Despite a steady increase in total blood collections and voluntary non-remunerated blood donors, China continues to have many challenges with its blood donation system. The country's donation rate remains low at 9‰, with over 60% of donors being first-time donors. Generally there is a lack of adequate public awareness about blood donation. The conservative donor selection criteria, the relatively long donation interval, and the small donation volume have further limited blood supply. To ensure a sufficient and safe blood supply that meets the increasing clinical need for blood products, there is an urgent need to strengthen the country's blood donor management. This comprehensive effort should include educating and motivating more individuals especially from the rural areas to be involved in blood donation, developing rational and evidence-based selection criteria for donor eligibility, designing a donor follow-up mechanism to encourage more future donations, assessing the current donor testing strategy, improving donor service and care, building regional and national shared donor deferral database, and enhancing the transparency of the blood donation system to gain more trust from the general public. The purpose of the review is to provide an overview of the key process of and challenges with the blood donor management system in China.

Keywords:
Blood supply, Blood donors, China
1.
Yu X, Huang Y, Qu G, Xu J, Hui S: Safety and current status of blood transfusion in China. Lancet 2010;375:1420-1421.
2.
An W: A survey on voluntary non-remunerated donation among 355 blood centers in China between 2006-2008 (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):22.
3.
Li C, Xiao X, Yin H, He M, Li J: Prevalence and prevalence trends of transfusion transmissible infections among blood donors at four Chinese regional blood centers between 2000 and 2010. J Transl Med 2012;10:176.
4.
Veldhuizen I, Folléa G, de Kort W: Donor cycle and donor segmentation: new tools for improving blood donor management. Vox Sang 2013;105:28-32.
5.
Shan H, Wang J, Ren F, Zhang Y, Zhao H, Gao G, Ji Y, Ness P: Blood banking in China. Lancet 2002;360:1770-1775.
6.
Gao F: Meeting the challenges in China. Transfus Int 2000;79:10-11.
7.
Wang J, Guo N, Guo X, Li J, Wen GX, Yang T, Yun Z, Huang Y, Schreiber GB, Kavounis K, et al: Who donates blood at five ethnically and geographically diverse blood centers in China in 2008. Transfusion 2010;50:2686-2694.
8.
Bi QY: Analysis on donation knowledge and donation motivators among voluntary blood donors (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):22.
9.
Feng LQ: Discussion on strategies in recruiting low-risk blood donors (in Chinese). Yi Yao Lun Tan Za Zhi 2011;32:118-120.
10.
Li HW, Yang BC, Zhu WG, Lu L, Yang SQ: Establishment and Management of a Network of Volunteers in Chinese Blood Donors (in Chinese); in The 6th National Congress of the CSBT. Guangzhou, Guangdong, China, 2012.
11.
Wang L: Management of voluntary blood donor volunteers (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):34.
12.
Zhou SH: Survey on blood donor recruitment during seasonal shortage in Chinese blood centers (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):22.
13.
Li GM, Liu QZ, Luo Y: Discussion on education and recruitment of family replacement donors (in Chinese). Zhong Guo Wu Zhen Za Zhi 2011;11:8935-8937.
14.
Tagny CT, Owusu-Ofori S, Mbanya D, Deneys V: The blood donor in sub-Saharan Africa: a review. Transfus Med 2010;20:1-10.
15.
Allain JP: Moving on from voluntary non-remunerated donors: who is the best blood donor? Br J Haematol 2011; doi: 10.1111/j.1365-2141.2011.08708.x.
16.
Hou HF, Cai YX: Analysis on family replacement donation in Hainan Province in 2011 (in Chinese). Zhong Guo Shu Xue Za Zhi 2012;25(suppl):5.
17.
Tison GH, Liu C, Ren F, Nelson K, Shan H: Influences of general and traditional Chinese beliefs on the decision to donate blood among employer-organized and volunteer donors in Beijing, China. Transfusion 2007;47:1871-1879.
18.
Zhang XY, Wu XM, Xu J, Xu Y: Discussion on the key elements in apheresis donor recruitment and retention (in Chinese). Zhe Jiang Yi Xue 2007;29:991-992.
19.
Zhao CP, Wang XF, Song HY: Psychological factors in voluntary blood donation: recruitment of voluntary blood donors in different populations (in Chinese). Yi Xue Xin Xi 2011;1:307.
20.
Lin Y, Pei H, Zhang YH: Application of conformity in blood donor recruitment (in Chinese). She Qu Yi Xue Za Zhi 2006;4:30-32.
21.
Xu XM, Chen YX, Liao RX, Wang CY, Mao AM: A survey on attitudes towards voluntary blood donation among 279 college students (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):39.
22.
Erwin K: The circulatory system: blood procurement, AIDS, and the social body in China. Med Anthropol Q 2006;20:139-159.
23.
Zaller N, Nelson KE, Ness P, Wen G, Bai X, Shan H: Knowledge, attitude and practice survey regarding blood donation in a Northwestern Chinese city. Transfus Med 2005;15:277-286.
24.
Zaller N, Nelson KE, Ness P, Wen G, Kewir T, Bai X, Shan H: Demographic characteristics and risks for transfusion-transmissible infection among blood donors in Xinjiang autonomous region, People's Republic of China. Transfusion 2006;46:265-271.
25.
Yan Z, Xu Y, Wang YM: Coping strategy for the trust crisis in blood donation (in Chinese). Zhong Guo Shu Xue Za Zhi 2012(suppl 1):194.
26.
Zhou YL: Control of Social Credit Risk in Blood Collection and Supply (in Chinese); in The 6th National Congress of the CSBT. Guangzhou, Guangdong, China; 2012.
27.
Xuan HX, Niu CL, Zhang MP, Gao LF: Strategies for recruiting apheresis donors (in Chinese). Lin Chuang Shu Xue Yu Jian Yan 2007;9:151-152.
28.
Liu M: Impact of after-donation follow up on donor retention (in Chinese). Lin Chuang Shu Xue Yu Jian Yan 2012;9:3018-3019.
29.
Wang YM, Zeng QJ: Recruitment and management of voluntary blood donors through information categorization (in Chinese). Yi Xue Xin Xi 2011;3:1159.
30.
Du LS, Liu XL, Li TJ: Strategies for donor recruitment and retention (in Chinese). Lin Chuang Shu Xue Yu Jian Yan 2010;12:257.
31.
Eder A, Goldman M, Rossmann S, Waxman D, Bianco C: Selection criteria to protect the blood donor in North America and Europe: past (dogma), present (evidence), and future (hemovigilance). Transfus Med Rev 2009;23:205-220.
32.
Wu JS: Analysis on Voluntary Blood Donors in Hefei City (in Chinese); in The 6th National Congress of the CSBT. Guangzhou, Guangdong, China; 2012.
33.
Sun Z: Analysis on recruitment and service of apheresis donors in Yichang (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):32.
34.
Yi ZM, Li RQ, Zhao SM: Analysis on recruiting voluntary blood donors on mobile collection vehicles (in Chinese). Chong Qing Yi Xue 2010;39:2990-2991.
35.
Kessler D: Blood donor, donation process, and technical aspects of blood collection; in Shaz B, Hillyer C, Roshal M, Abrams C (eds): Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects, 2nd ed. London, Elsevier, 2013, pp 37-44.
36.
Wang L: Analysis on reasons for donation reactions among college students (in Chinese). Zhong Guo Shu Xue Za Zhi 2012;25(suppl):31.
37.
Yang D: Survey on voluntary blood donors in Qianjiang (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):40.
38.
Cable RG, Glynn SA, Kiss JE, Mast AE, Steele WR, Murphy EL, Wright DJ, Sacher RA, Gottschall JL, Tobler LH, et al: Iron deficiency in blood donors: the REDS-II Donor Iron Status Evaluation (RISE) study. Transfusion 2012;52:702-711.
39.
Pi DW, Krikler SH, Sparling TG, Carter CJ, Wadsworth LD: Reappraisal of optimal hemoglobin standards for female blood donors in Canada. Transfusion 1994;34:7-10.
40.
Zheng WC, Shen CS, Rong Y, Wen CR, Zhan ZL: Reasons for deferral during rapid screening among voluntary blood donors (in Chinese). Zhong Guo She Hui Yi Xue Za Zhi 2012,29:442-444.
41.
Ren FR, Wang JX, Huang Y, Yao FZ, Lv YL, Li JL, Wen GX, Wen XQ, Liu J, Dong XD, et al: Hepatitis B virus nucleic acid testing in Chinese blood donors with normal and elevated alanine aminotransferase. Transfusion 2011; 51:2588-2595.
42.
Chen XF: Review on the Process of Development of Voluntary Blood Donation Regulation in Hainan (in Chinese); in The 6th National Congress of the CSBT. Guangzhou, Guangdong, China, 2012.
43.
Feng YQ, Cui X: Recruitment of postponed donors (in Chinese). Yi Xue Xin Xi 2011;24:5849.
44.
Zhang MP, Chen SF, Zhou XY, Tian ZB: Recruitment of temporarily deferred donors (in Chinese). Lin Chuang Shu Xue Yu Jian Yan 2010;12:354-355.
45.
Chen CY: Analysis on Temporarily Deferred Donors in Guizhong District (in Chinese); in The 6th National Congress of the CSBT. Guangzhou, Guangdong, China, 2012.
46.
Hu YN: Reasons for temporarily deferred donation in Dalian (in Chinese). Zhong Guo She Hui Yi Xue Za Zhi 2012;25(suppl):32.
47.
Sheng Q, Li CY, Shen ZL: Pre-donation deferral reasons and recruitment for voluntary blood donors (in Chinese). Shi Yan Yu Jian Yan Yi Xue 2009;27:699-701.
48.
Wang YM, Wu CN, Meng W: Pre-donation deferral among platelet apheresis donors and their recruitment (in Chinese). Zhong Guo She Hui Yi Xue Za Zhi 2010;23(suppl):33.
49.
Li YJ, An W, Liang XH: A survey on mobile blood collection vehicles and cabins in 355 blood centers (in Chinese). Zhong Guo She Hui Yi Xue Za Zhi 2010;23(suppl):20.
50.
Peng JH, Yang QH, Yang YS: Application of 4C promotion theory in blood donor recruitment in rural area (in Chinese). Zhong Guo She Hui Yi Xue Za Zhi 2009;22:586-589.
51.
Fu YH: Recruitment activities and management of mobile blood collection sites (in Chinese). Zhong Guo Yi Yao Zhi Nan 2011;9:330-331.
52.
Wu HD, Ying HX, Mao MJ: Effects of blood collection cabins in blood donor recruitment and retention (in Chinese). Zhong Guo Nong Cun Wei Sheng Fu Wu Guan Li 2011;31:1264-1266.
53.
Zhang J, Song Y, Hu B: Application of donor care in donor retention (in Chinese). Zhong Guo Shu Xue Za Zhi 2008;21:875-876.
54.
Chen HL, Liu FC, Xu CL, Xie Q: A survey among blood donors in Nanchang (in Chinese). Zhong Guo Shu Xue Za Zhi 2010;23(suppl):23.
55.
Li R: Blood screening procedures and blood donor retention (in Chinese). Guo Ji Jian Yan Yi Xue Za Zhi 2013;34:123-124.
56.
Li XJ: The application of nucleic acid testing in keeping blood donor (in Chinese). Guo Ji Jian Yan Yi Xue Za Zhi 2013;34:1230.
57.
Wang X: NAT Testing on HBV, HCV, and HIV among Voluntary Blood Donors in Tianjin (in Chinese); in The 6th National Congress of the CSBT. Guangzhou, Guangdong, China, 2012.
58.
Wang RF, Zhu LL, Zhou J: Recruitment and retention of apheresis donors (in Chinese). Zhong Guo Yi Yao Dao Bao 2011;8:127-129.
59.
Qu Z: Factors influencing retention of platelet apheresis donors (in Chinese). Zhong Guo Shu Xue Za Zhi 2012;25(suppl):3.
60.
Wang CM, Zhao HX, Liu CY: Effectiveness of accumulated points for retention of low-risk blood donors (in Chinese). Qi Lu Yi Xue Za Zhi 2013;28:173-175.
61.
Chen X, Zheng PX: Impact of follow-up on blood donor retention (in Chinese). Jian Yi Yi Xue Yu Lin Chuang 2011;8:1254-1256.
62.
Jiao DF: Discussion on use of free blood credit (in Chinese). Zhong Guo Shu Xue Za Zhi 2012;25(suppl):31.
63.
Shi L, Wang JX, Stevens L, Ness P, Shan H: Blood safety and availability: continuing challenges in China's blood banking system. Transfusion 2013;54:471-482.
© 2014 S. Karger GmbH, Freiburg
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.