Blood Banks Turn Away ‘Directed Donations’

Anyone hoping to protect hospitalized loved ones with their own “safe” blood, untainted with the AIDS virus, will probably be disappointed.

Many blood centers are opposed to “directed donations” and are standing fast against mounting pleas to share blood with friends and relatives.

Sacramento Blood Center has already turned down two efforts to waive its rule barring these types of donations and says it has no plans to change the strict policy.

A handful of blood centers in big-city, high-risk areas like San Francisco, Los Angeles and New York have made some provisions for directed blood donations.

Holding the Line

But, according to Dr. Paul Holland, medical director of the Sacramento Blood Center, these exceptions are far outnumbered by blood centers holding the line against directed donations.

The Red Cross, which is the largest blood-collecting agency in the country, will not handle directed donations.

Much confusion surrounds this issue. Some assume that buddy-to-buddy blood donations are a fact of life.

They are not. And when this is made clear, people react with shock and anger.

“We try to talk to them, but they get upset and talk about suing us and going to the papers,” Holland said. “We’ve had a couple (of requests)--the last one in April or June. They get upset, but they come to understand it when we explain it,” Holland said. Some confusion revolves around whether directed donations are barred by state law. State health codes do not deal with directed donations.

Policy, Not Law

“It’s a policy, not law,” Holland said, adding that directed donations may be more likely to be tainted than volunteer-donated blood. “The implication is that family blood is safe, but center blood is not,” he said. “That’s not so.”

Holland described two situations in which directed blood donations might run into trouble.

Imagine a mother asking a gay son to donate blood to help the father. Under those circumstances it might be a very difficult for the son to admit to being homosexual and in a high-risk group.

Also, families trying to stock their own blood bank might pay relatives for the blood. Doctors are subject to legal action if paid-for blood is used when volunteer blood is available.

Widespread directed blood donations “would put us back 30 or 40 years,” Holland said. “People would get out of the habit of giving and get in the habit of waiting.”

Holland also said volunteer blood has only a 100,000-to-1 chance of being tainted to begin with, and that was before special screening procedures were adopted recently.

83,000 Units Collected

Last year, the Sacramento Blood Center collected 83,000 units of blood, a collection level which took years to develop.

Irwin Blood Center, the San Francisco center that had the first acquired immune deficiency syndrome blood scare, does have a directed donations program. AIDS is a generally fatal disease, transmitted by the blood and body fluids, which cripples the body’s immunity system. High-risk groups include homosexuals and intravenous drug users.

The Irwin policy “came mainly from the public,” said Jack Miller, coordinator of the directed donations program. “But it was also an outgrowth of the auto-transfusion program.”

Auto-transfusion is a relatively expensive process which allows an individual to stock up “rainy day” personal blood for long-term storage.

Even with the pro-directed donations policy at Irwin, there are limits to what can be done. For instance, directed donations can only be used for elective surgery.

“It doesn’t work in emergencies,” Miller said. “The screening process takes time and we have to have the blood immediately. If you wanted directed blood in an emergency, you may as well get somebody off the street.”

Red Cross-affiliated hospitals generally have no directed donations policies, Miller said. Those affiliated with the American Assn. of Blood Banks more often do.

“It’s hopscotching all over. One here, one there,” he said, referring to the availability of directed donations.

Blood centers have territories assigned to them, and batches of blood from Irwin cannot be ordered for use outside its region.

“They would have to have their surgery transferred to one of our hospitals,” Miller said. That, or change the policy at Sacramento Blood Center.

But there is apparently no concerted effort to do this.

Holland said there was no organized independent plan by the board of directors to do so at his agency.