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Blood donor pool thinning throughout U.S.

| Sunday, Aug. 5, 2007

Frank Migliozzi is among the few. The proud.

The blood donors.

The Marine Reserve staff sergeant is among a much smaller number of Americans than previously believed who are eligible to donate blood, according to a study in the July issue of the journal Transfusion.

Only 37 percent are considered acceptable donors, although it has been long believed 60 percent were eligible, according to the study by the University of Minnesota's School of Public Health and Laboratory Medicine and Pathology.

About 111 million people are eligible to donate -- about 66 million fewer than believed, according to the study.

"It's a much better and more accurate way to define donor eligibility," said Dr. Darrell Triulzi, medical director of both the Institute for Transfusion Medicine -- the parent company of the Central Blood Bank -- and the University of Pittsburgh Medical Center's Division of Transfusion Medicine. "It was long overdue having a better study of who's actually eligible."

The pool of potential blood donors traditionally has been calculated based on the population from the ages of 18 to 65. However, many of those people are screened out because of high-risk behavior, disease exposure, chronic diseases, medications or travel to certain countries.

The study calculated would-be donors using 31 common reasons for exclusion and calculated how prevalent those factors are among Americans.

The good news is that the recalculations mean more eligible donors have been rolling up their sleeves than the 5 percent nationwide previously believed. A higher percentage of Pittsburghers donated -- about 8 percent of those the Central Blood Bank previously believed were eligible, Triulzi said.

Still, that is far fewer donors than needed to ensure an adequate blood supply, experts said.

"It's an important study," said Dr. Richard Shadduck, director of the Western Pennsylvania Cancer Institute at West Penn Hospital. "It's a problem in Pittsburgh. It's a problem in Los Angeles. it's a problem in Tokyo. It's a problem all over the world -- getting people to go in and donate.

"The only thing that motivates them is if a family member gets ill and then everyone hovers and wants to donate, but what happens the next week when they all disappear?"

Migliozzi, 45, of Ingram, who works in security at the 911th Airlift Wing in Moon, is a member of the Central Blood Bank's "Gallon Club," although he's given far more in the 24 years he has been a donor.

"To me, it's just something that needs to be done," he said.

That wasn't how it started.

"I was forced into giving blood. I was in the Marine Reserves, they were doing a blood drive and said, 'We need 100 participation.' End of story," Migliozzi said.

He now is a double red cell donor, a more time-consuming process in which a machine removes red cells from his highly coveted O negative blood and returns the platelets and plasma, enabling him to give two units instead of one.

"I have five kids; this is like a little getaway now," he joked, lying with feet up, his arm tethered to a machine, while he watched television.

Would-be donors are excluded from giving for even more reasons than the 31 used for the Transfusion study's calculations, but data on how prevalent those conditions -- such as vaccinations, recent blood donation, transplant or piercing -- are were not available, according to the study.

That could mean the pool of potential donors is significantly lower than 37 percent, according to the study's authors.

The Central Blood Bank asks potential donors 51 screening questions to determine whether they are eligible.

Those who work with the blood supply are concerned about the growing number of reasons added for excluding potential donors, based on assumptions of what might harm recipients rather than on scientific studies, Triulzi said. For example, ruling out people who got a tattoo or body piercing in the prior year, he said.

"You can imagine going to a college recruitment drive and deferring for tattoos," he said.

About 25 percent of donors are lost each year, he said.

As baby boomers age, more transfusions likely will be performed, Triulzi said.

Recent changes in Medicare and insurance policies that reduce the number of hormone injections patients can receive to boost the number of red blood cells likely will translate into more transfusions being needed, Shadduck and Triulzi said.

Triulzi and Dr. Bruce Dixon, director of the Allegheny County Health Department, said doctors sometimes are too quick to order transfusions before trying less-invasive treatments.

Triulzi spends much of his time educating doctors about indicators of whether a transfusion is necessary. During blood shortages, he takes more aggressive steps.

"We more intensely review blood orders when we have shortages -- in other words, we're rationing," Triulzi said.

The Central Blood Bank is running low, especially of type O blood, and is requesting people donate blood.

Additional Information:

Why the shortage?

U.S. population: 294 million

Eligible blood donors when screened only by age: 177 million

Eligible donors when screened with 31 common reasons for exclusion: 111 million

Numbers based on 2003 U.S. Census figures

Source: The journal Transfusion

Reasons people cannot donate blood for more than a year or permanently:

  • Heart disease
  • Cancer
  • Travel to a country with malaria
  • Developmentally disabled
  • Male-to-male sexual contact
  • Liver disease
  • Kidney disease
  • Travel to the United Kingdom from 1980 through 1996
  • HIV or AIDS
  • Sickle cell anemia

Reasons people cannot donate blood for 60 to 365 days:

  • Underweight
  • Getting a tattoo
  • Pregnancy
  • Abortion
  • Gonorrhea or syphilis
  • Lyme disease
  • Needle stick
  • Tuberculosis

Reasons people can not donate blood for up to 60 days

  • Illness, including a cold or the flu
  • Anemia
  • Allergies
  • Diabetes
  • Hypertension

For more information or to donate blood, call the Central Blood Bank at 1-866-DONORS1.

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