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There is still no substitute for human blood!
In hospitals across our region, patients receive life-saving
blood and blood products almost every minute of every day. There
is a lot to know about blood:
How is blood used? (Top)
Here are some typical surgeries and the average amount of needed
blood:
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Removal of lung portion |
2 units red blood cells |
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Open heart surgery |
3 units red blood cells |
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Removal of kidney |
2 units red blood cells |
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Exchange for a newborn with
Rh factor complication |
1 unit whole blood |
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Brain tumor |
2 units red blood cells |
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Leukemia for correction of
anemia and clotting disorders |
6 units red blood cells
20 platelet concentrates |
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Severe burns |
8 units plasma |
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Aneurysm repair |
6 units red blood cells |
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Organ transplants |
Up to hundreds of units |
What is blood needed for? (Top)
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Organ transplants |
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Treatment of cancer |
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Gastrointestinal disease |
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Trauma |
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Aneurysms |
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Anemia and clotting disorders |
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Premature babies |
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Accident victims |
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Open heart surgeries |
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Burns |
Who should donate blood? (Top)
Everyone. While only 5% of eligible people actually donate,
it is estimated that 95% of us will need blood or a blood product
during our lifetime. In our area, more than 1,600 units of blood and blood products
are needed each day for patients in local hospitals.
You can donate blood every 56 days. For information on when,
where and how to give, call: 1-800-GIVE LIFE
or, check out a Blood Drive near
you. If you are able to donate blood, you can also donate
platelets. For more information call 1-877-975-2835.
What are the different types of
blood? (Top)
Blood comes in different types. Each person has a specific ABO
type (A, B, AB, 0) and RH factor (positive or negative). Nearly
half of all the blood ordered by hospitals is Type 0 negative.
The most prevalent types of blood are 0 positive and A positive.
The least common types are B negative and AB negative. Only
fifteen percent of the population is negative for the RH factor.
Type 0 negative donors are always in demand because their blood
can be safely transfused to patients of all blood types, making
them "universal donors."
For example, a premature baby's life can depend on a transfusion
of 0 negative blood because the usual cross-matching and blood-typing
procedures may not be possible. Or in an emergency, a patient
may need a transfusion immediately, with no time to cross-match
blood. Often, the patient receives type 0 negative blood until
the emergency is over and the patient is stable.
Patients with any of the positive blood types can safely receive
type 0 positive blood.
Here is a breakdown of different blood types and their uses:
| Prevalence of Blood
Type |
| AB Neg. |
.6% |
1 in 167 |
| B Neg. |
1.5% |
1 in 67 |
| AB Pos. |
3.4% |
1 in 29 |
| A Neg. |
6.3% |
1 in 16 |
| 0 Neg. |
6.6% |
1 in 15 |
| B Pos. |
8.5% |
1 in 12 |
| A Pos. |
35.7% |
1 in 3 |
| 0 Pos. |
37.4% |
1 in 3 |
| Possible Transfusion
Combinations |
| Blood Type |
Can be given to patients with type |
| 0+ |
0+, A+, B+, AB+ |
| A+ |
A+, AB+ |
| B+ |
B+, AB+ |
| AB+ |
AB+ |
| 0- |
0+, A+, B+, AB+, 0- , A- , -B , AB- |
| A- |
A+, AB+, A- , AB- |
| B- |
B+, AB+, B- , AB- |
| AB- |
AB+, AB- |
What happens after blood is donated? (Top)
Collection Site
Immediately after the blood donation, Red Cross collections
staff stores the blood in transport containers designed to keep
the blood at a safe temperature until it reaches our laboratories
in either Charlotte or Durham, NC.
Laboratories
At the component laboratory, the blood donation's unique computer
barcode number is scanned, and the donation is entered into
a computer system that will track and monitor the blood's status
and progress until it is transported to a local hospital.
The Red Cross also sends samples of the blood donation to its
National Testing Laboratory and Nucleic Acid Testing Laboratory
in Charlotte. Each blood donation undergoes a series of tests
for transmissible diseases.
In the component laboratory, leukocytes (or white cells) are
removed and the blood is separated into its components: red
blood cells, platelets and plasma.
This separation allows a single blood donation to save as many
as three lives.
Next the blood is placed into quarantined, temperature-controlled
refrigeration units until the test results are received from
the testing laboratories. It usually takes 12-16 hours for testing
to be completed.
Distribution Center
Once the test results are received, blood that is safe for transfusion
is removed from quarantine and placed in Red Cross distribution
centers for release to patients. The Carolinas Blood Services
Region of the American Red Cross has six distribution centers:
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Asheville, NC |
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Charlotte, NC |
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Durham, NC |
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Wilmington, NC |
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Winston Salem, NC |
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Johnson City, TN |
From the distribution centers, the blood is transported to hospitals
based on the needs of patients. A hospital can order blood from
the Red Cross 24 hours a day, seven days a week, 365 days a
year. When an order is received, the staff at the nearest distribution
center packs the blood for delivery to the hospital requesting
it. Hospital personnel then transfuse blood or blood products
to a patient in need.
What are some blood products?
(Top)
Blood has been called the river of life because it carries oxygen
and nutrients throughout your body. As a volunteer donor, you
can share this precious gift of life with your community.
Blood may be transfused as whole blood or as one of its components.
Patients seldom require all of the components of whole blood.
Therefore, only that portion of blood needed by the patient
for a specific condition or disease is transfused. The remaining
components of the blood are saved for other patients, allowing
several patients to benefit from a single unit of donated whole
blood. Learn more about the following:
Whole Blood (Blood
Products)
Whole blood is living tissue, circulating through the heart,
arteries, veins and capillaries, carrying nourishment, electrolytes,
hormones, vitamins, antibodies and oxygen to the body's tissues.
Whole blood contains red blood cells, white blood cells and
platelets suspended in a watery fluid called plasma.
To separate these components, blood is treated to prevent clotting
and permitted to stand in a container. The red blood cells,
weighing the most, settle to the bottom. The plasma stays on
top and the white blood cells and platelets remain suspended
in the middle. Typically, a centrifuge is used to speed up this
separation process.
Red Blood Cells (Blood
Products)
Red blood cells (RBCs) are the most recognizable component of
whole blood. RBCs contain hemoglobin, a complex, iron-containing
protein that carries oxygen throughout the body and gives blood
its red color.
There are about one billion red blood cells in two to three
drops of blood, and for every 600 red blood cells, there are
about 40 platelets and one white cell. Improvements in cell
preservative solutions over the last 15 years have increased
the shelf life of red blood cells from 21 to 42 days. RBCs may
also be treated and frozen for extended storage, up to 10 years.
Manufactured in the bone marrow, RBCs are continuously produced
and broken down. They live for about 120 days in the circulatory
system and are eventually removed by the spleen. Red blood cells
are prepared from whole blood by removing the plasma and are
used to raise a patient's hematocrit and hemoglobin levels,
while minimizing an increase in blood volume.
Patients who benefit most from transfusions of red blood cells
include those with chronic anemia resulting from kidney failure,
malignancies or gastrointestinal bleeding; and those with acute
blood loss resulting from trauma. Since red blood cells have
reduced amounts of plasma, they are well-suited for treating
anemia patients who would not tolerate the increased volume
provided by whole blood, such as patients with congestive heart
failure or those who are elderly or debilitated.
Prestorage Leukocyte-Reduced
Blood (Blood Products)
Leukocytes (white blood cells), or the chemicals they produce,
cytokines, have been implicated as a cause of blood recipients
developing reactions to subsequent blood transfusions. Consequently,
the American Red Cross provides prestorage leukocyte-reduced
blood products for patient safety. This requires special preparation
of blood products to remove leukocytes by filtration within
48 hours of donation.
Plasma (Blood
Products)
Plasma is the liquid portion of the blood--a protein-salt solution
in which red and white blood cells and platelets are suspended.
Plasma is 90 percent water and constitutes 55 percent of blood
volume.
Plasma contains:
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Albumin (the chief protein constituent) |
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Fibrinogen (responsible, in part, for the
clotting of blood) |
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Globulins (including antibodies) |
Plasma serves to:
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Maintain satisfactory blood pressure and
volume |
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Supply critical proteins for blood clotting
and immunity |
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Provide the medium of exchange for vital
minerals, such as sodium and potassium, in order to maintain
a proper balance in the body, which is critical to cell
function |
Plasma is obtained by separating the liquid portion of blood
from the cells. Fresh frozen plasma (FFP) is frozen shortly
after donation to preserve clotting factors. It can be stored
for up to one year and thawed just before use. It is transfused
for bleeding disorders, which have no factor-specific concentrate
treatment.
Plasma Derivatives (Blood
Products)
Plasma derivatives are concentrates of specific plasma proteins
prepared from pools (many units) of plasma. Plasma derivatives
are obtained through a process known as fractionation, developed
during World War II. Plasma derivatives include:
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Factor VIII Concentrate |
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Factor IX Concentrate |
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Anti-Inhibitor Coagulation Complex (AICC) |
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Albumin |
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Immune Globulins, including Rh Immune Globulin |
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Anti-Thrombin III Concentrate |
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Alpha 1-Proteinase Inhibitor Concentrate |
Cryoprecipitated Antihemophilic Factor (Blood
Products)
Cryoprecipitate is the portion of plasma rich in clotting factors,
including Factor VIII and fibrinogen. "Cryo" is removed
from plasma by freezing and then slowly thawing the plasma.
It is used to prevent or control bleeding in those with hemophilia
and von Willebrand syndromes, the most common inherited major
coagulation abnormalities. It can also be mixed with thrombin
to create fibrosealant, which can be applied at a wound site
to prevent bleeding.
Platelets (Blood
Products)
Platelets (or thrombocytes) are small blood components that
help the clotting process by sticking to the lining of blood
vessels. Platelets are made in the bone marrow and survive in
the circulatory system for about nine days before being removed
from the body by the spleen. They help prevent massive blood
loss and blood vessel leakage resulting from trauma. Platelets
are also used to treat a condition called thrombocytopenia,
in which there is a shortage of platelets, and platelet function
abnormalities.
Platelets are prepared by using a centrifuge to separate the
platelet-rich plasma from whole blood. The platelet-rich plasma
is then centrifuged again to concentrate the platelets further.
Platelets may also be obtained from a donor by a process known
as apheresis, or plateletpheresis. The resulting donation contains
about six times as many platelets as a unit of platelets obtained
from whole blood. Platelets are stored at room temperature for
up to five days. You can learn more about donating platelets
at the Platelet
Donors Website.
White Blood Cells (Blood
Products)
White blood cells protect the body from invasion by foreign
substances, such as bacteria and viruses. Most white blood cells
are produced in the bone marrow, where they outnumber red blood
cells by 2 to 1. However, in the blood stream, there are about
600 red blood cells for every white blood cell.
There are several types of white blood cells. Granulocytes and
macrophages protect against infection by surrounding and destroying
invading bacteria, and lymphocytes aid in the immune defense.
Granulocytes are prepared by apheresis or by centrifugation
of whole blood. They are transfused within 24 hours after collection
and are used for infections that are unresponsive to antibiotic
therapy. The effectiveness of white blood cell transfusion is
still being investigated.
How is blood tested?
(Top)
Advances in donor screening and blood testing have dramatically
improved blood safety. All blood donated at American Red Cross
blood centers nationwide -- approximately 50 percent of the
nation's blood supply -- is tested in one of our National Testing
Laboratories (NTLs). These laboratories are designed to adapt
rapidly to changing technology and new scientific and medical
advancements.
The Process
At the time of donation, sample tubes of blood are also taken.
If you are a donor, you have probably noticed the bar code on
the tubes, the blood bags and your donor record. This is how
we track your donation.
The tubes are sent to the NTL where they are spun in a centrifuge
to separate the liquid portion (serum) from the cells (white
cells and red cells). The red cell portion is used to determine
your blood type and the serum is tested for viral diseases.
Test results are transferred electronically to the sending blood
center via computer within 18 hours. Blood given for the community
blood supply that does not pass the laboratory testing is destroyed.
If the donor's health is in question, he or she is notified
and may be counseled.
Type Testing
We test donated blood to determine the ABO and Rh type. After
you make your first donation, you will receive a Red Cross donor
card that tells you your blood type. It is important for a patient
to receive blood that is the correct match to prevent a serious
reaction. We also screen blood for antibodies that could trigger
a reaction.
Disease Testing
Every blood donation is screened using these tests to reduce
the risk of disease transmission. Disease tests implemented:
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HIV/AIDS HIV-I Antibody test 1985 |
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HIV-1/2 Antibody test 1992 |
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HIV-I p24 Antigen test 1996 |
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Hepatitis B Hepatitis B Surface Antigen
1971 |
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Hepatitis B Core Antibody 1987 |
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Hepatitis C Anti-HCV 1990 |
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Hepatitis ALT (Alanine Aminotransferase,
liver enzyme) 1986 |
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Syphilis Serologic test for syphilis 1948 |
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Human T-cell |
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Lymphotropic |
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Virus (HTLV) HTLV-I Antibody test 1989 |
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HTLV-I/II Antibody test 1998 |
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Hepatitis C |
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HIV/AIDS Nucleic Acid Testing (NAT) 1999 |
CMV (cytomegalovirus) testing is performed on some units of
blood for patients who require CMV negative blood, for example,
neonates weighing less than 1,500 grams, and immuno-compromised
or immune-suppressed patients. |
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In our area,
more than 1,600 units of blood and blood products are needed each day for patients
in local hospitals.
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