Dr. David R Buyer, MD, MBA, FACP

Tag: Blood donation

  • Blood Safety

    The World Health Organization (WHO) recommends that countries have a national blood system governed by a national blood policy. In 2013, 79% of high-income countries — including the United States — followed this recommendation. The United States keeps its blood supply safe by a number of mechanisms. Blood donors are screened, blood is quarantined and tested, and donors are disqualified from donating to ensure safety. Blood can come from voluntary, unpaid donors, family or replacement donors or paid donors. In the U.S., only voluntary, unpaid donors, family donors or replacement donors are acceptable. Voluntary, unpaid donors are the safest subset from which to receive blood donations.

    Donors are screened for potential infectious diseases by answering multiple questions. Questions cover topics related to travel, behaviors, personal history of transfusions or cancers, and receipt of tissue grafts, to name a few. Acceptable responses are updated as new information is learned. For example, living in the United Kingdom or certain other European countries precludes donation due to risk of Creutzfeldt-Jacob disease (so-called “mad cow disease”). Those who have traveled to certain countries or areas of countries may also be excluded from donating for a limited time. Anyone incarcerated for more than three days is deferred from donating for 12 months after release. Those who have engaged in illicit intravenous drug use are prevented from donating during their lifetime. Anyone who’s had tattoos applied in a regulated state (Illinois included) with sterile needles and non-reusable ink is eligible to donate.

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    “The United States keeps its blood supply safe by a number of mechanisms. Blood donors are screened, blood is quarantined and tested, and donors are disqualified from donating to ensure safety.”

    All donations are screened for hepatitis B and C, HIV, syphilis, HTLV I and II, West Nile virus and Chagas disease. Until the tests are complete and negative, the blood is quarantined from being used in transfusions. If a donor is deferred for any reason, they are placed on a list and no donations are accepted from that individual. According to the WHO, in high-income countries, the median risk of infection from donations is 0.003% for HIV, 0.03% for hepatitis B, 0.02% for hepatitis C and 0.05% for syphilis.

    Transfusion practices also contribute to safety. Limiting unnecessary transfusions lessens risk to patients. In the U.S., transfusion of red blood cells is generally not recommended unless the patient’s hemoglobin is less than 7 (normal is over 13.5 for women and 14.5 for men). Transfusion of platelets is only recommended for counts under 10,000 except in cases of active bleeding or essential surgery and procedures. Blood is typed and matched for both major (A, B, O) and minor compatibility. This matching is only considered valid for 72 hours and then must be repeated if more transfusions are needed. At the time of transfusion, both the blood product and patient are cross-verified by two healthcare professionals prior to initiating the transfusion.

    No one wants to receive a transfusion, but be assured that multiple layers are in place on both the donation and transfusion sides to ensure the safest possible procedure for patients.

  • Blood Donation

    Woman giving bloodFive million people in the United States get blood transfusions each year. Thirty-six thousand units of red blood cells, 7,000 units of platelets and 10,000 units of plasma are transfused each day. More than 6.8 million donors supply 13.6 million units collected, which can be split up and used for multiple types of transfusions. But despite these large numbers, blood shortages still occur: 38% of the population is eligible to donate but less than 10% do so. The biggest reason people don’t donate is that the thought of doing so never occurs to them.

    Reasons why people may be ineligible to donate include anemia, hepatitis B or C, HIV or being at high risk for having HIV, and travel to destinations with high risk of infectious exposures. With some exceptions, those taking regular medications are generally eligible to donate blood. Prescription blood thinners (e.g., Coumadin, Eliquis, Xarelto, Pradaxa, Plavix) and prostate medications (e.g., Avodart, Propecia, Proscar) are examples of prohibited medications. Those undergoing estrogen replacement therapy are not prevented from donating.

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    “Blood donation takes less than 90 minutes and is an easy way to help others.”

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    If you have had basal and squamous cell cancers removed within the past 12 months you are still eligible to donate. Blood cancers cause ineligibility, but other cancers that have not recurred for 12 months after completing treatment are acceptable. If you have controlled diabetes and high blood pressure, you are also eligible to donate.

    People with congestive heart disease are generally excluded from donating. However, those with coronary heart disease may be acceptable donors if there have been no symptoms, heart attack, bypass operation or angioplasty for six months. At one time, it was thought that donating blood decreased one’s cardiac risk. Unfortunately, this theory has not held up in clinical trials. People with heart disease should consult their physician prior to donation.

    This is a brief list of criteria and by no means exhaustive. Blood donation takes less than 90 minutes and is an easy way to help others.