When caring for patients, physicians and other health professionals rely on blood donation to support care ranging from trauma response to cancer treatment. But ongoing blood shortages mean many hospitals and health systems struggle to keep an adequate supply on hand. With the need for donating blood rising during seasonal shortages or public health crises, a single donation of blood can help up to three people. Donating blood when you can is vital because maintaining an adequate blood supply is a shared responsibility that strengthens patient care across the country.
Only about 3% of age-eligible people donate blood yearly, making it hard for the blood supply to meet demand. Meanwhile, 13.6 million units of whole blood and red blood cells are collected in the U.S. each year, according to the American Red Cross.
The AMA’s What Doctors Wish Patients Knew™ series gives physicians a platform to share what they want patients to understand about today’s health care headlines and how to take charge of their health through preventive care.
In this installment, Navneet Majhail, MD, MS, a hematologist and physician-in-chief of blood cancers at the HCA Healthcare Sarah Cannon Cancer Network, took time to discuss what patients need to know about donating blood.
HCA Healthcare is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
There are different components of blood
“Blood has four main components: plasma, red blood cells, white blood cells and platelets. Platelets are blood cells that help in clotting and prevent bleeding, and red blood cells facilitate oxygen transport from the lungs to your body’s tissues,” said Dr. Majhail. “In other settings, some patients’ blood plasma clotting factor levels might be low and put them at risk of bleeding.”
“We’ve learned over time that if we divvy up the whole blood unit into its components, we can focus on what a patient needs,” he said, emphasizing “we can use that unit of blood more effectively because you are splitting it up and you can have multiple products that can help multiple patients.
For example, in their cancer journey, some patients will be more anemic where they’ll need red blood cells, while others may need platelet transfusion since their platelet counts are very low,” said Dr. Majhail.
Blood donation greatly impacts patients with cancer
“There's a huge impact on cancer patients as far as the blood donation process is concerned,” said Dr. Majhail, who shared data from the American Red Cross and American Cancer Society that about “one in four cancer patients in the U.S. will need a blood transfusion.”
“If you look at the incidence of cancer in the United States, that translates to close to 2 million patients with cancer who are diagnosed each year,” he said. “And a quarter of all patients with cancer will need a blood transfusion each year.”
Not enough people donate blood each year
“Only 3% of Americans donate blood in a given year. That’s a gap where it’s so important—especially in cancer patients—as we think about blood donation,” said Dr. Majhail. “Many cancer patients, especially those with blood cancers, will not be able to get the treatments they need so desperately—which are life-saving—to get them through the cancer treatment process without giving them blood products.”
“That’s why this blood donation process is so critical for our cancer patients to make sure they get their lifesaving treatments in a safe way,” he said.
Blood supplies are low in winter and during holidays
There are times throughout the year when blood supplies are extremely low and there is an urgent need for donations. This typically is in “the winter months and during the holidays,” said Dr. Majhail. “Life happens, people are busy and they’re distracted by other things.”
“That’s why the blood supply tends to get a bit tighter during the winter and holiday months,” he said. “And that is all the more reason there should be a focus on that time to encourage donation to make sure we’ve got the blood supply in the country in a good place.”
All blood types are important
The main blood types are categorized by the ABO system, which means A, B, AB and O. Then there is the Rh factor—positive or negative—that results in eight common blood types: A positive, A negative, B positive, B negative, AB positive, AB negative, O positive and O negative. The blood type AB positive is a universal recipient. Meanwhile, type O negative is the universal donor.
“It’s sometimes hard to find blood donors, but the messaging should be all blood types are needed, and all blood types are important,” said Dr. Majhail. “We just want people go out there and donate their blood so that we have a blood supply for patients when it is needed.”
Certain conditions make you ineligible to donate
“If you think about the whole blood donation process, the criteria for who can and cannot be a donor basically focuses on two concerns,” said Dr. Majhail. “One is to keep the safety of the recipient or patient who might need a blood product in mind.”
“And then the second piece they're trying to keep in mind is the safety of the donor. It's a very safe process,” he added. “But having said that, they still want to make sure we are not putting any of our donors into even a small amount of risk in the process of donating blood.”
“A lot of the criteria of who's eligible or not eligible is focused on making sure the donation center is assessing the risk of infections that might be transmitted by blood, such as HIV and hepatitis B or C,” Dr. Majhail said, adding that you are also not eligible to donate blood if you have some cancers, such as leukemia or lymphoma—or if you have a congenital bleeding disorder, or if you are feeling sick, pregnant or have a fever.
“If the donor has had a blood disease or recent cancer or surgery, that makes them ineligible to donate blood,” he said. “There are other criteria such as intravenous drug use, recent unprotected sex with a new partner or multiple sexual partners which also makes you ineligible.”
“Sometimes if you’re on certain medications that we know can impact your recovery after a blood donation, that can be a reason not to be eligible to donate,” Dr. Majhail said. “The vast majority of people who can donate are able to do it because only a small proportion of potential donors have these issues which preclude them from donation.”
“As far as who is eligible to donate, the majority of able-bodied people in the United States can donate blood,” he said, adding people as young as 16 can donate, but rules vary by state.
Travel can impact donation eligibility
Looking at travel, “it is focused more on the risk of transmission of infectious diseases that can be potentially bloodborne,” said Dr. Majhail. “For instance, if you have traveled to an area where malaria is endemic, then for a short period of time you will not be eligible to donate blood to ensure that you don’t transmit malaria to a potential patient.”
“That's why the health history questionnaire that is filled out as a part of the process of blood donation is so important,” he said. “It helps us get a sense of if there is a condition that'll prevent you from donating in a safe way.”
It takes about 15 minutes to donate blood
“As someone comes in to donate blood, one of the health professionals will do an assessment—a mini physical if you will,” Dr. Majhail said. “They will check your vitals, such as your temperature to make sure you’re not having a fever and take your blood pressure.”
Potential donors will also get a quick finger-prick test to check your hemoglobin level, which indicates the amount of oxygen-carrying protein in your red blood cells. Women need at least 12.5 g/dL and men need 13.0 g/dL to donate safely. Low levels potentially indicate iron-deficiency anemia, which is a common reason for deferral.
Additionally, “they will go through your medication list to see what kind of medications you’re on and then will also have you fill out a detailed health questionnaire that goes through any of the criteria that would make a potential donor ineligible to donate,” he said. “Once that’s done, you will be seated in an infusion chair, where you can recline as a health professional places a needle into one of the big veins in your arm to collect a pint of blood.”
“From when you start donating to when you get done it is about 10 to 15 minutes, so it’s not a very long process,” Dr. Majhail said. “As soon as you’re done, you will stay around for another 15 to 30 minutes to make sure you’re doing okay . During this time, you hydrate, get some snacks and then leave the place knowing in your heart that you saved some lives today.”
Hydrate yourself before and after donation
“Before and after donating blood, it is a really important to hydrate yourself,” said Dr. Majhail. “The better hydrated you are, the easier it is to find the vein and start the process.”
“Also, since a pint of blood is removed in about 10 to 15 minutes, sometimes people can feel lightheaded,” he said. “So, in that context, hydration before and after the process is very helpful.”
Avoid alcohol after donating blood
After donating blood, “avoiding alcohol and strenuous activity for a day or two is also advisable,” said Dr. Majhail. “Most donors will be able to resume their routine activities fairly quickly.”
“If you have to do any strenuous activity, it might take a couple of days for your body to get back to that level of activity”, he added. “But the important thing is to listen to your body and make those decisions accordingly.”
A pint of blood is replenished within a month
“When you donate blood, you still have enough blood in you to maintain your normal body functions,” said Dr. Majhail. “The amount taken—about a pint of blood—is a fairly safe and manageable amount. It does not significantly reduce your overall blood volume.”
“Once you donate, typically your body will replete what you’ve donated within four to six weeks,” he said. “That is why the typical guidelines note that you can donate blood every 56 days.”
Platelet donation has less recovery
If you donate platelets, you are allowed to donate “every seven days,” said Dr. Majhail. “The platelet donation process itself is different than whole blood because you’re only taking out one component of your blood, which is platelets.”
“The recovery of platelets is much quicker than the rest of your blood, so that’s why you can do it every seven days versus 56 days for whole blood,” he said. “With plasma donation, you can do it once in a two-day period and no more than twice in a seven-day period.”
Patients with blood cancer need more donations
“The majority of treatments for blood cancers have a profound effect on the bone marrow, so it’s not unusual for patients’ blood counts to go down significantly as a part of this process,” Dr. Majhail said. “For us to give them the treatments they need to control their cancers, to keep that safe, we have to give them blood products to keep their hemoglobin, platelets and other blood components in a safe place, so they don’t get bleeding or other complications that’ll prevent us from treating them effectively.”
“That’s why the blood donation piece in blood cancer is so important for us. Compared to other cancer patients, blood cancer patients disproportionately use a larger amount of blood products than any other cancer,” he said.
Find opportunities to donate blood
“There’s a huge need for blood donations in the country for patients across the board, not just cancer,” Dr. Majhail said. “So, be on the lookout for opportunities to donate blood.”
“A lot of the blood donation programs across the country, which are all nonprofit, will organize blood donation drives in your workplace or other community locations, so look out for those opportunities so you can participate and donate blood,” he said. “At HCA Healthcare, we recognize the importance of blood donation, which is why we hold blood donor drives across our organization on a regular basis.”
“Also, reach out and find out where your local blood center might be and either volunteer or go there and donate blood,” Dr. Majhail said. “Don’t wait for a drive to come to you—go out there and find the opportunity to donate if you can.”
“Given how few people donate and how critical it is for our cancer patients, blood donation is important to save lives,” he said. “This is certainly something I would encourage everyone to prioritize.”
