The increased demand for blood coincides with a significant reduction in blood donations. From 2008 the shortfalls will grow to 32 to 35 percent of the total demand in 2015 in the area studied. The demographic trends will affect many regions in Europe similarly. Coordinated efforts will be required to prevent blood shortages based on these demographic trends in western societies.

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.

Changes in demography and medical practice impact the delicate balance between available blood supply and potential future transfusion needs. In times of pronounced demographic changes, regular monitoring of the blood demand and age structure of blood recipients and donors is required to allow strategic planning to prevent blood shortages or overproduction.

Identification of motivational factors can lead to the design of targeted motivation campaigns for blood donation. The underlying cause of the perceived well-being after blood donation requires further studies.