title: Mutual blood donation is safer at small blood collection stations in China.
abstract: BACKGROUND
  The assumption that the level of safety of voluntary non-remunerated donors is significantly higher than that of family replacement donors is supported by global data without stratifying for first-time or repeat volunteer, or according to age, but the viral marker prevalence between replacement donors and first-time voluntary non-remunerated donors is similar.
  
  
  METHODS
  From 2006 to 2013, replacement and voluntary donors were respectively recruited by the hospitals and the Center Blood Station in Zhaoqing, Guangdong, according to the existing procedures, and all the donors were screened for hepatitis B virus (HBV) surface antigen (HBsAg), antibodies against hepatitis C virus (anti-HCV), human immunodeficiency virus (anti-HIV) (1 + 2) and Treponema pallidum (anti-TP) by the enzyme immunoassays (EIAs), and alanine aminotransferase (ALT) in the Center Blood Station by kinetic analysis method. The risk factors related to blood safety were analyzed by Binary logistic regression analysis.
  
  
  RESULTS
  Between 252,202 volunteers and 2771 replacement donors, the prevalences of ALT > 40 U/L and anti-HIV (4.88% and 0.01% vs 4.44% and 0.07%, respectively) were not significantly different. The prevalences of HBsAg, anti-HCV and anti-syphilis in replacement group were higher than those in voluntary group, which were related to donor's sex, age and donation time. Overall prevalence of serological markers was higher in male replacement donors than in female, and in replacement donor over 30 years than in those below 30 years, but the positive prevalence in repeated replacement donors was lower than that in first-time replacement donors.
  
  
  CONCLUSIONS
  With appropriate intervention measures, such as pre-donor screening and other donor selection policy, replacement donors and voluntary donors provide a similar level of viral safety. Our donor selection policy in future should focus on retaining both young replacement and young voluntary donors as repeat donors and promoting the donation proportion of females, which will improve blood safety.
authors.affiliation: Department of Immunology, Southern Medical University, Guangzhou, China; Zhaoqing Center Blood Station, Zhaoqing, China.
authors.forename: Shang-Liang
authors.initials: SL
authors.lastname: Chen
authors.affiliation: Zhaoqing Center Blood Station, Zhaoqing, China; Department of Transfusion, Southern Medical University, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Zhaoqing Center Blood Station, Zhaoqing, China.
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Chen
authors.affiliation: Department of Transfusion, Southern Medical University, Guangzhou, China.
authors.forename: Wen-Jing
authors.initials: WJ
authors.lastname: Wang
authors.affiliation: Department of Immunology, Southern Medical University, Guangzhou, China.
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Li
authors.affiliation: Department of Transfusion, Southern Medical University, Guangzhou, China. Electronic address: Chengyaoli@hotmail.com.
authors.forename: Cheng-Yao
authors.initials: CY
authors.lastname: Li
authors.affiliation: Department of Immunology, Southern Medical University, Guangzhou, China. Electronic address: zhlchen@smu.edu.cn.
authors.forename: Zheng-Liang
authors.initials: ZL
authors.lastname: Chen
mesh_terms: D000328:Adult; D001782:Blood Donors; D058731:Blood Safety; D002681:China / Q000453:epidemiology; D046148:Donor Selection; D005260:Female; D006509:Hepatitis B / Q000097:blood* / Q000453:epidemiology; D006526:Hepatitis C / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008297:Male; D013587:Syphilis / Q000097:blood* / Q000453:epidemiology
keywords: Blood donor; Blood safety; China; Replacement donor; Volunteer