April 2011
How Are Blood Component Expiration Dates Determined?
By Billie Rubin, Hemoglobin’s Catabolic Cousin, reporting from the labs of Stanford Blood Center
The Food and Drug Administration (FDA) and the American Association of Blood Banks (AABB) set safety standards and requirements that blood banks must follow. One of these is the expiration date of various blood components. For red blood cells, the date depends on the types of anticoagulants and additive solutions; the most common systems currently in use have an expiration date of 42 days from the date of collection. But if the hermetic seal at the top of the blood collection bag is opened (when preparing to transfuse a unit), the expiration date is just 24 hours.
The FDA requires that the expiration date be exactly one year from the date of collection for frozen plasma. Platelets expire five days from the date of collection because they cannot be refrigerated.
The FDA sets these dates on the basis of safety and viability studies.
Lessons on Stress From Wild Baboons
By Kevin O'Neill, Business Development Specialist, Stanford Blood Center
After waiting for a year because of his packed speaking engagement schedule, we recently had the privilege of hosting Dr. Robert Sapolsky, PhD at our Café Scientifique series for a standing room only audience. He remarkably holds positions in four Stanford University departments: Biology, Neurology, Neurological Sciences, & Neurosurgery. He has published four acclaimed books, has received numerous prestigious national science awards, and was featured in a National Geographic special on stress.
Dr. Sapolsky’s talk, entitled “Stress, Coping, & Health: Lessons from Wild Baboons”, was drawn from his field studies over 30 years living with wild baboons. He was introduced to the habitat by a departing researcher. Initially, the baboons would curiously circle him from a distance of 500 yards, gradually gaining trust & proximity. Ultimately he acquired intimate knowledge of the personality traits and dominance characteristics of individual baboons within their troops. This enabled him to finally dart the baboons in order to draw blood samples that he analyzed from a stress perspective. Dr. Sapolsky drew parallels between stress-causing events in the lives of baboons and those of humans, sharing that “loner” baboons’ blood profile correlated closely with that of a depressed human. One was left with the impression that Dr. Sapolsky had barely scratched the surface of his vast knowledge of baboons, science, health, and its implications for healthier human lives.
For a short video on Dr. Sapolsky’s study of baboons and stress, click here.
You may also visit our website to hear the podcast from his Cafe Scientifique talk. Under "Past Events", scroll to January 27.
Between a Rock and a Heart Place
By John Williams, Marketing Manager, Stanford Blood Center
Isn’t the earth an amazing place? We abuse it every day and it still forgives us. I think we often fail to see it as a living organism. Flora and fauna are a pretty obvious aspect of earth’s living organisms, but much of the earth is comprised of rocks, of course.
I read an interesting article about igneous rocks by Mike Strickler, a geologist who goes by the name “Geo Man”. He considers basalt and granite to be the two most important rocks in the crust. He explains that basalt is extrusive, meaning that it is borne of the magma that breaks through the earth’s crust and erupts on the surface. Many different types of volcanoes are home to basaltic lava flow. What struck me was Mike’s analogy in the blog post: “Basaltic magma is like the blood of the earth - it's what comes out when the earth's skin is cut the whole way through.” Fascinating!
The earth as an ecosystem is analogous to the human body, and both organisms are fragile in their own way. Earth Day reminds us of the need to celebrate this amazing planet. Perhaps we should revel in awe of life each and every day by looking no further than our own being. Just like the continual flux of basalt in the earth’s crust, we have this life saving substance called blood running through our veins. Why not share some of this with those in need? Giving blood is giving life. The earth would appreciate it.
Type-2 Diabetes an Autoimmune Disease?
Guest post by Krista Conger, Science Writer for Communications & Public Affairs at Stanford School of Medicine. Click here to be taken to the original post on Scope, Stanford School of Medicine's blog.
Stanford researchers, led by pathologist Edgar Engleman, MD, reported today in Nature Medicine that type-2 diabetes is looking more and more like an autoimmune disease, rather than a strictly metabolic disorder. According to co-first author Daniel Winer, MD:
This work will change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for type-2 diabetes.
Winer shares co-first authorship with his twin brother, Shawn Winer, MD, PhD, and research associate Lei Shen, MD, PhD, (pictured above, right, with Engleman, left). Daniel Winer was a post-doctoral fellow in Engleman's lab when the research was conducted; both Winer brothers are now at the University of Toronto.
Type-2 diabetes is characterized by the gradual development of insulin resistance, which affects the ability of the body to properly metabolize glucose. It's associated with being overweight, but it can also have a genetic component. Despite the fact that millions of people have type-2 diabetes, the root cause of the insulin resistance is not known. In 2009, Daniel and Shawn Winer showed (also in Nature Medicine; subscription required) that T cells of the immune system were involved. Now they found that another immune cell, called a B cell, also plays an important role.
From our release:
The researchers found that mice genetically engineered to lack B cells were protected from developing insulin resistance even when they grew obese on the high-fat diet. However, injecting these mice with B cells or purified antibodies from obese, insulin-resistant mice significantly impaired their ability to metabolize glucose and caused their fasting insulin levels to increase.
Interestingly, treating the mice with a compound called anti-CD20, which targets mature B cells for destruction, kept the animals from developing insulin resistance. The human version of anti-CD20, called rituximab, is already FDA-approved to treat some blood cancers and autoimmune disorders.
The topic of diabetes has been covered a few times by experts at our Cafe Scientifique series. Click here to read an article from one such expert, Thea Cooper, co-author of Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle.
Photo by Lorna Tolentino
Type B: Passionate, Excitable, Creative Types
By Billie Rubin, Hemoglobin’s Catabolic Cousin, reporting from the labs of Stanford Blood Center
Type B+ blood is found in about 8.5% of people in our population, and B- is found in only 1.5%. Type B red blood cells have the B antigen on their surface and anti-A in their plasma. There's a popular belief in Japan that ABO blood types, in a manner similar to western astrology, can predict personality and compatibility. Type B individuals are said to be passionate, creative and excitable. Type A folks on the other hand are thought to be conservative, introverted and calm. Ring true?
Become a Blood Donor
Guest post by Susan Ipaktchian, originally published on Scope, Stanford University School of Medicine's blog.
Do you know your blood type? I was surprised when many of my friends and family members said they didn't know theirs. But here's an easy way to find out and also do a little good work at the same time - become a blood donor.
I've been a regular donor at the Stanford Blood Center for nearly six years. I already knew my blood type, thanks to an experiment in a high school biology class, and that's part of what prompted me to become a donor in the first place. I have AB+ blood, which is on the rare side (about 3.4 percent of Americans have that blood type). What I didn't know was that I had never had cytomegalovirus, or CMV, a widespread virus that rarely causes symptoms but can be dangerous to people who have weak immune systems. The Stanford center routinely tests donated blood for the presence of CMV antibodies as well as other viruses. That's because the center is primary supplier of blood products to Stanford Hospital & Clinics and Lucile Packard Children's Hospital, which cares for transplant patients and others with compromised immune systems.
Because I had never contracted CMV, I was asked to become a platelet donor. Platelet donations take a little longer (the whole process usually lasts about 2 hours), but they make it comfortable by providing individual DVD players and a library of movies and TV shows to choose from. You can relax in a warmed, reclining seat and watch a movie while an apheresis machine removes your blood, separates the components, retains the platelets and returns the remaining blood through the same needle.
Two weeks ago, I made a whole blood donation for a specific patient who matched my blood type. Whole blood donations are much shorter, usually under an hour for the entire process. But no matter which type of donation you make, you always get juice and a snack - great cookies! - at the end. (Fellow blood donors, which cookies are your favorites? I crave the chocolate-chocolate chip ones.)
Each blood donation also provides a nice little snapshot of your health. They'll check your blood pressure, pulse, temperature, cholesterol and hemoglobin (a protein in red blood cells that carries oxygen). Stanford's center posts the results in each donor's online profile, making it easy to track your numbers.
So, if you'd like to learn more about your overall health and do some good for others at the same time, contact your local blood center and find out about the guidelines for becoming a donor. And if you're squeamish or have medical reasons that prevent you from being a donor, consider volunteering to assist with some of the administrative tasks. They'll definitely appreciate the help.
Photo by American Red Cross - Oregon Trail Chapter
Where in the World is Scarlett O’Negative
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By Scarlett O'Negative
Stanford Blood Center is sometimes mistakenly thought to be a part of Stanford Hospital, when in fact it is part of Stanford University Medical School. We’re very proud to be part of this venerable institution. The cosmopolitan nature of the University is especially appealing.
Students, staff, and faculty come to Stanford from every part of the world. This brings me to one of my favorite subjects: maps. Among the many fine libraries at Stanford is the Branner Earth Sciences Library and Map Center, which has a collection of 270,000 sheet maps. Maps are particularly important when tracking the world’s hot spots, of which there are many right now.
Speaking of maps, there’s much talk during the Libyan crisis about the region of western North Africa known as The Maghreb. I’m in a place which translated from the Berber is known as “The place of the winds.” Two movie tickets to the first person to guess which capital of a Maghreb country this refers to.
Sit. Stay. Donate.
By Julie Ruel, Social Media Manager, Stanford Blood Center
In speaking with Dr. Sean Owens about the transfusion department he heads at UC Davis, I found they have a similar blood donation operation to Stanford Blood Center. They go to great measures to ensure a safe blood supply, rely on volunteer community blood donors, have certain weight and age requirements, and many of their donors return on a regular basis. But Dr. Owens is a Veterinary Clinical Pathologist at the UC Davis Veterinary Medical Teaching Hospital and his blood donors are dogs.
When the program began, the furry donors came from private rescue organizations. They lived at the facility and had part time jobs as lifesavers for sick and injured dogs. Their full time job was to work with the staff and learn how to be suitable family pets so they could eventually be adopted. They worked hard at this and succeeded at finding loving homes.
Because the hospital needed hundreds of blood donors and didn’t have the resources for enough trainers available for the dogs, Dr. Owens and his staff turned to the community. “It can be difficult for people to drive 30 minutes, stay for 45, then drive 30 minutes to get back home again. But they do it because of the benefit.” The owners are given heartworm pills, flea and tick medication and overall preventative maintenance for their pet (which dog owners will agree is a nice financial benefit!). The program also provides a rare opportunity for people to become involved in a unique way with veterinary medicine; something most wouldn’t otherwise have a chance to experience.
For many, the part of giving back to the community is especially rewarding. Each summer, the veterinarians and dog owners get together for a picnic in support of the special donors who are proudly in attendance as well. Often times, the doctors will recognize the name of a dog, remember the scenario in which its blood was used and share the story with the owner. Having that meaningful connection results in a high rate of regular, repeat donors. We’re quite certain the dogs insist on coming back, too.
The hospital is always on the prowl for new donors. Ultimately they plan on purchasing a mobile unit to expand their geographical reach and increase their donor base. They’ve raised about half of the $100K it would cost to purchase the vehicle. For now, they’ll continue to offer tummy rubs to keep their local donors happy and coming back.
If you’re in the Davis area and interested in getting your four-legged buddy involved in the program, please visit their website. There are a few things to know first. Potential doggie donors must:
• Weigh at least 50 pounds (60-80 pounds is preferred)
• Be between one and eight years of age
• Never have been pregnant
And yes, Max, you get to take home a bag of yummy treats each time for being such a good dog.
Is This My Ministry?
Below, blood donor Amy Zucker Morgenstern writes about why she began giving blood, some struggles she’s experienced along the way, and how she'll insist on continuing despite these obstacles.
According to the Stanford Blood Center, I’m a gallon donor. But they’re just being nice. They mean I’ve had over eight appointments. I think only about three of them have ended with my giving an actual pint of usable blood. I’m on the verge of giving up, and it has me feeling really sad.
To me, donating blood has always been one of those no-brainer acts of mercy, like giving clothes you don’t need anymore to a clothes closet instead of throwing them in the trash. That pint of blood is the difference between death and life to the recipient, while to the donor it costs nothing but the mildest of pain and a couple of hours (including the time spent getting to and from the center and eating the re-energizing snack of cookies and juice).
Also, when my father was badly injured some years ago, he received about 40 units of blood. He barely survived, but thanks in part to the generosity of many blood donors, he did. He lived to see his three grandchildren born, and he's watching them grow up. Each time we talk, I think about how close I came to losing him, to never having this conversation, never sharing this laugh. Blood donors gave me my dad, and I’ve felt ever since that I owe the world some blood. I hear from blood center staff that this is a common motivation.
Still, it took me years to start donating even after Dad's narrow escape, because I’ve always been queasy about needles, and have even been assured by nurses that they would really rather not deal with people who are shaky about the whole thing. However, when I shared my ambivalence with a nurse at the Unitarian Universalist Church of Palo Alto, where I'm the parish minister, she urged me to try at a blood center, as opposed to a blood drive. Not long after that conversation, I got pregnant, and while that ruled out donating for several months, the many blood tests involved made me sanguine (heh) about needles. I figured, how much worse could donating be?
So a couple of years ago, I donated for the first time, and it was true: it isn’t really any tougher than a blood test. And I felt fantastic. I bounced out of there, absurdly pleased with the little bruise on my arm, determined to donate once every eight weeks for the rest of my life.
However, it hasn’t gone so well. More often than not, I leave without having donated much blood, if any. I flunk the hemoglobin test, or no one can find a good vein, or the flow is so slow that I can’t fill a pint in the allotted time, or all of the above. I’m stubborn. I take iron, I drink my eight cups of water a day for three days before giving, I tell them up front that with my veins, they’re going to need a small needle and their best blood-drawer. But I’m getting discouraged. In October, when the very expert nurse said time was up, she said, “Maybe this isn’t your ministry.” Darn the woman. She knew just the language that would reach me, and she said it with such compassion. I barely got out of there without crying.
I decided to give it one last try, so after eight weeks I went in again, having observed a strict regimen of three days’ iron supplements and having drunk enough herbal tea over the same three days to float the QEII. The finger stick turned up a sub-par hemoglobin level. Sometimes you just need to warm up your hands, so the nurse asked if I wanted to do that and try again; I did; the second level was worse. I took a consolation cookie and went to work, reminding myself that I do have other ministries in the world. We all do.
I had said that that was the last try, but I’ve got to give it one more. This time I’ve been taking iron every other day (which, clearly, I ought to be doing for my own health anyway), drinking my eight cups every day (ditto), and I'll warm my hands before the hemoglobin test, the works. But it still might not be enough. It might be that this is just not one of the ways for me to bless the world. I wish that it bothered me purely because I want to help people, and not because my ego can’t abide my failing at anything I set out to do.
Have any of you experienced obstacles related to blood donation that you were able to overcome? If so, please share your story!
Click here to be taken to Amy’s blog.
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