Valley Interview : Head of Donor Services Strives to Keep the Lifeblood Flowing

While many Southlanders were celebrating the red, white and blue on the Fourth of July, the red was running low.

Blood supplies had dropped to a critical level, with the local chapter of the American Red Cross maintaining just five or six units of crucial type O-negative on its shelves some days.

Cheryle Babbitt, beginning her second year as the region’s managing director for donor services, was doing more worrying and working than celebrating.

Dips in the blood supply during the summer and after the winter holiday season are not uncommon. But this was the worst in several years and served to reinforce the point that donor recruitment continues to be an area of struggle for the agency.

In an interview with Times correspondent Eric Slater, Babbitt talked about why Los Angeles uses more blood than it produces, how her office is trying to change that and how misconceptions about the transmission of AIDS and other blood-borne diseases continue to affect donations.

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Question: What happened this year that allowed the blood supply to reach such a dangerous low?

Answer: Summertime is a time when areas across the country struggle. Companies are reluctant to hold blood drives on company time because they are already short-staffed. Also, during the school year we have blood drives at high schools and colleges.

In the springtime, blood collections typically are very good, and that gives us a chance to build our blood supply. This year our blood collections during those spring months and during the Christmas season were not good. We did not meet our expectations. Then when the holiday hit us, it made a situation that wasn’t good to begin with very bad. After the Fourth of July, we were down to about a half a day’s supply of O-positive and O-negative.

Q: Has the tenuous situation improved in recent weeks?

A: It certainly is much better than it was. It’s returned to near normal, except for O-positive and O-negative, and those are types where the shortage is chronic. After the Fourth of July, we did send out news releases, and certainly newspapers and radio stations helped improve collections.

Q: Such pleas for help are not uncommon, and yet instances of someone’s not getting blood in an emergency is virtually unheard of. Is the Red Cross crying wolf?

A: No one is dying. We would never wait until that time. What we use as an indicator is we like to have a total of 10 days of blood supply in the community. When our supply drops to one day, we would go to the media with a very serious appeal.

Q: O-positive is the most common blood type, and so large quantities are required. Why is O-negative, a fairly rare type, a problem in terms of supplies.

A: O-negative, the blood type of about 7% of the population, is called the universal donor, because O-negative can be given to a person with any blood type. Until they have the time to cross-match the blood, they can give them O-negative, so it goes to patients who are of a different type. Also, for neonatal and very young pediatric patients, O-negative is preferred. They haven’t yet developed a blood type yet, and O-negative is neutral, if you will.

Q: How much blood is used daily in Greater Los Angeles ?

A: Demand here is high, about 1,000 units a day. Here in Southern California we have many very large and sophisticated medical centers that are performing procedures that utilize a lot of blood. We have very busy emergency rooms.

Q: How much of that blood comes from outside the Los Angeles area?

A: We import about a third of our blood supply from outside blood centers.

Q: While local demand is high, there is also a huge population of potential donors. Why must blood be imported?

A: Typically, in small communities, in communities that are more homogenous, blood drives are more successful. Nationwide, only 4% or 5% of the population are blood donors, and that’s a very low percentage. Here in Los Angeles it’s less than 4%. If we could get that number as high as 7% or 8%, there would never be a shortage.

About 45% of our blood donors have given before, and we telephone them. But about 60% of those who make appointments don’t keep them.

Q: What is being done to increase donations locally?

A: We’ve really started to try to focus our attention on making stories available of actual recipients, put a human face on it. Donors want to know what happens when they donate blood.

We also spend a lot of time and effort working with companies, community groups and individual donors, communicating the need with them.

Q: Did the Northridge earthquake bring out blood donors in greater numbers and help increase supplies?

A: Lots and lots of people came out to donate blood, which is a very common thing following a disaster. But most of these disasters do not require a large amount of blood, and that certainly was true here in January. However, we were grateful because it did pull us out of a shortage.

Q: How long does a unit of blood last after it’s collected?

A: Red blood cells, about 42 days. Platelets last only only five days.

Q: Does the erroneous belief that diseases can be transmitted while donating blood continue to affect supplies?

A: Yes. Almost 25% of the population surveyed expressed the belief that they can get AIDS donating blood. I don’t know if those are people who have simply avoided the information that it’s simply not true, or they are people who just don’t want to hear it. It is safe to donate blood. There is absolutely no risk of infection of any kind.

Q: While there is no risk to those donating blood, those receiving a transfusion are susceptible to blood-borne diseases. Just how safe is the Red Cross blood supply today?

A: Thirty years ago, certainly, there was no risk of HIV. However, the greatest transfusion-associated risk has always been hepatitis, and 30 years ago the risk of getting hepatitis was significantly higher than now. Before the hepatitis-C test in 1990, the risk was 1 in 20 for hepatitis. Now it is about 1 in 3,300. That risk has been cut dramatically.

What HIV has done has created an apprehension and an awareness (of transfusion-related disease), though those dangers were already there.

Q: What are the chances of contracting HIV during a transfusion?

A: One in 1 million is about the risk now of contracting HIV from a blood transfusion. Clearly it was much higher than that in the past, especially before 1985, when the HIV test became available. Before 1985, all we could do was ask donors about behaviors that would put them at risk. And we weren’t asking them as pointed of questions as we are now.

The dangers have been significantly reduced.

Q: Has your stringent screening of donors, while protecting the blood supply, also disqualified donors who had given in the past?

A: We are now performing seven tests on each unit of blood, and each of those could come up positive. About 6% of our donors are notified that they can’t donate blood again for life. So if you make that a cumulative number--6% a year--it becomes pretty substantial. The tests are designed to give us false positives. So there have been people who have been told they cannot donate blood who actually come back negative when further tests are conducted.

Q: The American Red Cross has come under heavy criticism at times for handling blood in an allegedly unsafe manner. What are the perceived problems?

A: I can’t really speak for the Red Cross nationally or any other blood center. What we find are the criticisms come with deviations from procedure. What the Food and Drug Administration looks for when they inspect a blood center is, is the center following to the letter all the regulations? They also make sure they can track every unit of blood from the donor to the hospital. If they find any deviation, even if its clerical, they will cite us. What they are looking for is zero errors and perfection.

In this region we have had clerical citations. However, none of them have resulted in the release of contaminated blood.