Abstract: Objective To analyze the reasons and influencing factors for on-site attrition among first-time prospective apheresis platelet donors, develop a retention stratification model, and evaluate the conversion effect of repeated donations within one year. Methods A total of 496 first-time prospective apheresis platelet donors at the Shoushan Blood Donation Room of our center between August 1, 2024 and January 31, 2025 were enrolled. Data on demographic characteristics, donor recruitment channels, and reasons for on-site attrition were collected. Chi-square tests and multivariable logistic regression were applied to identify predictors of donation success. A retention stratification model was constructed based on significant predictors. The situation of repeated donations within one year after the first successful donation was observed. Results The overall on-site attrition rate was 66.9% (332/496). The causes of attrition were health- and procedure-related concerns (38.2%), abnormal blood counts (26.2%), and time constraints (19.0%). Multivariate regression analysis showed that age 18-35 years (odds ratio OR=0.494, P=0.001) and self-initiated recruitment (OR=2.659, P<0.001) were independent predictors of successful donation. There was no significant difference between the organization-organized group and the peer-referral group (P=0.143). The stratified model, derived from age and recruitment channel, demonstrated attrition rates of 47.4%, 67.4%, and 83.5% for the high-, medium-, and low-potential groups, respectively. Among the 164 donors who completed their first time donation, the one-year repeat donation rate was 33.5% (55/164), translating to an overall one-year retention rate of 11.1% (55/496) across the cohort. Self-initiated recruitment was an independent predictor of repeat donation (OR=3.612, P=0.014), while age showed no predictive value (P=0.695). Conclusion Donors younger than 36 years and those recruited through self-initiated channels are associated with higher apheresis platelet donation success rates. Self-initiated recruitment also predicts the likelihood of repeat donation within one year. The retention potential stratification model provides a reference for differentiated donor interventions, which may improve conversion rates and long-term retention of apheresis platelet donors.

Key words: Apheresis platelet donors, On-site attrition, Donor recruitment channel, Retention potential stratification