A population-based longitudinal study on the implication of demographic changes on blood donation and transfusion demand

Abstract

Key Points• Demographic changes have a direct impact on the blood supply, and demography can be used to predict blood donation rates in the future.• The transfusion demand cannot be predicted from demography.Transfusion safety includes the risk of transmission of pathogens, appropriate transfusion thresholds, and sufficient blood supply. All industrialized countries experience major ongoing demographic changes resulting from low birth rates and aging of the baby boom generation. Little evidence exists about whether future blood supply and demand correlate with these demographic changes. The $50% decline in birth rate in the eastern part of Germany after 1990 facilitates systematic study of the effects of pronounced demographic changes on blood donation and demand. In this prospective, 10-year longitudinal study, we enrolled all whole blood donors and all patients receiving red blood cell transfusions in the state of Mecklenburg-West Pomerania. We compared projections made in 2005 based on the projected demographic changes with: (1) number and age distribution of blood donors and transfusion recipients in 2015 and (2) blood demand within specific age and patient groups.Blood donation rates closely followed the demographic changes, showing a decrease of 218% (vs projected 223%). In contrast, 2015 transfusion rates were 221.3% lower than projected. We conclude that although changes in demography are highly predictive for the blood supply, transfusion demand is strongly influenced by changes in medical practice.Given ongoing pronounced demographic change, regular monitoring of the donor/recipient age distributions and associated impact on blood demand/supply relationships is required to allow strategic planning to prevent blood shortages or overproduction.

Longitudinal Changes in the Blood Supply and Demand in North-East-Germany 2005-2015

“…We found that whole blood donations can be reasonably predicted based on future trends of demographic structures, but they are also influenced by changes in donor recruitment activities [2,3]. In contrast, the transfusion demand for red blood cell concentrates (RBCs) is more influenced by changes in transfusion practice [2][3][4][5].…”

“…The data were obtained from the 40 hospitals in the state for the years 2005, 2010, and 2015 [1][2][3]. As pediatric and non-classifiable patients account for less than 3% of all RBC transfusions these were not analyzed in detail.…”

“…In contrast, the transfusion demand for red blood cell concentrates (RBCs) is more influenced by changes in transfusion practice [2][3][4][5]. In recent years all western countries observed a decrease in transfusion demand [4][5][6][7][8][9].…”

“…Conclusions: Regular monitoring of age-and sex-specific donation and transfusion data is urgently required to allow transfusion services strategic planning for securing future blood supply. years 2005, 2010, and 2015 [1][2][3] by addressing special aspects of the demographic changes in different parts of Germany as well as age and gender distribution of whole blood donors and RBC recipients.…”

“…About two-thirds of the transfusion demand is required for patients older than 65 years of age due to their higher likelihood for (co-)morbidities requiring blood transfusions. We used this major demographic change to prospectively analyze the impact of demographic changes on the blood supply by a longitudinal study starting in 2005 in the federal state Mecklenburg-Western Pomerania [1][2][3].…”