Safety of blood donation by individuals over age 70 and their contribution to the blood supply in five developed countries: a BEST Collaborative group study

Abstract

BACKGROUND Some countries impose an upper age limit on whole blood and double RBC donation while others do not. We evaluated the safety of blood donation in older individuals (≥71 years), and their contribution to the blood supply of five countries. STUDY DESIGN AND METHODS Twelve blood center members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative from four countries with no upper age limit for whole blood and double RBC donation (Canada, New Zealand, England, and the United States) or an upper age limit of 80 (Australia) provided 2016 data on donors and donations, deferral rates, and vasovagal reactions by donor age and sex. Donors under age 24 were included in the number of total donors and donations, but not in deferral and reaction rate comparisons. RESULTS Older donors accounted for 1.0% (New Zealand) to 4.3% (United States) of donors, and 1.5% (New Zealand) to 5.6% (United States) of donations; most were between ages 71 and 76. The deferral rate was higher in older compared to 24‐ to 70‐year‐old males, but very similar between older and younger females. In contrast, vasovagal reaction rates were either lower (male donors) or similar (female donor for reactions with loss of consciousness) in older compared to 24‐ to 70‐year‐old donors. CONCLUSIONS Exclusion solely based on older age appears to be unwarranted based on safety concerns such as donor reactions. Healthy older individuals can continue to safely donate and make a significant contribution to the blood supply past arbitrary age limits.

Growing evidence supports healthy older people continuing to donate blood into later life

“…When allowed to donate, older donors “punch above their weight,” making a more substantial contribution to the blood supply than younger donors. The BEST Collaborative study reported that while donors aged 70+ years accounted for only 1.0% to 4.2% of the donor population in each country, they contributed 1.5% to 5.7% of total donations . This is consistent with earlier research showing that older donors make more donations per year than younger donors .…”

“…While the existing research consistently finds young donors at particularly high risk of an adverse reaction to blood donation, it has remained unclear whether the oldest donors may be at increased risk of certain adverse outcomes compared to donors in their middle years or those approaching older age. The study by Goldman and colleagues on behalf of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative in this issue of TRANSFUSION provides valuable additional insights. The authors analyzed data from more than 200,000 donors over 70 years of age who presented at 12 blood centers across five countries (Canada, Australia, England/North Wales, New Zealand, and the United States), all of which, except Australia, had eliminated upper age limits.…”

Supplemental findings of the 2017 National Blood Collection and Utilization Survey

“…The previous increase in donations by adolescent donors was thought to be in response to an aging donor population and a need for younger donors . The number of source plasma collections continues to increase in the United States . In part because over half of plasma donors are aged 18‐34 years, some concerns have been reported that younger donors are donating plasma rather than blood because of financial compensation with plasma donation .…”

“…5,16 The number of source plasma collections continues to increase in the United States. [17][18][19] In part because over half of plasma donors are aged 18-34 years, 18 some concerns have been reported that younger donors are donating plasma rather than blood because of financial compensation with plasma donation. 17,19 Additionally, evidence indicates that adolescent (aged ≤18 years) donors face a greater risk of iron depletion and vasovagal reactions than adult donors.…”

“…[17][18][19] In part because over half of plasma donors are aged 18-34 years, 18 some concerns have been reported that younger donors are donating plasma rather than blood because of financial compensation with plasma donation. 17,19 Additionally, evidence indicates that adolescent (aged ≤18 years) donors face a greater risk of iron depletion and vasovagal reactions than adult donors. [20][21][22][23][24] Blood collection facilities might potentially be recruiting fewer adolescent donors as a result of these concerns.…”