Transfusion medicine | Blood donations from older people welcome

Wacken fan Victoria donates blood at a joint event organized by the Wacken Foundation and the University Hospital of Hamburg. Photo: dpa/Markus Scholz There is a touch of heroism about blood donation: the idea is that blood is donated in an emergency to save lives. However, these are not always acute emergencies. Overall, most blood supplies in Germany are needed as part of cancer treatment. Many types of cancer, such as leukemia, as well as chemotherapy, damage the bone marrow and suppress blood formation in these patients. Major interventions for heart disease come in second place. This is followed by stomach and intestinal diseases, including acute bleeding in the digestive tract. Only then do injuries and accidents with high blood loss occur, for which around twelve percent of the blood reserves are needed.

Around 15,000 blood donations are needed every day in Germany. Some of the products derived from this have a limited shelf life, including concentrates of blood platelets (thrombocytes). These can help stop severe bleeding - but they must be used within a few days. This is also why it is not simply the case that a particularly large number of people should donate blood at once, but rather “that the entire supply chain is designed to be flexible, redundant and crisis-proof,” as Tamam Bakchoul puts it. The specialist in transfusion medicine is vice president of the German Society for Transfusion Medicine and Immunohematology (DGTI), which is holding its annual meeting next week. Bakchoul works at the University Hospital of Tübingen.

»We need all blood types.«

According to the doctor, the difficulty is that the demand for hospitals that provide maximum care (such as university hospitals) cannot be precisely planned. Even now, in everyday life, there are always shortages, says Bakchoul. Things get tight in phases of waves of infection or during the holiday season. “We need all blood groups.” According to Bakchoul, donations from people with blood group zero Rhesus negative, the so-called universal donors, are particularly in demand. Because these people's red blood cells (erythrocytes) lack certain antigens, they are not attacked by the immune system of recipients with other blood types. Blood group zero Rhesus positive is also favorable - these donations are tolerated by all other Rhesus-positive recipients, although this only applies to the erythrocytes.

According to Ruth Offergeld from the Robert Koch Institute in Germany, the safety of the blood products as well as the entire donation and processing process is extremely high. This is ensured by a series of complementary measures. These include, among other things, the fact that voluntary donors can determine their suitability in advance and therefore do not come to donate in vain. Be it certain medications, chronic pre-existing conditions or recent trips to some countries and regions: information about possible restrictions is available from the regional blood donation facilities, often online, or, if there are too many details and constellations to take into account, also by telephone.

In 2023, the age limit for whole blood donation will fall from 65 in Germany, and older people are now also allowed to donate. This is definitely necessary, as Kristina Hölig explains. The DGTI president works as head of transfusion medicine at the University Hospital of the TU Dresden and for the DRK blood donation service Nord-Ost gGmbH.

Due to the larger proportion of older people in the total population, more blood products are needed to care for them. However, currently only three percent of the population donates regularly. Almost every second person has done it before, but this has not led to repeated donations. Hölig reports that the side effects of a donation tend to decrease with age. It just takes a little longer to readjust the hemoglobin level, which means you can't donate as often. But now many older people are also deferring donations because of their long-term medication.

On the other hand, the youngest people in particular - aged 18 and over - apparently have many more reasons for deferral, including previous trips outside Europe, tattoos or - especially in the case of young women - a body weight that is too low. Circulatory reactions after blood donation are also more likely to occur in young people - which makes older people even more encouraged to take part. It would also be important to attract more long-term donors in order to keep the supply stable permanently and even in times of crisis.

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