Dr. Joseph Kiss stared at the figures in disbelief.
Two-week projections showed - again -- that blood supplies at the Central Blood Bank could be dropping to record-low levels this month.
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| That's Rich Pawlish of Pleasant Unity with his arm out at an American Red Cross blood center in Greensburg last week. (Franka Bruns, Post-Gazette) |
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This comes just weeks after supplies dipped in July to their lowest point in 10 years, and some elective surgeries were canceled at local hospitals until emergency appeals for blood bolstered collections.
"It is heart-wrenching to realize how short-lived that blood response was," said Kiss, the blood bank's medical director. "I thought we'd be OK now. But we're showing the exact same pattern."
And so it goes. These summer dog days of falling stock prices and fallen CEOs have also been a time of falling blood supplies here and in other parts of the country. Summer typically is a slow time for donations, with folks on vacation and high school and college donors out of school.
But this has been particularly bad.
The goal is to have a four- to five-day supply of most of the blood types, but both the Central Blood Bank and Greater Alleghenies region of the American Red Cross have been operating with just a one- or 1 1/2 -day supply -- inventories that easily could be wiped out with just one major accident.
"Blood centers are living hand to mouth, basically," said Brooke Thaler, spokeswoman for America's Blood Centers in Washington D.C., whose 75 members in 46 states collect nearly half of the blood in the United States. "For many centers, collections are better than they were last year -- every year they go up. But the usage number increases more dramatically than increased donations."
Demand nationally is rising to meet the growing blood needs of an aging population and more sophisticated medical procedures.
The local Red Cross, which is based in Johnstown and serves facilities in 100 counties over six states, including St. Francis and Mercy hospitals and the Pittsburgh VA Medical Center, hasn't asked hospitals to delay elective surgeries -- yet. While it experienced a slight increase in donations during its last fiscal year, it's concerned about a recent downturn.
It collected 4,757 fewer units, and distributed 1,734 more, from January to June 2002 than during the same period last year. Collections were down again last month.
"Blood supplies tend to dwindle every summer, but this summer has been worse," said Timothy Miller, Red Cross senior director of donor services.
The Central Blood Bank, which supplies most hospitals and 90 percent of the region's blood products, saw demand rise by 4 percent and collections by 6 percent during the fiscal year that ended June 30. Most of that collection boost came in the three weeks after Sept. 11.
Even with that increase, the blood bank had to import 23,000 units, or 12 percent of total supplies, from other regions to meet demand last fiscal year.
The drop in collections is tied partly to increasing restrictions on donation -- from the proliferation of tattoos and body piercing to exposure to mad cow disease during overseas travel.
The shortage is expected to worsen Oct. 31, when federal restrictions take effect to block importation of blood from Europe to protect against mad cow disease.
Kiss said that these restrictions are making it more difficult to import blood from other strapped U.S. regions. "People are very protective of regional blood supplies. They're telling us, 'We can't afford to send you that.' "
There's also been a backlash from Sept. 11: For the Red Cross, the bad publicity over the handling of the Liberty money fund; for the Central Blood Bank, the attempt by hundreds to give blood -- including many first-time donors -- only to be told there was too much and to come back later. Some fulfilled that pledge; others did not.
"One of the challenges is getting the word out that blood is needed all the time," said Thaler of America's Blood Centers. "People believe you come and give blood only after the tragedy has occurred. It just doesn't seem to register."
She also acknowledged that the public has grown weary of the endless emergency appeals.
"But when blood centers say they need blood, they do mean it," she said. "They try as hard as they can not to go out on appeal."
Living with short supplies
So what are blood agencies doing to turn things around?
For the first time, the Central Blood Bank in July urged doctors to talk with patients facing elective surgery that required blood transfusions to donate blood ahead of time.
"We have never before advocated for people to donate for themselves," Kiss said. "We suggested that to avoid cancellation of elective surgery, doctors should advise their patients to donate their own blood or to recommend family members do so. That's novel for us."
Families of cancer patients, who need regular transfusions, also are being asked to donate to replenish supplies.
Among other initiatives, the Blood Bank has asked:
Doctors, staff and other hospital employees to be good role models and donate blood themselves.
Surgical staffs to conserve blood. This includes intraoperative blood salvage, in which a patient's spilled blood is cleansed and re-infused. In younger patients, doctors can draw blood during an operation, replace it with saline, then return it to the patient after the procedure.
Doctors to transfuse patients with one blood unit and then assess their condition before automatically transfusing with two units. In a third of cases, patients will need only one unit.
Bulletins also will be regularly distributed to doctors to give them updates on blood supplies so they can react immediately when inventories begin to dip.
In addition to expanding advertising and building up donor lists (even Caller ID has blocked access to some donors in telephone appeals), both the Blood Bank and Red Cross have established programs in which high schools and universities receive scholarship awards for successful blood drives. They're also pushing for drives over the summer. Penn-Trafford High School, for example, recently held a successful drive for the Red Cross.
The Red Cross is trying to hook elementary schoolchildren in Cambria and Somerset counties through a program developed around a children's book, "Ned and The Gift of Life," written by Red Cross board member Dr. Ronald Madison.
Youngsters are encouraged to suggest their parents and neighbors become donors.
Going high tech
Blood banks also are turning to new technology.
One of the newest advances is double red cell collection, which hasn't started here, but is making a big impact at other blood services across the country.
Donors are hooked to a machine that separates blood on the spot, keeping the red cells and returning other components to the body. Because only part of the blood is taken, banks can collect twice the red cells, totaling about a pint, from a single donor who doesn't feel the loss.
Donation takes longer -- 35 to 45 minutes vs. 15 for regular donation. And people can't give as often: only once every 112 days instead of every 56 days. Fewer people are eligible because weight and height requirements exceed those for regular donations.
But donors can give more blood with fewer visits, which makes the procedure appealing.
Las Vegas, in particular, has embraced this technology. Last year, the blood bank pulled in 7,700 extra donations without having to recruit extra donors, and donations continue to climb this year. In fact, 60 percent of all red cells are now collected with automated equipment manufactured by Haemonetics Corp. of Massachusetts, which is used at permanent facilities and in mobile units, said Ron Hein, executive director of United Blood Services in Las Vegas. It uses a smaller-gauge needle than regular donation and can collect double red cells or regular units.
"Our greatest success with this is in the high school program. The kids love this technology -- they're so high-tech savvy," Hein said. "This is where blood banking is going. First-time donors, they don't know the old way."
The local American Red Cross region in November or December plans to add two machines at its Johnstown collection site, and eventually acquire more for its mobile units, Miller said.
With this new system, the Red Cross plans to target O negative (the universal donor) and B blood types to alleviate the greatest shortages. It also will be ideal for the people who donate just once or twice a year.
The Central Blood Bank plans to explore this technology sometime over the next year.
The Red Cross hopes that the Food and Drug Administration will approve new technology that will allow it to freeze blood and extend the shelf life from 42 days to 10 years.
The technology has been approved for use by the military, and the Red Cross is conducting tests for use on the public. If approved, it could be on the market in less than a year, said Dr. Peter Page, senior medical officer for the National Red Cross in Washington, D.C.
But spokesmen for both blood banks say it's important for a community to fulfill its own needs.
"What this comes down to is volunteerism," Kiss said. "Compared to the kind of commitment you need to volunteer for other things, this is pretty simple. It's just 45 minutes or so out of your day a couple times a year.
What they need more of is people like Kevin Lorenzi. He was at the Central Blood Bank's Downtown Pittsburgh site, giving blood on a recent Wednesday.
Lorenzi, 24, a free-lance photographer, was donating a pint of Type A positive because he believes it's his civic duty.
"As human beings, it's our obligation to give blood," he said. "There's a need out there and everyone who is able should donate."
Virginia Linn can be reached at vlinn@post-gazette.com or 412-263-1662. Deborah Mendenhall is a former Post-Gazette staff writer.
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