Impact of demographic changes on whole blood donations between 2005 and 2020

Background

The German reunification in 1990 resulted in a decline in birth rates, particularly in the Eastern federal states. On the other hand, the baby boomer generation (born 1955-1969), the largest contributor to whole blood donations (WBD) during the last decades, is aging and will exit the donor pool in the coming years. To analyze the impact of these demographic changes on blood supply, we perform a prospective, longitudinal study on all WBD in Mecklenburg-Western Pomerania since 2005.

Methods

The four blood donation services in Mecklenburg-Western Pomerania (German Red Cross, Haema, and the university blood donation services Greifswald and Rostock) provided data on date of the donation, sex, and age of the donors for all WBD in the years 2005, 2010, 2015, 2019 and 2020. Donation rates per 1,000 inhabitants were calculated based on the population registry of Mecklenburg-Western Pomerania. The population prognosis of the Federal Statistical Office was used to build projections of blood supply for the year 2030, assuming constant age-related blood donation rates as in 2020.

Results

The absolute number of WBD (Figure 1A) continuously declined from 118,419 WBD in 2005 to 83,871 WBD (-29.2%) in 2019, and 76,912 WBD (-35.1%) in 2020. The decline in 2020 might have been slightly amplified by an effect of the SARS-CoV-2 pandemic (83,871 WBD in 2019 vs. 76,912 WBD in 2020, -8.3%). The donation rates per 1,000 inhabitants (Figure 1B) decreased by 31.3 % between 2005 (69.4/1,000) and 2020 (47.7/1,000). Assuming constant age-related donor frequencies as in 2020, the projected number of WBD in 2030 will further decrease to 67,724 WBD (-11.9% compared to 2020).

Conclusion

The demographic change after 1990 caused a pronounced decrease in WBD in Mecklenburg-Western Pomerania over the last 15 years. This decline continues but seems to slowly stabilize. However, as the baby-boom generation enters the age groups with higher blood demand, ensuring an adequate future blood supply remains a major challenge. Blood donation numbers and blood transfusion demand should be regularly monitored to recognize trends towards a supply-demand mismatch over time.

Offenlegung Interessenkonflikt:

Andreas Greinacher reports grants and non-financial support from Aspen, Boehringer Ingelheim, MSD, Bristol Myers Squibb (BMS), Paringenix, Bayer Healthcare, Gore Inc., Rovi, Sagent, Biomarin/Prosensa, personal fees from Aspen, Boehringer Ingelheim, MSD, Macopharma, BMS, Chromatec, Werfen (Instrumentation Laboratory), and non-financial support from Boehringer Ingelheim, Portola, Ergomed, GTH e.V., Universitätsmedizin Greifswald is one of the owners of a patent for a solid phase assay to detect HIT and VITT antibodies.

Linda Schönborn was supported by the Gerhard-Domagk-Program of the Universitätsmedizin Greifswald.

All other authors declare no conflict of interest.