A decadal profile of RhD-negative blood donors in Chongqing, China: demographics, phenotypic diversity, and donation behavior

Background: RhD-negative blood is a critical resource in transfusion medicine due to its rarity and clinical significance. This study provides the first comprehensive analysis of RhD-negative blood donors in Chongqing, China over a decade (2015-2024) to optimize scientific research evidence for optimizing strategies to recruit and retain RhD-negative whole blood donors. Methods: A retrospective cohort of 4,185 RhD-negative donors who donated whole blood to the Chongqing Blood Center from 2015 to 2024 was analyzed. Variables included age, gender, occupation, education level, Rh phenotypes, ABO blood groups, and donation frequency were collected and analyzed to identify factors influencing whole blood donation. Results: In this study, the RhD-negative whole blood donors mainly consisted of donors who had donated only once, with an overall male-to-female ratio of 1.01:1. One-time donors were predominantly students (33.2%) and young adults (49.2% aged 18-25). Active donors correlated with higher education (university degree: 38.6%). The ABO blood group distribution was O > A > B > AB and dominant Rh phenotype was ccdee (50.7%), with rare variants (e.g., CCdEE) absent. Conclusion: This study highlights the need for tailored donor retention strategies and dynamic inventory management for rare subtypes. The findings outline a roadmap for blood centers to address RhD-negative blood shortages and enhance transfusion safety.