Blood Community Experts Warn Against Non–Medically Indicated Directed Blood Donations

Accommodating requests for directed blood donations based on personal beliefs poses ethical, operational and safety risks and should not be supported in clinical practice, members of the AABB community wrote recently in Annals of Internal Medicine. Jeremy W. Jacobs, MD, MPH, served as first author of the editorial team, which included Claudia S. Cohn, MD, PhD, AABB’s chief medical officer; Meghan Delaney, DO, MPH, AABB president; Aaron A.R. Tobian, MD, PhD, AABB past president; and others.

Jacobs and his colleagues noted that while directed donation was historically used to reduce infection risk before the implementation of modern infectious disease testing, its use today is rarely medically necessary. Since the start of the COVID-19 pandemic, however, requests for directed donations have increased, often fueled by misinformation or unsupported concerns about COVID-19 vaccine components or donor characteristics. Furthermore, some states have introduced legislation to mandate such requests, which the authors believe risks politicizing blood donation.

In the editorial, the authors examine the medical risks, logistical challenges and ethical considerations associated with non–medically indicated directed blood donation. They emphasized that directed donations are not safer than the community blood supply, may delay transfusion in emergency situations, and could further strain blood collection systems.