What are the requirements and risks of blood donation?

Requirements and Risks of Blood Donation

Blood donation is generally safe with minimal risks, but donors must meet specific eligibility criteria to ensure both donor and recipient safety. The most common risks include iron deficiency, vasovagal reactions, and citrate-related events 1.

Eligibility Requirements for Blood Donors

General Health Requirements

• Donors must be in good general health
• Blood pressure should be below 140/90 mmHg (measured on at least two occasions) 2
• No active infections or illnesses
• Adequate hemoglobin levels (specific thresholds vary by donation center)

Age and Weight Requirements

• Typically 17 years or older (16 with parental consent in some jurisdictions)
• Minimum weight requirements (usually around 110 pounds/50 kg)

High-Risk Exclusions

Several groups are excluded from donation due to increased risk of transmissible infections:

• Men who have had sex with another man in the preceding 5 years 2
• Persons who report nonmedical intravenous, intramuscular, or subcutaneous drug injection in the preceding 5 years 2
• Persons with hemophilia or related clotting disorders who have received human-derived clotting factor concentrates 2
• Men and women who have engaged in sex in exchange for money or drugs in the preceding 5 years 2
• Persons who have had sex in the preceding 12 months with any person in the above categories 2
• Persons with known HIV infection or high-risk behaviors 2
• Inmates of correctional systems 2

Medical Exclusions

• Known diabetes mellitus 2
• Fasting plasma glucose level of 126 mg/dL or greater on 2+ occasions 2
• Moderate to severe pulmonary disease 2
• Evidence of renal tuberculosis, interstitial nephritis, or pyelonephritis 2
• Recent major surgeries or procedures
• Certain medications (varies by donation center)

Risks Associated with Blood Donation

Common Adverse Events

1. Vasovagal reactions:

   • Dizziness, lightheadedness, fainting
   • More common in first-time donors and younger donors

2. Iron deficiency:

   • Particularly with frequent donation
   • Can lead to anemia if not properly managed 1

3. Local complications:

   • Bruising at venipuncture site
   • Hematoma
   • Nerve irritation

4. Citrate-related reactions (primarily in apheresis donations):

   • Tingling sensations
   • Muscle cramps
   • Rarely, more severe symptoms 1

Rare Complications

• Arterial puncture
• Deep vein thrombosis
• Arteriovenous fistula
• Severe vasovagal reactions with injury

Risks to Recipients of Blood Products

Blood products undergo extensive testing, but minimal risks remain:

• HIV transmission: 6.8 per 10 million transfused components 2
• Hepatitis C: 8.7 per 10 million transfused components 2
• Hepatitis B: 2.8-3.6 per million transfused components 2
• Transfusion-related acute lung injury (TRALI): 8.1 per 100,000 transfused components 2
• Transfusion-associated circulatory overload (TACO): 1-8% of transfusion recipients 3
• Fatal hemolytic reactions: approximately 8 per 10 million RBC units 2
• Febrile non-hemolytic reactions: 1.1-2.15% depending on leukoreduction method 2, 3

Prevention of Adverse Events

For Donors

• Proper hydration before donation
• Adequate iron intake, particularly for regular donors
• Eating before donation
• Avoiding strenuous physical activity immediately after donation
• Following post-donation care instructions

For Recipients

• Implementing restrictive transfusion strategies (hemoglobin threshold of 7-8 g/dL) 2, 3
• Single unit transfusions when appropriate 3
• Slower transfusion rates for high-risk patients (1 unit over 4+ hours) 3
• Monitoring vital signs at baseline, 15 minutes after starting each unit, and within 60 minutes of completion 3

Common Misconceptions

A significant misconception that may prevent people from donating is the belief that donors can contract AIDS from the donation process. Nearly 25% of respondents in a national survey believed it was somewhat or very likely they could get AIDS from donating blood 4. This is completely false and represents a significant barrier to donation, particularly among minorities and those who have never donated.

Additionally, approximately 9.1% of people incorrectly believe it's acceptable to donate blood even with AIDS risk behaviors, which could potentially compromise blood safety 4.