I’ve been a Red Cross Blood Donor since the 80’s, and have given gallons of blood. Blood donation is mildly inconvenient, not painful, and saves lives. It is something I feel very strongly about, and I regular encourage others to become donors too (especially in the winter when blood supplies run dangerously low). About 7 or 8 years ago I stopped giving blood, and instead become an aphaeresis donor. I had never even heard of aphaeresis before then, but a friend of the family needed bone marrow, I took the blood test and did not match, but I was an HLA match and was thus able to give him platelets. And that’s how I learned about aphaeresis, a slightly more complicated form of blood donation that allows for the collection of specific blood components (most commonly platelets and plasma). Aphaeresis collection usually involves two needles, one in each arm, whole blood is drawn from one arm, passed through a centrifuge where the parts can be separated and collected, and then returned into the other arm. Like blood donation, the process is not painful, but unlike blood donation, it is very inconvenient as the process takes up to 2 hours (as opposed to 15-20 minutes for whole blood). Another important difference, donors must wait 56 days between whole blood donations, but aphaeresis donors may donate every 3 days if needed, and so aphaeresis donors often get emergency requests to donate when specific components are needed for specific patients (often the same patients to whom they just donated too). There are very few aphaeresis donors, and so my 39 aphaeresis donations were important, even more so as isolated blood components have a very short shelf life (far less than that of whole blood).
But I am no longer a donor. On my 40th visit to the local collection center, I was rejected. The reason? Fear of variant Creutzfeld Jacob Disease, more commonly known as Mad Cow Disease. New guidelines dictate that persons living for more than 3 months in England (and some additional locations) since 1980 are ineligible to donate so as to “keep vCJD out of the blood supply by avoiding collections from those who have been where this disease is found”. This, even though (quoting from the Red Cross) “There is no evidence that vCJD can be transmitted from donors to patients through transfusion” (the EU is reported to have received the first report of infection via transfusion, but this has yet to be verified). So, as a potential Mad Cow victim I am no longer eligible to donate blood or platelets. Sound policy? I am not so sure; to date the number of Mad Cow victims worldwide is estimated at under 150, compared to over 20,000 leukemia related deaths in 2003 in the USA alone. So, because of a far-fetched and as yet uncorroborated concern that may affect a very small number of people, thousands of leukemia patients risk not having the platelets they need to help they fight infection while undergoing therapy or recovering from transplants, or risk having to receive donations from multiple donors which greatly increases the odds of serious immune system reactions. And that is just leukemia patients, and just aphaeresis. The Red Cross has announced that its blood supply is “critically” low, and at the same time turns away donors due to rather far-fetched concerns.
The truth is that this is not the Red Cross’ fault. They have to follow Center for Disease Control guidelines, and when I contacted the CDC they basically said “sorry, that is policy for now, but it may change in the future”. But I have to wonder, is this policy driven by science and sound thinking or by fear of litigation? After all, there have been recent lawsuits against Blood Services by recipients who tragically contracted HIV via contaminated transfused blood. (I am not going comment on the validity of these lawsuits, frivolous litigation is a subject unto itself, um, oops, I guess I just did comment on it). I believe that the CDC has done a serious disservice to those most needing help by literally throttling the blood supply. Put it this way, if a leukemia patient was offered platelets and told that “the donor comes from a country where 100 people (.00016% of the population) died from contaminated cows, but there is no evidence that the donor did indeed ingest a Mad Cow, the odds are less than 0.01% that he did, and even if he did there is no evidence to suggest that the disease would be passed on to you, so do you want the platelets?”, what do you think the patient would say? Ironically, the Bone Marrow Registry does just this; although I can no longer give blood, I am still listed in the National Registry, and if I am ever found to be a match, the potential recipient will be given the choice of whether or not to accept my marrow; that makes lots of sense to me.
So why bring this up now? The US has its first mad cow (up in Washington State). Thousands of pounds of beef have been recalled in 8 states, the public is starting to panic, Japan has already banned US beef imports, and health officials are torn between the need to contain the potential risk and the fear of crippling the $40 billion a year beef industry (the impact on the economy and jobs in an election year must be terrifying the administration). But thus far I have yet to see what the CDC plans to do; should everyone living in the US be banned from blood donation too? That would be devastating, and is unlikely to happen. But maybe this new concern could force the CDC to rethink those guidelines that eliminated thousands of donors (including me). I hope so, as soon as they’ll accept me, I’ll be back in line!
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