Life events increase the chance of donor lapse

Understanding blood donors is key. What motivates and hinders people to donate blood? And how can these donors be more effectively recruited and retained? Tjeerd Piersma investigated how blood donor behavior is susceptible to change over the life course. He defended his PhD thesis on 8 September 2020.

Every day, blood transfusions are used to save lives after traumatic events as well as in treatments of cancer, hemophilia and autoimmune diseases. To ensure a sufficient blood supply, hospitals heavily rely on donors who voluntarily donate blood to help anonymous recipients. To match future demands of all needed blood types, blood banks are challenged to work towards a sufficient and healthy donor population. To that purpose, PhD student Tjeerd Piersma aims to answer the following research questions: Which individual, social and contextual factors are associated with blood donor behaviour, and what influence do these factors have across the blood donor career?

Donor lapse

In his thesis, Piersma shows how the donation decision is susceptible to change across the blood donor career as a result of life events. Childbirth, losing a job and starting a job increased the likelihood of donor lapse. Piersma: "These are usually changes that cause people to have less time, such as having a child or changing jobs. By being alert to these decisive moments, the blood bank could prevent donors from dropping out". In contrast, health-related events (i.e., blood transfusion in a family member, death of a family member) decreased the likelihood of donor lapse.

Interestingly, donors with the universal, O-negative blood group were less likely to lapse compared to donors with other blood groups. These donors might be driven by altruistic motivations as their blood can be used more efficiently and thus has a larger public benefit.

For his research Piersma used a combination of large-scale, longitudinal datasets from representative blood donor surveys and two national blood donor registers from the Netherlands and Denmark. By using these he was able to analyse dynamic blood donor careers of approximately 500 thousand donors while examining actual blood donations instead of self-reported donation intentions. Taken together, these data provide a life course perspective on blood donor behaviour. His results are internationally applicable, because results were obtained from the Danish data.

Donor recruitment

The reasons why people decide to become donors also varies. The so-called donor-recruits-donor strategy was especially reported by donors aged 35 or younger. Among older donors, the blood bank promotion team was the most prominant route of recruitment. Moreover, recruitment methods appeared to be associated with the length of the blood donor career. Given the wide variety of motivations for registration as a blood donor (e.g., altruistic feelings, warm-glow, moral responsibilities, or conforming to the family tradition), subsequent blood donor careers are highly person-specific, and some donors could use more support in becoming loyal donors over time.


Piersma pleads for the development of personalized, evidence-based recruitment strategies targeted to specific groups of non-donors. While it might be tempting to make more general use of the donor-recruits-donor strategy in light of its low costs and easy implementation, his results indicate that this is not effective in motivating diverse groups of new blood donors. Second, he stresses the importance of personalized donor retention by responding to changing donation motivations.

This may successfully increase the number of blood donations from a more diverse and loyal donor population guarantees a stable, adequate and sufficient blood supply, which saves lives.