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Annual transfusion rates in many European countries range between 25 and 35 red blood cell concentrates (RBCs)/1,000 population. It is unclear why transfusion rates in Germany are considerably higher (approx. 50-55 RBCs/1,000 population). We assessed the characteristics of transfusion recipients at all hospitals of the German federal state Mecklenburg-Western Pomerania during a 10-year longitudinal study. Although 75% of patients received ≤4 RBCs/patient in 2015 (1 RBC 11.3%; 2 RBCs 42.6%; 3 RBCs 6.3%; 4 RBCs 15.0%), the mean transfusion
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