TIME: Why Banked Blood Goes Bad (US needs donors!)

[Omaha Steve]

I became a regular blood donor after 9-11. Our union contract allows us to do this on company time as a public service.

http://www.time.com/time/health/article/0,8599,1669438,00.html

By ALICE PARK

It's been called the gift of life, but for many of the five million patients who receive blood transfusions every year, it can actually do more harm than good.

It's a problem that doctors have been wrestling with for several years, as study after study shows a disturbing spike in heart disease and death in patients receiving transfusions. The trend affects almost every group of critically ill patients — from trauma sufferers in the ER to heart attack victims, patients with anemia and those undergoing chemotherapy. This increase in death and heart disease, doctors say, is unrelated to infectious blood-borne diseases or allergic reactions that often follow transfusions. "After you control for sickness and all sorts of things, patients who receive transfusions still have more heart attacks. It makes no sense," says Dr. Jonathan Stamler, a professor of medicine at Duke University Medical Center.

Logically, and medically, patients who need transfusions — those with low blood counts — should benefit immediately from a transfusion of new oxygen-laden red blood cells. Yet many get sicker. Puzzled by the paradox, Stamler and his colleagues decided to look more closely at banked blood — to figure out whether it underwent certain changes that turned it from life-saving in the donor to potentially deadly in the bag.

Their finding, reported this week in the Proceedings of the National Academy of Sciences: nitric oxide (NO). A workhorse of the blood, the gas helps red blood cells ferry oxygen to tissues and props open tiny vessels to allow freer blood flow. It turns out that within hours of leaving the body, levels of nitric oxide in the blood begin to drop, until, by the time donated blood expires after 42 days, the gas is almost nonexistent. "The reality is that we are giving blood that cannot deliver oxygen properly," says Stamler, lead author of the study. "Many patients who are getting blood are being put at increased risk."

Previous trials have shown that heart disease patients, for example, who receive a blood transfusion to help restore oxygen to deprived tissues, have a 25% chance of having a heart attack and an 8% chance of dying within 30 days; similar patients who do not get transfused have an 8% chance of a cardiac event and a 3% chance of death. Stamler hypothesizes that without NO, red blood cells cannot drill their way into tiny blood vessels; rather, they pile up in narrow passageways, blocking blood flow instead of increasing it and hampering the heart.

FULL story at link.

[blondeatlast]

1. I wasn't transfused for anemia-related heart problem until I'd dropped

to 35%. My heart problem wasn't serious but my anemia was very much so. That was almost 2 years ago, and I'm happy to be posting my gratitude.

Please keep donating, gang; what the article doesn't say is most blood doesn't have the opportunity to sit that long.

I can't thank donors enough but I take every opportunity to try.

Thank you all--thank you, thank you, thank you.

And oh, yeah--thank you! :hug:

[Warpy]

2. Right, it usually doesn't sit that long

and now that they know what the problem is, correcting it shouldn't be that huge a deal.

Still, our best hope is for a non blood volume replacement capable of oxygen transport. They've been working on it for a long time and they're very close now.

[pitohui]

3. yeah, i agree, keep donating, similar story

in my case not me but my dad and my hubby's dad, both after their bypass surgeries proved to have aspirin/clotting problems and lost a great deal of blood

without blood transfusions they would not be with us now and they would have lost several years of active life -- neither one is in a nursing home, both live independently in their own homes

look, when you lose most of the blood in your body as my dad did, even with a transfusion, yeah, your risk of dying is fairly elevated...but you'd be 100 percent dead without the blood


don't do nothing because you can't do everything

[Newsjock]

4. This gay man says tough beans to y'all

I'd gladly donate, and I'm quite disease-free and not even "practicing" (as they say), but I still am not allowed to donate. Another way that America treats me like dirt.

Yes, this is a sore issue for me, every time the "blood drive" comes through at work.

[Dont_Bogart_the_Pretzel]

6. I hear you

I don't donate because all the questions. There's no telling who's got access to their database.

...and when I was younger I donated, but I got tired of the nurses who can't stick a needle in right.

[blondeatlast]

9. I'm O neg (the rarest) and I think it's outright discrimination and it needs to end.

I'd love to see some brave soul sue about it and take it all the way to SCOTUS.

So many in need, so many who would help, so many are outright, unfairly denied the opportunity.

I'm grateful that you'd be willing, but I'm damn glad to be here despite your comment.

[Ilsa]

12. It's the rarest for a recipient, but AB neg is rarer, technically.

IOW, type O can only receive O blood, and O positive can receive O+ and O-.

AB neg is rarer, but can receive AB-, A-, and B- in aboslutely necessary, so they are in a slightly better statistical position for available blood.

[blondeatlast]

14. My mistake--you are correct. nt

[wicket]

15. I'm with you

I think the Red Cross' policy is bullshit.

[pitohui]

16. i understand

that would be hard and being put on the spot at work as hell

[blondeatlast]

17. "Guilt" drives at work my my (transfused) blood boil. nt

[blondeatlast]

5. Thanks, OmahaSteve. I know you weren't trying to discourage anyone; my problem

was with the article not making it clear that most blood is used very quickly so that shelf life isn't normally a problem.

Typical media sensationalism; yes, there's a problem but it's hardly that prevalent.

[Ilsa]

7. As an O neg that is also negative for cytomegalovirus, I get the call

alot.

There have been times when I've been "guilted" into giving when I wasn't 100% -- I felt well, no symptoms, but slightly "off". Of course, I had to call the bloodbank the following day when I did get sick. I think the donation would be the last straw to tip me over into becoming symptomatic.

I've literally given gallons over the years. I started giving at age 23 and only stopped when pregnant or trying. I'll keep giving, even though there are scars on my arms and probably on my veins now.

[blondeatlast]

8. Thank you from the bottom of my heart. but I hate that you are "guilted"

into it.

Someone posted a thread suggesting that blood and organ donation (both of which I could benefit from) should be mandatory and I tore my hair out arguing AGAINST the idea. No one, but no one, should be forced into a medical procedure of any kind.

I'm O neg, by the way--so especially a big thanks from me. I once had to wait for a full transfuse because there was only enough to keep me stable (I received the full the next day, though).

:hug::hug::hug:

[Ilsa]

11. It's almost like survivor's guilt. I am lucky to so physically healthy.

I take a daily antidepressant because I am clinically depressed and it runs in my family. But I have good blood pressure, low cholesterol, and we have no cancer history in my family of origin.

They try to guilt me into donating. It is just that I feel an obligation to give when I am blessed with good health. Sometimes I have to tell them "no" if my life has been too stressed recently over my son's autism.

[blondeatlast]

13. There needs to be another way of "marketing" donation. I hate the

workplace drives (including fund drives) but see a lot of radio promotions, etc.

Again, I hate the use of guilt but I cannot thank you enough for donating.

And please, don't ever feel like you are obligated--but do know that it has saved a life; at least one pint I received I know had to be shipped from out of state, so... :shrug: :hi:

[backscatter712]

10. I donate.

No reason why I shouldn't.

I do wonder if it's possible to directly infuse blood with nitric oxide to solve this little problem.