Director, VRI, Epidemiology and Policy Science
VP of research and scientific programs, Vitalant


Image of Brian S. Custer, PhD, MPH


Brian Custer is the Director of Epidemiology and Policy Science at Blood Systems Research Insititute (BSRI) San Francisco and Vice President  of Research and Scientific Affairs at BloodSystems. He is also an Adjunct Professor in the Department of Laboratory Medicine at UCSF. He earned his MPH and PhD degrees from the University of Washington in Seattle. He conducts research on the epidemiology and health economics of the blood supply and transfusion medicine policy throughout the world, primarily focused on infectious diseases, donor health, and recipient outcomes. He is actively involved in several committees and working groups of AABB, a member of the Transfusion-Transmitted Infectious Diseases Working Party of ISBT, and an Associate Scientific Member of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. He also serves on the US Department of Health and Human Services Advisory Committee on Blood and Tissue Safety and Availability.

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Brian Custer, PhD, MPH
270 Masonic Ave
San Francisco, CA, 94118
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Phone (415) 901-0756
Fax (415) 901-0733

  • Director, Epidemiology and Policy Science, Vitalant Research Institute, San Francisco, California

  • Vice President, Research and Scientific Affairs, Vitalant, Scottsdale, Arizona

  • Adjunct Professor, UCSF Department of Laboratory Medicine
  • BS, Biology, University of Oregon, Eugene, OR
  • MPH, Epidemiology, University of Washington, Seattle, WA
  • PhD, Pharmaceutical Outcomes Research and Policy, University of Washington, Seattle, WA

Research Interests


Health outcomes research methods can provide important insights into blood supply safety and the implications of transfusion practices. My research program blends two areas together: epidemiology and health policy research. The epidemiological methods we use include traditional epidemiology and molecular epidemiology to understand disease in donors and recipients. This combined approach is critical for improving transfusion safety. In parallel, health policy evaluation with a focus on modeling, comparative effectiveness and comparative cost-effectiveness research provides a broader program-level understanding of the costs and consequences of blood safety and transfusion interventions on clinical and public health.  

  • Transfusion Transmissible Infections

    We use traditional and molecular epidemiology methods in studies of donors and donor behavior to gain insights into infections that could be transmitted to recipients through transfusion. We have conducted numerous studies examining risk factors for infection and symptoms associated with infections in donors. In addition, we have assessed donor motivations and compliance with donation eligibility rules. The range of infectious agents studied include: HIV, HCV, HBV, HTLV, WNV, T. cruzi, and bacteria.

  • Impact of Transfusion on Blood Recipients

    The other types of epidemiological studies we conduct are projects that seek to understand clinical and health outcomes in blood donors and recipients. This area of work is wide ranging but the common denominator is the use of study designs, such as cohort or case-control studies, to assess adverse events, including transfusion-transmitted infections or, separately, benefits related to receipt of transfusion.

  • Policy and Health Economic Analyses

    My other major area of research is in health policy with a specific focus on health economic analyses of blood safety interventions. This area of research has helped to define a growing awareness of the need for rigorous evaluation of the trade-offs and forgone benefits of using health care resources in blood safety in ways that may not maximize the overall health of the population or patients requiring transfusion.