Donating blood in Europe, the differences between Italy and other countries: between requirements and benefits

There are certain exclusion criteria, which may be temporary or permanent. You should wait if you have flu symptoms, recently done piercings and tattoos, surgery or dental treatment, but also if you are pregnant. Risky sexual behaviour is also monitored. Whereas you are permanently excluded if you have cardiovascular diseases, neoplasms, diabetes, chronic alcoholism and drug addiction.

These requirements are assessed by doctors prior to collection. The donor is asked to answer a questionnaire assessing his health status and the presence of risk behaviour. Afterwards, a doctor will review the questionnaire and make an examination of the donor, determining whether or not he or she is suitable for collection.

In Romania, it was decided to focus on tangible benefits. Donors receive meal vouchers to a value recently increased to 280 lei (around 56 euro), a day off work and the possibility of buying government bonds at favourable interest rates. Despite this, the number of donors remains low and there are regular campaigns to encourage them. The government has chosen a strategy that seeks to combine personal benefit with the collective value of the gesture. The problem, however, is structural: there is a lack of donation culture and ongoing involvement of citizens.

A health questionnaire with questions on general health, risky travel and personal behaviour is also provided in Romania. This is followed by a haemoglobin measurement and normal blood tests. If abnormalities or pathologies are detected, the donor is informed and referred for specialist checks.

At the opposite extreme is Ireland, where the cardinal principle is voluntary and unpaid donation. The Irish Blood Transfusion Service (IBTS), the national body responsible for collection, reiterates the rejection of any financial incentive, in line with the philosophy promoted by the European Blood Alliance. Donors are simply thanked in public ceremonies after 50 or 100 donations. The organisation is efficient mainly in cities (Dublin, Cork), with fixed centres and mobile clinics reaching rural areas. However, the numbers remain limited: in 2023, 11,000 new donors and just over 75,000 total donations were registered.

Here too, the criteria are strict: questionnaire on illnesses, travel and risky behaviour, with attention also paid to any medications taken. A haemoglobin check is compulsory with every donation and a medical examination is carried out before collection.

In Croatia, in addition to the benefits, the protocol includes two days paid leave for each donation, up to a maximum of 10 days per year. Those who have made numerous donations receive free supplementary health insurance and, in Zagreb, also free public transport passes (30 donations for men, 20 for women). In addition, they receive a free meal at the collection centres. Croatia collects about 190,000 units of blood a year, with a strong gender imbalance: 84% of donors are men. The country has a well-structured system and a Counseling Centre for donors who test positive for the mandatory tests, offering an accompaniment and prevention service that is unique in Europe.

The evaluation process includes a detailed questionnaire, haemoglobin and vital signs checks, and mandatory HIV, hepatitis, syphilis and other infections screening.

In Austria, blood donation is free and voluntary by law, considered a gesture of solidarity and safety. The risk, according to the authorities, is that paying donors may induce them to lie on health questionnaires. However, a fee of around EUR 40 per plasma donation is expected. Donors receive a free blood group check, infectious disease tests and a Red Cross basic membership card. Donations take place at fixed centres and mobile collections, often without an appointment.

Requirements include age between 18 and 70 (max 60 for first-time donors), weight over 50 kg and good health. The questionnaire includes questions on health, travel, piercings/tattoos (4-month waiting period), recent infections and risky lifestyles. Each donation is preceded by a full blood check.

Spain has blood transfusion centres in all the Autonomous Communities, with fixed stations and mobile units. Collection is facilitated by the territorial spread, but the problem remains the involvement of the population, especially the young. Communication campaigns are intensified during critical periods, such as the Christmas and Easter holidays. During these months, the greatest urgency is for plasma, which is needed to produce life-saving drugs. Dr Luis Larrea of the SEHH (Spanish Society of Haematology) emphasised the need to adapt communication to the new social languages in order to involve young people, as traditional means are no longer sufficient.

The eligibility criteria are similar to those in Italy: minimum age 18 years, minimum weight 50 kg, good health. Specific questions concern travel outside Europe, recent vaccinations, tattoos, piercings and risky sexual behaviour. HIV, hepatitis and syphilis tests are compulsory.

Lithuania: Young people on the rise, but beware of shortages

Over the past five to ten years, Lithuania has seen an increase in the number of donors, especially among young people. In 2025, the country collected over 32,000 donations in the first five months, about 500 more than the previous year. However, the demand from healthcare facilities is increasing and there are still periodic shortages, particularly during summer holidays and after public holidays. To encourage donations, the National Centre organises public events and offers initiatives such as the free distribution of iron supplements for donors with borderline haemoglobin levels.

In Lithuania, too, a detailed questionnaire is completed, with questions on travel, medication, risk behaviour and general health. This is followed by haemoglobin measurement and infectious diseases tests.

The Czech Republic offers a multifaceted reward system: in addition to a paid day off for each donation, donors can reduce their tax base and obtain public recognition from local administrations. In Prague, for example, frequent donors receive free public transport passes. However, despite these incentives, the number of young donors is declining: today the average age has risen to 42 from 33 ten years ago. The country is still self-sufficient, but health authorities are sounding the alarm about a future in which, without a generational change, stocks may not be sufficient.

Here too, the course starts with a comprehensive health questionnaire, haemoglobin check and vital parameters, and mandatory infectious screening. Any abnormalities are reported and investigated with further examinations.

The European picture reveals a complex mosaic: from the pure altruism of Ireland and Austria, to the material benefits of Romania, Croatia and the Czech Republic, to the efficient logistical organisation of Italy and Spain. But the common denominator remains one: without strong generational change and campaigns capable of speaking the language of the younger generation, even the most structured systems risk failing to ensure self-sufficiency in the future.

*This article is part of the European collaborative journalism project "Pulse" and was contributed by Julie Šafová ((Deník Referendum, Czech Republic), Justė Ancevičiūtė (Delfi, Lithuania), Andrea Muñoz (El Confidencial, Spain), Kim Son Hoang (Der Standard, Austria) and Marina Kelava (H-Alter, Croatia) and Maria Delaney (The Journal Investigates, Ireland)