The Drop is the official newsletter of ADRP. It is mailed directly to donor recruiter professionals and senior management of blood centers throughout the US, Canada, Africa, Asia, Australia and Europe four times yearly.
ADRP’s MISSION: To provide education, development and resources for the donor recruitment professional. Spring 2011 Inside this Issue: Trends, Strategies and Challenges Snapshots of the Blood Center Experience Page 5-9 Blood Donors In Short Supply Amid Mexico Drug War Pages 10-11 Study Finds Frequent Donors Iron Depleted Page 12 Spring Buzz Pages 14-16 Shortage of Hispanic Marrow Donors Leaves Blood Cancer Patients with Uncertain Futures Page 18-20 Continued on page 3 ADRP Conference Panel, the Drop Examines Challenges Facing Industry During the 2011 ADRP Conference, an industry expert panel will tackle hot topics facing blood centers, and, in particular, donor recruitment. Among the panelists will be Moira Carter, Ph.D., 2010-11 ADRP Vice President and the National Donor Services Manager for the Scottish National Blood Transfusion Service (SNBTS). Carter recently authored “Donor Recruitment in the 21st Century: Challenges and Lesson Learned in the First Decade,” for the journal Transfusion Medicine. The article, which the journal invited her to write, took three to four months of extensive research. “I am so grateful for the input from my international colleagues and peers who generously contributed to the article,” Carter says of those who helped make the process easier. In the paper, Carter reviewed the challenges blood services in the developed world have faced in the last decade, including donor base shrinkage, managing excess and variable inventory, changes in donor relationship strategies and the shift from a message of “constant, urgent need” for donations from all types of donors to a “be there when you are needed” approach. As she notes in the lead: “The first decade of the millennium has seen a fundamental shift in global sufficiency. In many developing countries, the major challenge remains the need to collect sufficient, safe blood from volunteer non-remunerated blood donors to support developing health care needs. “However, in the developed world the current challenges faced by blood services are more complex and constantly changing. This article will explore the impact of these challenges and consider the implications for blood services in the next decade in donor management and recruitment.” Featured Conference Presentation: TOWN HALL: FUTURE FOCUS INDUSTRY HOT TOPICS
Transcript
ADRP’s MISSION:
To provide education, development and resources for the donor recruitment professional.
Spring 2011
Inside this Issue:
Trends, Strategies and Challenges Snapshots of the Blood Center Experience
Page 5-9
Blood Donors In Short Supply Amid Mexico Drug War
Pages 10-11
Study Finds Frequent Donors Iron Depleted
Page 12
Spring Buzz
Pages 14-16
Shortage of Hispanic Marrow Donors Leaves Blood Cancer Patients with Uncertain Futures
Page 18-20Continued on page 3
ADRP Conference Panel, the Drop Examines Challenges Facing Industry
During the 2011 ADRP Conference, an industry expert panel will tackle hot topics facing blood centers, and, in particular, donor recruitment. Among the panelists will be Moira Carter, Ph.D., 2010-11 ADRP Vice President and the National Donor Services Manager for the Scottish National Blood Transfusion Service (SNBTS). Carter recently authored “Donor Recruitment in the 21st Century: Challenges and Lesson Learned in the First Decade,” for the journal Transfusion Medicine. The article, which the journal invited her to write, took three to four months of extensive research. “I am so grateful for the input from my international colleagues and peers who generously contributed to the article,” Carter says of those who helped make the process easier. In the paper, Carter reviewed the challenges blood services in the developed world have faced in the last decade, including donor base shrinkage, managing excess and variable inventory, changes in donor relationship strategies and the shift from a message of “constant, urgent need” for donations from all types of donors to a “be there when you are needed” approach. Asshenotesinthelead:“Thefirstdecadeofthemillennium has seen a fundamental shift in global sufficiency.Inmanydevelopingcountries,themajorchallengeremainstheneedtocollectsufficient,safeblood from volunteer non-remunerated blood donors to support developing health care needs. “However, in the developed world the current challenges faced by blood services are more complex and constantly changing. This article will explore the impact of these challenges and consider the implications for blood services in the next decade in donor management and recruitment.”
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ADRP Conference Panel, the Drop Examines Challenges Facing Industry(Continued from page 1)
ADRP’s VISION:We are the worldwide industry leader in the field of donor recruitment with an ongoing commitment to shaping international policies and standards and to develop marketing strategies and specialized resources for the donor recruitment profession. EXECUTIVE BOARDPresident Kelly HighDirector, CRM Business TransformationAmerican Red Cross National [email protected] Immediate Past President John HaginsChief Executive OfficerAmerican Red Cross Alleghenies [email protected] President-Elect David GrahamVice President, Donor & Hospital ServicesCommunity Blood [email protected] Treasurer Charles MooreDirector, Recruitment Call CentersAmerican Red Cross Southeast [email protected] Vice President Moira CarterNational Donor Services ManagerScottish National Blood Transfusion [email protected] Vice President Joe RidleyExecutive Director, Regional OperationsCarter [email protected] Secretary Amy HutchDirector, Donor RecruitmentUnited Blood Services, Las [email protected] Executive Director Deb [email protected]: 512.658.9414
With the help of several ADRP members, Carter addresses the major strategic challenges of :• Maintaininganadequatedonorbasewiththecorrectbloodgroupmix.• IntelligentInventoryControl.• Improvingefficiencyinthefaceofthecurrentglobaleconomicclimate.• RedesigningtheDonorExperience.
The paper also discusses donor recruitment and retention strategies and provides case studies from the SNBTS marketing strategy. It provides options to rethink the traditional supply and demand models. As ADRP prepares for its 2011 Conference, it asked blood centers around the globe to provide input on their status and challenges. Centers in the western, central and eastern United States, as well as overseas, shared their experiences related to demand, collections and best practices on page 5. Their responses provide glimpses of the trends and challenges many centers may be facing in this time of shrinking donor basesandfluctuatingdemand.
ADRP Panel To Address Industry Challenges
ADRP will focus on the industry challenges Carter recently addressed in her article during a session at the conference, Friday, May 20. “As blood inventories remain strong and draw suppression continues, blood centers struggle to see the challenges facing recruitment departments. This session has been designed to help by recognizing the issues facing the industry and recruitment departments and identifying ways blood centers have overcome challenges,” explains 2010-11 ADRP President Kelly High, who will facilitate the panel. “The recruitment message may need to change to be donor-, blood type- and product-specific.Ourfocusneedstobeonretentionandresponsiveness.Also,weneedtothinkoutoftheboxastohowwedeliversufficiencyandefficiencyinthecurrentclimate, and we need to get better at predicting demand and improving our reaction times to correct the inventory,” predicts Carter.
Panel Facilitator: Kelly High, 2010-11 ADRP PresidentDirector, CRM Business TransformationAmerican Red Cross, National HeadquartersAs Director, CRM Business Transformation, Kelly High is leading the change in business process and marketing infrastructure that will support the implementation of American Red Cross (ARC) BioArch CRM initiative, which includes the Donor Relationship ManagementSystem(DRMS),theTelerecruitmentEffectivenessProgram and rollout of the new Donor Marketing Strategy. Kelly
hasservedastheSeniorProgramManager,RecruitmentOptimizationforBHQintheSales and Marketing Department since March 2008. Kelly is a graduate of the College of Notre Dame of Maryland.
Panelist: Robert Carden, Ph.D. President and Chief Executive OfficerVirginia Blood ServicesDr. Robert Carden joined Virginia Blood Services (VBS) in 1997 with a background in top positions at several American Red Cross blood centers and two hospitals. During this time, he has moved VBStoself-sufficiency,awayfromadependenceonotherbloodcenters to meet local hospital needs throughout central Virginia. In thepastfiveyears,donationsatVBShaveincreasedanaverageof
10 percent a year. The organization has grown 65 percent since he joined, and it was namedGreaterRichmondAreaEmployerofChoice(Mid-sizedCompany)in2005
the Drop - ADRP’s Quarterly Newsletter Spring 2011 / Page 3
and 2007. He has been published in the Journal of Blood Services Management(inadditiontobeingEditor-in-Chief), Transfusion,HealthMarketingQuarterly,ClinicalLeadership and Management Review, and ADRP’s the Drop.
Panelist: Merlyn Sayers, M.D.President and CEOCarter BloodCareDr. Merlyn Sayers has served as PresidentandChiefExecutiveOfficerof Carter BloodCare since its formation in 1998. He is an internist with 25 years of experience in blood banking and transfusion medicine.
Panelist: Moira Carter, Ph.D.National Donor Services ManagerScottish National Blood Transfusion ServiceDr. Moira Carter has served as National Donor Services Manager for the Scottish National Blood Transfusion Service (SNBTS) since April 1997. She joined SNBTS in 1979 as a Research
Scientist to undertake a post into Rhesus Haemolytic Disease of the Newborn. Carter continued to work in researchwithSNBTS,primarilyinthefieldsofcellculture and immunology combined with a keen interest in
therapeutic monoclonal development. In 1997 she moved from the post of Head of Cell Culture and Immunology in SNBTS National Science Lab to her current post.
Panelist: Paula RobertsCorporate Director, Donor RecruitmentUnited Blood ServicesPaula Roberts joined Blood Systems (BSI) as the Corporate Director for DonorRecruitmentinOctober2000.She has worked in donor recruitment for more than 25 years, beginning
hercareeratTheBloodCenterinNewOrleansin1983andspendingthenext13yearswiththeAmericanRedCross in St. Louis, Missouri and Atlanta, Georgia. Her experience includes managing donor recruitment staff in bothfixedsiteandmobiledonorrecruitment.Overthepastfiveyears,herdepartmenthasbeenresponsiblefortheimplementation of a blood center management system and an online appointment scheduling system for blood drive sponsors and donors. Roberts has a bachelor of business administration degree from Georgia State University in Atlanta, Georgia.
Panelist: Jill AllenDonor Recruitment DirectorAmerican Red CrossFor more than 11 years, Jill Allen successfully served in a variety of blood bank recruitment capacities for the American Red Cross. Allen currently manages all apheresis and whole blood recruitment functions in
Utah, Montana and Idaho for the American Red Cross. In addition to her regional recruitment experience within the American Red Cross, she also serves on the National Donor Recruitment Process Council for the American Red Cross.
Panelist: Joyce KleistDonor Recruitment DirectorCarter BloodCareJoyce Kleist has worked for more than 25 years in the blood banking industry. Her career began at the Community Blood Center in Dayton, Ohiowheresheworkedfor16yearsas a Donor Services Manager. To be
closer to family, Kleist accepted the position of Director of Donor Recruitment with Northwest Florida Blood Center in Pensacola. In 2004, she joined Carter BloodCare in Bedford, Texas where she currently works as Director of Donor Recruitment.
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As ADRP prepared for its 2011 Annual Conference, it asked blood centers around the globe to provide a pulse on how they are doing. Centers in the western, central and eastern United States as well as overseas shared their experiences related to demand, collections and best practices. Their responses provide glimpses of the trends and challenges many centers may be facing in this time of shrinkingdonorbasesandfluctuatingdemand. How is your center responding to these and other challenges of the day? Join us for the “Industry Hot Topics Panel” town hall discussion at the ADRP conference, Friday, May 20, and share your challenges and successes. Not going to the conference, provide feedback on ADRP’s Facebook page or Blog.
Western United StatesStanford Blood CenterPalo Alto, California
The Stanford Blood Center, a department of the Stanford University School of Medicine, annually draws nearly 48,000 whole blood donations. It supplies the majority of its blood products to the Stanford Hospital and Clinics and the Lucile Packard Children’s Hospital, though it also services several other area hospitals, surgery centers and a clinic. Demand:“Overall,thedemandforredbloodcellshasdecreased, and the demand for platelets has increased at the hospitals Stanford Blood Center serves,” says Michele Hyndman, Stanford Blood Center’s Public Relations Manager. “[In the past six to 12 months] the increased demand for platelets has begun to steady out while the red blood cell utilization is continuing to decrease.” Center staff believe the decrease in red blood cell demand is due to the economic downturn: Fewer people have health insurance than in the past and the number of elective surgeries has dropped.
Today, April 28, 2011you are eligible to give blood if
you gave whole blood on or before: March 03, 2011
HISTORY
SERVICE AREA
CONTACT US
History The Coastal Bend Blood Center has worked with the community to save lives since 1969.
The Coastal Bend Blood Center, established in 1969, is an independent, non-profit 501(c)(3), community service organization committed to unifying, centralizing and consolidating blood donor services in the Coastal Bend. These services include donor recruiting, community education, drawing, processing and distribution. An effective and efficient organization, more than 90% of the Blood Center's annual expenditures go directly to program services to benefit the community.
In the beginning, the Blood Center drew 6,000 donors annually. Today, approximately 30,000 caring individuals volunteer as donors each year. These donors enable the Blood Center to provide services to 14 medical facilities in its 10-county service area of Aransas, Bee, Brooks, Duval, Jim Wells, Kleberg, Live Oak, Nueces, Refugio and San Patricio. Bloodmobiles operate seven days a week to ensure that hospital and patient needs are met in this large geographical area.
During the years since its inception, the Blood Center has seen considerable growth and regulatory changes. The Blood Center is a federally licensed and accredited facility and, as such, is responsible for meeting and exceeding the requirements and standards set forth by the Food and Drug Administration and the AABB (formerly the American Association of Blood Banks).
In addition, the Coastal Bend Blood Center is also a member of America’s Blood Centers, South Central Association of Blood Banks and the Texas Hospital Association.
HOME ABOUT US BLOOD DONATIONS BLOOD FACTS HIGH SCHOOL HEROES SPECIAL EVENTS EMPLOYMENT
Trends, Strategies and ChallengesSnapshots of the Blood Center Experience
Today, April 28, 2011you are eligible to give blood if
you gave whole blood on or before: March 03, 2011
HISTORY
SERVICE AREA
CONTACT US
History The Coastal Bend Blood Center has worked with the community to save lives since 1969.
The Coastal Bend Blood Center, established in 1969, is an independent, non-profit 501(c)(3), community service organization committed to unifying, centralizing and consolidating blood donor services in the Coastal Bend. These services include donor recruiting, community education, drawing, processing and distribution. An effective and efficient organization, more than 90% of the Blood Center's annual expenditures go directly to program services to benefit the community.
In the beginning, the Blood Center drew 6,000 donors annually. Today, approximately 30,000 caring individuals volunteer as donors each year. These donors enable the Blood Center to provide services to 14 medical facilities in its 10-county service area of Aransas, Bee, Brooks, Duval, Jim Wells, Kleberg, Live Oak, Nueces, Refugio and San Patricio. Bloodmobiles operate seven days a week to ensure that hospital and patient needs are met in this large geographical area.
During the years since its inception, the Blood Center has seen considerable growth and regulatory changes. The Blood Center is a federally licensed and accredited facility and, as such, is responsible for meeting and exceeding the requirements and standards set forth by the Food and Drug Administration and the AABB (formerly the American Association of Blood Banks).
In addition, the Coastal Bend Blood Center is also a member of America’s Blood Centers, South Central Association of Blood Banks and the Texas Hospital Association.
HOME ABOUT US BLOOD DONATIONS BLOOD FACTS HIGH SCHOOL HEROES SPECIAL EVENTS EMPLOYMENT
Page 5 / the Drop - ADRP’s Quarterly Newsletter Spring 2011
Page 6 / the Drop - ADRP’s Quarterly Newsletter Spring 2011
Response: “In prior years, Stanford Blood Center imported approximately 400 units of red blood cells from another blood center,” Hyndman says. “However, our ability to ramp up collections while demand began to decrease allowed us to nearly eliminate the need to import red blood cells. We also increased our platelet collections by opening a center on a day it had previously been closed and added additional apheresis machines and staff.” Strategy: According to Hyndman, Stanford’s goal is to collect the right product for the right patient at the right time. “The focus has been on recruiting the right blood types as they are needed and making our blood drives more efficient,”sheexplains.“Wemightshortenablooddrivefrom six hours to four hours if we historically collect a higher mix of a blood types that we are not in high demand for. However, if a certain blood drive has a high percentage oftypeOnegativedonors,wewilltrytoincreasethedrivefrequency.” Recruitment: Stanford has begun placing more emphasis on mobile recruitment. “We’re getting out to our donors rather than having them come to us,” Hyndman says. “We hired an additional mobile account representative and have optimized the number of telephone recruiters we have. We have also implemented goal systems for both mobile and telephone recruiters.” Motivation: Stanford held a blood-drive competition in 2010 called the Donor Cup to motivate sponsors. Twenty high-tech companies competed by hosting four drives each. Winnerswerechoseninfivecategories:highestprojectionaccuracy; highest percentage of participation; highest participationofrepeatdonors;highestparticipationoffirst-time donors; and most units collected. Communication: Stanford Blood Center publishes Coordinator Connection, a newsletter for blood drive coordinators, and hosts donor education events and blood center tours. “We are also [working at] better connecting staff, blood drive coordinators and donors with the patients who have used blood through stories and usage information,” Hyndman says. Predictions: In the short-term, Hyndman says Stanford expects the demand for platelets to remain stable, while the demand for red blood cells will continue to decrease. In the next one to three years, center staff anticipate that demand for red blood cells will stabilize and platelet demand will remainstable.Inthenextthreetofiveyears,however,Stanford expects demand for red blood cells to increase due to aging donor and recipient populations.
Central United StatesCoastal Bend Blood Center
Corpus Christi, Texas
The Coastal Bend Blood Center is an independent center that serves 14 medical facilities in 10 counties along the Gulf Coast in South Texas. The center received nearly 30,000wholeblooddonationsduringthe2009-10fiscalyear. Demand: “Contrary to the downward trend in many parts of the country, the Coastal Bend Blood Center has experienced an increase in demand for red blood cells since 2006,”saysErinSurvant,DirectorofDonorDevelopmentforthecenter.“Themostsignificantincreasewasseenin2008 with a 9 percent increase. The most recent two years showanaverageincreaseofapproximately3percentperyear. The past six months indicate that we will see roughly a 2 percent increase in red cell transfusion.” Center staff say that the reason demand is increasing in the Coastal Bend (and across most of Texas) isn’t exactly known, but it’s possible that it’s due to an aging population and an increase in locally treated cancer cases. Response: The center has increased the number ofdonorsdrawnbyapproximately3percentperyearsince2006,andcurrentlyhasabout30,000donorseachyear. It also has increased the number of double red cell collections.“Weoccasionallyfinditnecessarytoimportunits from other blood centers if our inventory drops below the desired range for a particular blood type,” Survant says. Strategy: The center has increased its number of donors by putting more emphasis on donor education, Survant explains. “We explain to them the needs of the community, we tell them what is happening in our hospitals and community (car accidents, shootings, etc.), and we hold multiple workshops throughout the year so that our chairpeopleanddonorscanseefirsthandhowimportantitis to be a blood donor,” she says. Motivation: “To keep both our recruiters and sponsors motivated, we have sent numerous people to continuing education courses; implemented educational workshops for
the Drop - ADRP’s Quarterly Newsletter Spring 2011 / Page 7
our donor clubs; nominated sponsors, organizations and recruiters for numerous awards; and increased involvement in outside community events and organizations,” Survant says. Predictions: The Coastal Bend Blood Center anticipates stability [in the demand for blood products] in the short-term and a decrease in near and far long-term due to blood utilization practices.
Eastern United StatesMiller-Keystone Blood Center
Bethlehem, Pennsylvania
Miller-Keystone is an independent blood center that is the only blood provider to 21 hospitals in 10 counties in eastern Pennsylvania and New Jersey. In 2010, Miller-KeystoneBloodcentercollectednearly113,000units. Demand: Until 2009, Miller-Keystone Blood Center experienced a steadily increasing demand for blood products, according to Catherine Palumbo, Director of Donor Recruitment and marketing for the center. “Since then, the center has seen a slight but steady decrease in red cells as our hospital customers focus on cost-cutting initiativesincludingtransfusionfrequencyandbloodusage,” Palumbo says. “During this same time period, however, the demand for single donor platelets has continued to increase steadily.” This is due to the center’s continued growth as well as increased need of an aging Baby Boomer population undergoing cancer and cardiac treatments. Response: “We have been fortunate to have gained new hospital customers in our service area to utilize the additional inventory [resulting from the decreased demand],” Palumbo says. Strategy: To address the slight decrease in demand for red cells, Miller-Keystone also has used the same strategy as the Stanford Blood Center in California: It focuses on collecting the right product from the right donor/blood type so as to be able to provide the exact blood products needed. It also has implemented economy drives for greater efficiency.
Recruitment Challenges: “Ourmobilerecruitersarenow faced with the downsizing and/or closing of blood drive sponsor organizations; increased on-site security measuresthatmakecold-callingmoredifficult;increasedcompetition for blood donors; and constantly changing/emerging methods of communicating with an audience that spansfivegenerations,”reportsPalumbo.Shealsonotesthat rising gas prices are keeping donors from visiting the center.
Motivation: To encourage recruiters to “think strategically and creatively,” Miller-Keystone offers incentives, public recognition and reminders of the importance of their job. “We consistently reinforce that they are directly saving lives in our community,” Palumbo says. It can be a tough job, as Palumbo points out: “The needs of blood drive coordinators change quickly–fromhowtheywanttobecontacted(bothinfrequencyand method of communication), to what needs they may have as far as support from their recruiter, to other constraints they may have on
their time.” To motivate those coordinators, Miller-Keystone, takes into account the demands on their time and pocketbooks, and plans drives and promotions accordingly.
Predictions: “We anticipate the demand for red cells to continue to slowly but steadily decrease, and the need for single donor platelets to continue to rise,” Palumbo says. “As a result, we will continue to evaluate and modify our practices to meet the demand of our hospitals, customers and blood donors.”
“We consistently reinforce that they are
directly saving lives in our community,”
Palumbo says.
IrelandIrish Blood Transfusion Service
Dublin, Ireland
The Irish Blood Transfusion Service (IBTS) is a national blood service under the purview of Ireland’s National Blood Centre.IthasaheadquartersinDublinand seven additional centers around the country that together collect nearly 150,000 whole blood donations each year. Demand: In Ireland, the demand for red cells increased slightly between 2006 and 2009, by roughly 1 percent each year. However, in 2010, demand decreased by about the same amount:3.17percent,accordingtoKieranHealy,IBTSNational Donor Recruitment and Service Support Manager. Response: IBTS met the increased demand with increases in whole blood collections from 2006 to 2009. In 2010, as demand decreased, so did collections. “The quantityofsuccessfuldonationsdecreasedby3.7percent,”Healy says. “It was mainly attributable to a reduction in the number of mobile collection clinics deployed.” Strategy: Just like its counterparts in the United States, IBTS now relies on collecting the right blood type to meet demand.“Ourrecruitmentandcollectionfocusisnowon maximizing the right-type mix at each clinic to reduce inventory wastage and outdating,” Healy explains. Recruitment: At IBTS, successful recruitment means spot-on predictions. “The role of recruiters is primarily focused on accurately predicting donor attendance and actualattempteddonationsateachfixedandmobileclinic,”Healy says. “The expectation is 95 percent accuracy, based on historical attendance/collection trends.”
Predictions: Also much like centers in the United States, IBTS predicts that demand for red cells will continue to decrease in the next couple of years, while the demand for platelets will decrease substantially (20 percent, according to Healy). The main reason? The roll-out of a blood usage optimization program within Ireland’s HealthServiceExecutive.
ADRP Common Challenge for the Future
Overthepastfewyears,manyU.S.bloodcentershave found themselves experiencing decreased demand. The response has been to focus on right-type collections, most also agree on the single-largest factor affecting blood demand in the future: an aging population. Palumbo with Pennsylvania’s Miller-Keystone Blood Center sums it up best: “We will lose many individuals from our donor pool, as general aging, medications and health issues will prevent many of them from donating,” she explains. “And many of these individuals will now
enter the pool of potential transfusion recipient, due to heart surgeries, joint replacements, chemotherapy treatments, etc. Unfortunately, the younger generations are not stepping up at the same rate as the older generation is being removed from the donor pool.”
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Untitled-2 1 4/22/11 2:52 PM
Blood is in high demand in Mexican hospitals these days. The terrible drug violence means more patients in emergency rooms with life-threatening injuries,likegunshotwounds,thatrequirebloodtransfusions. But the blood donation system in Mexico is dysfunctional: In many cases, patients or their loved ones are responsible for seeking out their own donors.
STR/AP Hospital workers in Ciudad Juarez walk by army soldiers sent as a precaution after gunmen shot 17 people dead a day earlier at a drug rehabilitation center in 2009. The violence in Juarez creates a need for more blood transfusions, but a disjointed system
makes blood hard to come by. Several years ago, Martin Gomez’s mother became sick. He took her to a hospital in the Mexican border city of Juarez, where doctors determined she was bleeding internally and needed a transfusion. But there was a problem: no blood. HismotherwasOnegative,oneoftherarestblood types. Hospital staff told Gomez it was up to himtofindtheblood. “Theytoldme,‘Yougofindit,’”Gomezsays.“AndIsaid,‘Whatdoyoumeanfindit?Where?’” He was told to call other hospitals, he says. “I had to get a phone book and start calling the hospitals and ask for the blood bank and then ask, ‘Do you have a unitofOnegative?’Andeveryhospitalsaidno.”
by Monica Ortiz UribeReprinted from www.npr.org / May 5, 2011
Blood Donors In Short Supply Amid Mexico Drug War
Hospital workers in Ciudad Juarez walk by army soldiers sent as a precaution after gunmen shot 17 people dead a day earlier at a drug rehabilitation center in 2009. The violence in Juarez creates a need for more blood transfusions, but a disjointed system makes blood hard to come by.
Page 10 / the Drop - ADRP’s Quarterly Newsletter Spring 2011
A Struggle For Change In Chihuahua Gomez was desperate. He began calling TV and radio stations, imploring them to broadcast a plea askingpeoplewithOnegativetocomedonateblood.Onlyonepersoncame. SoGomezcrossedtheborderintoElPaso,Texas,andwenttoanonprofitbloodcenter,wherehefinallyfound the blood his mother needed. Then he had to smuggle it back into Mexico. After a two-week struggle, Gomez’s mother died. Seven years later, Gomez now works for that same bloodcenterinElPaso—UnitedBloodServices. “Because of what happened to her is the reason why I work here,” he says. Gomez is in charge of recruiting volunteer donors at United Blood Services. But in Mexico, every hospital collects its own blood. Patients or relatives mustfinddonorstoreplacethebloodtheyuse,andGomez says it’s a broken system. “It’ssomethingthatIwishonedaycouldstop—that blood is not dependable on people donating last moment,” he says. So Gomez has been instrumental in helping a blood center at a hospital in northern Mexico make that change. Dr. Alfonso Avitia heads the Chihuahua State Blood Transfusion Center, about four hours south oftheborder.Hesaysthatfewerthan3percentofMexicans donate blood voluntarily. Thanks in part to trainingandequipmentdonationsfromGomezandUnited Blood Services, the city of Chihuahua now
has the highest percentage of volunteer donors in the country—about28percent.
Making Progress Onarecentafternoon,AvitiadrivesanoldNissansedan to the small town of Delicias, where an event almost unheard of in Mexico is taking place: a blood donation campaign. The campaign is held outdoors on a university campus. The mood feels festive. Students who have donated sit under tents and socialize while others sit quietlyoutsidethedonationtruckwaitingtheirturn.Pablo Gonzalez, 20, is one of those donating blood for thefirsttime. “I’m going to give some blood to the people who need it,” he says. Sixty-fivestudentsshoweduptodonate,andthatmakes Avitia proud. With all the drug-related violence going on in Chihuahua, Avitia says they’ve had to increase their stock by about 15 percent. Reforming the donation system now is more important than ever. “The community must realize that they are responsible for providing their own blood supply,” Avitia says. His goal is to create a regional blood bank supplied by volunteer donors across the state. Therehasbeenprogress—withtheexceptionofinCiudad Juarez, the largest and most violent city in the state.HospitalsinJuarezhaveyettoagreeonaunifiedplan. Meanwhile, blood banks struggle to keep their up their supplies.
Monica Ortiz Uribe for NPR: Nurse Pamela Saenz draws blood from a student from the Instituto Tecnologico de Delicias at a mobile blood bank in the northern Mexican city of Delicias, Chihuahua.
the Drop - ADRP’s Quarterly Newsletter Spring 2011 / Page 11
Six U.S. blood centers found that nearly half of their donorshadiron-deficienterythropoiesis(IDE),andnearlyone-seventhhadabsentironstores(AIS)–meaningthatalarge proportion of donors have iron depletion. The six centers were participants of the Retrovirus EpidemiologyDonorStudy-II(REDS-II)group’sDonorIronStatusEvaluation(RISE)study.TheRISEstudywasconducted between December 2007 and December 2009 to assess the effects of blood donation intensity on iron and hemoglobin (Hb) status. The results of the study were published in the March issue of Transfusion. The study was led by Richard G. Cable, M.D., of theAmericanRedCrossBloodServices’NewEnglandRegion. At America’s Blood Centers’ annual meeting last month, Dr. Cable spoke about the study results and answeredquestionsaboutitsimplicationsfordonors’health.Hesaidthatalittledeficiencyisnotnecessarilybadforpeople–buthenotedthattheredoseemtobehealthproblemswithmoresignificantirondepletion. In the Transfusion article, Dr. Cable and his colleagues ontheREDS-IIteamreportedthat,among2,425redblood cell donors, they found that 15 percent had AIS and 41.7 percent hadIDE.Thosepercentageswere16.4 and 48.7, respectively, for frequentdonors(menwhohadgiven three or more whole blood donations in the past year, and women who had giventwoormore).Ofwomenwhowerefrequentdonors, 27.1 percent had AIS and 66.1 percent hadIDE.
Study Finds Frequent Donors Iron Depleted
The researchers also were able to determine an associationbetweenAIS/IDEandfemaledonorsanddonors with lower donor weight. They point out that these factors could be used to alter standards for donation frequency,particularlyasrelatedtodonorsexandsize. They also found that donors who took iron supplementshadasignificantlylowerprevalenceofAISthan donors who did not take the supplements. However, the magnitude of the effect was small: 14.9 percent of donors who took iron supplements had AIS, compared to 15.2 percent of those who did not. They conclude that a trial of iron supplementation is warranted. The authors conclude that the health of blood donors “requiressignificantattention,”particularlyintermsof the importance of iron depletion and the ability of current donation standards to prevent it. Indeed, Gary M. Brittenham, in an accompanying editorial, notes that the Food and Drug Administration is currently considering whether it should change the recommended interval between donations, and whether it should adjust the levels
of Hb or hematocrit that are used as cut-off points for deferrals.
Citations: Cable RG, et al. Iron deficiencyinblooddonors:
analysis of enrollment datafromtheREDS-
II Donor Iron Status Evaluation(RISE)study. Transfusion. 2011Mar;51(3):511-22. Brittenham GM. Irondeficiencyinwhole blood donors.
Spring BuzzAustralians Work on Methods of Freezing Blood for Troops(Source: MedIndia.net; Rathi Manohar; Feb. 17, 2011)
The Australian Red Cross is collaborating with the country’s Department of Defense to develop more effective methods to freeze Australian blood for troops engaged in distantconflicts. Dr.DavidIrving,ExecutiveDirectorofResearchandBusinessDevelopmentfor the Australian Red Cross Blood Service, reports that research is underway on cryopreservation that involves freezing and thawing blood and blood products without tampering with its integrity. “Oncethesystemisdevelopedandthelogisticsfortransportationarefinalized,then,as long as there is a frozen chain from the source of freezing to the source of utilization, it (the blood) can be kept for some time, and some distance,” he said. Australian soldiers in far-off war zones now receive blood from the United States and Europe.
Blood Donor Forced to Retire at 81(Source: Northern District Times; Samantha Day; March 2, 2011) Notmanypeoplecansaytheyhavesavedmorethan1,300lives.Yetafter62yearsand210litersofblooddonations,AustralianblooddonorErnBickfordcan. The semi-retired builder has been donating plasma to Rosehill’s Red Cross Blood Service once a fortnight for more than 10 years. Now, as he marks his 81st birthday, he must retire from giving the gift of life. It was a sad moment for Bickford and the nurses at the center who said the ripe old age of 81 was the cut-off point for blood donations. “I just wish I could keep giving,” Bickford said. “I’ve known some of the nurses here for 20 years. I’m always doing odd jobs for them and they sit me down for renovation advice. There’s a social element to me coming here and I will miss that.” Bickford,whohasanO-negativebloodtype,begandonatingwithhisfather,areturned soldier, as an 18-year-old in 1949. “It’s nothing to come once every three months when one blood donation can save three lives,” he said. “It doesn’t cost anything and there’snothingsqueamishaboutit.It’s a wonderful cause and what these people do every day is phenomenal.”
Photo by: Phil Rogers
Spring Buzz
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Spring BuzzPhilippine Province Gets Blood Center(Source: Philippine Information Agency; Ben Moses Ebreo; March 7, 2011)
The Nueva Vizcaya government has allotted P4.1 million (approximately $95,000 USD) to establish a blood bank to serve the Philippine province. It will be housed in the Nueva Vizcaya Provincial Hospital in Bambang town. The center is part of the government’s thrust to fully establish the province as having relevanthealthfacilitiestocatertotheneedsofpoorsectors.“Oneofthecausesofdeathsduringemergenciesistheinsufficientsupplyofblood.Thatiswhywearesettingupanother one in the province,” Governor Luisa Cuaresma said. Patients needing blood currently get it from the Philippine National Red Cross. But due to the increasing demands of blood, supplies are depleted.
British Blood Bank Could be Privatized(Source: The Telegraph; Martin Beckford; Feb. 17, 2011 and News Mirror; March 10, 2011)
Private companies are in talks with the British Department of Health about taking over the storage and distribution of blood in the country under the plan to make the service more “commercially effective.” Like many public sector organizations, private companies already run the British National Blood Service’s call center, catering, security, legal department and someofficeadministrationfacilities. But under the new review led by the Department of Health and disclosed by the Health Service Journal, further functions such as thestorageofbloodanditsdeliveryaroundthecountry–whichisalreadypartcontrolledbythecourierfirmTNT–couldbesoldoff. Collection would likely still be run by the National Health Service, amid fears that potential donors would be put off if they believed their free act of giving blood was going to boost theprofitsofprivatefirms. As of March 10, 2011, more than 25,000 citizens had signed a petition organized by the British union Unite against plans to privatize parts of the British blood service. The Department of Health said: “During the review, we will be considering the experience and skills that exist in the private sector to identify opportunities for making NHSBT more commercially effective. ... We are not considering any functions that could risk destabilizing the current national donor system, particularly the interface with donors.”
the Drop - ADRP’s Quarterly Newsletter Spring 2011 / Page 15
India Fights Negative Perceptions of Blood Donation(Source: The Times of India May 7, 2011, 08.15pm IST)
There are negative perceptions about blood donation in India which is the major reasonbehindacuteshortageofvoluntarydonorsandshortfallofrequirementsinblood banks, pathologist and incharge, Allahabad Medical Association (AMA) blood bank, Dr. Archana Sharma said. She was speaking in a seminar on information about using blood components organized by AMA. Sheaddedthatsincemostofthebloodbanksarenotequippedwithmodernfacilitiesandequipment,patientsneedingaparticularbloodcomponenthavetoundergo the process of transfusion of whole blood which is against modern standards. As regards facilities available at AMA blood bank, she said with the availability of component separator and aspheresis machine, it has become possible to separate and preserve four components of a single unit of blood and utilize in treating patients of four different diseases. This means that donation of single unit of blood by one personcanfulfilltherequirementsoffourpatientsatatime.
Spring Buzz
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Medline Blood Donation Kits Save Time and Reduce Waste
Young and athletic, Teresa Hurtado-Diaz thought nothingoftherandombruisesandbonepainatfirst,shrugging it off as soreness, then as an infection. Weeks went by, and the pain increased, ushering the California girl into a San Francisco hospital, where she was poked, prodded and tested until finally,theleukemiadiagnosiscame.
She was 17 years old Doctors thought she’d need nothing more than two years of chemotherapy, but the disease worsened, and they recommended a bone-marrow transplant, giving her a surprising warning. Because she’sHispanic,she’dhaveadifficulttimefindingabone marrow donor, they told her. “I know our culture is not willing to donate organs because, at the beginning, before I knew (I had leukemia), I had never donated anything,” she said. Her parents and uncles registered to donate, but they weren’t matches for Hurtado-Diaz. That’s not surprising, said Kirsten Lesak-Greenberg, spokeswoman for the National Marrow Donor Program. Seventy percent of people who need bone marrowwon’tfindmatchesintheirfamily,shesaid. Growing ever sicker, Hurtado-Diaz’s name was added to a list of those awaiting marrow transplants.
‘Their only cure’ Hispanics needing bone marrow have a harder timefindingmatchingdonorsthandowhites,Asiansand American Indians because few Hispanics have registered to donate. Among the 8 million people signed up to be bone marrow donors, 800,000, or 10 percent, identify themselves as Hispanic or Latino, Lesak-Greenberg said. Though Hispanics comprise more than one-third of Texas’ population, only 17 percent of registered bone marrow donors in the state are Hispanic, she said. Overall,Hispanicshavea72percentchanceofeverfindingabonemarrowdonor,comparedtowhites,whohavea93percentchance,accordingtothedonorprogram.Onlyblacksfareworse,witha63percentlikelihoodoffindingadonor. More people of Hispanic and Latino descent are urgently needed to donate bone marrow, Lesak-Greenberg said. Patients needing marrow donations aremorelikelytofindamatchwithintheirown
racial or ethnic heritage because the tissue types used to match patients with donors are inherited, she said. Sincemostareunabletofinddonormatcheswithintheir family, patients are forced to rely on donations from others, often strangers, who are registered donors, she said. The shortage of donors creates problems for Hispanics battling leukemia and other blood cancers. “For a lot of these patients, their only cure is a transplant, so without one, a lot of times, they don’t make it,” said Yvonne Ybarra, director of the Be the Match Program for Central and South Texas. Minorities register to donate bone marrow less often because of fear, misconceptions, lack of family supportandfinancialconcerns,suchasworriesabouttaking time off to donate, Ybarra said. That’s especially problematic for Hispanic children, who have the highest rates of leukemia among all children. Another blood cancer, non-Hodgkin lymphoma, often treated with bone marrow donations,isthefifthmostcommoncanceramongHispanics.
A match Two thousand miles away from Hurtado-Diaz’s hospital room, Lydia Gonzales’ mother shook her from her slumber after a long night stocking shelves at Walmart. “You’re not going to believe this, but you’re a match,” she said. The Beeville woman registered in 2002 as a bone marrow donor to help a co-worker’s daughter who needed a transplant. Though she wasn’t a match for the girl, she remained on the list, and in an odd twist of events, the co-worker’s daughter suddenly got better without a transplant. By the time Gonzales got the call in 2006 that she was a bone marrow match for Hurtado-Diaz, she had forgotten she’d ever registered. Life had changed for Gonzales in those four years. Her sister had died of stomach cancer. She’d given birth to a son and moved home from San Antonio to Beeville to live with her mother and get help raising her little boy. All she knew of Hurtado-Diaz was that the girl was 17. Gonzalescould’vebackedoutthen,noquestionsasked, but instead, she traveled to San Antonio,
Shortage of Hispanic Marrow Donors LeavesBlood Cancer Patients with Uncertain Futures
Reprinted from Corpus Christi Caller
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where doctors took blood and walked her through mountains of paperwork. “I saw my mother bury my sister,” Gonzales said. “I don’t want to see another parent bury their child. If that ever happened to my son, I would hope someone would step up and help.” Forfivedays,Gonzalesreceivedinjectionsof a drug to stimulate her bone marrow to make whitebloodcells.Onthefifthday,doctorsdrewout stem cells in a procedure that Gonzales likened todialysis.Asthebagfilledwithanamberliquidresembling apple juice, Gonzales thought of Hurtado-Diaz’s mother and father. “I was excited about the fact that I could give a child back to their parents,” she said. “It was exciting that I was going to save somebody.” Later,GonzaleswouldfindoutshehadbeenHurtado-Diaz’s last chance. “If she didn’t want to donate, I was going to die,” Hurtado-Diaz said. “She was the only one.”
An angel As Gonzales recovered in a San Antonio hotel room, Hurtado-Diaz prepared for the easiest procedure of that week. By the time she sat down for an infusion of Gonzales’ stem cells, she had been through days of intensive chemotherapy and radiation treatments that left her dizzy, nauseous, tired and wincing from radiation burns inside her mouth and throat. The stem cell donation procedure took two hours and reminded Hurtado-Diaz of a blood transfusion. “I never thought that I was going to die,” she said. “I didn’t allow myself to think that. I told myself I wasn’t ready to die. I had a lot of things to do. I had my goals and dreams. That’s what I told my mind.” She recovered for a month and a half in an isolated, sterilized hospital room before the doctors allowed her to go home. To their surprise, she recovered rapidly, returning to school within six months, just in time to graduate alongside her friends, she said.
The National Marrow Donor Program does not share the identities of donors and recipients with each otherforthefirstyear,incaseproblemsariseduringrecovery, Lesak-Greenberg said. Onceduringthatyear,Hurtado-DiazgaveprogramofficialsabookaboutangelstopassontoGonzales.Inside the cover, she had scribbled an emotional “thank you” message, and signed it, “Love, Teresa.” Program officialspassedonthebookbuterasedHurtado-Diaz’sname, Gonzales said. Hurtado-Diaz said she was aching to meet her donor. “She saved my life,” she said. “Without her, I wouldn’t be here today. I can say that. She’s basically my guardian angel.”
‘We need to help’ NationalMarrowDonorProgramofficialspickedGonzales,43,andHurtado-Diaz,22,tomeeteachotherattheannualnationalconferenceforthefirsttime.Theprogram chooses only one pair each year to meet face-to-face. When Gonzales walked on stage, Hurtado-Diaz clasped her into a hug, sobbing and screaming into her ear, “You saved my life! You gave me a second chance!” Overeggsthenextmorning,theyswappedstoriesabout their families and their lives. Hurtado-Diaz had developed seasonal allergies after the donation, an inheritance from Gonzales. A 1988 study published intheNewEnglandJournalofMedicinefoundthatbonemarrowrecipientssometimesacquirethedonor’sallergies. Gonzales couldn’t stop watching Hurtado-Diaz with her six-year-old son, marveling at the way a woman she just met bonded with her son, her heart melting when the two strode hand-in-hand through the sunlit park. “I felt like I was meeting my long lost daughter for thefirsttime,”Gonzalessaid. Hurtado-Diazhassincebecomeanunofficialrecruiter for Hispanic bone marrow donors. Fluent in Spanish, the now 22-year-old often speaks to Hispanic groups, trying to dispel myths that marrow donation is dangerous or deadly.
Teresa Hurtado-Diaz (left) hugs Lydia Gonzales, of Beeville. Four years ago, Gonzales donated stem cells to Hurtado-Diaz, who was then battling leukemia. Hispanics needing bone marrow transplants have a harder time than most ethnicities finding matches.
the Drop - ADRP’s Quarterly Newsletter Spring 2011 / Page 19
“It’s not hard at all to donate bone marrow, and we need to help our community, we need to help our Hispanic people,” she said. Gonzales shies away from the limelight, shirking the praise heaped on her by strangers that hear her story. “They call you a hero, but hero is a big word,” she said. “I did what I think any of us would do.”
What Is Stem Cell Transplantation? The transplantation is the use of donor stem cells, most often collected from circulating blood, but they may also be collected from marrow. Siblings have the potential to match the patient most closely because the patient and donor received genes from the same parents, however, they do not always have closely matched tissue types. Umbilical cord blood is another source of stem cells for allogeneic transplantation, especially for children and smaller adults. About 70 percent of patients who need a stem cell transplant do not have a suitable donor in their family. An estimated 957,902 people in the U.S. are living with or in remission from leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma or myeloma.Source: The Leukemia and Lymphoma Society
Myths and Facts about Marrow DonationMyth: Marrow donation is painful.Fact: General or regional anesthesia is always used, and donors feel no needle injections during the donation. Most feel some pain in the lower back afterward for a few days.
Myth: All marrow donations involve surgery.Fact: A majority of donations don’t involve surgery becausedoctorsmostoftenrequestperipheralbloodstem cell donation, a nonsurgical procedure. The second type of procedure, marrow donation, is surgical, but less common.
Myth: Donating marrow is dangerous and weakens the donor. Fact: There are rarely any long-term effects from donation. After the donation, in which 5 percent or
less of marrow is drawn, the body replaces the marrow within four to six weeks.
Myth: Marrow donation involves a lengthy recovery process. Fact:Forfivedaysbeforedonation, peripheral blood stem cell donors take a drug to stimulate bone marrow to make more white blood cells, and may experience headaches, bone or
muscle pain, nausea, insomnia and fatigue. These symptoms typically disappear one or two days after donation. Marrow donors experience fatigue, soreness or pressure on their lower back and some discomfort walking, but can expect to be return to work, school and other activities within one to seven days.
Myth: Donors have to pay for the procedure.Fact: Donors never pay and are never paid to donate. The patient pays for medical costs and the National Marrow Donor Program reimburses donors for travel costs. Many donors do pay to have their tissue typed when they join the registry.
How do I register to be a bone marrow donor? Visit www.marrow.org or call
1-800-MARROW-2tojointheBetheMatch Registry or learn more about donating.Source: National Marrow Donor Program
“It’s not hard at all to donate bone marrow, and we need to help our
community, we need to help our Hispanic people.”
Share your blood center’s printed recruitment materials with fellow ADRP members! Trade information with conference attendees about promotional campaign materials during a special Tools of the Trade Reception on Wednesday, May 18.
During the conference, materials will be judged by the ADRP Awards Committee and attendees. The committee will present first-place ribbons and certificates during the conference.
All winners will be listed in the Drop as well as on the ADRP website.
All submissions are the property of ADRP and will be displayed during the ADRP conference for members to view and take pictures.
Mail your completed submission form and materials to:
