Background: The aim of the study was to identify characteristics of lapsed donors 4 years after the initial donation as well as self-reported barriers to return for further blood donations. Methods: A random number of 8,000 blood donors, donating for the German Red Cross Blood Service Baden-Wurttemberg - Hessen, were asked to fill in a self-administered questionnaire. The response rate was 38.5%. Donors were categorized as ”lapsed’ if they had not donated within the last 24 months. The odds of being a lapsed donor were determined in a multivariate logistic regression. Results: Multivariate analysis showed that lapsed donors were more likely to be female, between 26 and 33 years old, not employed, have moved, and were dissatisfied with the last donation experience. Furthermore, lapsed donors were less likely to have family members or friends who also donate blood. Medical reasons and having moved to another city were the most frequently named reasons preventing lapsed donors from continuing to donate blood. Conclusion: The importance of medical reasons and having moved was rated much higher than in previous studies. We conclude that barriers to return may vary considerably between countries and blood services. Therefore, donor surveys are required to guide reactivation campaigns
