The Ministry of Health and Welfare finalized the Second Basic Plan for Blood Management (2026-2030), which includes expanding blood donation participation and strengthening appropriate transfusion management to address instability in the blood supply caused by low birthrates and an aging population.
The ministry announced the basic plan for blood management to be applied over the next five years after a review by the Blood Management Committee on the 13th. The government set its vision as "blood management that reassures both donors and recipients," and said it will pursue four main tasks: ▲ building a foundation for blood donation participation ▲ strengthening the safety of blood products ▲ transfusion management at medical institutions ▲ strengthening the national blood management system.
◇ "Donations by young people, transfusions by older adults"… blood supply-demand imbalance deepens amid the demographic cliff
Korea's blood donation rate is high compared to major countries. As of 2024, the domestic blood donation rate was 5.6%, higher than Japan (4.0%) and France (3.9%).
However, the current domestic donation system relies excessively on certain age groups. In 2024, people in their teens and 20s accounted for 55.4% of all 2,855,540 donors, exceeding half. Compared with Japan (17.6%) and France (29.5%), the concentration among young people stands out.
Meanwhile, the number of transfusion patients is increasing mainly among older adults. The number of recipients aged 50 and older for red blood cell products rose from 347,000 (85%) in 2020 to 366,000 (87%) in 2024, and the number of transfusions also increased from 1.52 million to 1.58 million over the same period.
The base of the donor population itself is also shrinking. The donation-eligible population (ages 16-69) decreased by 300,000, from 38.97 million in 2022 to 38.67 million in 2024, and the actual number of donors fell from 1,327,000 to 1,265,000 over the same period. The population in their teens and 20s decreased by as many as 1 million, from 11.6 million in 2020 to 10.6 million in 2024.
◇ Lowering the barrier and boosting efficiency… considering eliminating ALT tests and easing age criteria
The government said it will consider raising the donation age limit and easing donor selection criteria. Under current standards, whole blood and plasma donations are allowed for ages 16-69 (those 65 and older only if they have donation experience between ages 60-64). Despite the global trend toward easing age criteria, these domestic standards have remained in place for nearly 10 years.
It will also push to eliminate ALT (alanine aminotransferase) testing, an indicator of liver function. ALT testing was introduced in 1990 as a surrogate marker for hepatitis B and C, but its usefulness has greatly diminished with the advent of nucleic acid testing (NAT). In fact, of 510,000 units of blood discarded over the past five years, 170,000 units, or 33%, were thrown out due to failing ALT criteria.
It is also considering switching malaria testing from conventional antibody testing, which has low efficiency (only 1 confirmed infection among 25,657 antibody-positive cases over 14 years), to more sensitive nucleic acid testing.
◇ Buses for areas without donation centers… expanded awards for frequent donors
Access to donation will also be expanded. There are currently 99 blood centers nationwide and 174 donation houses (donation cafes) in operation. For basic local governments without a donation house, the government will work with regional blood centers to operate donation buses regularly once or twice a month. It also plans to flexibly adjust operating hours to encourage office workers to donate after work.
Benefits for donors will be strengthened. Government commendations for frequent donors will be elevated from a Minister's citation to orders and medals and presidential and prime ministerial citations, and it will operate recognition programs such as invitations to KBO League and K League games. The government also plans to revamp donation certificates and the donation reimbursement points system, whose usage has declined. The usage rate of donation certificates fell from 9.7% in 2018 to 7.0% in 2024, and donation reimbursement points currently total 61.5 billion won (as of Nov. 2025).
◇ "Safe transfusion comes first"… expanding leukocyte-reduced blood and modernizing blood centers
Expanding the supply of leukocyte-reduced blood products is a key task for blood safety management. As of 2024, the domestic supply rate of leukocyte-filtered red blood cells is only 23.1%, lagging far behind Japan, Australia, and the United Kingdom, which have achieved 100%.
This gap is also linked to post-transfusion immune adverse events. As of 2024, Korea recorded 3,836 cases of febrile non-hemolytic transfusion reactions, far more than the United Kingdom (183) and Japan (305). The government also plans to revamp the blood fee system to reflect the additional time (about 50 minutes) and labor and space expenses required for leukocyte reduction.
It will also push to introduce the "two-unit apheresis platelet product," which collects two 250mL units of apheresis platelets from one donor at once. This method, already used by major countries such as the United States (45.1%), Australia (72.1%), and China (70.7%), reduces the number of transfusions and lowers the risk of infection.
It will continue to promote the establishment of a blood center reimbursement fee for irradiated blood products and the replacement of outdated blood testing equipment. The average age of buildings at six Korean Red Cross blood centers (Busan, Gwangju-Jeonnam, Daegu-Gyeongbuk, Daejeon-Sejong-Chungnam, Seoul Southern, and Seoul Central) is 37.8 years (as of Dec. 2025), making modernization urgent. The government plans to begin modernizing the Busan Blood Center from 2026 to 2028 and then sequentially upgrade the remaining five centers.
Transfusion management at medical institutions will also be strengthened. The government will expand the assessment of transfusion appropriateness, currently applied to knee arthroplasty and posterior spinal fusion, to other surgeries, and will link it to the healthcare quality assessment to enhance effectiveness. The transfusion rate for knee arthroplasty fell from 41.0% in 2020 to 32.2% in 2023, but the government assesses it remains high compared with major countries.
◇ 24/7 centralized monitoring… strengthening blood supply management using the post office delivery network
It will also draw up blood supply standards that reflect each medical institution's inventory levels and apply them on a pilot basis. Through the Blood Management System (BMS), it will switch hospital blood information from manual entry to automatic linkage, and the Blood Information Management System (BIMS) will adopt a 24/7 year-round centralized monitoring system. Of the nine top-tier information systems under the Ministry of Health and Welfare, eight currently operate 24/7 monitoring, but only the Korean Red Cross blood information management system remains limited to business-hour monitoring.
To improve blood transport in medically underserved areas, it is also considering using the nationwide post office logistics network. Currently, 80% of blood is transported directly by supplier blood center vehicles. For regions at risk of population extinction, the government plans to discuss providing public delivery services through the post office network with the Ministry of Science and ICT (Korea Post).
Minister Jung Eun-kyeong of the Ministry of Health and Welfare said, "The life-sharing practice of donors forms the foundation for a stable blood supply and patient care," adding, "The government will also strengthen the blood management system so that the public can receive transfusions with confidence."