Blood Donation - Complications

Complications

Donors are screened for health problems that would put them at risk for serious complications from donating. First-time donors, teenagers, and women are at a higher risk of a reaction. One study showed that 2% of donors had an adverse reaction to donation. Most of these reactions are minor. A study of 194,000 donations found only one donor with long-term complications. In the United States, a blood bank is required to report any death that might possibly be linked to a blood donation. An analysis of all reports from October 2008 to September 2009 evaluated six events and found that five of the deaths were clearly unrelated to donation, and in the remaining case they found no evidence that the donation was the cause of death.

Hypovolemic reactions can occur because of a rapid change in blood pressure. Fainting is generally the worst problem encountered.

The process has similar risks to other forms of phlebotomy. Bruising of the arm from the needle insertion is the most common concern. One study found that less than 1% of donors had this problem. A number of less common complications of blood donation are known to occur. These include arterial puncture, delayed bleeding, nerve irritation, nerve injury, tendon injury, thrombophlebitis, and allergic reactions.

Donors sometimes have adverse reactions to the sodium citrate used in apheresis collection procedures to keep the blood from clotting. Since the anticoagulant is returned to the donor along with blood components that are not being collected, it can bind the calcium in the donor's blood and cause hypocalcemia. These reactions tend to cause tingling in the lips, but may cause convulsions, seizure, hypertension, or more serious problems. Donors are sometimes given calcium supplements during the donation to prevent these side effects.

In apheresis procedures, the red blood cells are returned. If this is done manually and the donor receives the blood from a different donor, a transfusion reaction can take place. Manual apheresis is extremely rare in the developed world because of this risk and automated procedures are as safe as whole blood donations.

The final risk to blood donors is from equipment that has not been properly sterilized. In most cases, the equipment that comes in direct contact with blood is discarded after use. Re-used equipment was a significant problem in China in the 1990s, and up to 250,000 blood plasma donors may have been exposed to HIV from shared equipment.