title: Improved safety for young whole blood donors with new selection criteria for total estimated blood volume.
abstract: BACKGROUND
  Young age, first-time donation status, and estimated blood volume (EBV) are leading determinants of syncopal complications after whole blood donation. We evaluated a multifaceted safety initiative and more restrictive selection criteria for whole blood donation by individuals younger than 19 years.
  
  
  METHODS
  Measures introduced over 2 years addressed donor education, drive environment and supervision, and new eligibility criteria for EBV of 3.5 L or more based on height, weight, and sex for individuals younger than 19 years. Presyncopal and syncopal reactions after whole blood donation during the school year in the baseline, transitional (2008), and full implementation (2009) periods were evaluated.
  
  
  RESULTS
  Young donors (16- to 18-years-olds) gave 754,402 and 710,922 whole blood donations in the 2008 and 2009 school years accounting for 16% of the total collections in both 9-month study periods. The new selection criteria were associated with a significant reduction in the reaction rates among 16- to 18-year-olds. Sixteen-year-old donors had the greatest decrease in 2009 compared to baseline for presyncopal reactions (10.5% vs. 7.3%; odds ratio [OR], 0.67; 95% confidence interval [CI], 0.65-0.69) and syncope (43.1 vs. 37.1 per 10,000 donations; OR, 0.86; 95% CI, 0.77-0.96). Donor subgroup analysis by sex, age, and donation status demonstrated that age-related differences in reaction rates were eliminated in 2009.
  
  
  CONCLUSIONS
  The safety initiative with new selection criteria for EBV led to decreased complications among donors 16 to 18 years old, such that the risk for 16-year-olds was no longer different from that observed for 19-year-olds in the analysis stratified by age, sex, and donation status.
authors.affiliation: American Red Cross, Biomedical Services, National Headquarters, Jerome H. Holland Laboratory, Rockville, Maryland 20855, USA. edera@usa.redcross.org
authors.forename: Anne F
authors.initials: AF
authors.lastname: Eder
authors.forename: Beth A
authors.initials: BA
authors.lastname: Dy
authors.forename: Jean M
authors.initials: JM
authors.lastname: Kennedy
authors.forename: Jaime
authors.initials: J
authors.lastname: Perez
authors.forename: Patricia
authors.initials: P
authors.lastname: Demaris
authors.forename: Anthony
authors.initials: A
authors.lastname: Procaccio
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Benjamin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001782:Blood Donors; D001810:Blood Volume; D001827:Body Height; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D018579:Patient Selection; D012449:Safety; D012737:Sex Factors; D013575:Syncope / Q000517:prevention & control*