Findings from the 2021 National Blood Collection and Utilization Survey (NBCUS) have been published in Transfusion including blood donation and transfusion data in the U.S. According to the authors, response rates were “(49/53) 92.5 percent for community-based blood centers, (62/83) 74.7 percent for hospital-based blood centers, and (2,102/2,754) 76.3 percent for transfusing hospitals.”
Blood donation and transfusion data from the report showed that, “11,784,000 whole blood and apheresis red blood cell (RBC) units (95 percent confidence interval [CI], 11,392,000–12,177,000 units) were collected in the U.S., a 1.7 percent increase from 2019, when 11,590,000 units of whole blood and apheresis RBCs were collected. Additionally, the authors explained that “[t]he total number of whole blood units collected for allogeneic, nondirected transfusions during 2021 was 9,842,000 units (95 percent CI, 9,491,000–10,193,000 units), a 0.7 percent increase from 2019)…During the same time period, the number of apheresis RBC units collected increased by 7.3 percent, from 1,800,000 units in 2019 to 1,931,000 units (95 percent CI, 1,771,000–2,090,000 units) in 2021.”
Transfusion data form the NBCUS report showed that during 2021, “10,764,000 units of whole blood-derived and apheresis RBCs were transfused in the U.S. (95 percent CI, 10,357,000–11,171,000 units), a 0.8 percent decrease from 2019, when 10,852,000 units were transfused…Of the 10,764,000 units transfused [during 2021], 99.9 percent were allogeneic, nondirected transfusions; 10,000 units (95 percent CI, 2000–18,-000 units) were for directed transfusions, representing an increase of 11.1 percent from 2019.”
Additionally, data from the 2021 NBCUS report revealed that “121,000 whole blood-derived and apheresis RBC units (95 percent CI, 108,000–133,000 units) were rejected based on abnormal disease marker results after collection, a 17.5 percent increase from 2019 (when 103,000 units were rejected based on testing)…There were 305,000 whole blood-derived and apheresis RBC units (95 percent CI, 254,000–356,000 units) outdated during 2021, a 12.6 percent decrease from 2019, when 349,000 units were outdated.”
The total number on platelet units “distributed” in the U.S. during 2021 was 2,528,000 which represented a 0.8 percent “increase” from 2019. Of those. 2,422,000 “were apheresis platelets, an increase of 2.7 percent” compared to 2019, with 2,175,000 being transfused, a 3.0 percent decrease from 2019…In total, 3,114,000 plasma units (including fresh-frozen plasma, plasma frozen within 24 hours of collection, cryoprecipitate-reduced plasma, and liquid plasma; 95 percent CI, 2,929,000–3,298,000 units) were distributed in the U.S. in 2021,” which demonstrated a 16.2 percent increase from 2019. “There were 2,215,000 units (95 percent CI, 2,084,000–2,347,000 units) of plasma transfused in the U.S. in 2021, an increase of 1.4 percent from 2019 when 2,185,000 plasma units were transfused. Approximately 2,449,000 units (95 percent CI, 2,234,000–2,664,000 units) of cryoprecipitated AHF were distributed in the U.S. in 2021, an increase of 6.3 percent from 2019 when 2,304,000 units were distributed.”
The authors concluded that the “2021 NBCUS shows a continued stabilization in transfusions in the U.S. and marks the first time since 2008 that blood collections in the U.S. have not decreased year-to-year, suggesting a plateau has been reached for both blood collection and use…The stabilization of blood collection and use seen in 2021 suggests the blood supply is currently meeting demand. Furthermore, it appears the recent declining trends may have been driven mostly by a decline in demand. However, the demand for blood depends on a clinical need. Although patient blood management programs and restrictive use of transfusions in surgical settings have likely contributed historically to a decline in blood use, there is a lower limit to this trend.”
Citation: Free, R., Sapiano, M., Chavez Ortiz, J., et al. “Continued stabilization of blood collections and transfusions in the United States: Findings from the 2021 National Blood Collection and Utilization Survey.” Transfusion. 2023.