Blood Transfusion: Donating Blood
Guest: Dr. Jerry Squires – Pathology and Laboratory Science, MUSC
Host: Dr. Linda Austin – Psychiatrist, MUSC
Dr. Linda Austin: I’m Dr. Linda Austin. I’m interviewing Dr. Jerry Squires, who is Associate Professor of Pathology here at the Medical University of South Carolina. Dr. Squires, I understand you are the director of our blood transfusion program. Is that correct?
Dr. Jerry Squires: Yes, I am.
Dr. Linda Austin: In this podcast, let’s talk about issues related to donating blood. Why is it so important to donate blood?
Dr. Jerry Squires: Well, right now, there’s really no other source for the transfusion needs for patients in this country. There’s no artificial blood. There’s no substitute for blood, and the transfusion of red blood cells, or platelets, or plasma. It can be life-saving in many patients and, absolutely, makes certain procedures that we do possible.
Dr. Linda Austin: Now, tell me about the transport of blood. For example, if one were to donate blood in Columbia, could it make it here to Charleston if necessary, or are people really donating for the blood needs of their own community?
Dr. Jerry Squires: Actually, blood can be transported anywhere in the United States, anywhere in the world. In point of fact, most of the blood that we transfuse here at MUSC is collected either here in Charleston or somewhere else in South Carolina. In many instances, for rare blood types, for special kinds of blood products, we’ve received blood from Los Angeles, from the Northeast, from the Midwest.
Dr. Linda Austin: But, I’m sure, in acute situations, in emergencies, you really do need that local community-donated blood.
Dr. Jerry Squires: We absolutely do. And we have a very medically sophisticated community with MUSC and the other hospitals here in town. And the needs for blood in this community are, really, very high, because of the referral needs of our patients.
Dr. Linda Austin: How many sites are there here in Charleston where one can donate? Can you donate here at MUSC, for example?
Dr. Jerry Squires: Actually, you can, in the main hospital. There is a donation site that’s run by the Red Cross. But there are at least two other fixed collection sites that the Red Cross runs here in Charleston; one in West Ashley, one in Mount Pleasant. But what most people find most convenient are what the Red Cross calls mobile blood collection operations, where they will set up a blood drive; a blood collection operation, at a business, or at an event, or at some other place here in town. It’ll be there for one day, or two days. And people find that very convenient.
Dr. Linda Austin: Walk me through the process of donating blood. First of all, who is not a good candidate for blood donation?
Dr. Jerry Squires: Well, first of all, there’s an age requirement. The age requirement is, really, fairly liberal. If you’re 17 years of age or older, you can donate blood. There’s no upper age limit. But you have to be in good health, have no apparent cardiac problems, or breathing problems, or have not been exposed to any kinds of infectious diseases that might be transmitted through blood. In the United States, about 60 percent of the adult population is eligible to donate blood, yet about 5 percent of them actually donate.
Dr. Linda Austin: So, when one goes into a mobile unit or a transfusion center, what is the process?
Dr. Jerry Squires: The first thing the Red Cross or any blood collecting organization is going to do is ask your name, your address, your age; essentially, get some demographic information on you. The second thing they’ll do is ask you a series of questions that relate to, number one, your safety as a donor in giving blood, and, secondly, the safety of that blood that you’re about to donate for patients. The third thing that happens is that they’ll do, I suppose you could call it a mini physical. They’ll check your temperature. They’ll check your pulse. They’ll check your blood pressure. And they’ll check your iron level, or your hemoglobin level, to make sure, since we’re going to remove some of that iron, or some of that hemoglobin, that the Red Cross does not leave you a little anemic as a result of the experience.
Once that is done, then you get to donate blood. And, actually, the actual donation process itself takes about five to ten minutes. Once you’re done with that, they ask you to wait around for a little while; drink a soda, drink some juice, have a cookie, and then you can be on your way.
Dr. Linda Austin: And that’s all there is to it?
Dr. Jerry Squires: That’s all there is to it.
Dr. Linda Austin: Now, are there advantages to donating for the donors, such as should they, or their family, need blood in the future, are they preferred in any way, or is it a purely altruistic endeavor?
Dr. Jerry Squires: This is a purely altruistic endeavor. There are no incentives provided by blood centers. There’s no payment provided by blood centers. Really, the payback here is that if you donate, if your family donates, if other members of the community donate, should you need blood, it’s going to be there. If you don’t, and if your family doesn’t, and if other members of the community don’t, blood is not going to be there when you need it.
Dr. Linda Austin: But aren’t there certain circumstances whereby friends and family will donate for a given person who has very high needs, or are they just doing that in an altruistic way, generally, to be helpful?
Dr. Jerry Squires: Generally, it’s simply altruistic. And it isn’t absolutely necessary for people to do that. There are very rare circumstances when a mother might need to donate blood for a newborn baby, or other very rare circumstances like that, where, what we call, a directed donation is appropriate. There are other circumstances called autologous donations where if you’re planning a surgery, and you can anticipate when that surgery is going to be, and if you’re in otherwise good health, you can donate blood for yourself. It’s called an autologous donation; relatively rarely used, certainly not necessary, but a few physicians and a few patients feel comfortable in doing that.
Dr. Linda Austin: How far ahead of surgery can one donate?
Dr. Jerry Squires: Up to 42 days prior to surgery, but no closer than one week prior to surgery.
Dr. Linda Austin: And, I would think that that might offer some peace of mind for folks who might be concerned about receiving blood from somebody else.
Dr. Jerry Squires: Certainly, that does provide a certain degree of peace of mind related to infectious disease transmission. But I think one of the things that people need to realize is how unlikely the transmission of disease, through blood transfusion, really is anymore.
Dr. Linda Austin: And I want to talk about that in another podcast; about receiving blood, but one more question about donating blood. Women who menstruate heavily may run borderline anemic. What is the cutoff for hematocrit?
Dr. Jerry Squires: There’s a hemoglobin of 12.8 grams per deciliter, or a hematocrit of 38 percent.
Dr. Linda Austin: Okay, so, if a woman knows that she tends to run around that level, she may not be the best candidate then?
Dr. Jerry Squires: She may not. But she will be screened when she goes to the blood center. And if she is anemic, or below that cutoff, she’ll be deferred for that particular donation. That isn’t a permanent deferral. Please, come back.
Dr. Linda Austin: Are there ever situations in which, through the screening process, a potential blood donor learns that they may have some sort of illness?
Dr. Jerry Squires: Absolutely. First of all, the Red Cross does some very simple screening of blood pressure, pulse. In many instances, this will be the first time the individual finds out that their blood pressure is elevated, or that they’re hypertensive, in which case, the blood center, the Red Cross will refer them to their local physician, their private physician for therapy, if that’s necessary. But, in addition, a number of tests are run on every unit of blood; tests for hepatitis B, hepatitis C, HIV, syphilis, for a variety of other diseases that can be transmitted by blood. If any of those tests turn out to be positive on a donated unit of blood, the donor will certainly be notified, so that the donor can follow up, again, with their private physician to determine whether any therapy is appropriate or necessary.
Dr. Linda Austin: How do people feel after a blood donation?
Dr. Jerry Squires: In most circumstances, people feel just fine after a blood donation. There are generally no consequences. Very few people may feel a little tired for a day or so. In extremely rare circumstances, a donor may feel a little faint at the time of donation. They generally recover very quickly, and there are no long-term serious consequences whatsoever.
Dr. Linda Austin: Dr. Squires, thank you so much.
Dr. Jerry Squires: Thank you.
If you have any questions about the services or programs offered at the Medical University of South Carolina, or if you’d like to schedule an appointment with one of our physicians, please call MUSC Health Connection at: (843) 792-1414.