- The Washington Times - Tuesday, September 11, 2007

lood-drive advertisements typically carry an alarmist tone, with good reason. Make a donation, save a life. Supplies are short.

The latter may be more true than people realize.

A new study by the University of Minnesota says the number of potential blood donors in the United States is far smaller than previously thought.

The updated figures show just 37 percent of the population, or 111 million people, are eligible to donate blood. Existing research had said about 177 million were able to donate.

The study looked at newer exclusions, such as high-risk behavior, established by the American Association of Blood Banks.

Stephanie Millian, director of biomedical communication with the national headquarters of the American Red Cross, says efforts to ensure donor and recipient safety contributed to driving down the pool of eligible donors.

“The industry is adding on more criteria every day,” Ms. Millian says.

The list of reasons people may not be able to donate blood is lengthy, including disqualification because of older age or having had blood transfusions.

“All those things add up,” she says.

Dr. Jeffrey McCullough, a professor of laboratory medicine and pathology at the University of Minnesota, says he wasn’t shocked by his study’s findings.

“Over the last 25 years, since the onset of the AIDS epidemic, blood centers have put in place a lot more lab tests and questions about donors’ medical history or behaviors that might put them at risk,” Dr. McCullough says.

Once you add up those factors, “there’s an awful lot more people not eligible to be donors than we thought,” he says.

That said, the changes made to the blood donation system have “made a huge difference. Blood is much safer these days than at the onset of the AIDS epidemic,” he says.

One way to increase the blood supply is to use filtration systems to turn potentially tainted blood into healthy blood. But any failure in the testing system — “No test is perfect,” he says — could lead to tainted blood.

Synthetic blood remains a dream for scientists hoping to increase the blood supply.

“There’s still nothing approved by the FDA,” Dr. McCullough says, despite all the work done by private companies seeking to find a suitable blood substitute.

“It turns out there really aren’t any chemicals that will work very well,” he says.

Some blood substitutes circulate in the blood for a few days, not the 60 days of normal blood cells, and others become toxic in the body after a short period.

Dr. Gerald Sandler, director of the transfusion medicine program at Georgetown University Hospital, says the University of Minnesota report struck him as solid and alarming.

“It’s written by knowledgeable scientists, and it provides the scientific basis for what’s been obvious to us,” says Dr. Sandler, former vice president of the national blood program for the American Red Cross.

Existing technology does help the overall blood supply situation. Pathogen inactivation techniques, available now, involve heating liquid blood products involving clear solutions. The method has its limits.

“If you have red blood cells and small clotting cells called platelets, they can’t be heated or treated with chemicals,” Dr. Sandler says.

Dr. Kirsten Alcorn, medical director of transfusion services at the Washington Hospital Center in Northwest, says schools need to be more proactive in getting the message out to the next generation of blood donors.

“Plant the seed so they know about donations, and teach them about what the criteria are,” Dr. Alcorn says.

This young population also must learn that their actions could have an impact on their availability to donate. A person who gets a tattoo must wait a year before he or she is eligible to donate blood, she says. The same is true for body piercing or if having sex with a high-risk partner.

“They might think twice about their tattoos and piercing then,” she says.

If someone takes intravenous drugs, the deferral period is forever, she adds.

For years, blood donation stories in the media and the text attached to various blood drives have implored donors to step up. It’s not just rhetoric, Dr. Alcorn says.

“If people are ringing the warning bell, it’s real,” she says. “We know the gap between supply and demand is getting smaller … pretty much on a monthly basis.”

The repercussions for blood supply shortages can be felt by one’s neighbors.

“Patients having to wait to have surgeries. People not feeling well who depend on transfusions to prevent bleedings,” she says.

Dr. Wendy Paul, medical director of Howard University Hospital’s transfusion service, says age plays a part in who can donate blood.

Teens 16 and older are allowed to donate, but some states allow younger children to give with a parent’s permission, Dr. Paul says.

Senior citizens also can give blood, but their health issues can complicate matters.

In some cases, “donating can cause harm to the donor,” Dr. Paul says, if their current state of health is precarious.

Ms. Millian says the University of Minnesota study could drive innovation in the synthetic blood field and push current work in the blood sterilization field. It also could help efforts toward conversion of type AB blood into type O blood, which remains years from completion.

“Future biomedical technology is important, but we need to make sure there’s enough blood to go around,” she says.

Dr. Alcorn says the study’s impact on the country’s blood supply comes near the sixth anniversary of the September 11, 2001, terrorist attacks.

“When 9/11 happened, blood donors came out of the woodwork all over the country,” she says.

But the country needs blood “all the time,” she cautions, “not necessarily the day of the disaster, but maybe the next day.”

“The blood donated on September 11 wouldn’t be available September 11,” she continues. “It takes time to get the blood from the donors to the recipient patients.”

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