Dwindling blood supply could lead doctors to make tough calls
Allegheny General Hospital has never had to delay an urgent procedure because of a lack of blood supply, but the supply had once gotten to a point where the hospital has split platelet units to preserve a dwindling number of blood units.
Dr. Allan Philp, trauma surgeon and chief medical officer at AGH, said the blood supply at the hospital has not truly recovered from the COVID-19 pandemic in 2020, when even regular donors were not able to give blood to blood banks. The supply in Western Pennsylvania again hit a low point this summer, with the American Red Cross and Vitalant saying there has been a significant decrease in blood donations starting in June.
Hospital doctors and department heads evaluate their upcoming blood needs to plan for the supply they have, Philp said, which has become a more regular practice over the past few years.
“There were times when the whole region was within a day of not having enough product,” Philp said. “Thankfully we've never gotten to the point, at least in Western PA where we have had to ration blood. We would identify the challenge and the acuity of the situation; the operating surgeon is going to know how to work it out.”
The American Red Cross said Aug. 5 its national blood supply has fallen by more than 25% since July 1, creating a shortfall of more than 19,000 blood donations in July. At the same time, Vitalant said during the week of July 4, its national blood supply hit an 18-month low.
Both agencies urged people to donate blood if possible, with Type-O blood — the type that can be transfused into any blood type — being particularly in demand.
Philp said AGH primarily gets its blood from Vitalant, and the hospital requests units based on its current supply and upcoming need.
Donated blood can only be stored for 42 days, said Red Cross regional communications director Nicole Roschella, which is why donations are constantly needed to refill the supply.
Philp added that AGH used about 1,700 units of product in June, a figure that includes red blood cells, whole blood, platelets and plasma. According to Philp people may need a blood transfusion for not only emergency procedures, but for elective surgeries and cancer treatments as well.
“Some cancer patients, it's not uncommon for them to use a unit of blood. It's often hard on their blood marrow, they might be getting a unit of blood every other week,” Philp said.
“Anything surgical, we've become a victim of our own success, where we're able to do a lot of things minimally invasively. We sometimes have more bleeding than anticipated.”
Philp said AGH could also work within the region to get blood units from other sources if necessary. Vitalant and Red Cross each serve numerous hospitals and health care agencies in the region, and each has to manage blood supply as well.
Pharmacist Matthew Schnur, vice president of ancillary services at Butler Memorial Hospital, said the hospital is not currently experiencing a shortage of blood products. He also said Independence Health System hosts regular blood drives throughout its facilities to help augment its supply.
“While blood products continue to be in limited supply nationally, our blood bank at Butler Memorial Hospital is accustomed to regularly managing them without disruption,” Schnur said. “We continue to work with our blood product suppliers, such as Community Blood Bank and the American Red Cross, to manage our resources closely.”
A UPMC spokesperson said the health system uses “a well-developed blood management program across our health system to ensure the best decisions about use and alternative strategies are used that focus on our patients’ needs.”
Philp said even a stable blood supply could drop to a critical point if a hospital sees a higher demand because of emergencies or scheduled procedures. He said he encourages people who are able to donate to give blood whenever possible, because even donors themselves could find themselves in need of a blood transfusion at some point.
“You never know when someone in your family is going to be diagnosed with cancer or a heart surgery. It’s one of those things that isn’t on people’s radar,” he said.
