Following the Red Cross Blood Trail

Blood donated in the CNY area ultimately ends up at the state’s main lab in West Henrietta, south of Rochester, then Charlotte, North Carolina

By David Figura

It all starts with a person sitting down, getting a needle or two stuck in their arm and making a donation at a local Red Cross blood drive event.

But where does the blood go from there? How does it get to a local hospital for such uses as a surgery or stabilizing a car accident victim?

Rachel Elzufon Couch, the state’s Red Cross transportation supervisor, outlined the blood trail for CNY donations recently.

During the blood collection events, donations are extracted from individuals as either whole blood, platelets, plasma or double red blood cells. Also, testing is done for donors with blood that can be used for pediatric or sickle cell disease patients.

Whole or unprocessed blood contains red cells, white cells and platelets (comprising about 45% of the blood’s volume), which are suspended in plasma (about 55% of the volume).

Platelets are small, colorless cell fragments in the blood with the main function of interacting with clotting proteins to stop or prevent bleeding. They are commonly used for patients undergoing cancer treatments, organ transplants or other surgical procedures.

During the platelet collection process, two needles are stuck in a donor’s arm and during that time a special centrifuge process performed at the donation site separates the platelets out and the red blood cells go back into the donor’s arm.

Individuals can also donate just blood plasma or double red blood cells during a blood donation event.

Once a person in the greater Syracuse area or elsewhere in Upstate New York donates his or her blood or parts of their blood, the donations are kept separate and transported by Red Cross staff or volunteers, ultimately ending up at the state’s main lab in West Henrietta, south of Rochester off the NYS Thruway.

Red Cross staff fill six test tubes from each donation at the blood collection site. Once those test tubes are delivered to the West Henrietta lab, a courier then drives five samples from each donation to a lab in Charlotte, North Carolina. There, the samples are tested for bloodborne diseases including HIV, hepatitis, syphilis and West Nile Virus. The sixth sample is kept at the West Henrietta lab.

“We usually get an answer from Charlotte within 24 to 48 hours,” Couch said. “It’s an intricate process. We hold ourselves to an extremely high standard. It’s important for these results to be accurate.”

Staff at the West Henrietta lab, using a centrifuge, take portions of the donated whole blood and “manufacture it” into various blood products for use in transfusions. The main ones, along with platelets, include:

• Red cells: These cells carry oxygen from the lungs to the body’s tissue and carbon dioxide back to the lungs and exhaled. Red blood cells have a shelf life of about 42 days and can be used for patient suffering from an iron deficiency, anemia, trauma, surgery (general, heart), neonatal (deliveries), hip replacements, sickle cell or blood disorders.

• Plasma: This is the liquid portion of the blood. Once processed, it gets frozen and has a year shelf life. It is composed of 92% water, 7% vital proteins, such as albumin, gamma globulin, anti-hemophilic factor and other clotting factor and 1% mineral salts, sugars, fats, hormones and vitamins. It can be used for patients suffering from trauma, shock, massive bleeding, burns, liver failures, severe infections and bleeding disorders.

• Cryoprecipitate (Cryo for short): This is a portion of the plasma rich in clotting factors, including Factor VIII and fibrinogen. This blood product, which is frozen and has a one-year shelf life, is used for patients suffering from hemophila, von Willebrand disease and coagulation disorders.

In regard to the platelet donations, they require additional work at the West Henrietta lab, with the white blood cells being separated out. Platelets have a shelf life of only about five days, Couch said.

Couch said whole blood, used for giving transfusions to trauma patients, is not separated. Requirements for its use include that it must be Type O and the donor must have no history of pregnancy and that the blood must contain no trace of aspirin. These requirements minimize the risk of the patient rejecting the blood, she said.

From the West Henrietta lab, the blood is then transported by volunteers or a paid courier to one of one of four donation centers in the Upstate region. They are located in Liverpool, Buffalo, Binghamton and Albany, where it is stored for distribution.

Depending on the blood or blood products, some of it is refrigerated, some of it stored on dry ice, in temperature-stabilizing packs or just packed in regular ice.

“We have enough product kept in Liverpool for several weeks,” Couch said.

The Red Cross has an “order management department” that works closely with local hospitals and medical facilities and the local Red Cross donation centers.

Hospitals and other medical facilities put in regular online orders to the donation centers to maintain their blood supplies, along with emergency (STAT) requests, via an online program the Red Cross has set up.

From Liverpool and other distribution centers, the blood is then delivered to the local hospitals mostly by volunteer drivers.

In some cases, if the needed blood product is not available at the local donation center, volunteer drivers have to go to West Henrietta first, then drive to the local medical facility where the blood product has been requested. Often, depending on the need, volunteer drivers or a paid courier from the West Henrietta office will drive straight to the medical facility.

Couch said she has a soft spot in her heart for the volunteer drivers.

“It’s amazing what these men and women do. I work with them every day. They make you feel better about the world,” she said.