Introduction: basic principles of blood donor selection

The basic principle of blood donor selection is simply stated: it should be safe for the donor to give blood and the donation should not harm the recipient.

The processes involved in achieving this deceptively simple aim are complex and so interwoven that no attempt can be made to separate out the criteria which might be considered specific for the microbiological safety of the donation.

Increasing public concern and litigation has led to many debates on the meaning of ‘safe’. Calman (2001) draws attention to the importance of clarifying the language of risk; the relationship between safety and perception of safety is debated by many authors in the Millennium Festival of Medicine (2001) (please refer to Chapter 26). A new tool for communicating risk perception is introduced by Lee, et al. (1998). Sadly this excellent and clear method has not yet seen wider acceptance.

The term ‘donor selection’, with its implication that there is an abundance of potential donors from amongst whom the blood services have only to select those who meet their current pre-set criteria, is misleading and outdated. Today, it is the donor who selects the activities he/she participates in and therefore ‘donor qualification’, implying positive action by the donor might be a more appropriate term.

This chapter will examine the problems involved in setting and implementing the selection/qualification criteria, highlight inconsistencies and seek solutions.