Supplemental findings from the 2021 National Blood Collection and Utilization Survey (NBCUS) have been published in Transfusion. The 2021 NBCUS supplemental data reported represents 92.5 percent of community-based blood centers, 76.3 percent of transfusing hospitals, and 74.7 percent for hospital-based blood collection centers. The authors explained that a 5.5 percent decrease in the number of presenting donors occurred in 2021. Additionally, 54.1 percent of presenting donors were female, an increase from 49 percent in 2019.
The 2021 NBCUS supplemental data indicated an 18.7 percent decrease took place in total donor deferrals as 2,010,000 [95 percent CI, 1,921,000–2,099,000] versus 2,472,000 from 2019. “Donor deferrals were mostly driven by low hemoglobin or hematocrit followed by other non-medical reasons (24.6 percent), pulse (6.9 percent), and blood pressure (6.4 percent).” The authors did find that a 26.4 percent increase in deferrals for medication use occurred. Additionally, a 4.8 percent increase took place in 2021 for successful donations 11,507,000 [95 percent CI, 10,866,000–12,149,000] when “compared with 2019 (10,981,000). [The] total number of successful racial or ethnic minority donations” declined by 35.4 percent.
The authors explained that, “[m]ost successful donations during 2021 were from donors aged 25–64 years, with 68.8 percent (7,920,000/11,507,000) of successful donations occurring in this group.” Specifically, donors between the ages of 45–64 “accounted for 42 percent of successful donations during 2021, and donors aged 25–44 years accounted for 28 percent. The age group that saw the greatest increase in successful donations between 2019 and 2021 was donors aged 65 years and older (40.7 percent increase).” Younger donors experienced declines in successful donations (31.9 percent for donors aged 19–24) and 60.7 percent for those between the ages of 16 and 18). “Repeat allogeneic donors who donated successfully decreased by 4.5 percent [and] [f]irst-time allogenic donors also decreased, by 22.3 percent, between 2019 and 2021, with 2,213,000 first-time donors in 2019 and 1,719,000 (95 percent CI, 1,594,000–1,844,000) first-time donors in 2021.”
The 2021 NBCUS supplemental data revealed increases overall in “per unit cost of blood products reported by hospitals.” According to the authors, the 2021 NBCUS findings showed “increases in prices [for] leukoreduced apheresis platelets ($516 per unit in 2019 vs. $567 per unit in 2021), pathogen-reduced apheresis platelets ($617 per unit in 2019 vs. $660 per unit in 2021), and leukoreduced RBCs ($208 per unit in 2019 vs. $214 per unit in 2021).” The median price paid per leukoreduced red blood cell (RBC) unit varied by region with a cost as low as $203 to as high as $225. The median cost of apheresis platelet units ranged from $537 to $589.
The authors further explained that, “most transfused RBCs (80.9 percent) were aged 1–35 days at the time of transfusion,” which is similar to the finding of the previous NBCUS.” The 2021 NBCUS supplemental data also showed that, “molecular genotyping to identify non-ABO RBC antigen expression among blood donors and recipients remains uncommon, although it increased somewhat in 2021.” The authors mentioned that, “the number of reactions per 100,000 components transfused also decreased slightly between 2019 and 2021, with 293.7 reactions per 100,000 components transfused in 2019 and 273.8 (95 percent CI, 255.6–291.9) reactions per 100,000 components transfused in 2021. Additionally, the 2021 NBCUS findings indicated that, the most common type of transfusion-associated adverse reaction was febrile, nonhemolytic transfusion reaction, with an estimated 18,918 (95 percent CI, 17,085–20,751) reactions occurring during 2021.” The authors concluded that, “the ongoing COVID-19 pandemic has likely caused continuing disruptions for blood collection centers and transfusing facilities. Despite these disruptions, data from the 2021 NBCUS suggest a reversal in the trend of declining blood donations.”
Additional 2021 NBCUS data is also available and all the findings from the NBCUS will be used to update the America’s Blood Centers U.S. Blood Donation Statistics and Public Messaging Guide. This document is updated annually to included the latest statistics for blood donations and blood transfusions.
Citation: Kracalik, I., Sapiano, M., Wild, R., et al. “Supplemental findings of the 2021 National Blood Collection and Utilization Survey.” Transfusion. 2023.