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

作者全名："Su, Shu; Sun, Yang; Gu, Xiaoyun; Wu, Wenjie; Su, Xiaodong; Ma, Ting; Song, Aowei; Xie, Xinxin; Wang, Liqin; Cheng, Qianke; Guo, Lingxia; Zhang, Lei; Yang, Jiangcun"

作者地址："[Su, Shu; Sun, Yang; Ma, Ting; Song, Aowei; Xie, Xinxin; Wang, Liqin; Zhang, Lei; Yang, Jiangcun] Shaanxi Prov Peoples Hosp, Dept Transfus Med, 256 Youyi West Rd, Xian 710068, Peoples R China; [Su, Shu] Chongqing Med Univ, Affiliated Hosp 2, Dept Epidemiol & Biostat, Chongqing, Peoples R China; [Sun, Yang] Shaanxi Prov Peoples Hosp, Data Ctr, Xian, Peoples R China; [Gu, Xiaoyun; Wu, Wenjie; Cheng, Qianke] Shaanxi Hlth Informat Ctr, Dept Informat Technol, Xian, Peoples R China; [Su, Xiaodong] Shaanxi Prov Peoples Hosp, Dept Med Record Management, Xian, Peoples R China; [Guo, Lingxia] Hlth Commiss Shaanxi Prov, Planning Dev & Informat Off, Xian, Peoples R China; [Zhang, Lei] Xi An Jiao Tong Univ, China Australia Joint Res Ctr Infect Dis, Sch Publ Hlth, Hlth Sci Ctr, Xian, Peoples R China; [Zhang, Lei] Alfred Hlth, Melbourne Sexual Hlth Ctr, Artificial Intelligence & Modelling Epidemiol Prog, Melbourne, Vic, Australia; [Zhang, Lei] Monash Univ, Fac Med, Cent Clin Sch, Melbourne, Vic, Australia"

通信作者："Yang, JC (通讯作者)，Shaanxi Prov Peoples Hosp, Dept Transfus Med, 256 Youyi West Rd, Xian 710068, Peoples R China."

来源：JMIR PUBLIC HEALTH AND SURVEILLANCE

ESI学科分类：　

WOS号：WOS:001180585700001

JCR分区：Q1

影响因子：8.5

年份：2024

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：healthy donor effect; blood donors; predonation; health profile; longitudinal study; propensity score matching

摘要："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."

基金机构："Foundation of Chongqing [CSTB2023NSCQ-MSX0198]; Chongqing Health Commission and Science and Technology Bureau [2024QNXM056]; Second Affiliated Hospital of Chongqing Medical University Research [2023IITXG26]; National Natural Science Foundation of China [81950410639]; Outstanding Young Scholars Funding [3111500001]; Xi'an Jiaotong University Basic Research and Profession Grant [xtr022019003, xzy032020032]; Xi'an Jiaotong University Young Talent Support Grant [YX6J004]; National Key R&D Program of China [2022YFC2505100]"

基金资助正文："We thank the following individuals at the Shaanxi Provincial Blood Center: Hengxin Li, Xiaoli Cao, and Zhendong Sun. We also acknowledge the data interpretation assistance of Ke Ding at the Hanzhong Blood Center, Bing Shi at the Yanan Blood Center, Erqin Bai at the Yulin Blood Center, Shengli Yan at the Weinan Blood Center, Guoqiang Zhang at the Tongchuan Blood Center, Hailin Zhang at the Baoji Blood Center, Zhangxue Hu at the Ankang Blood Center, Guancheng Yuan at the Shangluo Blood Center, and Xin Liang at the Xianyang Blood Center. JCY is supported by the 2021 Science and Technology Talent Support Program of Shaanxi Provincial People's Hospital (grant 2021LJ-14) . SS is supported by the National Natural Science Foundation of China (grant 82304246) ; the Natural ScienceFoundation of Chongqing (grant CSTB2023NSCQ-MSX0198) ; the joint project of the Chongqing Health Commission and Science and Technology Bureau (grant 2024QNXM056) ; and the Second Affiliated Hospital of Chongqing Medical University Research (grant 2023IITXG26) . LZ is supported by the National Natural Science Foundation of China (grant 81950410639) ; Outstanding Young Scholars Funding (grant 3111500001) ; Xi'an Jiaotong University Basic Research and Profession Grant (grants xtr022019003 and xzy032020032) ; Xi'an Jiaotong University Young Talent Support Grant (grant YX6J004) ; and part of National Key R & D Program of China (grant 2022YFC2505100) .r Foundation of Chongqing (grant CSTB2023NSCQ-MSX0198) ; the joint project of the Chongqing Health Commission and Science and Technology Bureau (grant 2024QNXM056) ; and the Second Affiliated Hospital of Chongqing Medical University Research (grant 2023IITXG26) . LZ is supported by the National Natural Science Foundation of China (grant 81950410639) ; Outstanding Young Scholars Funding (grant 3111500001) ; Xi'an Jiaotong University Basic Research and Profession Grant (grants xtr022019003 and xzy032020032) ; Xi'an Jiaotong University Young Talent Support Grant (grant YX6J004) ; and part of National Key R&D Program of China (grant 2022YFC2505100) ."