Teenage blood donation: demographic trends, adverse reactions and iron balance

Background Young (16‐ to 17‐year‐old) volunteers donate substantially and disproportionately to the blood supply in the United States, accounting for less than 3% of the general population but about 10% of allogeneic whole blood collections. Donating blood, while quite safe overall, has some attendant risk, and teenage donors are the most susceptible to adverse reactions and injuries, as well as iron deficiency after blood donation. Aim To describe demographic trends in blood donation and the risk of adverse reactions and iron depletion among teenage (16‐ to 17‐year‐old) blood donors compared to older donors. Methods Review of demographic data and studies on blood donation by 16‐ to 17‐year‐olds. Results Adverse reactions after whole blood donation are most likely to occur in the youngest donors. The odds of syncope‐related injury after donation for a 16‐ or 17‐year‐olds are 2·5‐fold higher than 18‐ and 19‐year‐olds and 14·5‐fold higher than adults 20 years old or older, even after taking into consideration first‐time donation status and other predisposing factors. Moreover, iron deficiency, prevalent among teenagers, is aggravated by blood donation. Effective interventions to reduce the risk of reactions and mitigate iron deficiency are supported by research studies and large operational trials in blood centres, but have not been universally implemented. Conclusion Teenage donors continue to contribute substantially and disproportionately to the blood supply despite their higher risk of adverse reactions and possible adverse consequences of iron depletion after blood donation. Further measures could protect adolescent blood donors from donation‐related reactions, injuries and iron depletion.