Lessons learned from crises in blood donation services: A systematic review of operational practices.

BACKGROUND AND OBJECTIVES: Blood donation services are vital to healthcare delivery, ensuring the continuous availability of safe and adequate blood products, particularly during periods of disruption and crisis. Disruptive events such as pandemics, mass-casualty incidents, (natural) disasters, pandemics, armed conflicts and blood shortages can affect donor availability, logistics, workforce capacity, communication and operational continuity. This study systematically identifies and synthesizes lessons learned from crises affecting blood donation and translates them into a structured framework of operational practices. MATERIALS AND METHODS: A systematic literature review between 2010 and 2025 was conducted using four databases. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 142 included publications were analysed using qualitative content analysis with MAXQDA and organized using an analytical framework adapted from the International Society of Blood Transfusion (ISBT) COVID-19 Operational Recommendations Framework. RESULTS: The analysis identified six overarching dimensions of operational practice in blood donation services: collaboration, coordination and standards; blood supply chain design and management; resource management; disaster preparedness and risk management; communication; and operations. Three overarching operational practice themes emerged: coordinated governance and communication, operational continuity and organizational resilience. CONCLUSION: Crises affecting blood donation services generate transferable lessons for maintaining safe and reliable blood supply operations under disruptive conditions. This review provides a structured synthesis of cross-crisis operational practices and offers an evidence-based foundation for blood services.