Blood transfusion is vital in modern medicine, saving lives in cases of hemoglobin disorders, transplants, major surgeries, trauma, and cancer treatments. This study primarily aimed to evaluate blood donation trends in Iran.

A time trend ecological study with a nationwide cross-sectional design was conducted over a six-year period, from 2017 to 2022. The analysis focused on aggregate data obtained from the Iranian Blood Transfusion Organization (IBTO) database. We used trend analysis for proportions to examine the trend in blood donation and the chi-squared test to compare the characteristics of blood donations.

A total of 12,352,275 blood donations were collected during the six- years study. The donation rate changed dramatically in 2020. Trend analysis revealed a significant decrease in donation rate (number of donations per 1000 population) from 25.78 in 2017 to 22.67 in 2020 (Slope = -0.001, p_trend < 0.000), followed by a significant increase to 26.25 in 2022 (Slope = 0.002, p_trend < 0.0001). There was a significant difference in gender, age groups, blood groups, and donation statuses (p < 0.0001) during the years. Age groups younger than 36 years showed a decrease from 46.35% in 2017 to 35.47% in 2022 (p < 0.0001).

Although a decrease in blood donations was observed due to factors such as the COVID-19 pandemic, donation rates have since returned to and even exceeded previous levels, confirming the success of the measures taken by IBTO. However, a decline in donations among individuals younger than 36 years old remains one of IBTO’s major concerns.