Need for Blood Donations Rising, Number of Donors Lowering

How important is donating blood for the country? How important is a blood transfusion for the lives of patients needing them? In recent years, the need for blood donations is increasing, however the number of donors is decreasing. There are many patients waiting in hospitals for whole blood transfusions, and other types of transfusions. But due to donor deferral, and statistics showing mal-effects of blood donation, the amount of donors is decreasing. This problem is evident throughout America, but is also affecting our local community of Lincoln, Nebraska. Organizations such as the American Red Cross and the Nebraska Community Blood Bank work each day to help solve the problem of low donor numbers, and high need for blood throughout the community of Lincoln, and nationally. Efforts such as advertisement, and increased number of blood drives are used to try and increase number of donors per year. But factors such as donor deferral, and mal-effects of blood donation begin to cause people to refuse to donate blood. And most often, people don’t even consider donating blood because they either don’t care, or they are not aware of it being available.

To completely understand the topic of blood donation and what is associated with it, it is important to know what a blood transfusion (the typical use of the blood that is donated) is. Also the many types of blood transfusions that are used to treat patients, and the parts of blood used and their purpose in the treatment process.

Firstly, a blood transfusion “is a safe, common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels” (“What is a Blood Transfusion?”). According to the National Heart, Lung, and Blood Institute, blood transfusions are done to replace blood lost in a patient during surgery or trauma. They are also done when a patient is suffering from an illness that affects the body’s ability to create proper blood. These factors help enforce the claim that blood transfusions are vital for the lives of patients needing that type of treatment. The U.S. Department of Health and Human Services, along with the National Heart, Lung, and Blood Institute gives a statistic that helps enforce the claim that the need for blood donations is vitally important for the lives of patients in need. In America, almost 5 million people per year need a blood transfusion (“What is a Blood Transfusion?”). And taking a look at The Nebraska Community Blood Bank’s website, they inform each visitor that “every 2 seconds someone needs blood” (Nebraska Community Blood Bank)

Secondly, there are many types of blood donations, and blood transfusions. And these transfusions are used in order to treat certain conditions. The American Cancer Society has extensive information on the different types of blood transfusions, and the specific purposes of each type. The most common type of blood transfusion is a red blood cell transfusion. A red blood cell transfusion is most often used to treat anemia, or low red blood cell counts, or for patients with a low hemoglobin level. Along with that, red blood cell transfusions are used for patients in surgery. To add, the parts of blood are “red blood cells, white blood cells, platelets, and plasma” (What is a Blood Transfusion?”). And these parts of blood are collected through whole blood donations, double red cell donations, and platelet donations (NCBB).

Another type of transfusion is a plasma transfusion. “Plasma can be donated in a process called apheresis, or sometimes called plasmapheresis” (“Blood Transfusions for People with Cancer”). A specific condition that requires plasmapheresis to treat it is called Multiple Myeloma. Multiple Myeloma is a cancer of the plasma cells. Along with multiple myeloma, a plasma transplant is used to treat people who are not able to clot their blood correctly. Plasma, once donated, is usually frozen and stored for up to a year. Platelets, like plasma, are transfused into patients who are not able to clot correctly. However, platelets are not identified by type. So unlike other parts of blood, platelets are universal and anyone is able accept them. “Platelets can also be collected by apheresis. This is sometimes called plateletpheresis” (“Blood Transfusions for People with Cancer”). According to the American Cancer Society platelet transfusions are used to not only treat patients who are unable to clot, but they are also used to treat patients whose bone marrow cells don’t create enough platelets. This problem is caused by chemo or radiation therapy.

There are two other types of transfusions, cryoprecipitate transfusions, and white blood cell transfusions. Cryoprecipitate “is the name given to the small fraction of plasma that separates out (precipitates) when plasma is frozen and then thawed in the refrigerator” (Blood Transfusions for People with Cancer”). These transfusions are given to patients who are missing critical blood clotting factors such as Factor VIII, Von Willebrand Factor, and Fibrinogen. However, this is a rare type of transfusion. Along with cryoprecipitate, there is one last type of transfusion which is a white blood cell transfusion. White blood cell transfusions are used when white blood cells are damaged due to chemotherapy, or when patients show critically low white blood cell counts. Like cryoprecipitate transfusions, white blood cell transfusions are quite rare due to new drugs that replace the need for transfusions. These drugs are known as “colony-stimulating factors or growth factors” (“Blood Transfusions for People with Cancer”).

Although types of transfusions is important, an even more important part of blood transfusions and blood donation is blood type, and the parts of the blood. There are many types of blood which include, A, B, AB, and O. And each type is either positive or negative. Transfusions depend on the type of blood because blood type has to match the type of the patient when a transfusion occurs. However, type O blood is universal. The parts of blood are “red blood cells, white blood cells, platelets, and plasma” (What is a Blood Transfusion?”). During a blood donation, the blood bank conducting the drive “collect, test, and store blood” (“What is a Blood Transfusion?”). And before donating, phlebotomists, test blood to make sure donors are healthy enough to donate and to determine each donor’s blood type. Phlebotomists “draw blood for tests, transfusions, research, or blood donations. Some explain their work to patients and provide assistance when patients exhibit adverse reactions after their blood is drawn” (“Phlebotomists”). A phlebotomist is an important part of the donation/transfusion process.

Along with the definition of a blood transfusion and information about blood transfusions and donation, it is also important to understand who requires blood transfusions for treatment. How many people are waiting for/receiving transfusions in America per year? To reinforce the statistic, there are approximately five million people in America that wait for/receive a blood transfusion per year. Within that five million, patients requiring blood transfusions for treatment range from cancer patients, patients suffering from diseases of the blood, and trauma patients. According to the American Cancer Society, “some cancers cause internal bleeding which can lead to anemia from low red cell counts.” Their findings show that low red blood cell counts are usually what causes a patient to need a transfusion. Specifically, cancers of the bone marrow such as leukemia, or cancers that originate from blood-making cells cause low blood counts. Cancer also affects blood counts by affecting organs such as the kidneys and the spleen, which are both extremely important in the blood filtration process. Along with cancer’s individual effects on the blood of a patient, surgery, chemotherapy, radiation, and bone marrow transplants sometimes cause a need for a transfusion (“Blood Transfusions for People with Cancer”).

Although blood transfusions are often a useful treatment for the effects of certain cancers, there are also patients suffering from other diseases that are in grave need of a blood transfusion. An article written by The National Heart, Lung, and Blood Institute on “Who Needs a Blood Transfusion?” there are many different disorders and diseases that require a blood transfusion to treat it. Severe infections and liver disease impedes the body’s ability to create blood, so a transfusion is used to give the patient healthy blood while they are recovering. Also illnesses that cause anemia, which include a wide variety of illnesses and diseases, require a blood transfusion to help treat the patient. Lastly, bleeding disorders often cause patients to need a blood transfusion for in most cases survival. An example of a bleeding disorder is hemophilia. (“Who Needs a Blood Transfusion?”).

The last example of a patient who is most likely a candidate for a blood transfusion is a patient who experienced bleeding during surgery, or a traumatic injury. Blood transfusions are a “vital and integral part of modern health care” (Kaur et al. 103). Severe injuries from war, car crashes, or natural disasters that result in blood loss require blood transfusions for treatment. Also, an interesting fact given by the National Heart, Lung, and Blood Institute, “about one-third of all heart surgery patients have a transfusion” (“Who Needs a Blood Transfusion?”).

This compilation of knowledge regarding blood donation and transfusion leads to a few questions. If this is such a problem, why isn’t anyone stepping forward and changing the system?” There are organizations such as the American Red Cross and the Nebraska Community Blood Bank that work to solve this problem, but why are donor counts still low? What causes people to donate blood? And what causes people not to donate blood? How has donor deferral been such an impacting factor on the amount of blood donations in recent history? And how has the effects of donating blood seen in others caused others not to donate?
When considering an option to solve the problem of low blood donation counts, it is important to know what causes people not to donate. It is also important to know what causes people to donate, and to use that information to influence those who choose not to. A study done in 2007 by B. Nilsson Sojka and P. Sojka of the Department of Laboratory Medicine (Transfusion Medicine), and Department of Community Medicine and Rehabilitation (Rehabilitation Medicine) investigated the motives for donating blood along with some reasons for why people don’t donate blood. To conduct this study they administered a questionnaire to 600 blood donors with a history of at least one previous whole blood donation. Although they administered to 600 people, only 531 people actually filled out the survey. Once the survey was finished, it was concluded that “altruism was the most common general motive for donating blood and also for continuing to be an active donor” (Sojka and Sojka, 56). According to Meriam Webster’s Dictionary, altruism is an “unselfish regard for or devotion to the welfare of others.” In other words, altruism is doing something due to the belief that someone is in need of your help. Along with altruism, the second most common reason for why people donate blood was social responsibility/obligation (Sojka and Sojka, 56). In this case, the donor feels like because they are healthy and able to donate, it is their social duty to give to others. According to the study done by Sojka and Sojka, other reasons for why people donate that the study found were influence from friends, health care occupation, and recruitment by blood bank or military service.

When trying to help increase the amount of blood donors, knowing what causes people to donate blood is extremely important. But there are also factors that cause people to not donate. The most common reason for why people choose not to donate blood was laziness. “This reason was reported by 19.1% of the donors,” (Sojka and Sojka, 61). And the second most common reason for why people chose not to donate blood was a fear of needles. However, when considering the mass amount of patients that are in need of a blood transfusion per year (five million), it is quite sad that laziness is the leading cause of low donor counts.

Secondly, an interesting question to consider when analyzing why blood donation needs to increase is, “How has donor deferral been such an impacting factor on the amount of blood donors in recent history?” A study done between 2001 and 2006 aimed to “analyze actual deferral and return donation data from the American Red Cross to further assess the impact of donor deferral on donor availability” (Zou et. al, 2531). When conducting the study, they analyzed the deferred donors and classified them into three groups based on their donation history. No prior donation or deferral, prior donation but no deferral, and prior deferral. “A mean (average) of 12.8 percent of a total of 47,814,370 donor presentations between 2001 and 2006 resulted in a deferral” and “an additional 1,042,743 donors were lost due to deferrals for donor safety-related reasons during the same period” (Zou et. al, 2531). Out of the total donor presentations in a five year span, 7,162,928 of those donors were deferred from donating. That still leaves around 40 million people that were not deferred. However, according to the author this number leads to one conclusion. “The results call attention to the impact of donor deferrals on donor availability and the need to monitor and assess the necessity and effectiveness of such deferrals” (Zou et al, 2538). To eliminate some of that massive number that is causing a drop in donation counts and blood units available the deferral process needs to be addressed. If the process is minimized without compromising safety, it only allows for an increase in donation counts per year.

Lastly, a reason why blood donor counts are not completely compensating for the great need for blood units is the effects of donating blood seen in other donors. These effects, when made known to first-time donors especially, along with returning donors, often deters people from donating blood. A study was done in 2003 with a goal to report adverse effects in blood donors after donating whole-blood. During this study, 1000 donors were examined three weeks after they gave a whole-blood donation. “Thirty-six percent of the donors had one or more adverse effects. The most common systemic adverse effect was fatigue (7.8%)” (Newman et al. 598). Along with fatigue, bruising, soreness, and hematomas were common effect of whole-blood donation. Although the study wasn’t intended to give reason to why people choose not to donate, a simple deduction can be made. Once a potential donor who is hesitant to donate hears about people experiencing these effects, it causes them to change their mind. With this study finding many different adverse effects, there is possibility that this information causes potential donors to make a final decision. To not donate their blood. Instead of sharing adverse effects of donating, advertisement should be made to show the positive effects of donating blood on the lives of donors and transfusion recipients.

There are endless statistics and facts that attempt prove that there is a problem within the blood donation/transfusion system. However it’s believable when the problem is publicized within popular media. According to an article written by Mikaela Conley for ABC News, in 2012 “The American Red Cross today reported dangerously low levels of blood and platelet supplies, with 50,000 fewer blood donations than expected for the month of June” (Conley). Along with that statistic, Stephanie Millian, a spokeswoman for the Red Cross reported that “donations are down more than 10 percent across the country,” and that “We have almost half the amount of available blood on the shelves compared to last year” (Conley). This problem is real. There is a need for 38,000 units of blood every day for patients throughout the United States according to Stephanie Millian. If the Red Cross is losing 50,000 donations per month, that results in at least 600,000 units of blood not donated per year. With this knowledge, it emphasizes how important it is to spread awareness. How blood donation is vital for the well-being of the community of Lincoln, and the entire country.

Although the need for blood donations is increasing due to the extremely high amount of patients whose treatment demands a blood transfusion each year, the amount of donations are not keeping up. Factors such as mal-effects of blood donation scaring others to donate, and donor deferral are causing those who donate to choose not to donate. This problem is growing to a larger issue as the health screening process begins to be more specific, requiring more and more from donors. And as donor recruitment is becoming increasingly difficult. However, finding proper ways to recruit, exposing the positive effects of blood donation on donors and patients receiving transfusions, and encouraging others to donate, the need for blood donations hopefully won’t be so grave.


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