Blood and organ donation: health impact, prevalence, correlates, and interventions

Abstract

Objective: Without a supply of blood, health services could not meet their clinical needs. Similarly, organs for transplantation save and transform lives. Donations are acts of generosity that are traditionally seen as altruistic, and accordingly, interventions to recruit and retain blood and organ donors have focused on altruism. We review the predictors, prevalence and correlates of these two behaviours, how effective interventions have been, and draw common themes.

Design: Narrative review.

Results: We highlight that both recipients and donors benefit, and as such neither blood nor organ donation is purely altruistic. We also highlight health problems associated with both types of donation. In evaluating interventions, we highlight that a move to an opt-out policy for organ donation may not be the simple fix it is believed to be, and propose interventions to enhance the effectiveness of an opt-in policy (e.g. social media updates). We show that incentives, text messaging, feedback and a focus on prosocial emotions (e.g. ‘warm-glow’, ‘gratitude’) may be effective interventions for both blood and organ donation. Interventions designed to reduce fainting (e.g. water pre-loading) are also effective for blood donation.

Conclusions: We conclude that affect is key to understanding both types of donation and in designing effective interventions.

Keywords:

• Blood donation
• organ donation
• altruism
• reciprocity

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 There may also be an additional cost as in some cases the donor finds out that they are not actually related to their relative.

2 The MOA approach recommends that behavioural economic games are used to assess these mechanisms so as to avoid social desirability effects when simply asking people why they donate blood or register to be an organ donor (Ferguson, 2015a; Ferguson & Lawrence, 2015).

3 A person may be permanently (can never give blood) or temporally (can give blood after a designed time window) deferred from blood donation. Permanent deferrals occur if, for example, the person has had a blood transfusion (or blood products) since 1st January 1980. Temporary deferrals can be on grounds of anaemia, travel abroad, sexual behaviour, tattoos, or intravenous drug taking.

4 Singapore operates a priority system, with those on the organ donation register given greater priority to organs if needed. This powerful policy is likely to over-ride other factors.

Additional information

Notes on contributors

Eamonn Ferguson

Eamonn Ferguson currently has funding from the UK National Health Service Blood and Transplant (NHSBT) Trust fund to examine perceptions of trust and discrimination with respect to recruiting Black, Asian and Ethic Minority (BAME) blood donors (TF082). Professor Ferguson is also working on a collaborative project with Australian Red Cross to explore interventions to the enhance the conversion rate of 1^st time to 2^nd time blood donors based on warm-glow messages. Professor Ferguson sits on the NHSBT Research and Development – Behavioural Research Strategy Group (July 2018) and the NHSBT ‘For the Individual Assessment of Risk’ (FAIR) Steering group (November 2018).

Catherine Murray

Catherine Murray is currently funded by the University of Stirling as a Research Fellow to support health and behaviour research. She has no conflicts of interest.

Ronan E. O’Carroll

Ronan E. O'Carroll has previously worked with NHSBT on a trial aimed at using anticipated regret to increase organ donor registrations. He is the British Psychological Society Representative on the Executive Committee of Scottish Intercollegiate Guideline Network (SIGN) (2009–date). He served on the UK National Institute of Clinical Excellence (NICE) organ transplantation clinical guideline development group (2010, 2013, 2016). He was appointed as an Expert Adviser for the NICE Centre for Guidelines (2017–2020). He was a member of UK National Institute of Health Research (NIHR) Health Services & Delivery Research Grants Board (2010–2017) and the UK NIHR Programme Grants Board for Applied Research (2011–2014). In 2017 he was appointed to the NIHR Policy Research Unit Commissioning Panel.