January 10, 2025 • 20 mins
In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., speaks with Kristen Ruby, D.O., M.P.H., to discuss National Blood Donor Month and the impact blood donors make.
Timestamps:
00:00 Introduction
00:47 Celebrating blood donors
03:43 Types of blood donors
11:16 Diversity of blood inventory
17:17 Thank you
19:22 Outro
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Kreuter (00:07):
This is Lab Medicine Rounds, a curated
podcast for physicians,laboratory professionals, and
students. I'm your host, JustinKreuter, a transfusion medicine
pathologist and assistantprofessor of laboratory medicine
and pathology at Mayo Clinic.Today, to start off the new
year, we're rounding with Dr.Kristen Ruby. She is also an
assistant professor oflaboratory medicine and
(00:29):
pathology here at Mayo Clinic,and she is also the medical
director of our Mayo Clinicblood donor program to talk with
us about National Blood DonorsMonth and the impact that blood
donors make.
Thanks for joining us today, Dr.Ruby.
Dr. Ruby (00:45):
Thank you. It's a pleasure to be here.
Dr. Kreuter (00:47):
So this first question maybe is a little bit
of an odd one, but I always liketo start off with the why
question. So why should we becelebrating blood donors?
Dr. Ruby (00:57):
So I think blood donors are so important. We
really could not provide thetype of medical care we do today
without them. And that's becauseblood donors are literally
giving a piece of themselves tohelp someone in need. They give
their blood or portions of theirblood. And for those of you
listening who aren't aware,blood is a special type of fluid
(01:18):
connective tissue that consistsof cells.
So it consists of red bloodcells, which are the cells that
carry oxygen. We've got whiteblood cells that fight
infections and platelets, whichhelps stop bleeding. So the
cellular part of blood, but alsoa fluid part of blood called
plasma, which has nutrients,hormones, and proteins such as
antibodies. So blood is a reallycomplex tissue, and because of
(01:39):
that, we actually don't have agood synthetic or artificial
alternative. So, you know, wecould try to just replicate,
like, one portion of blood suchas red cells, but even red blood
cells alone are incrediblycomplicated.
There are over 600 knownantigens on red cells and over
40 different recognized bloodgroup systems, which is why
(02:00):
there's so much variationbetween blood people and why we
really need a diverse bloodsupply. There are some clinical
trials underway at attempts totry to grow red blood cells in
the laboratory. But right now,there still is no truly safe or
effective product on the marketat this time. So currently, if a
(02:20):
patient needs blood, the onlyway we can get it is by
collecting it from anotherhuman. So getting back to your
question, why blood donorsshould be celebrated?
It's really because they offersomething that is critical for
sick patients. It's critical forsurgical procedures requiring
blood, and it's life saving formany, many people. And we have
no alternative, so we can't getit anywhere else. So we rely on
(02:43):
voluntary blood donors doingthis out of the goodness of
their heart to help people inneed. And that's why it's so
special, and we really need tocelebrate this group of
dedicated people.
Dr. Kreuter (02:53):
Wow. I really appreciate you kinda kicking us
off with this. I mean, it reallysounds like blood donors are
really the ultimate enablers. Inother words, we can have all the
fancy equipment or resources,but if there is not somebody
that is willing to come in andspend a little bit of their time
and donate their blood, thatkinda makes all the fancy
(03:14):
equipment and technology themoot point.
Dr. Ruby (03:17):
Exactly. Blood is a major part of health care. It's
a procedure that we do everyday. Surgeons require it. And
not just surgical procedures.
People in the hospital who areanemic just require it as well
to get, you know, oxygendelivery to their tissues so
they can keep healing.
Dr. Kreuter (03:34):
Right. So all these different diverse patient
populations, diverse clinicalsituations are needing people to
come in and donate their blood.So I'm on board. Definitely, we
need to celebrate this group.What do we know about blood
donors, as a group?
Dr. Ruby (03:50):
I kind of like to think of blood donors in 2
groups, and I think of it almostfrom a procedural perspective in
terms of the donation process.So I like to think of those who
donate whole blood and those whodonate a portion of their blood
via apheresis. So whole blooddonation is what I think most
people think of when it comes toblood donation. They'll come in.
(04:12):
They'll go through aquestionnaire.
So let's talk about the process,I guess. So in the United
States, there's a few minimumrequirements for being a blood
donor because this is a processin the US that's regulated by
the Food and DrugAdministration, the FDA. So
because of that, we have someminimum requirements such as
being a £110. The reason forthat is we don't wanna take too
(04:34):
much of your blood. It's allrelated to the blood the average
blood volume for someone of thatweight.
We don't wanna do anythingharmful to these healthy people.
So we've got a 110 poundrequirement. In most states, you
need to be at least age 16 or 17with parental consent.
Otherwise, age 18 and older, butmost blood centers have no upper
(04:54):
age limit. So anybody prettymuch can donate if you're an
adult.
And then you have to pass alittle physical, which usually
includes a finger prick to makesure your hemoglobin is high
enough and, mini questionnaire.Once you get through that, then
you get to the actual blooddonation part. So for going back
to kind of that separated group,I we've got the process for
(05:14):
whole blood donation where aneedle goes into the arm, your
whole blood comes out and goesinto a bag. That's a whole blood
donation. And once that goes tothe lab, it can then be
separated into its differentcomponents, such as red blood
cells or platelets or plasma.
The other process is once you'rein that chair ready to donate
blood, your blood could go outand instead of directly into a
(05:35):
bag, it can actually go into amachine called an apheresis
machine. And what that machinedoes is it centrifuges. It spins
the blood. And when you're doingthat, you can separate it out
into its different layers. Soyour red blood cell layer, your
buffy coat layer, which has theplatelets and the white blood
cells, and then your plasmalayer.
We could take off just theplasma or just the platelets and
(05:57):
put that into a bag. And theneverything else can go back to
that blood donor. And that's away that you can give just a
portion of your blood. I like tothink of blood donors as those 2
kind of groups, a whole blooddonor or an apheresis donor. And
it's interesting to think aboutit that way because there's
different frequencies at whichyou can donate.
So if you're a whole blooddonor, you can come back to us
(06:20):
every 8 weeks, generally at mostblood centers, that's the rule,
which is up to 6 times a year.And for platelet donors, it's
every 7 days at most places,which is up to 24 times a year.
So you can see that, you know,you can donate multiple times a
year, not just one time a year.So I think that's what I know
about blood donors from thecollection perspective. There's
(06:42):
a lot of other things we knowabout blood donors, such as the
blood types, like the 4 mainblood types.
I think most people think ofblood group a, blood group b, a,
b, and o. And what that isreferring to is the type of
antigens that we have on our redblood cells. So, for example,
group a donors have a antigen ontheir red blood cells. Group b
(07:04):
donors have b antigen on theirred blood cells. Group a b has
both a and b, and group o hasneither a or b on their red
blood cells.
And that's important because inthe United States, the majority
of blood donors are group oblood type, and then the next
most common is a followed by band and group AB. And that may
not be the same in everycountry, but in the United
(07:27):
States, that's what it is here.So that's important when we're
figuring out which blood apatient needs. We need to make
sure we have a a mix of thosedifferent blood types so that we
have everything we need for thepatients in the hospital. In the
United States, I'd say there'sabout 6,800,000 people in the
United States that donate blood,which is it's coming out to
(07:48):
about 13,000,000 units of bloodevery year.
So that is a lot of blood. Andhere in Olmsted County in
Minnesota, there's someone whoneeds a blood transfusion about
every 10 minutes. But across theUnited States where there's
bigger cities, the need is evengreater. And a blood product is
needed about every 2 seconds. Sothere's a constant need for
(08:10):
blood across the United States,not just here, but across the
world as well.
And we need blood donorscontinuously. Once you donate
blood, there is a limit to howlong that blood is good for
depending on the differentpreservatives used. So most red
blood cells are good for justover a month at 42 days, and
platelets are just good forabout 5 days. So we need people
(08:34):
coming in all the time to donateto replenish the supply so that
we never run out for the peoplewho do need it. For more
laboratory education, includinga listing of conferences,
webinars, and on demand content,visit
Dr. Kreuter (09:02):
So as you kind of went through there in talking
about the process about how someways we can think about the
blood donors as a group, I'm I'mreally very much respecting just
how many people we need to havecome in to support our
communities, because certainlyany one of us may end up in the
(09:23):
emergency room later today. Andit's the blood that was donated
yesterday that's gonna behelping me out tonight,
presumably. So these people arereally important. Do you ever
hear stuff like people are like,I'm not a group o donor. Right?
I think a lot of times peopleare used to hearing, like, the
call for o negative donors or opositive donors, and maybe
(09:45):
somebody's out there that'slike, maybe they're group AB,
and so they're like, man, I'mnot valuable as a donor. I mean,
is there some kind of a, like, ahierarchy for ABO types?
Dr. Ruby (09:56):
Every donor is valuable. Let me put it that
way, because every donation canbe turned into many different
blood products. So although ABblood may not be as compatible
for every patient for red bloodcells, their plasma is like
gold. Their plasma can be givento pretty much any patient. So
(10:16):
there's a role for every donor,and every unit of blood is
unique just like every person.
There's a lot of testing that wedo on units once they get to the
laboratory to determine whichantigens they express. And we
haven't really talked about thisyet, but sometimes when a person
is exposed to someone else'sblood, a response can be to
(10:38):
create antibodies againstanything they see as foreign.
And because of that, not only doyou have to match the blood for
something that's compatible, butyou may need to avoid certain
antigens to make sure thatthey're not going to destroy the
blood that you give. So there'sa lot of testing that happens to
make sure a unit is compatiblejust beyond the ABO blood type.
(10:59):
And because of that, everysingle unit is valuable.
Dr. Kreuter (11:03):
Wow. So you just kinda knocked me to the curve
there with, like, is there ahierarchy for ABO? Right? It
sounds like we need all of theblood types to donate. And what
you're highlighting there aboutthe diversity is really
important.
What do we know about thediversity of the blood
inventory?
Dr. Ruby (11:20):
Well, we try to make it as diverse as possible, which
is why we really want a lot ofdifferent people to donate
because the variety of peoplethat we have that are sick that
need blood is diverse. So forexample, there's a lot of sickle
cell patients or thalassemiapatients that may need blood on
a routine basis. And a lot ofthe blood donors out here in the
(11:42):
United States may be Caucasianand they may not have the same
antigen profile that'scompatible. So we need people
from all sorts of communities,every community to donate, to
ensure that we have come outcompatible blood for every
patient that's out there.
Dr. Kreuter (11:57):
Wow. So highlighting the fact that if
we're talking about taking careof patients that are diverse, it
requires a diverse blood supply.So, yes, we need all of the
blood donors. People who arewilling to come in and donate,
need them to come in. So we canalso celebrate them as blood
donors, but also highlights thediversity in that group too.
(12:18):
So I like that, because I thinkthere's a little bit of a, well,
I somebody else is gonna answerthe call. I think especially
those of us in the communitythat represent ethnic
minorities, you know, tounderstand that the blood that
you're donating may be verysignificant in helping care for
a patient from your same ethnicgroup.
Dr. Ruby (12:40):
Exactly. And there are times when a blood that is
compatible is is very difficultto find, and we may need to do
minority ethnic group can beincredibly valuable because then
that blip will be closer to homefor someone, and we won't
(13:00):
necessarily have to search quiteas far and wide to find
something that will really savetheir life.
Dr. Kreuter (13:05):
As we're talking here, I'm thinking about how
we're celebrating those who havedonated blood. And one of the
challenges is just the theconfidentiality, right, that we
always have to respect. And so Ithink blood donors may have the
experience of coming in andanswering all those questions
all over again every time forthat blood donor questionnaire
(13:25):
because that's what's requiredand to donate their blood, but
then they don't necessarily hearwhat their donation enabled. Can
you share a story? Again, thisis anonymous, not something
that's happening today, butmaybe in your past, a patient
that you've been involved withwhere blood products made a
(13:47):
significant difference, andmaybe we can kinda use that as a
fill in story.
People can understand that theblood that's being donated, this
is the kind of stuff that we'retalking about.
Dr. Ruby (13:58):
Yeah. I can even just share my own family experience.
Hemophilia runs in my family.And growing up, my mom's
brothers had hemophilia, andthere was no synthetic
alternative at the time. So theonly way they could get
replacement factor 8, which is acoagulation factor, it stops
bleeding, was through plasmadonations.
(14:19):
And so they were able to livemany more years than they would
have otherwise because ofdonations from other people. So
that's just a plasma example.Another example is gallbladder
surgery. My mom underwent it.It's a very routine procedure.
Sometimes complications happen,and unfortunately for her, that
(14:40):
was one case where there was ableed found afterwards. She
became hypotensive, was notdoing so well, and they realized
that she was bleeding, and theyended up having to give her 8
units of red blood cells inorder to stabilize her to go
back to surgery and and fix whathappened. So for her, that blood
(15:00):
saved her life. It made adifference. It gave her some
time to stabilize.
But these are just examples frommy family. I mean, throughout my
practice, I've seen emergencycases, people coming in from car
crashes where we've given over a100 red blood cells, you know,
in the emergency department, inthe operating room, and not just
(15:22):
red blood cells, but alsoplasma, platelets, cryo, like,
every blood product that wecould give to help stabilize
these people. And without that,these people would have died. So
it is a necessary critical part.And without it, we could not do
the types of procedures that wedo to save people in these
emergency type situations.
Dr. Kreuter (15:43):
And we really appreciate the diverse
situations you just shared thereas like with your family, with
hemophilia. That was one Ihadn't even thought of, but
you're you're spot on. Right? Alot of times we're talking about
trauma care, or we're talkingabout patients who have cancer,
we're talking about, like,neonates. So babies that are
(16:03):
born prematurely are all kind ofcommon patient populations that
are really dependent on blooddonors, but there's a whole
diverse larger group.
You mentioned hemophilia in thepast was very much dependent on
blood donors. Mentioning yourmother coming in for gallbladder
surgery was something wherepeople are not anticipating a
(16:27):
transfusion. And when you talkabout 8 units, I imagine if we
were in a different time anddidn't have those 8 units, that
there would have been adifferent outcome. That sounds
like a significant amount ofsomebody's blood that's
circulating.
Dr. Ruby (16:40):
Definitely. And so I feel so grateful that that
resource was available to her tohelp save her life. But you're
right. Like, I gave a lot ofexamples of emergency kind of
situations like that, butthere's many patients that are
outpatients who this little bumpis able to keep them out of the
hospital and to keep them livingtheir daily lives and to support
(17:03):
them in a way that they can walkup the stairs without becoming
short of breath. A little boostlike that can help everyone stay
out of the hospital and try tolive as normal as a life of as
they can.
Dr. Kreuter (17:17):
Oh my gosh. That really is impactful for me. I
mean, my time when I'm out on myown versus if I in the hospital
is is night and day. Maybe Iwanna maybe wrap up our
conversation today by maybeasking, you know, what would you
like to say to our listeners whoare blood donors?
Dr. Ruby (17:35):
I just wanna say thank you. Me saying thank you is one
thing we also try to say thankyou by giving gifts. We have,
like, sweatpants. We also giveaway things like mugs. Every
drop counts, and that is true.
Most people try to donate out ofthe goodness of their heart, but
we also try to say thank you bygiving little things away like
(17:59):
that. You know, there are somepeople who can't donate because
of the restrictions of weightand age or a medical condition,
or maybe you're sick and youjust can't donate or you can't
tolerate donation. And that'sokay too. But I want people to
know that even if you can'tphysically donate, there's still
other ways that you can help.You can spread the word.
(18:21):
You can encourage other peopleto donate your local blood
collection center and helporganize a blood drive. Some
collection centers have mobilebuses where you can send it to
your school or your someorganization in your community,
and you can definitely helpfacilitate that. And if you're
not willing to do that, there'sother ways you can help just by
(18:42):
supporting someone who wants totry to donate. For example, say
say there's a busy parent, andyou providing childcare for an
hour will allow them to take thetime to donate, or you could
even offer a ride to someone toa donation location. So even if
you can't be the one to do thedonation, there are so many ways
(19:04):
that you can help and beinvolved.
And I just wanted to say thankyou to all of those people too.
Thank you for those who donate.Thank you for those who support
the donation process. All ofthose efforts are so incredibly
important and very much valued,and we could not do it without
you.
Dr. Kreuter (19:22):
We've been rounding with Doctor. Ruby talking about
National Blood Donors Month,this January. A huge thank you
to all the blood donors outthere. As Dr. Ruby's
articulated, you guys are theultimate enablers of the medical
practice these days.
So thank you, Dr. Ruby, forjoining us.
Dr. Ruby (19:41):
Thank you so much.
Dr. Kreuter (19:42):
And to our listeners, thank you for joining
us today. We invite you to shareyour thoughts and suggestions
via email tomcleducationmayo.edu. If you've
enjoyed this podcast, pleasesubscribe. And until our next
rounds together, we encourageyou to continue to connect lab
medicine and the clinicalpractice through educational
This is Lab Medicine Rounds, a curated
podcast for physicians,laboratory professionals, and
students. I'm your host, JustinKreuter, a transfusion medicine
pathologist and assistantprofessor of laboratory medicine
and pathology at Mayo Clinic.Today, to start off the new
year, we're rounding with Dr.Kristen Ruby. She is also an
assistant professor oflaboratory medicine and
(00:29):
pathology here at Mayo Clinic,and she is also the medical
director of our Mayo Clinicblood donor program to talk with
us about National Blood DonorsMonth and the impact that blood
donors make.
Thanks for joining us today, Dr.Ruby.
Dr. Ruby (00:45):
Thank you. It's a pleasure to be here.
Dr. Kreuter (00:47):
So this first question maybe is a little bit
of an odd one, but I always liketo start off with the why
question. So why should we becelebrating blood donors?
Dr. Ruby (00:57):
So I think blood donors are so important. We
really could not provide thetype of medical care we do today
without them. And that's becauseblood donors are literally
giving a piece of themselves tohelp someone in need. They give
their blood or portions of theirblood. And for those of you
listening who aren't aware,blood is a special type of fluid
(01:18):
connective tissue that consistsof cells.
So it consists of red bloodcells, which are the cells that
carry oxygen. We've got whiteblood cells that fight
infections and platelets, whichhelps stop bleeding. So the
cellular part of blood, but alsoa fluid part of blood called
plasma, which has nutrients,hormones, and proteins such as
antibodies. So blood is a reallycomplex tissue, and because of
(01:39):
that, we actually don't have agood synthetic or artificial
alternative. So, you know, wecould try to just replicate,
like, one portion of blood suchas red cells, but even red blood
cells alone are incrediblycomplicated.
There are over 600 knownantigens on red cells and over
40 different recognized bloodgroup systems, which is why
(02:00):
there's so much variationbetween blood people and why we
really need a diverse bloodsupply. There are some clinical
trials underway at attempts totry to grow red blood cells in
the laboratory. But right now,there still is no truly safe or
effective product on the marketat this time. So currently, if a
(02:20):
patient needs blood, the onlyway we can get it is by
collecting it from anotherhuman. So getting back to your
question, why blood donorsshould be celebrated?
It's really because they offersomething that is critical for
sick patients. It's critical forsurgical procedures requiring
blood, and it's life saving formany, many people. And we have
no alternative, so we can't getit anywhere else. So we rely on
(02:43):
voluntary blood donors doingthis out of the goodness of
their heart to help people inneed. And that's why it's so
special, and we really need tocelebrate this group of
dedicated people.
Dr. Kreuter (02:53):
Wow. I really appreciate you kinda kicking us
off with this. I mean, it reallysounds like blood donors are
really the ultimate enablers. Inother words, we can have all the
fancy equipment or resources,but if there is not somebody
that is willing to come in andspend a little bit of their time
and donate their blood, thatkinda makes all the fancy
(03:14):
equipment and technology themoot point.
Dr. Ruby (03:17):
Exactly. Blood is a major part of health care. It's
a procedure that we do everyday. Surgeons require it. And
not just surgical procedures.
People in the hospital who areanemic just require it as well
to get, you know, oxygendelivery to their tissues so
they can keep healing.
Dr. Kreuter (03:34):
Right. So all these different diverse patient
populations, diverse clinicalsituations are needing people to
come in and donate their blood.So I'm on board. Definitely, we
need to celebrate this group.What do we know about blood
donors, as a group?
Dr. Ruby (03:50):
I kind of like to think of blood donors in 2
groups, and I think of it almostfrom a procedural perspective in
terms of the donation process.So I like to think of those who
donate whole blood and those whodonate a portion of their blood
via apheresis. So whole blooddonation is what I think most
people think of when it comes toblood donation. They'll come in.
(04:12):
They'll go through aquestionnaire.
So let's talk about the process,I guess. So in the United
States, there's a few minimumrequirements for being a blood
donor because this is a processin the US that's regulated by
the Food and DrugAdministration, the FDA. So
because of that, we have someminimum requirements such as
being a £110. The reason forthat is we don't wanna take too
(04:34):
much of your blood. It's allrelated to the blood the average
blood volume for someone of thatweight.
We don't wanna do anythingharmful to these healthy people.
So we've got a 110 poundrequirement. In most states, you
need to be at least age 16 or 17with parental consent.
Otherwise, age 18 and older, butmost blood centers have no upper
(04:54):
age limit. So anybody prettymuch can donate if you're an
adult.
And then you have to pass alittle physical, which usually
includes a finger prick to makesure your hemoglobin is high
enough and, mini questionnaire.Once you get through that, then
you get to the actual blooddonation part. So for going back
to kind of that separated group,I we've got the process for
(05:14):
whole blood donation where aneedle goes into the arm, your
whole blood comes out and goesinto a bag. That's a whole blood
donation. And once that goes tothe lab, it can then be
separated into its differentcomponents, such as red blood
cells or platelets or plasma.
The other process is once you'rein that chair ready to donate
blood, your blood could go outand instead of directly into a
(05:35):
bag, it can actually go into amachine called an apheresis
machine. And what that machinedoes is it centrifuges. It spins
the blood. And when you're doingthat, you can separate it out
into its different layers. Soyour red blood cell layer, your
buffy coat layer, which has theplatelets and the white blood
cells, and then your plasmalayer.
We could take off just theplasma or just the platelets and
(05:57):
put that into a bag. And theneverything else can go back to
that blood donor. And that's away that you can give just a
portion of your blood. I like tothink of blood donors as those 2
kind of groups, a whole blooddonor or an apheresis donor. And
it's interesting to think aboutit that way because there's
different frequencies at whichyou can donate.
So if you're a whole blooddonor, you can come back to us
(06:20):
every 8 weeks, generally at mostblood centers, that's the rule,
which is up to 6 times a year.And for platelet donors, it's
every 7 days at most places,which is up to 24 times a year.
So you can see that, you know,you can donate multiple times a
year, not just one time a year.So I think that's what I know
about blood donors from thecollection perspective. There's
(06:42):
a lot of other things we knowabout blood donors, such as the
blood types, like the 4 mainblood types.
I think most people think ofblood group a, blood group b, a,
b, and o. And what that isreferring to is the type of
antigens that we have on our redblood cells. So, for example,
group a donors have a antigen ontheir red blood cells. Group b
(07:04):
donors have b antigen on theirred blood cells. Group a b has
both a and b, and group o hasneither a or b on their red
blood cells.
And that's important because inthe United States, the majority
of blood donors are group oblood type, and then the next
most common is a followed by band and group AB. And that may
not be the same in everycountry, but in the United
(07:27):
States, that's what it is here.So that's important when we're
figuring out which blood apatient needs. We need to make
sure we have a a mix of thosedifferent blood types so that we
have everything we need for thepatients in the hospital. In the
United States, I'd say there'sabout 6,800,000 people in the
United States that donate blood,which is it's coming out to
(07:48):
about 13,000,000 units of bloodevery year.
So that is a lot of blood. Andhere in Olmsted County in
Minnesota, there's someone whoneeds a blood transfusion about
every 10 minutes. But across theUnited States where there's
bigger cities, the need is evengreater. And a blood product is
needed about every 2 seconds. Sothere's a constant need for
(08:10):
blood across the United States,not just here, but across the
world as well.
And we need blood donorscontinuously. Once you donate
blood, there is a limit to howlong that blood is good for
depending on the differentpreservatives used. So most red
blood cells are good for justover a month at 42 days, and
platelets are just good forabout 5 days. So we need people
(08:34):
coming in all the time to donateto replenish the supply so that
we never run out for the peoplewho do need it. For more
laboratory education, includinga listing of conferences,
webinars, and on demand content,visit
Dr. Kreuter (09:02):
So as you kind of went through there in talking
about the process about how someways we can think about the
blood donors as a group, I'm I'mreally very much respecting just
how many people we need to havecome in to support our
communities, because certainlyany one of us may end up in the
(09:23):
emergency room later today. Andit's the blood that was donated
yesterday that's gonna behelping me out tonight,
presumably. So these people arereally important. Do you ever
hear stuff like people are like,I'm not a group o donor. Right?
I think a lot of times peopleare used to hearing, like, the
call for o negative donors or opositive donors, and maybe
(09:45):
somebody's out there that'slike, maybe they're group AB,
and so they're like, man, I'mnot valuable as a donor. I mean,
is there some kind of a, like, ahierarchy for ABO types?
Dr. Ruby (09:56):
Every donor is valuable. Let me put it that
way, because every donation canbe turned into many different
blood products. So although ABblood may not be as compatible
for every patient for red bloodcells, their plasma is like
gold. Their plasma can be givento pretty much any patient. So
(10:16):
there's a role for every donor,and every unit of blood is
unique just like every person.
There's a lot of testing that wedo on units once they get to the
laboratory to determine whichantigens they express. And we
haven't really talked about thisyet, but sometimes when a person
is exposed to someone else'sblood, a response can be to
(10:38):
create antibodies againstanything they see as foreign.
And because of that, not only doyou have to match the blood for
something that's compatible, butyou may need to avoid certain
antigens to make sure thatthey're not going to destroy the
blood that you give. So there'sa lot of testing that happens to
make sure a unit is compatiblejust beyond the ABO blood type.
(10:59):
And because of that, everysingle unit is valuable.
Dr. Kreuter (11:03):
Wow. So you just kinda knocked me to the curve
there with, like, is there ahierarchy for ABO? Right? It
sounds like we need all of theblood types to donate. And what
you're highlighting there aboutthe diversity is really
important.
What do we know about thediversity of the blood
inventory?
Dr. Ruby (11:20):
Well, we try to make it as diverse as possible, which
is why we really want a lot ofdifferent people to donate
because the variety of peoplethat we have that are sick that
need blood is diverse. So forexample, there's a lot of sickle
cell patients or thalassemiapatients that may need blood on
a routine basis. And a lot ofthe blood donors out here in the
(11:42):
United States may be Caucasianand they may not have the same
antigen profile that'scompatible. So we need people
from all sorts of communities,every community to donate, to
ensure that we have come outcompatible blood for every
patient that's out there.
Dr. Kreuter (11:57):
Wow. So highlighting the fact that if
we're talking about taking careof patients that are diverse, it
requires a diverse blood supply.So, yes, we need all of the
blood donors. People who arewilling to come in and donate,
need them to come in. So we canalso celebrate them as blood
donors, but also highlights thediversity in that group too.
(12:18):
So I like that, because I thinkthere's a little bit of a, well,
I somebody else is gonna answerthe call. I think especially
those of us in the communitythat represent ethnic
minorities, you know, tounderstand that the blood that
you're donating may be verysignificant in helping care for
a patient from your same ethnicgroup.
Dr. Ruby (12:40):
Exactly. And there are times when a blood that is
compatible is is very difficultto find, and we may need to do
minority ethnic group can beincredibly valuable because then
that blip will be closer to homefor someone, and we won't
(13:00):
necessarily have to search quiteas far and wide to find
something that will really savetheir life.
Dr. Kreuter (13:05):
As we're talking here, I'm thinking about how
we're celebrating those who havedonated blood. And one of the
challenges is just the theconfidentiality, right, that we
always have to respect. And so Ithink blood donors may have the
experience of coming in andanswering all those questions
all over again every time forthat blood donor questionnaire
(13:25):
because that's what's requiredand to donate their blood, but
then they don't necessarily hearwhat their donation enabled. Can
you share a story? Again, thisis anonymous, not something
that's happening today, butmaybe in your past, a patient
that you've been involved withwhere blood products made a
(13:47):
significant difference, andmaybe we can kinda use that as a
fill in story.
People can understand that theblood that's being donated, this
is the kind of stuff that we'retalking about.
Dr. Ruby (13:58):
Yeah. I can even just share my own family experience.
Hemophilia runs in my family.And growing up, my mom's
brothers had hemophilia, andthere was no synthetic
alternative at the time. So theonly way they could get
replacement factor 8, which is acoagulation factor, it stops
bleeding, was through plasmadonations.
(14:19):
And so they were able to livemany more years than they would
have otherwise because ofdonations from other people. So
that's just a plasma example.Another example is gallbladder
surgery. My mom underwent it.It's a very routine procedure.
Sometimes complications happen,and unfortunately for her, that
(14:40):
was one case where there was ableed found afterwards. She
became hypotensive, was notdoing so well, and they realized
that she was bleeding, and theyended up having to give her 8
units of red blood cells inorder to stabilize her to go
back to surgery and and fix whathappened. So for her, that blood
(15:00):
saved her life. It made adifference. It gave her some
time to stabilize.
But these are just examples frommy family. I mean, throughout my
practice, I've seen emergencycases, people coming in from car
crashes where we've given over a100 red blood cells, you know,
in the emergency department, inthe operating room, and not just
(15:22):
red blood cells, but alsoplasma, platelets, cryo, like,
every blood product that wecould give to help stabilize
these people. And without that,these people would have died. So
it is a necessary critical part.And without it, we could not do
the types of procedures that wedo to save people in these
emergency type situations.
Dr. Kreuter (15:43):
And we really appreciate the diverse
situations you just shared thereas like with your family, with
hemophilia. That was one Ihadn't even thought of, but
you're you're spot on. Right? Alot of times we're talking about
trauma care, or we're talkingabout patients who have cancer,
we're talking about, like,neonates. So babies that are
(16:03):
born prematurely are all kind ofcommon patient populations that
are really dependent on blooddonors, but there's a whole
diverse larger group.
You mentioned hemophilia in thepast was very much dependent on
blood donors. Mentioning yourmother coming in for gallbladder
surgery was something wherepeople are not anticipating a
(16:27):
transfusion. And when you talkabout 8 units, I imagine if we
were in a different time anddidn't have those 8 units, that
there would have been adifferent outcome. That sounds
like a significant amount ofsomebody's blood that's
circulating.
Dr. Ruby (16:40):
Definitely. And so I feel so grateful that that
resource was available to her tohelp save her life. But you're
right. Like, I gave a lot ofexamples of emergency kind of
situations like that, butthere's many patients that are
outpatients who this little bumpis able to keep them out of the
hospital and to keep them livingtheir daily lives and to support
(17:03):
them in a way that they can walkup the stairs without becoming
short of breath. A little boostlike that can help everyone stay
out of the hospital and try tolive as normal as a life of as
they can.
Dr. Kreuter (17:17):
Oh my gosh. That really is impactful for me. I
mean, my time when I'm out on myown versus if I in the hospital
is is night and day. Maybe Iwanna maybe wrap up our
conversation today by maybeasking, you know, what would you
like to say to our listeners whoare blood donors?
Dr. Ruby (17:35):
I just wanna say thank you. Me saying thank you is one
thing we also try to say thankyou by giving gifts. We have,
like, sweatpants. We also giveaway things like mugs. Every
drop counts, and that is true.
Most people try to donate out ofthe goodness of their heart, but
we also try to say thank you bygiving little things away like
(17:59):
that. You know, there are somepeople who can't donate because
of the restrictions of weightand age or a medical condition,
or maybe you're sick and youjust can't donate or you can't
tolerate donation. And that'sokay too. But I want people to
know that even if you can'tphysically donate, there's still
other ways that you can help.You can spread the word.
(18:21):
You can encourage other peopleto donate your local blood
collection center and helporganize a blood drive. Some
collection centers have mobilebuses where you can send it to
your school or your someorganization in your community,
and you can definitely helpfacilitate that. And if you're
not willing to do that, there'sother ways you can help just by
(18:42):
supporting someone who wants totry to donate. For example, say
say there's a busy parent, andyou providing childcare for an
hour will allow them to take thetime to donate, or you could
even offer a ride to someone toa donation location. So even if
you can't be the one to do thedonation, there are so many ways
(19:04):
that you can help and beinvolved.
And I just wanted to say thankyou to all of those people too.
Thank you for those who donate.Thank you for those who support
the donation process. All ofthose efforts are so incredibly
important and very much valued,and we could not do it without
you.
Dr. Kreuter (19:22):
We've been rounding with Doctor. Ruby talking about
National Blood Donors Month,this January. A huge thank you
to all the blood donors outthere. As Dr. Ruby's
articulated, you guys are theultimate enablers of the medical
practice these days.
So thank you, Dr. Ruby, forjoining us.
Dr. Ruby (19:41):
Thank you so much.
Dr. Kreuter (19:42):
And to our listeners, thank you for joining
us today. We invite you to shareyour thoughts and suggestions
via email tomcleducationmayo.edu. If you've
enjoyed this podcast, pleasesubscribe. And until our next
rounds together, we encourageyou to continue to connect lab
medicine and the clinicalpractice through educational
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