Belgium Cuts Blood Transfusions by One-Third Since 2011

Belgium has achieved a remarkable one-third reduction in blood transfusions per inhabitant since 2011, according to data from the Federal Agency for Medicines and Health Products (FAGG/AFMPS). In 2011, 45.8 blood transfusions were administered per 1,000 inhabitants; by 2024, that figure had fallen to 31.5 — a decline of approximately 31 percent. Medical professionals attribute this progress to more conscious use of blood products, improved surgical techniques, and the widespread adoption of patient blood management (PBM) protocols.

A Shift in Clinical Practice

At the heart of this decline is a fundamental change in how doctors approach transfusion decisions. Clinical studies over the past 15 years have established that patients can safely tolerate lower hemoglobin levels than previously thought before a transfusion becomes necessary.

“Clinical studies show that we can let the amount of hemoglobin in the blood drop further before administering a transfusion,” said Professor Veerle Compernolle, a clinical biologist at Ghent University Hospital (UZ Gent), in an interview with VRT NWS. At UZ Gent alone, absolute transfusion numbers have dropped by 25 percent since 2011.

Professor Compernolle emphasized the principle driving this shift: “Every medical intervention has a chance of side effects, and if something isn’t necessary, you simply better not do it.” Blood transfusions, while life-saving, carry risks including transfusion reactions, infections, and immunological complications.

Better Surgery, Better Preparation

Two main factors explain the decline. First, surgeons now place greater emphasis on minimizing blood loss during operations through improved techniques and better monitoring of blood coagulation. Second, pre-operative care has improved significantly: patients’ iron levels are routinely checked before surgery, and iron supplements are prescribed when deficiencies are found, as iron is essential for hemoglobin production.

This approach is part of a broader global movement known as Patient Blood Management (PBM), an evidence-based, multidisciplinary strategy endorsed by the World Health Organization. In April 2025, the WHO published updated guidance on implementing PBM, reflecting growing international recognition of its benefits for patient outcomes and healthcare efficiency.

The Paradox: Less Demand, Persistent Shortages

Despite the dramatic reduction in transfusion rates, blood donations remain critically needed — and the system faces familiar pressures. The Rode Kruis Vlaanderen (Red Cross Flanders) recorded 246,468 blood donations in 2025, a slight decrease from the previous year, though over 15 percent came from new donors.

“People go on vacation and the children are at home. There are always fewer blood donors in the summer,” said Jan Poté, interim spokesperson for Rode Kruis Vlaanderen, speaking to VRT NWS. “So don’t forget to come by before the holidays so we can keep the blood supply at a good level.”

The situation is particularly acute for O-negative blood, the universal donor type that can be given to patients of any blood group. As of June 2026, the O-negative supply is critically low.

Rising Demand for Plasma

While whole blood transfusions are declining, demand for blood plasma is steadily increasing. Plasma is used to produce life-saving medications including immunoglobulins for immune deficiencies, clotting factors for hemophilia, and albumin for burn victims.

“We need many more new donors for plasma than for blood,” Poté noted. “You can donate blood every four months, but plasma every 14 days. The need for plasma is great and will remain so in the coming years.”

Regional Disparities

Donation rates vary significantly across Flanders. Antwerp is the largest donor province with 69,167 donations in 2025, while Limburg recorded the fewest at 30,165 — a gap attributed to limited access to donor centers. With only two fixed donor centers serving a province of approximately 900,000 inhabitants, the Rode Kruis has been working to expand infrastructure, including opening a dedicated plasma center in Pelt in November 2025.

What This Means for Belgian Healthcare

The one-third reduction in transfusions represents a significant achievement in both patient safety and healthcare efficiency. By reducing unnecessary medical interventions, Belgian hospitals are improving outcomes while potentially lowering costs. The trend aligns with a broader global shift toward evidence-based, conservative medical practices.

However, the persistent blood shortages — particularly during summer and winter holidays — highlight an ongoing vulnerability. As the population ages and demand for plasma-derived products grows, maintaining a robust donor base remains essential. The Rode Kruis continues to encourage new donors to step forward, particularly those with O-negative blood and those willing to donate plasma.

As Professor Compernolle summarized: “Blood transfusions are life-saving, but blood should only be administered when necessary.” Belgium’s healthcare system has clearly taken that message to heart — but the need for donors has never gone away.