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Published on July 21, 2020

What happens to the blood you donate?

Blood Journey

If you’ve ever donated blood, maybe you wondered what happened to the blood that just left your arm.

If you donate through a Cape Cod Healthcare blood drive, your donation never leaves Cape Cod, but there are a few steps it goes through before it helps one or more of your neighbors. We asked Lok Tse, Supervisor of the Transfusion Medicine Services and the Blood Donor Program for Cape Cod Healthcare, to explain the process.

“The first thing is that we always let people know how grateful we are that they take the time to donate blood,” he said.

“The blood is collected into a plastic blood bag containing anticoagulant (CP2D). We hang the unit to remove the leukocytes by filtration and then we put the unit into a cooler containing ice to bring the temperature down toward 1 to 10 degrees Celsius” (33.8 to 50 degrees Fahrenheit).

Plasma and Red Blood Cells

The blood is then taken to the Blood Donor Center at Cape Cod Hospital, where it is spun in a refrigerated centrifuge for five minutes at 3900 rpm to separate the plasma from the red blood cells within 8 hours of collection. Plasma makes up about 55 percent of blood’s total volume.

“The plasma is frozen in a minus 30 degrees Celsius (minus 22 degrees Fahrenheit) freezer. Fresh frozen plasma or FFP is good for one year,” he said.

An additive solution (AS-3) is added to the red blood cells, which preserves them for 42 days when refrigerated between 1 and 6 degrees Celsius (33.8 to 42.8 degrees Fahrenheit).

“We also collect 5 tubes of blood when we draw a unit of blood from a donor. Those tubes are sent out to the Rhode Island Blood Center for donor testing,” he said. “They test for blood type, antibody screen, HIV (the virus that causes AIDS), syphilis, HTLV (human T-lymphotropic virus) , hepatitis B virus, hepatitis C virus, Babesia, Zika virus, West Nile virus, and Chagas for first-time donor. They do the testing overnight and we get the results around noon the next day.

“If any of the viral markers are positive, we discard the blood and will not use it for transfusion. We send the donor a letter to notify them that they tested positive, and that they need see his/her doctor and get follow-up medical attention.”

Platelets

There’s a different process for collecting platelets. That process can take up to two hours (compared to 10 to 15 minutes for whole-blood donation, not counting an intake process of about 20 minutes). Whole-blood collections often happen in the bloodmobile and other mobile sites away from the hospital, while platelet collections happen at the hospital blood donor center.

An apheresis machine (Trima Accel Automated Blood Collection System) draws blood from a donor, separates platelets and returns the red blood cells and plasma back to the donor.

Platelets are stored at room temperature (20 to 24 degrees Celsius or 68 to 75 degrees Fahrenheit) and must be used within five days. Testing for viral markers is the same as for whole blood donation. In addition, platelets are tested for bacterial contamination.

Storage

After the units have been labeled, they are safe for use. The platelets, red blood cells and fresh frozen plasma are stored at Cape Cod Hospital and Falmouth Hospital until they are needed by patients.

“We have OB (obstetrics) patients who may need blood after delivery. They use red blood cells, platelets and sometimes plasma,” said Tse.

“We have surgery patients who need red blood cells and platelets, sometimes plasma. We have oncology patients who may need red cells and platelets. And then we have trauma patients who need red blood cells, platelets, plasma and sometimes cryoprecipitate.

“We have a massive transfusion protocol (MTP). It's a pre-packaged order containing four units of red blood cells, four units of plasma and one unit of platelets. This is given to someone who has massive bleeding from a traumatic injury, like a car accident or a gun shot. Sometimes we don't even know the name of the patient, because blood is needed so quickly to save his/her life.”

Your Donation is Needed

Because the blood products have a short shelf life, donors are needed every week of the year.

Only three percent of people in the U.S. give blood.

“We constantly need platelet donors and whole blood donors to replenish our inventory,” Tse said.

All of the blood donated on Cape Cod stays on Cape Cod.

“We still have to purchase some blood products from Rhode Island Blood Center, mainly platelets, cryoprecipitate and red blood cells. Our goal is to increase collections, so that we're self-sufficient.”

COVID-19 Safety

The coronavirus, known as COVID-19, does not pose any known risk to blood donors during the donation process or when attending blood drives. Blood centers are regulated by the FDA and must follow specific guidelines to ensure donor safety at all times.

Blood donors are needed every day to help our patients in need. If you have never donated before or have not done so within the last 56 days, please consider donating.

For more information or to schedule a donation, visit the Nicholas G. Xiarhos Blood Donor Center website. Appointments are required.