Donors
In 2011, 17,984,000 indi-viduals presented to donate blood. Much as reported in earlier surveys, most donors presented at blood centers (93.5%), and only 6.5%
presented to donate at hos-pital donor centers. Of the presenting donors, there were 9,203,000 allogeneic nondirected donors who successfully gave blood in 2011, compared to
10,805,000 allogeneic donors in 2008, for a drop of 14.8%. In 2011,
2,840,000 (30.9%) were first-time donors and 6,364,000 (69.1%) were repeat donors.* These repeat allogeneic donors provided 9,534,000 dona-tions, the equivalent of 1.5 donations per repeat alloge-neic donor, the same rate of donation reported in 2008.
There were 43,000 directed donors reported who suc-cessfully donated an
alloge-neic unit intended for a specific patient, and 46,000 units were collected (man-ual and apheresis collec-tions combined). Many blood centers and hospitals reported that they were unable to specify which donors had directed their donation.
There were 89,000 autolo-gous donors reported who successfully donated a unit intended for themselves.
Facilities reported 117,000 units collected (manual and apheresis collections com-bined) for a rate of 1.3 units per autologous donor.
Of the 17,984,000 present-ing individuals, 2,455,000 were deferred for various reasons (13.7% in 2011, compared to 12.6% in 2008). The deferral rate was slightly higher in hospital collection environments (16.5%) than in that in blood centers (13.5%).
Donors were most com-monly deferred for low hemoglobin (48.8% of
deferrals), defined as not meeting Food and Drug Administration (FDA) blood hemoglobin level require-ments for blood donation.
As seen in Figure 7-1, other categories for deferral included high- risk behav-ior associated with men who have sex with other men (MSM; 0.4% of defer-rals), other high-risk behav-ior (as identified on the Donor History Question-naire, or DHQ; 1.0%), pre-scription drug use (3.6%), tattoos/piercings (4.0%), specific foreign travel (7.4%), and other medical reasons (19.2%). High-risk behavior deferrals are intended to reduce the risk of transmission of infectious diseases, including HIV and hepatitis viruses. Deferrals for other medical reasons may include exposure to human-derived growth hor-mone, bovine insulin, Hep-atitis B Immune globulin, or unlicensed vaccines or pre-senting with physical con-ditions or symptoms that disqualify a person from donating blood. Another
*Repeat donors as defined by the report-ing facility.
THE 2011 NATIONAL BLOOD COLLECTION AND UTILIZATION SURVEY REPORT
36 Current Issues in Blood Collection and Screening
15.7% of donors were deferred for other reasons, which included low weight, inadequate interdonation interval, being under the donation age, and lan-guage.
There were 102,000 units, from 1.1% of donors (0.7%
of the total units tested), that were discarded for abnormal disease marker results.
Collection from younger donors has been an area of interest in recent years. In 2011, 3,202,000 units were collected from donors aged
16-24. This number repre-sents approximately one-fifth of all allogeneic collec-tions (20.5%). Of these donations, 1,646,000 were collected from high school–
age donors (16-18 years old), representing 10.5% of all donations. This survey also determined that 1,219,000 donations, or 7.8%, were collected from people over the age of 65 years in 2011.
There were 1,735,000 units collected from minority populations (including Afri-can, Asian, and/or His-panic). While some
facilities were unable to specifically report by popu-lation, these donations con-tinue to contribute
substantially to the nation’s blood supply (11.1%), a slight increase from the per-centage reported for 2008.
Mobile blood drive sites were the source of
10,466,000 units, or 66.6%
of collected units. Of these, approximately 11%, or 1,155,000 donations, were from automated collections.
In 2011, blood centers obtained the greatest pro-portion of their collections through mobile blood
Low Hemoglobin 48.8%
Prescription drug use 3.6%
Other Medical Reasons 19.2%
High Risk Behavior (MSM) 0.4%
High Risk Behavior (Other) 1.0%
Travel 7.4%
Tatoo/piercing 4.0%
Other 15.7%
Figure 7-1. Donor deferrals 2011.
drives (67.5%), while hos-pitals reported the use of mobile blood drives for 52.7% of collections; these rates represent an increase of 5% from 2008 for both facility types.
Donor Hemovigilance This survey has allowed the collection of baseline donor hemovigilance data for the US donor population. For the purposes of this survey, severe donor adverse events were defined as adverse events occurring in donors that were attributed to the donation process, including major allergic reaction, loss of conscious-ness of a minute or more, loss of consciousness with
injury, and nerve irritation.
In this survey, 21,000 of these events were reported by collection organizations for 2011 (Table 7-1). The rates of severe adverse events were 21,000/
16,141,000 collection pro-cedures (0.13%) in 2011 and 16,000/17,779,000 collection procedures (0.09%) in 2008. These rates were not statistically different, however; the vari-ability may be due to inconsistent application of the definition of severe reactions.
As in 2008, the rate of severe adverse reactions per unit collected was the same as that by procedure;
in 2011, it was 0.13%
(21,000/15,721,000 units
collected). There were no differences between the reaction rates for manual collections and for auto-mated procedures, nor were there differences between blood centers and hospital collectors in reac-tion rates. Addireac-tional aggre-gate detail about donor reactions is expected in the coming years with greater participation nationally in the national donor hemov-igilance program, Donor Hemovigilance Analysis and Reporting Tool (Donor HART). Blood donation, either through traditional manual WB collection pro-cesses or using automated procedures, rarely results in an untoward consequence.
Table 7-1. Donor Adverse Reaction Rate by Facility and Procedure Type
Reaction Rate for Manual
Collection Procedures (%) Reaction Rate for Automated
Collection Procedures (%) Overall Rate (%)
2011 2008 2011 2008 2011 2008
Blood Center 0.14 0.09 0.10 0.11 0.13 0.09
Hospital 0.10 0.10 0.15 0.06 0.11 0.90
Total 0.13 0.09 0.11 0.10 0.13 0.09