@article {4012, title = {Adverse Reactions to Allogeneic Whole Blood Donation by 16- and 17-Year-Olds.}, journal = {//JAMA}, volume = {299}, year = {2008}, month = {2008}, pages = {2279 - 2286}, publisher = {Biomedical Services, Medical Office, National Headquarters, American Red Cross, Washington, DC (Drs Eder and Benjamin and Ms Dy); Emory University, School of Medicine, Atlanta, Georgia, and Southern Region, American Red Cross, Douglasville, Georgia (Dr Hi}, address = {Copyright 2008 by the American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use. American Medical Association, 515 N. State St, Chicago, IL 60610.}, abstract = {Context: Donations by minors (16- and 17-year-olds) now account for approximately 8\% of the whole blood collected by the American Red Cross, but young age and first-time donation status are known to be independent risk factors for donation-related complications., Objective: To evaluate adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds compared with older donors in American Red Cross blood centers., Design, Setting, and Participants: Prospective documentation of adverse events among 16- and 17-year-old donors using standardized collection protocols, definitions, and reporting methods in 2006. Data were from 9 American Red Cross blood centers that routinely collect from 16- and 17-year-olds, a population that provides 80\% of its donations at high school blood drives., Main Outcome Measures: Rate of systemic (syncopal-type) and phlebotomy-related donor complications per 10 000 collections., Results: In 2006, 9 American Red Cross regions collected 145 678 whole blood donations from 16- and 17-year-olds, 113 307 from 18- and 19-year-olds, and 1 517 460 from donors aged 20 years or older. Complications were recorded in 15 632 (10.7\%), 9359 (8.3\%), and 42 987 (2.8\%) donations in each corresponding age group. In a multivariate logistic regression model, young age had the strongest association with complications (odds ratio [OR], 3.05; 95\% confidence interval [CI], 2.52-3.69; P < .001), followed by first-time donation status (OR, 2.63; 95\% CI, 2.24-3.09; P < .001) and female sex (OR, 1.87; 95\% CI, 1.62-2.16; P < .001). Infrequent but medically relevant complications, in particular physical injury from syncope-related falls, were significantly more likely in 16- and 17-year-old donors (86 events; 5.9/10 000 collections) compared with 18- and 19-year-old donors (27 events; 2.4/10 000 collections; OR, 2.48; 95\% CI, 1.61-3.82) or adults aged 20 years or older (62 events; 0.4/10 000 collections; OR, 14.46; 95\% CI, 10.43-20.04). Sixteen-year-old donors who experienced even a minor complication were less likely to return to donate within 12 months than 16-year-olds who experienced uncomplicated donations (52\% vs 73\% return rate; OR, 0.40; 95\% CI, 0.36-0.44)., Conclusions: A higher incidence of donation-related complications and injury occurs among 16- and 17-year-old blood donors compared with older donors. The increasing dependence on recruiting and retaining young blood donors requires a committed approach to donor safety, especially at high school blood drives., Copyright 2008 by the American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use. American Medical Association, 515 N. State St, Chicago, IL 60610.}, keywords = {Adolescent, adverse reaction, Blood Donors, Blood Transfusion, Patient Safety, Risk Factors}, isbn = {0098-7484}, author = {Eder, Anne and MD, PhD and Hillyer, Christopher and Dy, Beth and Notari, Edward and Benjamin, Richard and MD, PhD} }