Improving Safety for Young Blood Donors

Young blood donors between the ages of 16 and 18 years contribute substantially to the blood supply in the United States, accounting for about 14% of the allogeneic whole blood collected by the American Red Cross in 2010. However, studies have consistently demonstrated that the donors' age, total blood volume, and first-time donation status independently contribute to the risk of syncopal reactions after whole blood donation. Efforts to improve the donation experience are crucial not only to ensure the health and well-being of blood donors but also to sustain an adequate blood supply. Even minor reactions or temporary deferrals discourage individuals from donating blood again. Shifting population demographics and advances in medical care in the United States and other countries predict that the need for blood will increase, whereas blood donation by the older generations declines each year. Broad deferral strategies and precautionary measures have further winnowed the eligible donor pool, but their contribution to transfusion safety remains controversial. Consequently, blood centers that depend on recruiting and retaining adolescent blood donors have made concerted efforts to improve safety, especially on high school blood drives. Population-based operational tactics to improve donation safety focus on donor education, the drive environment, or recruiting individuals who are less likely to have reactions. Physiologic strategies modulate the donors' response to blood loss, decreasing their susceptibility to a donation-related reaction. This review examines the published data supporting the measures recently taken by blood centers to reduce the risk of syncopal reactions among young, whole blood donors.