Chapter 19
Donor Program Management
Rebecca J. Nusbaum
Hemosolutions, Colorado Springs, Colorado, USA
Introduction
There are several reasons to explore the option of starting an animal blood bank. Veterinarians who infrequently perform transfusions or clinics that are located in an area without ready access to blood products might find that having blood donors available is the best way to meet their needs. Even though there are several commercial blood banks located throughout the United States and Canada, there might still be a need for a clinic to have its own supplemental source of blood products.
Depending on the goals of the blood bank, there are many questions that will need to be answered, including whether the blood bank is meant to support a specific clinic or provide blood products at a local, regional, or national level; what blood products will be available; what additional services will be provided; where the donors will be acquired; if the donors will be housed at the facility or if they will be volunteer donors housed with families; what type of compensation, if any, will be provided; how relationships with local veterinarians will be fostered; what steps will be taken to provide a safe product and a service that is trusted; who will provide the labor; how the supplies and equipment will be purchased; whether the program will be profit or non-profit; how the product will be paid for; and what protocols will be used to protect the blood bank from liabilities. There are many variables to consider when starting a blood bank. Regardless of the size, needs, and specific goals of the blood bank, this chapter will provide a basic structure for individuals who wish to operate a veterinary blood bank.
Licensing requirements
Licensing is not currently required to provide blood products in the United States, but California has written blood bank licensure requirements that are overseen by the California Food and Drug Administration. Most blood banks, although not required, voluntarily follow specific guidelines and recommendations from organizations such as the Association of Veterinary Hematology and Transfusion Medicine (AVHTM), the International Association of Veterinary Blood Banking (IAVBB), the American Association of Blood Banking (AABB), the American College of Veterinary Internal Medicine (ACVIM), and the Veterinary Emergency and Critical Care Society (VECCS).
Donor management
There are many decisions to be made regarding the operation and maintenance of a canine and feline donor program, including how donors will be acquired and whether they will be volunteer donors housed with families or reside at the facility. Community-based volunteer donors, much like the human programs used by the American Red Cross or Canadian Blood Services, are well received and can provide a large number of repeat donors depending on the community size. Prior to housing donors at a closed facility, checking local, regional, and/or state/provincial regulation is strongly recommended. Depending on the state, the facility might be required to follow United States Food and Drug Administration guidelines. Additionally, if the blood bank is not also operating as a veterinary clinic, there might be additional city codes that require compliance.
Acquisition of resident donors might include sources such as licensed animal dealers, rescue organizations, shelters, and owner relinquishment. Consideration must be given to ensure the quality of life for donors that are housed at the facility. Regardless of what is required by law, an animal blood bank should provide products in an ethical manner. Ensuring that veterinary care, high-quality food, indoor and outdoor activities, enrichment, and compassionate and loving human interaction with each of the animals are provided is the responsibility and duty of the blood bank.
Feline donor management
Privately owned feline donors are not typically ideal candidates for feline blood programs. Most commonly, cats require general anesthesia or sedation for a safe, atraumatic blood donation. Although anesthetic and sedation protocols can be developed to maximize donor safety, assessment of the liability a blood bank is willing to assume for a privately owned cat must be taken into consideration. The risk for harm to the donor is difficult to justify. Anesthesia should ideally be reserved for medical necessity, not for donating blood. Efforts to eliminate sedation are being explored within the veterinary field, but it requires careful donor selection for temperament and stress-free handling procedures (see Chapters 15 and 16).
To reduce the liability associated with using privately owned cats as donors, some blood banks might chose to have in-house volunteers donors and after a predetermined number of donations or amount of time spent in the program, adopt them into homes.
Canine donor management
Because it is difficult to ensure quality of life for permanently housed canine donors while maintaining profitability, most blood banks operate using volunteer canine donors. These donors are part of a family, living in private homes and considered by most to be companions. Their owners therefore require detailed and comprehensive information and thorough communication. When enrolling a canine donor, it is imperative that the owner understands everything that will be done with their pet. All of the owner’s questions should be completely and honestly answered. Many owners enter the program because of their love for animals or because they have had personal experience with a pet requiring a transfusion. The importance of appreciating donors cannot be overstated; without them, there is no blood supply.
Donor recruitment
There are many reasons people choose to volunteer their dogs to donate blood (Box 19.1). Understanding the owner’s motivation will help to recruit the most suitable donors. Most people are not volunteering their pet for monetary gain or incentives. Because they care about animals, they have a genuine interest in helping to secure a much needed resource for other pets. These owners are preferable since they are often more committed to the care of their pet, are more likely to seek preventative veterinary care, and have a positive disposition. Their pets are therefore more likely to be healthy, which creates a safer blood product for the recipient.
Caution should be taken when recruiting an owner who is only interested in volunteering their pet for the incentives offered. This can become especially dangerous if there are multiple blood banks in the area that the owner can enroll the pet into, allowing for exploitation and harm to the animal. Establishing how honorable owners’ intentions are can be acquired with good communication and a complete history. Although this is most unlikely to occur except on rare occasions, educating the owner regarding the negative and harmful effects that might arise from excessive donations might deter them from this practice.
Donor recruitment
Recruiting donors can be an expensive prospect. Each program must determine which methods of donor recruitment are cost effective for their needs (Table 19.1). Advertising with a local chapter of the Humane Society or the Society for the Prevention of Cruelty to Animals is an excellent way to reach people who are interested in animal welfare. However, participating in marketing events sponsored by these larger national organizations can be cost prohibitive. Fundraising events for smaller rescue organizations typically focus on the pet owner population and might be more cost effective. Some communities offer “dog jogs” and other venues sponsored by dog friendly businesses (Figures 19.1 and 19.2). Although these events can be fairly expensive advertising options, the population is typically more targeted, so the cost to donor recruitment ratio might be more favorable. Dog parks are also a viable avenue for acquiring large breed dogs that qualify for the program. When taking this approach, checking with city ordinances to prevent violation of soliciting laws is recommended. Presenting a display (e.g., sign) that encourages park attendees to consider seeking information on their own terms is often more effective.
Table 19.1 Advantages and disadvantages of possible donor sources
| Donor source | Advantages | Disadvantages |
| Newspaper advertising Radio advertising | Reaches a greater number of prospective donors Less time commitment | Expensive relative to donor yield Audience not targeted to pet owners Impersonal |
| Advertising at humane society or SPCA fund-raising events | Targeted marketing audience | Expensive relative to donor yield |
| Participation in pet-focused community events | Targeted marketing audience Personal contact with owners High percentage of interested owners follow through to become donors Ability to pre-screen for qualifying donors | Increased time commitment Requires “sales” skills |
| Solicitation at local dog parks | Targeted marketing audience Personal contact with owners High percentage of interested owners follow through to become donors Ability to pre-screen for qualifying donors Inexpensive | Increased time commitment Requires “sales” skills Requires compliance with city ordinances |
| Recruiting clients from the clinic where the blood bank is located | Targeted marketing audience Personal contact with owners High percentage of interested owners follow through to become donors Ability to pre-screen for qualifying donors Inexpensive | Requires commitment and training of the clinic staff Can require additional time during appointments |
| Veterinary referrals | Targeted marketing audience Ability to pre-screen for qualifying donors Inexpensive Owners feel more comfortable when blood donation is encouraged by their veterinarian More likely to be receiving preventative care | Requires commitment and training of the clinic staff Might require incentives to motivate clinic staff Might require additional time during appointments |
| Breeders | Targeted marketing audience Personal contact with owners Ability to pre-screen for qualifying donors Inexpensive One owner might have multiple donors Owners may refer you to other breeders | Owner stipulations may restrict protocols Animals in active breeding programs might be prevented from donating due to concerns regarding infectious disease transmission Breeding animals might travel |
| Kennel clubs/shows/trials | Targeted marketing audience Ability to pre-screen for qualifying donors Inexpensive More likely to be receiving preventative care Word of mouth advertising might result | Owner stipulations might restrict protocols Concerns for performance might prevent donation prior to a trial/show, requiring more flexibility on the part of the blood bank |
| Rescue groups | Can decrease cost for veterinary organizations Less time-consuming because there might be multiple donors recruited from fewer personal communications | Fulfilling individual donation requirements might be compromised by adoption Impeding an adoption to complete a donation agreement is not in the best interest of the pet |
| Social media | Inexpensive Large audience | Requires permission from current donors if pictures are to be used Potential for spread of misinformation Could require increased time commitment |
| Human blood banks | Relatively inexpensive Individuals already understand the importance and process of blood donation | Marketing is not targeted at pet owners |
| Word of mouth | No cost Complimentary Individualized recruitment | Requires commitment to excellent donor customer service Misinformation can occur |
SPCA, Society for Prevention of Cruelty to Animals.
Figure 19.1 Donor recruiting event flier.
Figure 19.2 Donor recruiting event flier.
Breeders, breed organizations, members of kennel clubs, and individuals that compete with their dogs can also function as suitable resources for donors and can allow for selection of specific breeds. To maintain show ring readiness, some owners oppose shaving prior to donation. However, there are techniques that can be employed to preserve the show ring appearance while still allowing for aseptic venipuncture. Utilizing rescue organizations as a source of donors can be very rewarding. Partnering with a rescue organization can not only provide donors, but can also increase adoption rates. However, the likelihood of recovering the cost for screening these donors prior to their adoption must be evaluated. A commitment to continued donations should never be a requirement of adoption, which is ultimately more important for the animal’s well-being. New owners can be provided with information regarding donation, but should not be pressured to continue in the program.
If the program is affiliated with a veterinary clinic, prospective donors can be approached during preventative care visits or blood donor information in the form of posters or pamphlets can be provided in the waiting room. Blood typing can also be offered when performing routine blood work, as a part of emergency preparedness and donor screening. This often opens the door for discussions about blood donation.
Incentives
Although many people receive personal satisfaction from knowing their pet is saving lives, some might need additional motivation before committing to the program. Before deciding to offer an incentive, careful consideration of the organization and goals of the blood bank are required. Human blood donor programs have moved away from paying their donors; it has been documented that when converting from paid donors to volunteer donors there was not a disruption or a shortage in the blood supply (Eastlund 1998). Safe and reliable blood resources can be produced via charitable community donor programs and are well received.
Some blood banks choose to offer incentives upon enrollment in the program, while others elect to reward the owner only after the donor completes an agreed commitment (DeLuca et al. 2006). Delaying compensation until multiple donations have been completed might allow the blood bank to provide incentives of higher value. Incentives such as complimentary lab work and discounted or no-cost transfusion products in the event a transfusion is needed by the donor can be offered (Box 19.2). Some clinics provide credit toward the donor’s routine veterinary care for all the of family pets. Other creative avenues for incentives could include donor family events.
When determining the level of incentive to offer, consider these factors: the cost of recruitment and screening, annual laboratory fees, staff payroll, and the price of supplies, as well as incidental costs such as fees for using the building and owner travel time. These costs must be offset by the income that is derived from the products received from the donors. It is also important to evaluate if all the components derived from the donor’s blood are marketable. Since dog erythrocyte antigen (DEA) 1 negative blood is typically in higher demand, it might be sold at a higher price, so the blood bank might choose to offer increased incentives to DEA 1 negative donors. It might also be possible to get sponsorships or donated items from pet food companies and franchises to give to the donors. This might require the program to be non-profit or the company might request specific paperwork to be submitted for review, but the option can be explored.
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