Blood donors are the foundation of the blood supply. A session at the AABB Annual Meeting in October 2025 featured abstracts highlighting new information on donors and donation patterns.1
Emily Coberly, MD, of the American Red Cross (ARC) presented the results of a 2024-2025 AABB Transfusion Medicine Subsection survey of directed blood donation practices in the US and Canada. The respondents were grouped into hospitals without donor collection (82%), hospitals with donor collection (13%), and blood collection centers (5%). Ranges for groups are as follows. Twelve to fifty percent of facilities did not ask for indications for directed donation when processing requests. Some respondents accepted requests for a donor to be a patient’s family member or friend, or to not have received a COVID-19 vaccine. Transfusion medicine physician review of requests was required by 20-59% of respondents, but 10-40% did not allow refusal of requests. Of the 40-70% of respondents who received requests for nonmedical indications in the preceding 5 years, 7-29% stopped accommodating requests, 14-67% had no exclusion criteria (eg, did not exclude donation by the patient’s mother), and ABO compatibility of the donor with the patient was not checked by 14% of blood centers and 29% of hospitals with blood collection. For hospitals without collection who provided product discard rates, those rates increased from about 13% in 2019 to about 26% in 2023 even though those products could have been transfused to other patients. Sixty-five percent of hospitals did not include directed donation information in transfusion consent forms or educational materials. It was concluded that nonmedical directed donation practices vary widely and may benefit from determination and adoption of best practices. Best practices could combat misinformation.2,3
Two abstracts used data from the Transfusion-Transmissible Infections Monitoring System (TTIMS),4 in which the ARC participates. Eduard Grebe of the Vitalant Research Institute presented data relating deferral policy periods to the duration of HIV infection at the time of donation. The policies and their periods were indefinite donor deferral for males who had sex with males since 1977 (period ending in 2016), 12-month deferral (2016-2020), 3-month deferral (2020-2023), and individual donor assessment (IDA) (2023-present).5 The hypothesis was that a person with HIV infection who perceives their risk and donates to be tested has a short infection duration at donation. Duration was estimated from each donation’s viral load and anti-HIV signal intensity. The median infection durations showed no decline from period to period, indicating no increased transmission risk.
Another abstract—presented by Galen Conti, MPH, of the ARC—used TTIMS data to compare first-time blood donors (FTDs) during the last year of the previously mentioned 3-month deferral period to FTDs during the first year of the IDA period. The latter policy is more inclusive, so it was not unexpected that FTDs increased by 3%. However, the increase was uneven. For example, female FTDs fell by 1%, and FTDs in the South and West were unchanged. Male repeat donors increased, but female repeat donors decreased. Whether increases in donors produce increased blood availability is to be determined.
Umesh Singh, MBBS, PhD, MPH, presented ARC data on whole-blood (WB) and apheresis platelet donations during 5 disasters between 2001 and 2017 inclusive and one 2024 appeal for donations. Spikes in WB donations after the disasters disappeared after 3-4 weeks. The increase in WB donations after the appeal was less pronounced and disappeared after about 8 weeks. The increase in platelet donations 1-2 weeks after each disaster was not as large as for WB. Platelet donations increased for about 8 weeks after the appeal. Blunted and delayed increases in platelet donations were attributed to limited collection capacity and to platelet donors being older and showing more sustained engagement. First-time WB donors increased after disasters and the appeal, but first-time platelet donors showed little change. Those first-time WB donors were younger and often did not return or were delayed in their return. Planned appeals to stabilize the blood supply and target repeat donors for platelets were recommended.
It is hoped that additional analysis of data from these studies and more data from those studies that are ongoing will lead to improved donor management and a more stable blood supply.
References
1. Oral Abstract Spotlight Session: Cutting Edge Insights into Blood Donations and Allocations. Transfusion 2025;65:52A-56A.
2. Jacobs JW, Booth GS, Lewis-Newby M, Saifee NH, Ferguson E, Cohn CS, Delaney M, Morley S, Thomas S, Thorpe R, Raza S, Weaver MS, Woo JS, Sharma D, So-Osman C, Yurtsever N, Tormey CA, Waters A, Goldman M, Yan MTS, Fasano RM, Stephens LD, Allen ES, Erikstrup C, Infanti L, Schlafer TD, Warner MA, Winters JL, Tobian AAR, Bloch EM. Medical, Societal, and Ethical Considerations for Directed Blood Donation in 2025. Ann Intern Med 2025;178:1021-1026.
3. U.S. Food & Drug Administration. Important Information About Directed Blood Donations that are Not Medically Indicated. https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-information-about-directed-blood-donations-are-not-medically-indicated. Cited 2025 Dec 12.
4. Custer B, Stramer SL, Glynn S, Williams AE, Anderson SA. Transfusion-transmissible infection monitoring system: a tool to monitor changes in blood safety. Transfusion 2016;56:1499-1502.
5. U.S. Food & Drug Administration. Recommendations for Evaluating Donor Eligibility Using Individual Risk-Based Questions to Reduce the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products: Guidance for Industry. https://www.fda.gov/media/164829/download. Cited 2025 Nov 27.
