Retention of blood donors

Abstract

The rise in human life expectancy and improvements in medical technology have led to a constant increase in the demand for blood transfusions. However, aging of the donor population resulting in higher morbidity and new donor screening deferral criteria to increase safety against transfusion transmitted diseases have decreased the availability of eligible blood donors.(1) Worldwide, the current challenge that blood banks are facing is to recruit and retain qualified blood donors to fulfill the rising transfusion needs. The knowledge of the donors profile among those who return for further donations is the first step to understand blood donors' behavior at each location. In this issue, Lourencon et al.(2) show the return rates of first-time donors in Ribeirao Preto, Sao Paulo. First-time donors are of great importance because they represented the continuation of blood supply.(3) Their conversion into repeat donors is easier to achieve than recruiting people who have never donated. The authors tracked almost 120,000 donors over 10 years and reported that 40% and 53% of first-time donors returned within one and two years after donation, respectively. Some selected demographic characteristics were also associated with a higher likelihood of return. Although the authors concluded that the percentage of first-time donors who return for further donations was low, their rates were similar to those found in developed countries such as the United States(4) and Norway(5) and higher than those recently described in China,(6) a developing country. It is noteworthy that the procedures to attend first-time and retain qualified donors at the Hemocentro de Ribeirao Preto, were described in the manuscript. Routinely, blood donation candidates receive a folder containing preliminary guidelines on blood donation and illiterate candidates watch a video containing the same information as in the folder, including blood donation intervals. In order to provide special care to first-time donors and improve communications between staff and candidates, a visual identification of donor status is used; this seems to contribute to a more personal approach. Finally, qualified blood donors are systematically invited to return for donation after a threemonth interval. Motivation to donate blood can vary broadly from altruistic reasons, such as helping someone who needs a transfusion or collaborating to the well-being of the community, to strictly personal reasons, such as getting a day off work or having blood tested for transmitted diseases, for instance. The decision to donate blood and return for further donations depends not just on altruism, but also on social responsibility, personal credit, social pressure, satisfaction, family motivation, personal characteristics and, mainly, a positive donation experience. Consequently, blood banks must develop strategies and incentives to retain donors such as a shorter waiting time, more personal attention, entertainment, enhancing blood donor satisfaction, minimizing adverse reactions of donation and offering a convenient and accessible place to donate. Special attention must be paid to the impact of donor deferral on donor availability. Custer et al.(7) showed that the effects of deferral on blood donors' return were more pronounced than expected, affecting both first-time and repeat donors. A balance between rational screening criteria and blood safety is therefore important to maintain the blood supply while mitigating the risks for donors and recipients. In conclusion, some of the recruitment and retention approaches applied in Ribeirao Preto may be used as inspiration by other blood banks. Strategies to encourage blood donors to return to donate more frequently, to create the right environment and make the process of giving blood a good experience, may play an important role to maintain an adequate blood supply. Studies on motivation, return rates, impact of deferral and adverse events among blood donors are being carried out in the Retrovirus Epidemiology Donors Study-II (REDS-II), International Component in Brazil, and together, with other regional studies, as the one presented here, may be helpful to better understand blood donors' behavior and fulfill blood transfusion requirements for our country, not only in quantity but also with quality.