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How Donated Blood Makes Many Treatments Possible

NEW YORK (Aug 1, 2013)

Every day at NewYork-Presbyterian, patients are able to undergo surgery, be treated for trauma, and undergo treatment for diseases such as thalassemia or sickle cell anemia because people somewhere else rolled up their sleeves and donated blood.

All blood used at NYP comes from volunteers. It is supplied primarily through a partnership with the New York Blood Center, which recruits donors, collects the blood, tests the donations for a number of infectious diseases, labels the blood, and packs and ships it to area hospitals once it is safe to release. NYP's transfusion departments then handle the tasks of storing and dispensing blood, along with the critical step of crossmatching the patients' blood with donor blood to ensure compatibility. Both organizations quite literally provide a lifeline to people in difficult situations.

Kathleen Crowley
Kathleen Crowley

"You don't realize how much you are relying on the kindness of the donors who make the blood available," said Robin Hussey, M.T. (ASCP) SBB, Manager of the Transfusion Medicine Service at NewYork-Presbyterian/Columbia University Medical Center. For example, she noted that people undergoing organ transplants need both donor organs and blood for transfusion. Without both, surgeons could not perform the operation.

A blood transfusion is considered the administration of blood or a component of blood (e.g., red blood cells, plasma, platelets, or cryoprecipitate) through a needle or catheter (narrow tube) into a patient's vein. While some patients donate their own blood before a scheduled procedure, the vast majority of transfusions are from volunteers who have altruistically donated blood.

At NYP, stored blood is highly regulated and continuously monitored for temperature and shelf life. For example, a unit of blood is stored at 2 to 6 degrees Celsius and has a shelf life of approximately 35 to 42 days depending on the anticoagulant (anti-clotting agent) in which it is stored. Platelets have the shortest shelf life and are viable for 5 days from donation when stored at 22 degrees Celsius. However, by the time the hospital receives the platelet, the shelf life is only 3 days, making continuous donation essential.

"Part of our job is daily and constant monitoring and inventory management of all of the blood components and different blood types," said Kathleen Crowley, MLS, (ASCP) CMSBBCM, Manager of Transfusion Medicine and Cellular Therapy at NewYork-Presbyterian/Weill Cornell Medical Center. "This is a huge job because we transfuse a lot of blood."

When a patient at the hospital needs a transfusion, the transfusion medicine department receives a sample of the patient's blood and screens that blood for the presence of antibodies, which may interfere with compatibility testing and obtaining a compatible unit of blood for that patient. Only then is a compatibility test performed.

In rare cases, the patient's blood undergoes a test known as phenotyping to provide a more detailed determination of blood type to find the best match for transfusion. Phenotyping is especially important for patients who receive transfusions frequently, such as patients with thalassemia who receive transfusions as often as every two weeks.

Timing is essential. "The crossmatching test takes about an hour to complete, so we are always working on many cases simultaneously to make sure blood is available quickly for the patients," said Ms. Hussey. "It is a lot of coordinating and making sure the samples are processed and triaged appropriately so the most critical patients get blood expeditiously."

When patients enter the hospital, they may not expect to need a blood transfusion. But when they do, the transfusion medicine departments are ready to ensure they receive blood as quickly and safely as possible.

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