For National Blood Donor Month, MNT spoke with a super donor, a recipient who was resuscitated thanks to a donation, and the medical director for the American Red Cross to learn more about how blood transfusions save numerous lives.
However, since COVID-19 became a pandemic, blood supplies have run critically low, with the American Red Cross (Red Cross) declaring it was experiencing its worst blood shortage in more than a decade. It also states that, compared with last year, the number of new donors dropped by 34%.
With a unit of blood being needed every 2 seconds, the Red Cross says it would need more than 1,000 additional blood donations each day to meet current demand.
The situation has not been much different around the world either.
The United Kingdom’s National Health Service (NHS) has said blood stocks could drop to “critical” levels over winter this year. Also, in December, the Irish Blood Transfusion Service (IBTS) had to import blood from the NHS, as blood stocks dwindled due to high community transmission of COVID-19.
“There’s a wide spectrum of patients that require blood transfusions, whether it’s trauma, burn patients, labor and delivery, cardiac surgeries, organ transplants, cancer patients, and individuals with blood disorders, such as sickle cell disease,” said Dr. Baia Lasky, the medical director for the Red Cross.
And as blood products cannot be artificially produced, the only viable source is donors.
Giving someone a ‘second chance’ at life
Donating blood can be an emotional experience for both the donor and the recipient.
Shaun Brennan, who has been giving blood since 1985, describes his donations as “lifesaving accomplishments” and a proud experience.
“I’m spiritual, I believe in a higher power. And I believe this is a gift that I was given. [I] think I have a responsibility to share that I’m very healthy,” he told Medical News Today.
Shaun said he hoped his numerous donations would assure people that they can live an “active, happy, healthy, normal lifestyle” while donating lifesaving products.
“I haven’t taken a sick day since November 1985. [D]onating lifesaving blood platelets and plasma has never made me ill. I don’t have any problems with my veins or anything of that nature. I’m very active. I have a running streak of over almost 9 years of running without missing a day,” he elaborated.
Meanwhile, on the other end of many transfusions has been Brian Boyle, who needed dozens of units of blood and plasma after sustaining critical injuries in a car crash.
“Giving blood, to me, represent[s] life. When a donor goes to a blood drive and they give blood, they’re not just giving blood [and] time. They’re giving life to a patient in need,” he said.
Speaking to MNT, Brian recounted his experience of being given another shot at life.
“In the summer of 2004, I was 18 years old. I [had] just graduated from high school and was preparing for my upcoming freshman year in college. I was going to the swim team. And on my way home from swim practice, on July 6, I was struck on my driver’s side door by a speeding truck about 5 minutes from my house, and the injuries were catastrophic. My heart went across my chest. I sustained shattered ribs, a shattered pelvis, collapsed lungs, severe nerve damage to my left shoulder. Pretty much every major organ was damaged or lacerated or failed in some way. I experienced 60% blood loss at the accident scene,” he said.
Thanks to 36 blood transfusions, 13 plasma treatments, and multiple operations, Brian now leads a healthy life with his family.
“If I didn’t have all those blood products available during my time of need, I wouldn’t have survived,” he said.
“I was able to get back into life again, live my dreams of going to college, doing the swim team, just living life, and then a few years later, getting married. And then having a family of my own, having two wonderful children now, life is so great.”
– Brian Boyle, a blood transfusion recipient
He has been so grateful to his blood donors that it spurred him to become a donor himself and set up local blood drives.
“I’m a very proud blood donor. Since leaving the hospital, I’ve given 3 gallons. I wanted to become a Red Cross volunteer after leaving the hospital, because when I learned how much blood I received when I was an [intensive care unit] patient, I was so inspired to be able to give back and to say thank you,” he said.
Shaun told MNT hearing stories like Brian’s inspired him to donate blood.
“That’s the reason I subject my body to this, sitting in a donor chair over 500 times. I think of the patients in critical need. We’re counting on these lifesaving products, and if they get them, they have a fighting chance to continue living. That’s why I do what I do. [I]t’s all about saving lives,” he said.
Dr. Lasky described blood donations as a powerful act.
“Being the link from vein to vein, from the donor to the recipient, and to see that connection of life is very powerful,” she said.
The physiology of blood donation
During a typical blood donation, a person donates only about 0.1 gal of blood, or 10% of their total blood volume, which takes 5–10 minutes.
After the blood is collected, it is sent off to get sorted and tested.
Standard whole blood collections are separated into red cell and plasma components, while platelets and some blood types of plasma are collected via an automated process called apheresis, which pulls out the platelets or plasma and returns everything else to the donor. The blood is then tested to determine the blood group and is checked for viruses.
The donor and the recipient go through different physiologic experiences.
The donor’s body works on compensating for its losses, while the recipient’s body works on reaching a state of balance and incorporating the new cells.
After losing blood, cells, and accompanying fluids, the donor’s body ramps up its capacity at a spectacular rate to replace what it lost during the donation. To put this into perspective, the body makes 2 million new red cells per second.
Both volume and overall oxygen-carrying capacity are slightly reduced due to the lost red cells, which is why some people may feel lightheaded and dizzy after giving blood. To compensate for this loss, the bone marrow increases the output of red blood cells.
“I think people may not realize that blood transfusions are in a sense an organ transplant. It’s just when you donate a kidney, you don’t grow a new one. [B]ut your bone marrow is generating new cells all the time,” Dr. Lasky explained.
If only plasma is donated, the liver works to replace the lost plasma proteins, which is why donors need to have unimpaired, healthy liver function.
The way the donated blood is incorporated into the recipient is also quite straightforward.
“When someone receives a red blood cell transfusion, hopefully, nothing happens. Besides that, they get the boost of red cells and therefore oxygen-carrying capacity in their body,” Dr. Lasky said.
The recipient’s body also has to work on adjusting the new acid-alkaline balance.
Donating blood with a chronic illness
When it comes to the topic of who can donate blood, the most basic requirements are to be at least 16–17 years old, weigh at least 110 pounds, have blood pressure of 90–180 millimeters of mercury (mm Hg) systolic and 50–100 mm Hg diastolic, and be in good health.
However, chronic illnesses, for the most part, are not a cause for rejection or deferral.
According to Dr. Lasky, people with autoimmune conditions, such as rheumatoid or psoriatic arthritis, asthma, or diabetes, can donate blood provided that they are under a physician’s care and that the condition is appropriately managed. People with Crohn’s disease can also donate blood as long as they have no symptoms. All donors must be healthy and well on the day of donation.
Some drugs that doctors recommend for the treatment of chronic conditions may also require a medication holiday before one can donate blood.
Dr. Lasky said monoclonal antibodies and biologics, such as Humira (adalimumab), are acceptable.
“Upadacitinib (Rinvoq) is a 1-month deferral. Mycophenolate mofetil (CellCept), [which is an] immune suppressant, is a 6-week deferral. Methotrexate, [a disease-modifying antirheumatic drug], is a 3-month deferral,” she added.
Why regular donation is crucial
Most blood products have a short shelf life and perish after a certain time — this is about 35–42 days for red blood cells, and 5–7 days for platelets.
Plasma, on the other hand, can be frozen for up to 1 year.
Hence, regular blood donations could become lifelines for emergencies and for people with long-term conditions.
“Whenever I am in a situation where I see donors actually sitting in the chair and [allowing] us to collect blood from them, it’s so powerful to me, that they’re sitting there and donating a piece of themselves — it’s a piece of their life,” Dr. Lasky said.
Donating blood has also never been easier. Nonprofits such as the Red Cross have even made their pre-donation health questionnaires available online to save people time.
When asked to rate the discomfort he felt while donating blood on a scale from zero to 10, Shaun said “two” despite not being a fan of needles.
“Overall, the experience is pretty easy. Again, once you get past the fear of needles, and you have a mindset that you’re saving lives, it’s an amazing feeling. It really is as a donor,” he said.
Dr. Lasky said the experience is highly variable from donor to donor.
“The majority of our donors just experience a minor sting from the needle stick. Others may feel nauseous and sometimes may faint. Most apheresis donors experience some mild tingling from the citrate, which is remedied with TUMS (calcium carbonate) to replace the calcium,” she explained.
It is also worth knowing that a person can save three lives with a single donation.
That is why both Shaun and Brian plan on continuing to donate blood.
“Never in over 500 donations have I ever had any complications. I will be sitting in the donor chair within the next week or 2 to make my 503rd donation,” said Shaun.