Donation-related adverse reactions and individual voluntary donation behavior following adjustments of the upper age limit for blood donation: a multicenter retrospective cohort study
10.13303/j.cjbt.issn.1004-549x.2026.09.004
- VernacularTitle:献血年龄上限调整对献血不良反应与个体无偿献血行为的影响：一项多中心、回顾性队列研究
- Author:
Chenying WANG
1
;
Jue WANG
1
;
Changping LI
2
;
Wei CHEN
1
;
Ying LI
3
;
Dan BAO
3
;
Yuanqin ZHANG
3
;
Xin ZHAO
4
;
Jinfeng ZENG
5
;
Yuwei HU
1
;
Shuchang DAI
1
;
Xiaoqiang WU
4
;
Weimin FAN
3
Author Information
1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu 610052, China
2. Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
3. Jiangxi Provincial Blood Center, Nanchang 330200, China
4. Hainan Provincial Blood Center, Haikou 570311, China
5. Shenzhen Blood Center, Shenzhen 518035, China
- Publication Type:Journal Article
- Keywords:
voluntary blood donation;
upper age limit for blood donation;
older blood donors;
donation-related adverse reactions;
donation safety;
blood supply
- From:
Chinese Journal of Blood Transfusion
2026;39(9):1168-1178
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the risk of donation-related adverse reactions, donation behavior, and contributions to the blood supply among donors aged 56-65 years following extension of the upper age limit for voluntary blood donation, and to provide real-world evidence for optimizing blood donation age policies in China. Methods: A multicenter retrospective cohort was established using blood donation databases from Hainan, Shenzhen, and Jiangxi. A total of 1 180 767 donors contributing 2 020 407 whole-blood and apheresis donations were included. Donations were classified by donor age at each donation into the 18-55-year and 56-65-year groups. Generalized estimating equation (GEE) models were used to compare the risks of overall, local, and systemic donation-related adverse reactions between the two age groups. Restricted cubic spline analysis was used to assess the continuous association between donor age and the risk of overall adverse reactions. Poisson GEE models were used to compare annual donation frequency, and donation participation and contributions to the blood supply among donors aged 56-65 years were evaluated. The study was approved by the Ethics Committee of the Institute of Blood Transfusion, Chinese Academy of Medical Sciences (No.2025012) and registered with the Chinese Clinical Trial Registry (ChiCTR2500114960). Results: A total of 1 960 711 donations were included in the 18-55-year group and 59 696 in the 56-65-year group. The overall donation-related adverse reaction rates were 3.890‰and 0.704‰, respectively. Multivariable GEE analysis showed that, compared with donors aged 18-55 years, those aged 56-65 years had lower risks of overall adverse reactions (adjusted OR=0.294, 95%CI: 0.217-0.398, P<0.001) and systemic adverse reactions (adjusted OR=0.163, 95%CI: 0.101-0.263, P<0.001), whereas no statistically significant difference was observed in the risk of local adverse reactions (adjusted OR=1.337, 95%CI: 0.487-3.670, P=0.573). Donor age was nonlinearly associated with the risk of overall adverse reactions (P overall<0.001, P nonlinear<0.001), with the risk generally decreasing with increasing age between 18 and 65 years. The mean annual donation frequency was higher among donors aged 56-65 years than among those aged 18-55 years (1.63 vs 1.24 donations per year; adjusted IRR=1.34, 95%CI: 1.30-1.39, P<0.001). During the study period, donors aged 56-65 years contributed 2.95% of all donations; their whole-blood donations and whole-blood collection volume accounted for 2.36% and 2.37% of the corresponding totals, respectively. Conclusion: Under current health screening and standardized donor management, donors aged 56-65 years did not show an increased risk of short-term donation-related adverse reactions and demonstrated a higher annual donation frequency, together with a measurable contribution to the blood supply. These findings support appropriately extending the upper age limit for voluntary blood donation under strict health screening to broaden the donor pool and supplement the blood supply.
