Regional and temporal variation in American Red Cross blood donations, 1995 to 2005

Effects of meteorological factors on blood donation

BACKGROUND AND OBJECTIVES

Blood donation can be affected by various factors including time, weather, and other events (such as disasters). To better understand how meteorological factors affect blood donation, this study builds a novel predictive model for blood supply in North Taiwan to facilitate better blood supply chain and inventory management.

MATERIALS AND METHODS

This study uses a two-step prediction model that combines generalized additive models (GAM) and time series models to investigate the meteorological and the day-of-the-week effects on blood donation. For the period 2010-2014, blood donation data and weather information of Big Taipei area are described and analyzed. A bootstrap method was also implemented on the residuals produced by the two-step model to construct the prediction intervals.

RESULTS

Daily average temperature and daily cumulative precipitation have non-linear effects on blood donation. By including weather information into the model, the prediction model not only can account for the fluctuation affected by the day-of-the-week effects but also the weather (e.g., temperature and rainfall) effects. The prediction intervals can be used to detect the anomaly donation patterns or to signal possible shortages when there is a forecast of an extreme weather event.

CONCLUSION

The findings underscore the need for quantitatively modeling meteorological effects in blood supply chain management, and provide important implications for the authority of a blood center to take necessary intervention and measures to reduce shortages and excessive expirations.

Reasons of under-representation of Iranian women in blood donation

The under-representation of women in blood donation can lead to blood shortages. We aimed to determine the factors, which encourage or impede blood donations in women. The findings can help us in designing effective recruitment strategies that could encourage women to donate blood to cover the patients’ needs. This cross-sectional study was conducted in Shiraz, Iran, from the 1st of January 2017 to the 1st of August 2017 on women aged 18–60 years old. The demographic characteristics of the participants, the reasons that motivate blood donors and the factors that discourage non-donors were surveyed. Reasons for lapses in donors were also mentioned. The most frequent reasons for blood donation were altruistic causes (94.4%), moral and personal obligations (89.1%), the feeling of responsibility (82.7%), and awareness of the positive effects on their health (77.4%). The most common deterrents in non-donors were fear of developing anemia (68.4%) or weakness and dizziness (66%), unsuitability due to certain medical conditions (62.4%), and lack of a situation in which they were asked to donate blood (61.8%). Although altruistic reasons are the chief motivating factors for women to donate blood, the overall female contribution in blood donation remains low. Therefore, it is necessary to take measures aiming at informing women about the importance of blood donation and to reduce fears based on misinformation. Confidence in the blood donation organization must be a major consideration in future recruitment strategies to reassure women about the safety of blood donation.

What are the perspectives for blood donations and blood component transfusion worldwide? A systematic review of time series studies

BACKGROUND

Analysis of the literature suggests that changes relating to blood donations and blood component transfusion are occurring due to the aging of the population.

OBJECTIVE

To gain better understanding of the demand and supply of these inputs over time, and to identify the main associated demographic characteristics.

DESIGN AND SETTING

Systematic review conducted on time series relating to blood donations and blood component transfusions worldwide.

METHODS

A systematic review of the literature was conducted based on articles that presented time series relating to blood donation or blood component transfusion.

RESULTS

We found 1,814 articles. After the deletion process, only thirteen were read. Overall, these suggested that there is increasing demand for blood components and decreasing donation. The existence of seasonality regarding blood donation was pointed out. Men usually donated more blood and demanded more blood components than women. Approximately 50% of blood transfusions were performed in people aged ≥ 60 years.

CONCLUSIONS

This analysis on articles that presented time series relating to blood donations and blood component transfusion showed that aging of the population was the main factor associated with the increasing demand for blood and the decreasing supply of blood.

Changes in the Whole Blood Donor Population in South-West Germany: 2010 versus 2016

BACKGROUND

In the recent past, the discrepancy between blood supply and future demand may have been overestimated. As medical progress develops rapidly, it will be essential to monitor ongoing demographic changes in the donor population regularly and to re-evaluate retention and recruiting strategies. The aim of the current study was to compare first-time donor (FTD) characteristics and their return rates. We therefore compared whole blood (WB) donations in total and the annual donation frequencies in 2010 and in 2015/2016. Furthermore, we evaluated whether over the same observation period, medical reasons for deferral underwent a change (2010 vs. 2015).

METHODS

The return probability of FTD within 12 months was analysed in 2010 and 2015 with respect to successful donation versus deferral and with regard to age. The total number of WB donations was investigated, and age distribution was compared between 2010, 2013 and 2016. WB donation frequencies were calculated with respect to age and gender in 2010 and 2016. In a second analysis, medical reasons for deferral were differentiated into 14 categories and a possible impact of time (2010 vs. 2015) on the respective percentage was studied.

RESULTS

We observed a significant decline of the FTD return rate from 42.5% to 38.8% in donors that successfully donated WB while the rate remained unchanged in deferred FTD. At the same time the mean FTD age decreased from 29.1 ± 11.6 to 28.5 ± 11.7 years in 2016. Analysis of total WB donations revealed an increase of all donations from donors ≥60 years, a constant percentage from donors <30 years but a declining proportion of donors aged 30-59 years from 2010 to 2013 to 2016. In parallel, annual mean WB donation frequencies decreased over time. Deferrals due to travel history increased significantly from 2010 to 2015 both in FTD and repeat donors.

CONCLUSION

There is ongoing demographic change in our WB donor population. Our data prove a need for a re-evaluation of retention and recruitment strategies since previous marketing campaigns seem to have neglected the age group 30-59 years. This must be addressed in further studies as this age group will be highly relevant for assuring future blood supplies since donor recruitment from adolescents will be limited due to declining birth rates. Furthermore, deferral due to travel history is increasing significantly. Thus we will require further studies on the possible impact on donor retention.

The beliefs and willingness of men who have sex with men to comply with a one-year blood donation deferral policy: a cross-sectional study

BACKGROUND

In 2016, the US Food and Drug Administration ended the lifetime blood donation deferral for men who have sex with men (MSM) and replaced it with a 1-year deferral period. It is currently unknown how many MSM may meet the new deferral policy and how many are willing to comply with it.

STUDY DESIGN AND METHODS

An anonymous survey was shared on MSM-focused social media sites between May and July 2016 and enrolled self-identified American MSM who were at least 18 years old. The survey assessed the willingness of MSM to donate blood, donation history, and knowledge regarding current blood donation needs and testing limitations.

RESULTS

A total of 764 men met criteria to be included in the final data set. Only 8.9% (95% confidence interval [CI], 6.9%-10.9%) met the current 12-month deferral criteria, yet 90.6% (95% CI, 88.5%-92.7%) were interested in donating. Among men interested in donating blood, 57.9% (95% CI, 54.3%-61.4%) would consider donating blood without meeting the 12-month deferral criteria. Overall, 26.7% (95% CI, 23.6%-29.8%) admitted to donating blood at least once in the past despite not meeting deferral criteria.

CONCLUSIONS

Few MSM met the current deferral criteria, yet many were interested in donating, even without meeting deferral criteria. Possible motivations to donate without meeting deferral criteria may include a perceived shortage of donated blood and infallibility of current blood testing technology to detect human immunodeficiency virus. If the current 1-year deferral is maintained, it is essential that there is outreach to the MSM community to explain and educate why this policy exists.

Recruitment and retention of blood donors in four Canadian cities: an analysis of the role of community and social networks

BACKGROUND

This study approaches the decision to donate blood as a dynamic process involving interplay between blood donors' personal motives, donors' social contexts, and the donor recruitment and retention activities of blood collection agencies.

STUDY DESIGN AND METHODS

Data were gathered from four blood donation clinics using in-depth interviews with Canadian Blood Services employees, donors, and nondonors in 25 organizations participating in Life Link, a donor recruitment program that supports organizations to educate employees about the benefits of blood donation. Further data were obtained from ethnographic observations of blood collection and donor recruitment activities.

RESULTS

Thematic analysis resulted in three umbrella themes: leveraging social networks, embedding the clinic in the community, and donating blood and social reciprocity. Donor recruitment activities at all four clinics enhanced awareness of blood donation in the workplace by using experienced donors to motivate their coworkers in making a first-time donation. Clinic employees reported varying success in improving awareness of blood donation in the broader community, in part because of varying employee engagement in community-wide activities and celebrations. Altruistic motives were mentioned by experienced donors, who also identified a desire to reciprocate to their community as another strong motive.

CONCLUSION

This study contextualizes donor recruitment and retention as involving activities that tie blood donation to meaningful aspects of donors' social networks and community. The findings point to the need for further analyses of the institutional dimensions of blood donation to develop effective strategies beyond appeals to altruism.

Temporal distribution of blood donations in three Brazilian blood centers and its repercussion on the blood supply

Background

Seasonal distribution of blood donation hinders efforts to provide a safe and adequate blood supply leading to chronic and persistent shortages. This study examined whether holidays, geographical area and donation type (community versus replacement) has any impact on the fluctuation of donations.

Methods

The numbers of blood donations from 2007 through 2010 in three Brazilian Retrovirus Epidemiological Donor Study II (REDS-II) participating centers were analyzed according to the week of donation. The weeks were classified as holiday or non-holiday. To compare donations performed during holiday versus non-holiday weeks, tabulations and descriptive statistics for weekly donations by blood center were examined and time series analysis was conducted.

Results

The average weekly number of donations varied according to the blood center and type of week. The average number of donations decreased significantly during Carnival and Christmas and increased during the Brazilian National Donor Week. The fluctuation was more pronounced in Recife and Belo Horizonte when compared to São Paulo and higher among community donors.

Conclusion

National bank holidays affect the blood supply by reducing available blood donations. Blood banks should take into account these oscillations in order to plan local campaigns, aiming at maintaining the blood supply at acceptable levels.

Blood donation clusters in Québec, Canada (2003-2008): spatial variations according to sex and age

BACKGROUND AND OBJECTIVES

The detection of spatial clusters of blood donation rate is an important issue, especially for targeting spatial units with significantly low rates, where it could be possible to increase the numbers of donors. The objective of this study is to detect spatial clusters of high or low blood donation rate in Québec according to sex and age of the donors.

MATERIALS AND METHODS

Blood donation data were obtained from Héma-Québec over a period of 5 years. We aggregated these data for each of 101 municipalités regionales de comté (i.e. counties) for men, women and four age groups. To detect spatial high/low donation rate areas, we used the Kulldorff's scan statistics. Kappa coefficient was used to assess discordance between clusters obtained for the different groups (18-29, 30-39, 40-49, 50-59, 60-69 years old). T-test analyses were conducted to identify significant associations between spatial clusters and socio-economic variables.

RESULTS

The results indicate the presence of several geographical areas with high or low blood donation rates for each group. The size, the location and the socio-demographic profiles of low/high clusters vary according to sex and age categories.

CONCLUSION

The Kulldorff's scan statistics are an efficient tool to assess the blood donation performance across a country or even a specific region over a period of several years. In terms of strategic planning and monitoring, it can be used as a fully operational tool to target areas with significantly low rates (for all donors or specific demographic groups) in future blood donation campaigns.

La géographie du don de sang au Québec : quelles variations régionales ?

Les travaux sur le don de sang ont jusqu’à maintenant privilégié l’étude des variables individuelles d’un point de vue démographique et psychologique (les motivations au don, par exemple). Pourtant, les notions actuelles de géographie sociale et de la santé sont tout à fait à propos pour l’étude des donneurs de sang québécois. Cette étude vise trois objectifs principaux : 1) analyser la répartition spatiale des dons de sang au Québec ; 2) analyser les distances séparant les lieux de résidence des lieux de collecte ; 3) mettre en relation le profil sociodémographique des municipalités régionales de comté (MRC) avec les nombres de donneurs et les fréquences de dons de sang. La méthode fait appel aux systèmes d’information géographique et à la statistique descriptive (corrélation, analyse de classification) pour explorer la géodémographie du don de sang sur une période de cinq ans (2003-2008). Les résultats mettent en valeur le rôle de certaines variations régionales entre les milieux urbains et ruraux et démontrent l’apport important des banlieues dans la réserve collective de sang. À partir de ces constats, certaines pistes de réflexion et d’action sont avancées, toutes en lien avec l’objectif ultime d’assurer un approvisionnement de sang continu et à long terme.

A stochastic simulator of a blood product donation environment with demand spikes and supply shocks

The availability of an adequate blood supply is a critical public health need. An influenza epidemic or another crisis affecting population mobility could create a critical donor shortage, which could profoundly impact blood availability. We developed a simulation model for the blood supply environment in the United States to assess the likely impact on blood availability of factors such as an epidemic. We developed a simulator of a multi-state model with transitions among states. Weekly numbers of blood units donated and needed were generated by negative binomial stochastic processes. The simulator allows exploration of the blood system under certain conditions of supply and demand rates, and can be used for planning purposes to prepare for sudden changes in the public's health. The simulator incorporates three donor groups (first-time, sporadic, and regular), immigration and emigration, deferral period, and adjustment factors for recruitment. We illustrate possible uses of the simulator by specifying input values for an 8-week flu epidemic, resulting in a moderate supply shock and demand spike (for example, from postponed elective surgeries), and different recruitment strategies. The input values are based in part on data from a regional blood center of the American Red Cross during 1996-2005. Our results from these scenarios suggest that the key to alleviating deficit effects of a system shock may be appropriate timing and duration of recruitment efforts, in turn depending critically on anticipating shocks and rapidly implementing recruitment efforts.

Under HEMA conditions, self-replication of human erythroblasts is limited by autophagic death

The number of erythroblasts generated ex-vivo under human-erythroid massive-amplification conditions by mononuclear cells from one unit of adult blood (~10(10)) are insufficient for transfusion (~10(12) red cells), emphasizing the need for studies to characterize cellular interactions during culture to increase erythroblast production. To identify the cell populations which generate erythroblasts under human-erythroid-massive-amplification conditions and the factors that limit proliferation, day 10 non-erythroblasts and immature- and mature-erythroblasts were separated by sorting, labelled with carboxyfluorescein-diacetate-succinimidyl-ester and re-cultured either under these conditions (for proliferation, maturation and/or apoptosis/autophagy determinations) or in semisolid media (for progenitor cell determination). Non-erythroblasts contained 54% of the progenitor cells but did not grow under human-erythroid-massive-amplification conditions. Immature-erythroblasts contained 25% of the progenitor cells and generated erythroblasts under human-erythroid-massive-amplification conditions (FI at 48 h=2.57±1.15). Mature-erythroblasts did not generate colonies and died in human-erythroid-massive-amplification conditions. In sequential sorting/re-culture experiments, immature-erythroblasts retained the ability to generate erythroblasts for 6 days and generated 2-5-fold more cells than the corresponding unfractionated population, suggesting that mature-erythroblasts may limit erythroblast expansion. In co-cultures of carboxyfluorescein-diacetate-succinimidyl-ester-labelled-immature-erythroblasts with mature-erythroblasts at increasing ratios, cell numbers did not increase and proliferation, maturation and apoptotic rates were unchanged. However, Acridine Orange staining (a marker for autophagic death) increased from ~3.2% in cultures with immature-erythroblasts alone to 14-22% in cultures of mature-erythroblasts with and without immature-erythroblasts. In conclusion, these data identify immature-erythroblasts as the cells that generate additional erythroblasts in human-erythroid-massive-amplification cultures and autophagy as the leading cause of death limiting the final cellular output of these cultures.

Erythroid cells in vitro: from developmental biology to blood transfusion products

PURPOSE OF REVIEW

Red blood cells (RBCs) transfusion plays a critical role in numerous therapies. Disruption of blood collection by political unrest, natural disasters and emerging infections and implementation of restrictions on the use of erythropoiesis-stimulating agents in cancer may impact blood availability in the near future. These considerations highlight the importance of developing alternative blood products.

RECENT FINDINGS

Knowledge about the processes that control RBC production has been applied to the establishment of culture conditions allowing ex-vivo generation of RBCs in numbers close to those (2.5 x 10 cells/ml) present in a transfusion, from cord blood, donated blood units or embryonic stem cells. In addition, experimental studies demonstrate that such cells protect mice from lethal bleeding. Therefore, erythroid cells generated ex vivo may be suitable for transfusion provided they can be produced safely in adequate numbers. However, much remains to be done to translate a theoretical production of approximately 2.5 x 10 RBCs in the laboratory into a 'clinical grade production process'.

SUMMARY

This review summarizes the state-of-the-art in establishing ex-vivo culture conditions for erythroid cells and discusses the most compelling issues to be addressed to translate this progress into a clinical grade transfusion product.