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The blood business

A community endeavor becomes a big industry

Tuesday, September 01, 1998

By Ellen Mazo, Post-Gazette Staff Writer

It wasn't so long ago that when the notices went up on bulletin boards in office buildings throughout the city, faithful donors routinely lined up for blood drives.

 
  Lillian Giles grimaces as Joyce Herman, a medical assistant for the Central Blood Bank, inserts a needle in her arm during a blood drive at the Hill House in the Hill District last week. (Matt Freed/Post-Gazette)

Karen Lindley (Type A negative) and Ronald Lenz (Type A positive) were at Gulf Oil Corp.'s Downtown headquarters, where donating blood was as much a part of company life as the annual Christmas party.

Lindley, 43, of Franklin Park, who later became a nurse, and Lenz, 65, of Shaler, who retired when Gulf Oil left town in 1986, are still regular donors of much-needed platelets at the Central Blood Bank - and reminders of how much the business of donating blood has changed over the years.

For years, blood drives thrived on donations of thousands of employees in companies the size of a small town.

The drives were conducted either by the Central Blood Bank or the American Red Cross - competitive, yet allies in the overall purpose of providing local hospitals with blood supplies.

But when the industries closed, or laid off most of their workers, major sources of blood dried up as donors relocated.

 
  Related articles:

How to donate blood

Fast facts on blood

   
 

The giving of blood has always been a community responsibility.

It now is a business endeavor.

The cost of recruiting donors; collecting blood and screening it for infectious diseases, such as the HIV/AIDS virus or various forms of hepatitis; and storing blood and distributing it to hospitals has steadily increased over the years.

While medical experts know that blood donations start with the good will of givers, it takes more than good intentions to keep the operation functioning efficiently.

According to the American Association of Blood Banks, there are about 100 independent blood banks in the United States, as well as about 2,400 community, regional and Red Cross Blood Centers, hospital-based blood banks and transfusion services.

But medical experts predict the not-for-profit industry may be forced to consolidate into two or three major companies in the country overseeing the collection and distribution of products and transfusion services. Consolidation would streamline operations and cut costs, they said.

"Blood supply is truly a limited resource," said Dr. Joseph Kiss, Central Blood Bank's medical director.

 
  Gathering and processing blood is a $25 million-a-year business for the Central Blood Bank. (Matt Freed, Post-Gazette)

It cannot be manufactured, and in this city of major trauma and transplant centers, the need for blood supplies is great.

To meet the region's needs, blood centers must register about 1,400 donors every 24 hours.

Nationally, more than 40,000 donors are needed daily, according to the American Association of Blood Banks.

Recruiting, collecting, testing and distribution of blood, and manufacturing of blood products, has become competitive as cost-conscious hospitals look for the best deal.

In Pittsburgh, a unit of blood - slightly less than a pint - costs from about $69 to $72.

The two major blood supply organizations here are the Central Blood Bank, a subsidiary of Pittsburgh-based Institute of Transfusion Medicine, and the American Red Cross Blood Services, headquartered in Johnstown, Cambria County.

The Central Blood Bank, by far the larger in operation and local distribution, was established in 1950 to centralize the collection and distribution of blood for local hospitals. It costs the Central Blood Bank $25 million each year to gather and process blood and blood products.

As a subsidiary of the Institute for Transfusion Medicine, the Central Blood Bank has laboratories and clinical services available, said William H. Portman, the institute's president and chief executive officer.

Moving to expand its services even more, the institute in May bought United Blood Services of Chicago.

"The alliance with Chicago gives us a broader base," Portman said. "It gives us a larger donor pool, allows us to share costs and positions us to be a survivor as an independent organization."

When it comes down to it, though, blood service organizations know they are all going after the same donors.

The Central Blood Bank provides blood and blood products to 38 hospitals in Western Pennsylvania. It operates about 90 percent of the blood collection system in the region, and considers itself competitive with the American Red Cross.

The Central Blood Bank covers six counties in southwestern Pennsylvania - Allegheny, Armstrong, Butler, Mercer, Westmoreland and Washington - northern West Virginia and eastern Ohio.

The Red Cross's Johnstown center oversees the collection of blood in 66 counties in Pennsylvania, West Virginia, Virginia, Ohio and Maryland.

The Red Cross uses a consultation service to assist physicians with patient diagnostic problems and other transfusion issues, said Marianne Spampinato of the American Red Cross Blood Services in Johnstown.

The Johnstown region is the 12th largest region among 38 in Red Cross Blood Services.

Several months ago the Red Cross, which has blood supply contracts with Mercy Hospital, St. Francis Health System, The Western Pennsylvania Hospital and the Veteran's Administration Hospital in Oakland, opened a blood distribution center in Oakland.

"We wanted to be closer to our customers," said Spampinato said.

The Red Cross also sends blood supplies elsewhere, if needed.

"The Red Cross is always on standby to support the military blood supply," said Spampinato. "In Kenya and Tanzania [in the wake of the U.S. embassy bombings] for instance, we were asked to provide 100 blood products, which we did."

In times of local disaster, the community responds, blood bank officials said.

One example was when an Allegheny County Port Authority bus crashed on the Martin Luther King Jr. East Busway in a snowstorm in January 1996.

The Central Blood Bank was flooded with donors.

"We didn't need them then, but it was really encouraging to know that people wanted to help," Portman said.

Blood services groups wish they could learn how to bottle that sense of urgency.

"We know it's not easy to get people to donate blood," said Dr. Michael Israel, medical director of the Mercy Hospital Transfusion Service.

No longer able to rely on big companies for their donors, blood bank and Red Cross recruiters are going into high schools, colleges and universities, and in some cases, giving prizes to donors for their efforts. Operators routinely call former donors seeking additional support.

The Central Blood Bank last week held a reception for Lindley and Lenz, the former Gulf Oil workers, honoring them for each donating platelets 100 times.

While some may say that the competition gives donors choices, other industry observers fear that donors may just say it's not worth trying to figure out where to give blood.

The Red Cross has turned to the computer. It sends out appeals via e-mail on college campuses.

"It pretty much boils down to asking people," Spampinato said.

With more than 50 percent of the population eligible, fewer than 5 percent give blood, medical experts say.

"Inventories can get depleted rapidly, particularly with trauma patients or major surgery," Israel said.

The situation becomes particularly tense near holidays when blood supplies run low.

The coming Labor Day weekend is no exception.

Holidays often are when hospitals need blood the most because of traffic accidents.

"We're more than 800 units behind what we hope to be [before Labor Day]," Spampinato said. "It is as if we lost a day. We need to make that up in the coming days."

The Central Blood Bank anticipates it will be 1,700 units short for Labor Day week, which starts Sunday.

"Part of the problem we get into is that blood has a [limited] shelf life," said the Central Blood Bank's Kiss.

"We know what we have, and from experience, what we're going to need," he said. "Then we'll have a surgeon screaming, 'But my patients needs it.' That's a tough situation for us."

Surgeons and anesthesiologists say, however, they've never been without the blood supplies they require.

"It's clear, the blood bank scrambles when we need them to," said Dr. Richard McHugh, anesthesiologist at Allegheny General Hospital.

Doctors have also done their part by devising new procedures that require fewer units of blood, said Kiss.

Drugs have helped, too.

Research continues to develop drugs that can be used to either enhance the development of blood cells, or even replace them.

"When I finished my residency 20 years ago, they said they were closer to having manufactured blood products," McHugh said.

"Researchers are still saying that.

"The point is, we still need blood donors."



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