Ongoing blood shortage takes toll on most at-risk patients

Blood shortage may delay college student’s treatments as she waits for transplant

Since the age of 6, Hagan Hill has needed blood donations to manage a rare liver disease. Across the nation, the pandemic has made it more difficult for patients like her to get the blood they desperately need.

The South Texas Blood & Tissue Center lost 1,000 blood drives, the equivalent of 7,600 blood donations, this year because of the COVID-19 pandemic. This fall, the community blood center continues to struggle to get the 500 donations it needs every day to meet the needs of patients in hospitals across the region.

That includes patients like 20-year-old Hagan, whose family hopes there will be enough blood when she is finally scheduled for a second liver transplant. Because the procedure involves transplanting a partial liver from a living donor, it was considered elective surgery and was delayed due to the coronavirus outbreak.

Jeanie Hill, Hagan’s mother, said that when the lifesaving procedure can finally be scheduled, it will not take place unless adequate amounts of blood are available.

“Think of it – it could be your loved one who may need a lifesaving liver, heart or kidney transplant – and you would want them to live,” she said. “So we are pleading with the community to please step forward, because you may need it yourself someday.”

Hagan has required blood transfusions since her diagnosis of autoimmune hepatitis and primary sclerosing cholangitis at the age of 6. She received a liver transplant at 14, after an episode of massive gastrointestinal bleeding, but her condition now requires another transplant.

She also suffers from severe anemia. The shortage of blood over the summer forced her to take an iron treatment instead of a blood transfusion, her mother said.

“We would have preferred Hagan to have received a blood transfusion vs. iron,” Jeanie said. “Blood obviously would work faster to raise her iron level, therefore she would receive the benefits quickly.”

The COVID-19 pandemic has affected blood donations not only in South Texas but across the nation, said Elizabeth Waltman, Chief Operating Officer of the South Texas Blood & Tissue Center, a subsidiary of San Antonio-based BioBridge Global.

“For most blood centers, blood drives produce about 70% of the donations in a typical year, and most of those drives were cancelled over the summer because of the pandemic,” she said. “Usually when there are shortages, community blood centers work together to fill the need, but in this case, the shortage is nation-wide and no one has blood to send.” 

Blood collections typically increase during the fall, because school-related drives normally provide up to a quarter of all donations. But because of the pandemic, universities and high schools are hosting very few blood drives, so thousands of additional blood donations are being lost, creating uncertainty for patients needing blood.

The center is asking the community to step up and donate blood during a time of critical need. It is also asking businesses and organizations to work with it to find new ways to host blood drives and encourage donation this fall, even if employees and students are still at home.

“For every patient who needs blood, it’s a 9-1-1 situation,” Waltman said. “We have had a lot of community support already, but the community needs more drives for the people who need blood in South Texas.”

In South Texas, donors wanting to give blood and organizations to sponsor a drive can contact the South Texas Blood & Tissue Center at 210-731-5590 or visit SouthTexasBlood.org/Give-Now. Donors also can give at University Hospital by calling 210-358-2812 or visiting DonateBloodToday.com. To sign up as an organ donor, visit DonateLifeTexas.org.

All donations are by appointment only to help maintain proper social distancing.

How can I find out my blood type?

Simple tests can reveal if you’re O-positive, AB-negative or something in between

If you’re curious about your blood type, there are several ways to discover it.

The easiest way is to donate blood with the South Texas Blood & Tissue Center. We’ll run tests to determine your type and put it on your donor profile.

Science of blood typing

The most common blood typing is the ABO and the Rh systems. They are determined by:

  • The presence or absence of type A or B antigens on your red blood cells. If you have type A antigens on your red cells, you have type A blood. Same goes for type B. If you have neither A nor B antigens on your red cells, you are type O. If you have both, you’re type AB.
  • The presence or absence of what is known as the Rh factor. If you have it, you are Rh positive. No Rh factor? Rh negative.
  • Your blood type is determined by your genetics – you get it from your parents. While the ABO system is most commonly used, there are hundreds of other types, some of them extremely rare.

The system for determining blood types has been around since 1900.

Figuring out your type

We run simple tests on your blood donation to determine its type:

  • A sample of your blood is mixed with antibodies that react to type A, and another is mixed with antibodies that react to type B.
  • We look at the samples after they spin around a centrifuge.
  • How the samples react to the antibodies – or if they react – determines your ABO type.
  • Another small sample is mixed with an anti-Rh serum, and if the cells clump together, you are Rh positive.

Drastic decline in marrow donor registrations leave blood cancer patients searching for matches

September is Childhood Cancer Awareness Month, and many pediatric patients fighting blood cancers are facing a new uncertainty because of the COVID-19 pandemic — fewer people are signing up to be lifesaving marrow or stem cell donors.

The South Texas Blood & Tissue Center (STBTC) is encouraging individuals age 18 to 44 and in general good health to sign up for the national marrow registry, Be The Match, to support children fighting cancer and searching for their matching donor.

“Because of the pandemic, registrations to the Be The Match Registry have drastically decreased,” said Samuel Hillhouse, Be The Match program administrator at STBTC. “We have had 69 registrations in September this year, compared to 639 in the same month last year. This leaves many patients who have no matches on the registry with little hope of receiving a transplant.”

For patients like Kane Goodwin, a marrow transplant is the difference between life and death.

Kane was only 4 years old when his parents took him to the emergency room for unusual bruises in 2017. He had dangerously low platelet levels and required blood and platelet transfusions immediately.

Their emergency room visit turned into a 93-day hospital stay as Kane fought aplastic anemia, a rare blood disorder.

Like patients fighting blood cancers or blood diseases, Kane’s best hope for a cure was a matching marrow donor—someone who has the same genetic tissue typing of the immune system.

While many patients struggle to find the match they need, Kane thankfully found his donor quickly on the Be The Match Registry.

In the weeks leading up to his lifesaving transplant, Kane also required blood every few days. Patients who receive a marrow transplant can use up to 140 units of blood and platelets.

“When he needed it, it was life or death,” his mother Kate said. “I think about it all the time. What if he needed blood and they didn’t have it? We were really lucky that blood was there in that situation.”

Fortunately for Kane’s family, there was blood available when he needed it, thanks to donors with the STBTC, a subsidiary of BioBridge Global.

However, the loss of blood drives during the pandemic, which in a typical year provide up to 70% of all donations, means less blood is available for cancer patients like Kane.

“Blood transfusions are a critical part of fighting cancer, and it’s absolutely necessary to have blood readily available for patients like Kane,” said Dr. Samantha Gomez Ngamsuntikul, Associated Medical Director with STBTC.

Thanks to blood donors and his marrow donor, Kane survived aplastic anemia and is now a healthy 6-year-old. His family continues to raise awareness for the thousands of children who still need a marrow or stem cell transplant to fight their blood cancer or blood disease.

To become a potential marrow donor, join the registry by texting KANE to 61474. The community can also support cancer patients by donating blood at an STBTC donor room. Donations are by appointment only and can be scheduled at SouthTexasBlood.org/Give.

You can have your ink/piercing and give blood, too

Tattoos, piercings can’t keep you from saving a life with a blood donation

One of the biggest misconceptions about giving blood with the South Texas Blood & Tissue Center is that a tattoo or piercing disqualifies you from donating.

Guidelines

With just a few exceptions, that isn’t the case. You can have recent ink or piercing and be a blood donor right away if done under this guidance:

  1. Your tattoo has to be done in a state-regulated facility
  2. The artist must use sterile needles
  3. The ink must be one-time-use only
  4. The tattoo must be completely healed. This means no signs of peeling, no scabbing or itching and the tattoo no longer needs to be treated with ointment.
  5. If you have a tattoo in the area where the needle for a blood donation goes (in the inside of your elbow), you will need to give your tech permission to insert it.

Unregulated shops

Tattoo shops are regulated in all but 10 states and the District of Columbia. But under new FDA changes this year, you only have to wait three months instead of twelve to give blood after getting inked in:

  • Georgia
  • Idaho
  • Maryland
  • Massachusetts
  • Nevada
  • New Hampshire
  • New York
  • Pennsylvania
  • Utah
  • Wyoming
  • District of Columbia
  • State-regulated tattoo facilities are required to pass certain safety and health standards to avoid contaminating blood with bloodborne conditions, mainly hepatitis.

Piercings

Similar guidelines apply for piercings. You can donate blood right away if they are completely healed and done in a state-regulated facility with single-use equipment. You’ll have to wait three months if they were not.

Blood supply drops to half of what is needed as blood drives at schools and colleges are canceled

The blood supply in South Texas has reached critically low levels, declining to around half of what is needed to adequately serve patients throughout the region.

The South Texas Blood & Tissue Center, a subsidiary of San Antonio-based non-profit BioBridge Global, urgently needs 500 donations per day through Monday to re-build the supply.

The shortfall comes at a time when collections normally are rising, the start of the new school year. But because of the coronavirus pandemic, universities are not hosting blood drives and there is only one high school drive scheduled during September.

There are only 60 blood drives scheduled this month, compared to 200 in September of last year, as businesses and other organizations also have canceled drives because of the pandemic.

In a typical year, school-related drives provide up to a quarter of all donations at the community blood center.

The South Texas Blood & Tissue Center is asking the community to make an appointment to give at one of its seven donor rooms across South Texas, or a nearby blood drive. Potential donors can find out more and make an appointment at SouthTexasBlood.org.

To help with the ongoing need, Santikos Entertainment is partnering with the center for an emergency blood drive Friday at the Casa Blanca Movie Theater, 11210 Alamo Ranch Parkway from 10 a.m.- 6 p.m. As a thank-you, all donors at the theater will receive a movie ticket and a voucher for a free Whataburger burger. Donors will need to make an appointment online here or by calling 210-731-5590.

Blood donations are needed for a range of treatments, from cancer to trauma to childbirth, even during the COVID-19 pandemic. The community blood bank has put numerous protocols in place to keep donors safe, from mandatory masks to social distancing. All blood donations also are tested for COVID-19 antibodies.

What medications can I take if I want to give blood?

For the most part, taking over-the-counter and prescription medications will not prevent you from giving blood at the South Texas Blood & Tissue Center.

Below are some examples and answers to common questions.

Pain relievers and common prescriptions: Yes

As far as OTC pain relievers like Aleve, Advil or Tylenol go, you can give blood without any problems after taking them. Same goes with prescriptions for conditions like type 2 diabetes and asthma.

You can give whole blood if you take aspirin, but not platelets because aspirin affects the way they function. You won’t be able to give platelets right away if you’re taking drugs like Feldene or Plavix to prevent a stroke or heart attack.

Click here to see a full list of medications that may affect your ability to give a whole blood donation.

Antibiotics: Yes and no

There’s one large group of prescription drugs that can prevent you from donating: antibiotics. We don’t want to take a donation from you if you have circulating bacteria in your system.

However, you can give blood seven days after finishing your last dose of an antibiotic for an infection, and if you are taking antibiotics for preventive reasons – like acne – you still can donate.

No ‘blood thinners’

If you have been prescribed “blood thinners” to prevent blood clots and strokes, you may not be able to donate because of the risk of excess bruising or bleeding.

Click here to see a full list of medications that may affect your ability to give a platelet donation.

Other medications: It depends

Prescription acne medications like Accutane and hair-loss prescriptions like Propecia have been shown to cause birth defects, so your last dose will need to be a month before your blood donation.

Some cancer treatments, including drugs for multiple myeloma and basal cell skin cancer, and immunosuppressants like Cellicept also can cause birth defects if your blood is transfused to a pregnant woman.

Fortunately, if you have finished taking most of the prescriptions on our Medical Deferral List, you will be able to donate after a waiting period, ranging from a few days to three years.

Some are ‘always no’

There are a few drugs that permanently prevent you from giving blood. If you ever took the drug Tegison (prescribed for psoriasis), human growth hormone made from human pituitary glands, or insulin from cows manufactured in the United Kingdom, we can’t take your donation.

Feel free to contact our Donor Eligibility line, 210-731-5555, extension 2243, or send an email to DonorEligibility@SouthTexasBlood.org if you have any questions.

FDA changes status of convalescent plasma program

New Emergency Use Authorization could make COVID-19 therapy more readily available to coronavirus patients

The Food and Drug Administration has changed the status of COVID-19 convalescent plasma therapy from a clinical trial to an Emergency Use Authorization.

The change should provide faster and easier access to the therapy by waiving some regulatory requirements before hospitalized patients with COVID-19 can receive transfusions of convalescent plasma.

Convalescent plasma is donated by those who have recovered from a COVID-19 infection and still have antibodies to COVID-19 in their blood. It is transfused to current patients, possibly providing passive immunity via anti-COVID antibodies.

The South Texas Blood & Tissue Center is the only organization in San Antonio collecting convalescent plasma donations and distributing them to local and area hospitals. The community blood center began collections as part of a clinical trial being conducted by the Mayo Clinic.

The FDA noted in its announcement on Sunday that convalescent plasma “may be effective in treating COVID-19 and that the known and potential benefits of the product outweigh the known and potential risks of the product.”

Carabin Shaw PC and Wyatt Law Firm PLLC are sponsoring a program to give convalescent plasma donors with STBTC a $50 Visa gift card for donating. The cards are being supplied by the firms and are not funded by the South Texas Blood & Tissue Center, a subsidiary of BioBridge Global. The cards will be distributed while supplies last.

Anyone interested in donating convalescent plasma can contact the South Texas Blood & Tissue Center at COVID19@SouthTexasBlood.org or visit SouthTexasBlood.org.

STBTC is taking donations by appointment only at the Donor Pavilion in San Antonio and its donor room in Victoria.

Plasma donors also must meet all other requirements to give blood.

The Emergency Use Authorization allows the distribution of convalescent plasma for its use by health care providers to treat suspected or laboratory-confirmed COVID-19 patients.

The Mayo Clinic recently reported data from 35,000 patients treated with convalescent plasma in its clinical trial. The report said there were fewer deaths among people given plasma within three days of diagnosis as well as those given plasma with the highest levels of antibodies.

The FDA’s Emergency Use Authorization authorizes the use of COVID-19 convalescent plasma, but its use has not been fully approved or licensed by the FDA.

The Emergency Use Authorization allows its use “only for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of drugs and biological products during the COVID-19 pandemic,” under federal law, the FDA stated, “unless the authorization is terminated or revoked sooner.”

‘Old’ science leads in fight against COVID-19

Convalescent plasma, first discovered in the 19th century, authorized for use in fight against coronavirus

A doctor’s reaction to a potential epidemic almost 90 years ago forms the basis for one of the few therapies for patients with COVID-19 today. That therapy was in the news recently, as the FDA issued an emergency use authorization for it on Sunday, Aug. 23, with the goal of making it more widely available.

Back in 1934, Dr. J. Roswell Gallagher, staff physician at a boys’ school near Philadelphia, knew he had to act fast when one boy came down with the measles, then gave it to two others in the school’s infirmary.

So he looked back to science from the turn of the 20th century. Research showed that “antiserum” – plasma, the liquid part in the bloodstream – could be used to prevent or treat diseases.

Gallagher collected and purified plasma from the first boy to recover from the measles and gave it to 62 other students.

Three developed mild symptoms. No one else got sick.

‘Antiserum’ therapy makes a comeback

As patients began suffering from COVID-19 earlier this year, Dr. Arturo Casadevall, chair of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health, remembered the lessons Gallagher had practiced decades ago.

Casadevall proposed bringing back “antiserum” – now known as convalescent plasma – as a treatment in an op-ed article in the Wall Street Journal in late February.

As reported on the Johns Hopkins University site The Hub, Casadevall’s idea spread quickly.

Teams were assembled, protocols were defined and groundwork was laid for a clinical trial using convalescent plasma to fight COVID-19, including the clinical trial being run by the Mayo Clinic, of which the South Texas Blood & Tissue Center is a part.

Warp speed deployment, results

A clinical trial at Methodist Hospital in Houston was established for the use of convalescent plasma on March 24. Less than a week later, the first patients received it.

The first dose was collected at the South Texas Blood & Tissue Center in early April and quickly transfused to a seriously ill patient— who has since recovered and now is eligible to donate himself.

Nationally, tens of thousands of patients have received convalescent plasma. A preliminary look at patient data by the Mayo Clinic showed a 50 percent decrease in mortality rates in patients receiving the transfusions, especially if they receive plasma soon after a positive test.

The Collective Grief of COVID-19

Grappling with any kind of loss involves a grief process, even if the loss isn’t tangible.

We are all dealing with non-tangible losses during this COVID-19 pandemic such as:

  • Physical connections
  • “Old normal” or ”remember when” routines
  • Our safety and certainty about the future
  • Dread that there are more losses to come (anticipatory grief – dreading something bad will happen, but being unable to see it).
  • Grief is messy! We need to embrace the mess and honor the struggle we’re going through.

You might be experiencing stages of grief dealing with the COVID-19 pandemic:

  • Denial – I can’t believe this is still going on
  • Anger – I’m so mad that… (examples: my kids can’t go to school, I can’t see my loved ones/friends in person, why aren’t others doing what they should be doing)
  • Bargaining – If/then… (example: if I wear a mask, then I can see my friends)
  • Depression – The world as we knew it at the beginning of 2020 is gone (and who knows what is yet to come)
  • Acceptance – COVID-19 is still here and not going away soon. What can I do to live productively in it?
  • Find/make meaning out of the losses – work in progress
  • Grief brings baggage from previous losses.

Strive to find balance in what you’re thinking about.

Try to stay in the “now” and let go of what you can’t control.

Practice self-compassion. Name your feelings (emotions need motion).

Self-care tips:

  • Breathe – Inhale smelling your favorite flower. Exhale like you’re blowing out birthday cake candles
  • Drink water
  • Get up and move (stretch, play…)
  • Look for small wins, 3 good things every day
  • Limit your intake of news

Donor highlight: William Berlin

My son, William Berlin, was born on September 15, 1995. He loved spending time with his family and friends. I have so many memories of him making people laugh. Once, I told him to audition for the character position at Six Flags Fiesta Texas. I did not know he was actually auditioning for a dance position. When I heard the music, I thought to myself, “He has to dance! I think I made a mistake.” I just cracked up laughing.

He came out from the audition, all sweaty, and said “Mom, what did you do to me?” William didn’t get that position, but he did get the character that stands to take pictures with the kids. After his audition, we both went to the car and laughed about the whole thing.

My son always wanted to give. He was little when he asked me what an organ donor was. When I told him, he said that he would be an organ donor when he grew up. When I started having trouble with my liver, William said he would donate half of his for me. I had to tell him he couldn’t donate just yet.

William always wanted to donate blood, too. When he was 15, he was so disappointed that he could not donate blood yet. When he turned 16 and got his driver’s license, he signed up to donate his organs. At 17, he begged me to donate blood and brought home a permission slip. Ever since that day, he would donate his blood any chance he could get.  

On November 16, 2017 he was hit by a truck. He fought to stay alive for 2 weeks. He passed away at the age of 22 and was able to help other people by donating his organs. He was able to donate his kidneys, corneas, and tissue.

It has been two and a half years since my son passed away, and I am still trying to process his death. Our experience with William’s donation process was surreal. Everything happened so fast. They kept him alive until all the paperwork and staff were ready for him.  During that process, our family was able to say our last goodbyes. 

We are proud, honored, and sad that he was able to do what he always wanted to do.

For more information about blood and tissue donation, please click here.