Adjusting our management of female blood donors: the key to an adequate blood supply

1and can be divided into those that always have a sufficient RBC supply for their hospitals and those that do not. Blood centers that have a large nonmetropolitan territory and serve areas of low blood usage are able to collect beyond their needs and can export blood. In contrast, blood centers that supply blood to hospitals in large metropolitan areas often are unable to meet hospital needs all the time because of either undercollection or high blood usage in large cities. Such blood centers rectify the imbalance between demand and supply by contracts with exporting blood centers. Table 1 shows the results of a survey from seven blood centers that serve 7 of the 11 largest metropolitan communities in the US. The survey shows that metropolitan blood centers do not meet the demand within the metropolitan community and must import blood, because the donor pool is inadequate or the cost of incremental donations is too high. Imports work well during the fall, spring, and most of the winter but often are insufficient during the summer and winter vacations, when all blood collection facilities are stressed because schools are closed and many blood donors are away on vacation. Besides the issue of having an adequate A total supply, there is the issue of having a sufficient quantity of all ABO-Rh blood groups. Supplies of some ABO-Rh blood groups are more difficult to sustain because they are overtransfused (Group O+, all D‐ blood groups) or undercollected (Group B+), whereas other blood groups are overcollected (Group A+, AB+) and thus have higher expiration rates. Thus, blood centers in large metropolitan communities might have RBC shortages for all groups or specific groups, and the probability of such occurrences is greater in the summer and during or after the winter