Characteristics of Chinese blood donors and their return behavior

Background: Blood component donation by apheresis has become more common in modern blood transfusion practices. However, apheresis donation still remains less common in China. It is important to understand the typical apheresis donor characteristics and explore factors associated with their donation behavior.;Methods: This study utilized data set of the Retrovirus Epidemiology Donor Study-II (REDS-II) International Program, which collected the demographics, donation characteristics and screening tests information of all blood donors who donated in five participating Chinese blood centers. In study 1, characteristics of 54,267 WB donations from first time and repeat donors who donated between January 1 and March 31, 2008 at the 5 blood centers in China were compared. They were followed for 2.5 years. Logistic regression was done to identify factors associated with their return behavior. A recurrent-event Cox proportional-hazard model was used to evaluate the overall effect of demographic variables and return behavior among first-time donors. In study 2, demographic characteristics, TTI rates and 1-year return rates were compared between 5,147 post earthquake first time donors (PEFTD) (5/13-5/19, 2008) and 3,176 first time donors (FTD) (5/13-5/19, 2009) from five Chinese blood centers using chi-square tests. Adjusted logistic regression was used to detect earthquake effect on donor return. In study 3, Donor demographic and TTI screening reactive rates were compared for WB and apheresis donations among all successful donations at the five blood centers in 2008 and 2009. Logistic regression was used to identify independent factors associated with apheresis donations.;Results: We found: (1) Compared to first time donors, repeat donors tended to be male, older (≥ 25 years), of Han ethnicity, and larger-volume donors (300 or 400 mL). The return rates by the end of the study among first-time and repeat donors were 21% and 54% respectively. Donors with previous donation history were more likely to return and the number of pervious returns was positively associated with future return; there was a dose-response relationship (OR: 3.31, 4.82 and 8.16 for 1, 2-3 and more than 3 times as compared to 0). Donors who donated at mobile collection vehicles were more likely to return than those who donated in blood centers (OR: 3.27, 95% CI: 2.76-3.88). The logistic regression in all WB donors and Cox hazard model in first time donors showed consistent demographic and donation predictors of return: female sex, older age (≥ 25 years), larger volume (300 or 400 mL), and mobile vehicle. (2) After a large natural disaster, there is an overwhelming increase of donations, mostly first-time donors. Those first time donors (PEFTD) were different in demographic characteristics with common first-time donors (FTD): there were more educated middle-aged male donors in PEFTD. PEFTD had significantly lower one-year return rates than FTD (8% vs. 13%). (3) From January 1, 2008 to December 31, 2009, there were 512,594 WB and 26,199 apheresis donations at five blood centers. Apheresis donations accounted for 4.9% of all donations. Apheresis donations have lower reactive rate than WB donations for HBsAg, anti-HCV, anti-HIV and syphilis screening testing. The characteristics of apheresis donations differed among the five Chinese blood centers, and the demand, policy and facility of AP donations varied among the five centers.;Conclusions: Converting first-time donors to repeat donors is essential for maintaining supply. PEFTD were an untapped resource and promotion of regular blood donation should be implemented to ensure an adequate blood supply at all times. Retention efforts should be focused on specific groups that have higher return likelihood, such as women, donors older than 25 years and large volume donors (300 or 400 mL). Studies are needed to explore the reasons why donors under 25 years and donors with higher education, who account for about 50% and 80% of all donors, are less likely to return. The characteristics of apheresis donations in China are different from WB donations and differ among the five Chinese blood centers. Some of the differences are likely due to different recruitment policies. Further studies should be conducted to understand what motivates Chinese blood donors to participate as apheresis donors. (Abstract shortened by UMI.).