BLOOD DONORS AND BLOOD COLLECTION Understanding the plasmapheresis donor in a voluntary, nonremunerated environment Liliana L. Bove, Tim Bednall, Barbara Masser, and Mark Buzza BACKGROUND: Increasing demand for plasma- derived products presents a major recruitment and retention challenge for blood collection agencies; however, little is known about what motivates individu- als to become committed plasmapheresis donors. This study explored triggers for individuals’ first plasma donation and factors associated with continuing donations. STUDY DESIGN AND METHODS: A total of 103 plasma donors were recruited into 11 focus groups. Reasons for donating were discussed using a semi- structured questioning approach. Transcripts were ana- lyzed using a grounded theory approach. Categories of perceptions, beliefs, and attitudes were developed from the data, cross-validated, and when relevant, assigned to higher-order themes. RESULTS: Awareness of plasmapheresis was most often gained when donors were unable to donate whole blood. Accordingly, the main trigger for conversion to plasma donation was a personal request by collection staff. A key benefit of plasma donation was its increased frequency, which facilitated the establishment of a routine and relationship development with staff and donors, whereas the key reported sacrifice was the greater donation time. Disappointment was the main response to an inability to donate. Functional tokens and refreshments were valued by donors, although it was felt that money spent on tokens would be better invested in making operations more efficient. CONCLUSION: Suitable whole blood donors should be made aware of plasmapheresis and its associated ben- efits through collection staff. Sustained donation can be encouraged by the establishment of a regular schedule and positive interactions with collection staff and other donors to enhance the donors’ subjective well-being. P lasma-derived intravenous immunoglobulin (IVIG) is a key clinical product, which is used to treat a range of neurologic, hematologic, and immunologic disorders. As such, IVIG is the key driver of plasma supply globally. 1 The demand for IVIG internationally, and hence the need for source plasma, has grown strongly in recent years. For example, Canada has experienced more than a 50% increase in grams of IVIG issued per 1000 population over the 5 years from 2003/ 2004 to 2008/2009. 2 Australia also has experienced 83% growth in overall IVIG use in the 5 years between 2004/ 2005 and 2009/2010 and a 79% increase in IVIG supplied per 1000 population between 2003/2004 and 2009/2010. 3 It is predicted that IVIG usage will continue to grow sig- nificantly, 4 with the future demand for IVIG in developed countries largely being driven by populations that are increasing in age 5 and weight 6 and the emergence of IVIG for the treatment of age-related disorders. In the Australian context, domestic demand for IVIG currently exceeds plasma supply. Australia has a policy commitment to becoming self-sufficient in IVIG (with contingencies); however, achieving this will require a 123% increase in plasma supply from 2005/2006 levels by ABBREVIATION: TTM = transtheoretical model of behavioral change. From the Department of Management and Marketing, The Uni- versity of Melbourne, and Research & Business Development and Operations, Australian Red Cross Blood Service, Melbourne, Victoria; and the School of Psychology, The University of Queensland, St Lucia, Queensland, Australia. Address reprint requests to: Liliana Bove, Department of Management and Marketing, The University of Melbourne, Mel- bourne, 3010, Australia; e-mail: lbove@unimelb.edu.au. This research was conducted in accordance with the National Health and Medical Research Council’s National State- ment on Ethical Conduct in Human Research as cleared by the ethics board of the University of Queensland. Received for publication November 9, 2010; revision received March 14, 2011, and accepted March 14, 2011. doi: 10.1111/j.1537-2995.2011.03168.x TRANSFUSION 2011;51:2411-2424. Volume 51, November 2011 TRANSFUSION 2411