AABB2025: Non-Medically Indicated Directed Blood Donation Requests Increasing

In recent years, there has been an increase in the number of non-medically indicated directed blood donation (DBD) requests, according to new data presented during Monday morning’s oral abstract session titled, “Cutting Edge Insights into Blood Donations and Allocations.”

The data, presented by Emily Coberly, MD, from the American Red Cross, was derived from the recent AABB Transfusion Medicine Subsection Survey on Directed Blood Donation Practices. The survey was designed to better understand current DBD practice patterns and utilization across the United States and Canada. Conducted from October 2024 to January 2025, the survey was sent to 594 AABB-accredited facilities, of which 35% responded.

The findings revealed that while there has been an increase in non-medically indicated DBD requests; the clinical scenarios for them varied widely. Approximately 50% of blood collection center respondents did not know the rationale for individual DBD requests, 34% of respondents noted patient/guardian requests for DBD from family/friends and 14% noted DBD requests from donors who have not received a COVID-19 vaccine. Practices surrounding these donations are inconsistent, with many centers not requiring physician review of orders, nor checking donor compatibility by ABO type.

Throughout the past five years, 70% of blood centers, 54% of hospitals with on-site donor collections and 40% of hospitals without on-site donor collections reported handling non-medical-directed donations. Some centers have ceased accommodating these requests, citing misalignment in exclusion criteria between centers and hospitals, as well as inconsistent additional charges. Many centers reported wasting directed donor units, with some hospitals discarding over 25% of directed donor units. Only 37% of transfusion services returned unused DBD units to general inventory compared to 54% of on-site donor collections.

Overall, the survey highlighted the variability in practices and opportunities for standardization of DBD and presented an opportunity for establishing unified procedures to ensure efficient, safe blood handling.