Blood-donor shortage in U.S. worsens

LOS ANGELES — In the blood business, Labor Day is the last hurdle of the donor-dry summer. Soon, college and corporate blood drives will begin to replenish reserves.

But a dwindling pool of donors nationwide could turn seasonal shortages into a year-round drought, blood experts say. On average, 5 percent of U.S. adults donate blood.

Some regions are in deeper trouble than others. For example, the American Red Cross Blood Services of Southern California imports 40 percent of its needs from the Midwest and rural areas in other parts of the country. An earthquake or bridge collapse could easily triple the organization's needs.

"The general public presumes that nobody's going to bleed to death because there's not enough blood," said Dr. Jeffrey McCullough, a professor at the University of Minnesota and an expert on the nation's blood supply.

But locating donors, he said, "is more and more difficult, and the reforms make it more and more expensive." An average adult has about 10 pints of blood, and a major trauma victim can need up to 100.

In the Puget Sound area, the blood supply is "adequate," according to the Puget Sound Blood Center, which handles blood donations in the region. The agency typically tries to keep a four-day supply on hand. But this week supplies are about half that because the Labor Day holiday last weekend meant fewer people were donating blood, said Michael Young, a spokesman for the blood center.

Generally, the public's concern is blood safety, not supply. That has been the case since the 1980s, when HIV-tainted blood infected more than 12,000 patients nationwide through transfusions.

Today a battery of tests screens blood for HIV, hepatitis, West Nile virus and other pathogens. A series of questions excludes donors who have visited countries with malaria or mad-cow disease.

Temporary restrictions on everything from travel to tattoos often end up deterring donors permanently. A study by McCullough in the July issue of the journal Transfusion concluded that 37 percent of the U.S. population is eligible to give blood, down from an estimated 60 percent in the 1990s.

"The blood supply is extraordinarily safe," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania and a former member of a federal advisory committee on blood safety. "But you have to remember that having blood available is part of safety, too, particularly if you have some kind of disaster and you need a lot."

The supply is also extremely expensive.

From 1979 to 2000, the average price that hospitals nationwide paid for a unit of red blood cells grew from $32 to $96. By 2004, the most recent year tallied in the U.S. government's biannual survey, the price had reached $201 a unit, which is roughly one pint, although prices vary regionally.

The blood-bank system that people take for granted began during World War II as a way for citizens to help wounded soldiers. Dr. Charles Drew discovered how to preserve and store blood and organized the first blood drive. Neither subsequent generations nor immigrants have embraced the donor habit as enthusiastically.

"We don't have a blood-supply problem, we have a blood-donor problem," said Teresa Solorio, spokeswoman for American Red Cross Blood Services of Southern California. "It's easier to get people to donate money than to donate blood."

Meanwhile, even with the development of blood-conserving surgeries, the need for blood has risen because of medical advances and an aging population that needs hip replacements, heart surgery and cancer treatment.

Blood shortages occur across the nation, especially in large metropolitan areas, which tend to be faster-paced and have less of a sense of community than parts of the Midwest and South, blood experts say.

Blood type, like eye color, is inherited. About 45 percent of whites have type O blood; an estimated 65 percent of Hispanics have it. People with type O blood can receive only type O, and demand is growing as the Latino population grows.

Adding to the demand is the key role type O blood plays in emergencies: It alone can be transfused into patients with any of the four basic blood types — A, B, AB or O — without causing serious, even fatal, complications. This universality makes it crucial to have a supply for trauma patients who could bleed to death in the 20 minutes it takes to test and match blood.

The Bioethics Center's Caplan argues that blood banks nationwide need to keep longer hours and make the process more inviting for all donors.

"We haven't made blood donation as painless, as simple and as rewarding as it should be," he said.

Seattle Times staff reporter Carol Ostrom contributed to this report.