Keys to open the door for blood donors to return.

Because of demographic changes, the worldwide shortage of blood will likely be aggravated in the foreseeable future. Hence, the retention of already active blood donors (BDs) is becoming more and more important. Moreover, a substantial increase in blood donations could be achieved by a relatively small increase in BD return. Blood donation services are therefore well advised to understand their BDs' motivations to become regular and committed BDs and to consider this in planning BD retention programs. Focusing on the published literature of the last decade, we summaries some key recommendations in considering BD retention strategies. Whereas starting a career as a BD is mainly driven by external stimuli, becoming a committed BD needs a well-developed identity role; that is, a BD with a high level of intrinsic motivation. Active communications with the BD right from the beginning, introducing distinct measures to support the development of a BD's distinct identity, increasing convenience of the blood donation process, having well-trained and motivated staff, applying distinct measures to reduce anxiety as well as adverse events, making BDs satisfied with their blood donation experience, appropriate use of incentives, quickly recapturing temporarily deferred BDs, and appealing to BDs' personal motivations and moral norms--all of these are major keys to achieving this important aim.