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Wednesday, May 21, 2008

Blood Donation More Risky For Teenagers

Compared to older blood donors, sixteen and seventeen year olds are much more likely to experience complications related to donation, such as fainting and bruising. This was published in a study in JAMA published on May 21, 2008.

According to the authors, blood donation centers are continuously challenged with finding more safe blood as donors dwindle. They write: "The unremitting need and increasing demand for blood components constantly challenges blood centers to maintain a safe and adequate blood supply from a decreasing pool of eligible donors that is now estimated at only 38 percent of the U.S. adult population." To find eligible donors, blood centers have advocated several measurements for recruitment, including legislation allowing the collection of blood from donors aged 16 to 17 years in states that do not presently allow it. Of the American Red Cross's present donations, 14.5% of come from the 16 to 19 year old group annually, according to the article.

It has previously been suggested that younger donors are more susceptible to complications from donation. To investigate this, Anne F. Eder M.D., Ph.D., of the American Red Cross, Washington, D.C., and colleagues examined the adverse reactions experienced by 16 and 17 year olds. Data was collected in 1996 from nine American Red Cross blood centers which regularly collect donations from this age group, which comprises approximately 80% of donations in high school blood drives. In this time, 145,678 whole blood donations were collected from 16- and 17-year-olds (group 16-17), 113,307 from 18- and 19-year-olds (group 18-19), and 1,517,460 from donors age 20 years or older (group 20+).

Complications, including loss of consciousness or bruising, were present in 10.7% of donations made by 16-17, 8.3% made by 18-19, and 2.8% made by 20+. In comparison to 18-19 and 20+, the 16-17 group was more likely to experience some loss of consciousness or major complications. Injuries directly related to fainting were not common, and for every 10,000 blood collections there were 86 events in group 16-17. That said, this was 2.5 more likely in this group than group 18-19, and 14 times more likely than in group 20+. Almost half of all injuries in total occurred in sixteen and seventeen year old donors. Many episodes required outside medical care, including many involving concussion, laceration involving stitches, dental injuries, or broken jaw.

These complications correlated repeat donor rates. Sixteen year old donors with even minor complications were 60% less likely to return to donate within 12 months in comparison with those who experienced no complications (52% versus 73% return rate). The researchers write that this likely influenced donors interest in returning: "Consequently, any negative experience diminishes the likelihood of return blood donation, and increases the possibility that a short-term yield in donations incurs the ultimate expense of deterring future blood donation by young donors. These findings are particularly pertinent at a time when blood centers are becoming increasingly reliant on young donors to maintain an adequate blood supply. "

They conclude, stating that these results should be considered in the application of new legislation. "These data on common and infrequent complications of blood donation should be considered when age limits are deliberated by state authorities. The relatively comparable reaction rates in 16- and 17-year-old donors, and their increased complication rates compared with young adults and adults, suggest the need for a consistent approach. Blood centers have an obligation to constantly monitor risks of blood donation and to make a concerted and committed effort to achieve the lowest possible rate of complications. Although zero risk may not be attainable even in adults, the rate of complications in minors calls for ongoing attention to a sustained operational effort that is continually focused on donation safety."

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