Who needs blood transfusions? Where does all the blood go?

Farm accident from a few years back involving a local farmer.

IIRC he gave most of the blood onsite to himself as they could not get to him at first.

My father got transfusions during surgeries. My older brother stayed for two weeks on ECMO and required blood. My elderly mom suffers from reccurent anemia of unknown origin and is transfused several times a year as a result.

Two family members have had transfusions during surgery.

I’m ashamed to say that I quit donating out of sheer laziness.

I used to donate every 60 days like clockwork, because my building had a blood donation center on the first floor.

When I changed job locations, and it became more of a pain. . . I gradually tapered off. I haven’t given in over a year now.

But this thread has motivated me to get going again.

I went into the hospital with necrotizing fasciitis (flesh eating bacteria), requiring several lengthy surgeries. As far as I know, I did not require blood transfusion during surgery. But odd things happened during my lengthy recovery. One was that my body stopped making red blood cells.*

This is treatable, but it takes a while. To get me through the short term, I received two units of blood.

During my lifetime, I’ve donated more than two units. My father was a multi-gallon donor.

  • Another odd thing was that my body became depleted of manganese.

I donated until tattoos became an issue.

FWIW it isn’t an issue when I donate, as long as I got the tattoo in a licensed tattoo parlor.

It’s been two years now, so it no longer matters.

Regards,
Shodan

It must vary by state, since “licensure” varies by state.

In Pennsylvania, for instance:

And I haven’t been able to go two years without new ink in a long time.

The blood bank where donate blood in California has the waiting period after tattoos as 1 year.

Great thread on a subject I’m passionate about.

My mother has a bone marrow cancer with a long name in the Leukemia family. One of the effects is, unsurprisingly, that her marrow is not making enough red blood cells. This gets worse as the disease progresses. In the 20 months since it was diagnosed, she’s had numerous transfusions, totaling 72 units of blood, which means 72 donations from 72 people.

I had a life threatening accident as a child (ruptured my spleen) and through the hospital stay was subjected to many needles and blood tests. This led to a bit of a phobia, one that I vowed to overcome when my mom got ill. I’ve now given blood 6 times and plan to continue for the rest of my life, for as long as I can. I’m getting better and think I am overcoming my phobia. The first time I gave, I was crying a little, shaking, and could barely answer questions. They tried to let me off the hook, but I insisted. It was embarrassing but I suppose they’ve seen it all.

My last donation was this weekend. While I was eating a cookie and drinking an apple juice afterwards, I was talking to an older gentleman. It turned out that that day had been his 224th time donating. He was about 70. I did the math and if he started when he was 20, it works out to donating approximately every 10 weeks for 50 years. Wow. I’ll be thinking about him for a long time and trying to emulate his dedication. I wonder if there was some event in his early life that resulted in him making a promise to himself that he would give blood as often as he could. That could be me in another 35 years.

I encourage everyone to donate. I feel a bit of shame that it took a crises in my family to force me to deal with my issue, but if things can have a silver lining, this is one for me. If I keep at it for my whole life, I’ll eventually be paying it forward.

I’m among the many people who don’t give blood because they “don’t feel like it”. Why don’t I feel like it? Because when I had 4 vials taken from me, about half a pint according to what I was told when I was asked, they had trouble collecting the last of the 4th vial, and I felt incredibly drained. I assume that there’s no way that I could actually manage to get my body to deliver a pint of blood in a short period of time, and that even if I did so, I would feel in jeopardy of my life. I would like to give blood, and would gladly go out of my way to do so one vial at a time, but they take want to take it one pint at a time.

My O-negative father donated dozens of times when he was younger - and earlier this year, he “got a lot of it back” when he had a diverticular bleed and subsequently had 18 inches of his colon removed. My niece also had a transfusion a couple years ago when she was discovered to be severely anemic, and also had iron infusions.

I donated a few times in my late teens, and after I blacked out on the table the 3rd or 4th time I donated, they recommended that I not do it any more, so I haven’t. I signed up to donate plasma when I was in college, and chickened out on that; really, I didn’t need $20 THAT badly. My sister donated white cells for a while ($30 for 2 hours of her time) and a friend donated platelets ($60 for 3 hours) and at that time, both arms were in use so doing homework was tricky. The nurses and other attendants would turn pages if necessary.

The friend who donated platelets gave birth to a very premature baby a few years later, and even heel sticks depleted her blood to the point where she received transfusions; in her case, a “unit” was 15ml/kg, so for a while, they would hook up a syringe full of blood to her IV line, and infused that over a couple of hours. ETA: She’s now 23 years old and is completely normal.

Some blood is also processed for products or used for research.

What you describe goes a bit beyond “don’t feel like it”. It’s normal to feel a bit anxious beforehand (I inevitably tense up before/while they’re jamming that fucking pipe in my vein) - but if you feel ill after giving a just a few vials of blood, then it’s fair to be excused from any sort of obligation to donate entire pints of it.

A very minor point in an otherwise very well written post. It is entirely possible - and, depending on your mother’s blood typing results it may in fact be probable - that she could have gotten 72 units over that period from less than a dozen individual donors. If, for example, she was AB negative and also has one or more minor blood type variants, there may only be a small number of good donors for her.

Again, a minor point, but it further emphasizes the importance of having as many blood donors available as possible.

I’ve heard that a lot of blood is used in the development and manufacture of drugs and medical devices. Donation at hospitals have the best shot at being used for a transfusion and not sold for huge profits.

I hate those pricks.

I was similarly declared unsuitable for an unlicensed piercing.

For many operations, the doctor will order blood to be kept on standby if the patient needs it, and AFAIK, it is returned to the bank if the patient does not. They do their best to re-infuse the patient’s own blood, using a device called Cell Saver, especially if the patient is a Jehovah’s Witness (their interpretation of the Bible prohibits blood transfusions).

I have a friend who had bariatric surgery years ago, and will be having a 40-pound abdominal pannus removed in the next few months, along with a hysterectomy and hernia repair. I KNOW they’ll have a lot on hand for her.

Most surgeries are really not all that bloody. My two breast surgeries last fall led to a blood loss of about 100ml each time, which is negligible.

And one of the cardinal rules about blood transfusions is this: NEVER give a single unit. If they got just one, they didn’t really need it. Does anyone know if there are exceptions to this? My guess is that this isn’t the case with small children.

Absolutely. Blood and blood products are often ordered to be on standby in the hospital’s blood bank where it can delivered in < 30 min (usually more like 15-20 min). If they really need it close by, they can use a temperature-monitored cooler - that allows for return to inventory if it’s not needed (and all QC metrics are met).

True, but maybe less than you think. National guidelines for that combination of procedures (and assuming no other issues like odd antibodies or bleeding disorders) would be 2 units at most - and perhaps as little as a type and screen depending on the type of hysterectomy.

Exactly. Many, many surgical procedures are so bloodless these days that you see silly total blood loss estimates in the surgical note: “EBL: 8 ml” or “total blood loss <5 ml” (both of those were from notes I read in June).

This was the standard mantra until about 2010 or so. Now the opposite is true: if anyone except the OR (and the ICU under specific circumstances) orders two units of red cells at the same time, they will be getting a call from the blood bank doc on call - and that doc will likely be assuming that the order was either made in error or made by an intern (pretty much the same thing :wink: At the same time, presumptive criteria for who is eligible for a unit have gotten much tighter, too. Why? Partially it’s about conserving a scarce resource. But large studies also showed that giving more.blood than necessary was actually causing more problems than it solved.

While i was in the hospital after my accident, I had a vacuum dressing and continued to bleed as tissue sloughed off. I was receiving EPO but still needed a unit every couple of days.

PRBCs (packed red blood cells - blood with most of the plasma and other cells centrifuged off) are usually given a unit at a time, as are other fractions. Whole blood is not, unless the rules have changed on that.

No, my friend probably won’t need blood for her hysterectomy, but the panniculectomy? Ooooooohhhhhh, yeah.

I can see, though, if a person was expected to lose a total of one pint or less anyway, that in many cases, just letting them lose the equivalent of one donation (i.e. not compensating for it at all) might be reasonable. Is that flawed logic most of the time?