis: Red Cross Faces Severe Blood Shortage. https://www.redcross.org/about-us/news-and-events/press-release/2024/red-cross-declares-emergency-blood-shortage-calls-for-donations-during-national-blood-donor-month.html
2. Transfusion (2022). Donor Motivation and Psychosocial Research. Merlyn Sayers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545312/
3. Cerus Corporation. (2024). Pathogen Reduction. https://intercept-cryoprecipitation.com/pathogen-reduction/
4. Global Newswire. (2022). Secure Transfusion Solutions Presents Data Demonstrating Feasibility and Safety of its Novel Compensated Blood Donation Model. https://www.globenewswire.com/en/news-release/2022/10/17/2535691/0/en/Secure-Transfusion-Solutions-Presents-Data-Demonstrating-Feasibility-and-Safety-of-its-Novel-Compensated-Blood-Donation-Model.html
5. Compliance Policy Guide, CPG Sec. 230.150: Blood Donor Classification Statement, Paid or Volunteer Donor. (2019). https://www.fda.gov/media/75039/download
By Joe Ferrara, Bloodwise Solutions, Inc.
Questions? Comments? Please email joe@bloodwise-solutions.com or visit www.bloodwise-solutions.com
Note: This blog post originally appeared as a LinkedIn post in June 2024
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