BALTIMORE On a Friday afternoon in August, a
few donors trickle in to the Baltimore Red Cross donation room,
filling only a small fraction of the dozen or so steel-blue
Nationwide, regional branches of the Red Cross, the
humanitarian organization that collects, processes, and
distributes blood in the United States, have been struggling in
American blood banks experienced one of their driest
summers in history this year, the extreme of a seasonal drought
that is leading some experts to question the growing list of
safety criteria for blood donors.
Sixty six million Americans are excluded from donating
blood based on a list that some doctors call overly
restrictive. The figure, recently calculated by researchers at
the University of Minnesota, represents more than a third of
adult Americans who would otherwise be eligible.
In Washington's Georgetown University Hospital, officials
came close to canceling nonemergency operations several times
The hospital counts on having at least 130 units of this
blood on hand. But "there have been times in the past few days
where we've had only eight units," said Dr. Gerald Sandler, the
director of transfusion medicine.
"This is the worst blood shortage that I have experienced
since I began directing transfusion services in 1968," Sandler
said, citing overseas travel restrictions as a major factor.
Many potential donors may be turned off from donating
altogether after being turned away at blood drives, said Dr.
Harvey Klein, chief of transfusion medicine at the National
Institutes of Health.
The restrictions do not faze the most faithful donors, like
Towson, Maryland resident Carol Cook. He had been donating
platelets at least once a month since 1995, until he came down
with Lyme Disease last summer and was excluded from donating.
"I was naturally upset that I wouldn't be able to come down
and donate as regularly as I had and I'd have to wait a year.
So the year is up, and I'm back," Cook said.
Only 5 percent of eligible donors currently give, according
to the Red Cross. And three-quarters of rejected first-time
donors never return, Klein said.
"Getting people motivated to donate ... is not easy.
Therefore, deferring people who have made that decision, who
are active blood donors, is a disaster," he said.
HALF A DAY'S SUPPLY
"Some of the criteria clearly are more stringent than they
need to be. And this really affects the day to day availability
of blood. It's one of the reasons that we don't have enough
blood on the shelf," Klein said.
In many of its facilities, the American Red Cross has only
half a day's supply of blood rather than the three to five day
reserve needed to prepare for emergencies, according to
regional Red Cross Chief Executive Officer Gary Ouellette.
In recent years, a quarter of American hospitals have been
forced to postpone or even cancel nonemergency operations --
including heart bypass procedures and hip replacements -- due
to lack of blood, Klein said.
After the HIV epidemic first tainted the nation's blood
supply in the 1970s and 80s, infecting thousands of hemophiliac
patients among others, the Food and Drug Administration began
scrutinizing donors even more carefully and blocking them based
on their travel and sexual practices.
Screening donors is a critical part of protecting the blood
supply, particularly against new diseases that tests cannot
detect in the blood itself, said Dr. Alan Williams, associate
director for regulatory affairs in the FDA's Office of Blood
Research and Review.
But some experts say the precautions go too far.
For example, since mad cow disease -- a lethal brain
disorder known formally as bovine spongiform encephalopathy --
broke out among British cattle in the 1980s, only 55 people
have contracted the human version of the disease.
Of those, only four seem to have caught the disease from
transfused blood. Yet anyone who visited Britain for more than
three months since 1986 is barred from donating blood in the
United States for life, said Klein.
"These are really not safety measures as much as they are
feel-good measures," Klein said.
"Travel to so-called malarial areas is another very good
example of probable overkill because of precaution. Really,
malaria isn't introduced into the United States by people who
spend five days in Cancun," he added.
The FDA recently removed exclusions aimed at West Nile
virus symptoms once a blood test for the disease was developed,
Williams said. But the British travel restriction has been
upheld over several reviews by his committee.
Williams and Klein agree there is no such thing as 100
percent risk-free blood. And availability is also a safety
Katie McGuire of the American Red Cross said the growing
list of restrictions has created extra challenges in recruiting
volunteers. This summer, the organization raffled American Idol
concert tickets and collaborated with sports teams in attempts
to attract younger donors, particularly as usually avid
baby-boomer donors slip into poor health.
Jennifer Garfinkel, a spokesperson for the American
Association of Blood Banks, said that, in disaster situations,
"It's the blood on the shelves that saves lives. It has already
been processed, tested, given the green light to be