Technology eases blood demand, changing philosophy of donor collections
By Rick Wills
Published: Saturday, Oct. 12, 2013, 9:00 p.m.
Hospitals in Western Pennsylvania are using blood transfusions less and less, the result of fewer elective surgeries and advances in medical technology that have made the need for blood less frequent, medical officials say.
This has caused a shift in the nation's blood banks “from a collect-as-much-as-you-can mentality to a collect-to-need mentality,” said Dr. Darrell Triulzi, medical director for the Institute for Transfusion Medicine in Green Tree, a partner with the University of Pittsburgh, and a past president of AABB, formerly the American Association of Blood Banks.
“They started collecting only what they needed. That's new to the industry. We're still learning how to do that well,” he said.
From 2008 to 2011, demand dropped by 8.2 percent, according to a report from the American Association of Blood Banks. It expects that drop to continue.
Patients who do not need blood transfusions tend to recover more quickly, said Rita Schwab, director of the Center for Bloodless Medicine & Surgery at Allegheny General Hospital, North Side.
The center was established in 1998 primarily to find a way to perform surgeries on Jehovah's Witnesses, who object to blood transfusions for religious reasons.
Since then, the center's mission has evolved. It now works to help any patient avoid unnecessary blood transfusions during surgery, Schwab said.
“We are trying to reduce the number of transfusions,” she said, though “there are times when a blood transfusion is the only thing that will save a patient's life.”
Donated blood is well screened, but blood transfusions may transmit pathogens, such as HIV or Hepatitis C. Transfusions may suppress the immune system because donated blood always has different antibodies.
“Every case is different, but a transfusion tends to suppress the body's immune system, which can be especially problematic for cancer patients,” Schwab said.
Transfused blood is also expensive. Two units can cost from $500 to $1,100, Schwab said.
People also have been postponing elective surgeries for financial reasons, hospital officials say.
“The economy hit surgery very hard. If people could put it off, they usually did,” Schwab said.
Blood centers are focusing on blood management — determining whether a patient even needs a transfusion, experts say.
“It's made some blood banks have to look into staffing. It is in their best interest to have an appropriate amount of blood on hand,” said Jennifer Garfinkel, a spokeswoman for the AABB.
Pittsburgh's Central Blood Bank emphasizes collecting blood based on need, said Michele Tysarczyk, executive director.
“We educate our donors on the importance of their specific blood type and how that type determines the most effective donated product. The Institute for Transfusion Management and local hospitals are working together to manage blood usage more effectively. However, the daily need remains significant,” Tysarczyk said.
Use of robots to perform hysterectomies and urological procedures has largely eliminated the need for transfusions because they are less invasive, medical experts said.
Electrocautery involves use of a scalpel with an electric current that seals a wound during surgery, while advances in laparoscopic surgeries have made many procedures minimally invasive. Cell salvage involves recovering blood lost during surgery and reinfusing it in the patient.
The Associated Press contributed to this report. Rick Wills is a staff writer for Trib Total Media. He can be reached at 412-320-7944 or at email@example.com.
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