Blood bank trends in Kuwait: five-year analysis of donations and investigations

Abstract

Background: Reliable national transfusion services require continuous surveillance of donation activity, inventory losses, transfusion-transmissible infection (TTI) screening, and immunohematology workload. Kuwait’s centralized service is coordinated by the Kuwait Central Blood Bank (KCBB). Study design and methods: We performed a retrospective analysis of officially requested KCBB annual reports (January 2019–December 2023). Collated variables included donation volumes, donor sex and ABO/RhD distribution, discarded components, and NAT screening outcomes for HBV, HCV, and HIV. Patient-side indicators comprised total immunohematology samples, antibody screening/identification, antenatal testing, and alloantibody profiles. The analysis was descriptive, presenting distributions and temporal trends without inferential testing. Results: Donations averaged ~82,000 annually, with a decline during the COVID-19 pandemic (2020–2021) and recovery to ~85,000 in 2023. Male donors accounted for >85% of donations. O RhD+ positive (38.7%) and B RhD+ positive (23.7%) were the most common blood groups, while RhD-negative donors comprised 8.6%. Wastage varied yearly, predominantly impacting fresh frozen plasma. NAT-reactive TTI prevalence remained low: HBV 0.06–0.11% (60–110 per 100,000), HCV 0.03–0.08% (30–80 per 100,000), and HIV 0.02–0.05% (20–50 per 100,000) annually. Immunohematology workload (total samples and test activity) fell during 2020–2021 and increased again by 2023. A wide spectrum of clinically significant alloantibodies was identified, most frequently within the Rh, Kell, and Kidd systems, with additional MNS and P1PK specificities. Among antenatal samples, antibody positivity averaged 3.8% (peak 4.7% in 2021); anti-D predominated, followed by anti-K. Discussion: KCBB data highlight persistent male predominance among donors, RhD-negative scarcity (8.6%), and variable component wastage, especially FFP. These findings support targeted donor-recruitment strategies, obstetric–transfusion planning for RhD-negative supply, and strengthened inventory management to improve resilience and safety of Kuwait’s blood supply.