Donor retention as a function of donor reactions to whole-blood and automated double red cell collections

Background: Although reactions to whole-blood (WB) donation are known to decrease donor retention, potential effects of reactions to automated double red cell (2RBC) donation upon retention have not been investigated. Study Design and Methods: The authors investigated effects of donor status (first-time, experienced) and reactions (absent, present) upon retention of all male allogeneic WB and 2RBC donors (n = 45,296) donating within the American Red Cross Central Ohio Region during a 12-month period. Donor age, race, and status (first-time, experienced); phlebotomist's reaction rating; and phlebotomy procedure (WB, 2RBC) were collected for the initial donation by each donor. Dates of any donation attempts in the 12 months starting from the donor's first eligible date after the initial donation were also collected. Results: On average, WB donors were less likely to react and more likely to donate again and returned more quickly to donate than 2RBC donors, even after accounting for differential delays in eligibility. Reactions decreased the likelihood of repeat donation among all first-time donors regardless of initial phlebotomy procedure. Among experienced donors, however, reactions depressed retention of WB donors by 27.6 percent, whereas reactions lowered retention of 2RBC donors by just 3.6 percent. Conclusion: Although 2RBC donors were more likely to react, first-time 2RBC donors were no more affected by reactions than first-time WB donors. Experienced WB donors suffered a larger drop in retention as a function of reactions, in fact, than did experienced donors who gave 2RBC donations. Potential reasons for this data pattern require further investigation.