How Is The Blood Supply In The US?

Replying to update this post. In answering this post in GQ I did some searching through my emails and compared it to my blood donations. I find 20 units of red blood cells donated since February of 2014 when I started getting emails about the locations the blood was used, and 15 units were accounted for in the emails. From this I deduce that 25% of the time my blood was either used for research purposes or eventually got too old and was discarded.

As I said, my blood is appropriate for 40% of all patients, so that will affect usage rates, but if we assume that 25% of the time O positive blood sits on the shelf until it hits the expiry date the blood supply in the US must be pretty good in general. Local shortages can have a big effect on this of course, and if someone needs a unit of blood they usually need it right now.

A new update; I just received an email from the American Red Cross stating:

So out of 22 units of blood accounted for since February of 2014 seventeen have been used by patients and five have been used for research purposes or discarded for being too old.

It moves the usage rate on my blood up a little bit, but still slightly more than one in five units is either used for research or discarded; which to me indicates a pretty robust blood supply.

The US was the world’s second largest exporter of blood in 2017, right after Ireland. About a billion dollars worth of blood was exported in 2017.

They may also be selling other components, like white cells or platelets, and the rule regarding whole blood has long been “never give a single unit.”

For the most part, paid donations ended in the 1970s, mainly due to the prevalence of hepatitis.

The issue of discarded donations used to come as a surprise to me. But I got a little bit of insight into the protocols a month or two ago.

My mother is a retired a hospice nurse. Her retirement job is to work on Red Cross Blood Donation drives 5 days a week. She is not one of the phlebotomists but she does the intake data.

About a month ago she was on a drive and it was getting towards the end of the day. The air conditioning in that part of the building where the drive was being held failed. None of the power supplies to the devices or storage units failed. The supervisor decided that it was not a safe work environment. That stopped the Drive early and all of the donated blood was considered discarded.

I do not mean to imply that it was discarded on site. But it was all considered to be damaged in some way and none of the donations that day could be used. All of the bags were taken out and marked and put back in the storage boxes so that they could be disposed of later.

I was stunned.
I live in New York City and always donate at one of the New York blood center sites. I assume my donations are not discarded.

I have not donated for a year for medical reasons but I am now permitted to donate again. I have AB negative blood which is fairly rare and so I always donate two units of red blood cells only.

Must ask the administrator who does my intake if I can get data on the use of my past donations!

Blood products, particularly Factor 8, are a hot topic in the UK just now as there is an enquiry going on relating to the infection of haemophiliacs and others with HIV and Hep C with Factor 8 derived from American donors. Story from Sky News

A guy on the radio described how, as a student in 1980’s America, he was selling plasma at $10 a pop to pay for booze and drugs. He said that he would sit in a scruffy waiting room with a bunch of down-and-outs waiting to have it taken. He said that the people running the place had no training and scant attention was given to hygiene.

Getting back to this question:

Because blood is perishable AND expensive, I think the supply is deliberately kept on the razor’s edge of being adequate/inadequate. If the supply gets low, the collection agencies (e.g. Red Cross) just start beating the bushes a bit more to scare up more donors. More advertisements, more emails, more phone calls, more blood drives. If the supply gets excessive to the point where they are discarding a lot of unused blood, they dial back the pressure, so to speak.

I used to work with a woman who had a rare-ish blood type. The blood bank had her on speed dial and they’d ring her up if they needed some for somebody. She’d go way more frequently than the rest of us, because she’d get these extra requests in between any normal donations she’d give.

I’m not eligible to give blood because I lived in Europe. The Europeans don’t seem to have a problem with European blood, so I can only conclude that if my blood is considered unacceptable then our blood shortage can’t be THAT severe.

Yeah. This.
I keep getting emails offering me a beautiful Autumn fleece vest with the blood service logo embroidered on it if I will Russian and donate a few pints of RBC. It’s kind of crazy.

I don’t want anything from them and in fact I find the idea of the incentives like this to be highly offencive. Save your money and handle more blood.

I’m O+, which means that my blood is more widely usable than most blood types (O- is the most widely usable). I used to donate every 8 weeks because a convenient blood drive was held that often at my place of employment. Those blood drives recently disappeared - and now the Red Cross harasses me relentlessly if I don’t donate (at a more distant Red Cross donation center) exactly every 8 weeks.

Are they only doing that to O+/O- donors, or do they go after other donors like that too?

The link you provided includes animal blood.
Human blood is not generally exported, plasma is exported. Since the US allows paying for plasma it is one of the world leaders in plasma. For example, the plasma and plasma products used in Canada are 80% American.
The UK does not produce plasma because of mad cow disease risks and uses American plasma for the most part.

Well, I wouldn’t exactly call it relentless, but they do gentle reminders. One thing is, while there are rare blood types that would intuitively seem more needed, the more common blood types like yours are appropriate for more patients, so they need more of the common types and it all kind of balances out.

I usually donate a double unit of red blood cells which can only be done every 112 days, so if you switched to that type of donation you’d be harassed less frequently. The center where you donate has to be set up for the slightly more time-consuming pheresis donation so that might be an impediment.

If you’re eligible this might be a good time to donate. Hurricane Florence shut down bloodmobiles and donation centers across at least two states and I’d assume supplies are depleted.

Edited to add: If you’ve got any kind of endurance activity planned you might want to postpone a double red donation until afterwards. I did a 10K three days after a double red and my time was not stellar. I really could have used more oxygen carrying capacity after around 5K.

They are indeed set up for that. I tried it once some years ago, and the citrate made my lips tingle. It was a very disconcerting sensation, so I’ve stuck with conventional whole-blood donation ever since.

I found it uncomfortable as well, and stick to whole blood donations. At the blood bank it looks like about 1/2 the people choose the apheresis machines that do the double red blood cells.

Nice username/post combo.

O+ is probably more widely used than you would think. Many hospitals will give it to adult male trauma patients and to female trauma victims beyond their fertility years.

In the news here this month, so they are continuing to work on it.

Mad Cow Disease. The Europeans can’t just disallow “everyone who has ever lived in Europe”, so they make more careful distinctions.

Last I looked, Aus disallows people who lived in certain areas in Europe in certain years.

I’m not allowed to give blood here (in Aus) for even more obscure reasons.

I rarely have that kind of side effect when I do the two pint RBC donation. Many years ago I did whole platelet aphoresis donation. In that case my tongue and my nose and my lips tingled.