Heat Deters Blood Donors

Doctors may make patients wait for semielective procedures that rely on blood.

February 11, 2009, 12:05 AM

June 11, 2007 — -- During a heat wave in the summer of 2004, a patient at the Arizona Heart Institute in Phoenix went to Grayson Wheatley, a cardiovascular surgeon there, in need of heart surgery.

Wheatley had already performed a similar open-heart procedure earlier that morning, but when it came time to perform the bypass surgery in the afternoon, he just couldn't do it.

The problem wasn't with Wheatley or the patient. Rather, a severe blood shortage, caused in part by a heat wave that had hit the region, meant that the hospital's blood supply was very low, Wheatley said. If there were complications, there was no way to guarantee that enough blood would be available to complete the procedure.

"You have to psych yourself up to get heart surgery, so it was an emotional letdown [for the patient] to have to wait," Wheatley said.

Once again this year a heat wave is contributing to severe blood shortages in the West, where the rising mercury has led to low donor turnout and even the cancellation of some blood drives at facilities ill equipped to handle the high temperatures.

Though doctors and blood-bank representatives said they have yet to hear of any surgeries postponed yet this summer, there are fears that the postponements, which were relatively widespread during the summer of 2004, may occur before the summer is up. If shortages are severe enough, they could threaten the treatment of emergency-care patients as well.

If they are postponed even a few days because of a blood shortage, the impact can be "fairly traumatic for the patients," according to Neil Blumberg, the director of transfusion medicine and the blood bank at the University of Rochester Medical Center. "It's not minor surgery. These are usually big operations, not immediately life-saving … where nobody likes to wait for long periods."

The Southern California Red Cross made a public appeal for blood donations Monday after the severe heat caused it to cancel four separate drives last week at sites whose cooling systems could not lower temperatures enough to ensure a safe and comfortable environment for donors. Monday, the region had only a 1.5-day supply of blood, including less than three hours of Type O-negative blood, according to Cliff Numark, the director of donor recruitment for the Red Cross in Southern California.

The Arizona Red Cross made a similar public appeal for donors today after reporting severely low blood supplies, including only three hours' worth of Type O-negative blood and six hours of Type O-positive blood. The Red Cross' optimal supply size is approximately five days' worth of blood.

Last week that branch was forced to cancel a blood drive after one of its mobile units never made it to a blood-drive site because the van could not cool down to a sufficiently low temperature to ensure adequate comfort for donors and staff.

"Our blood supply is dangerously low," said Debra Deininger, the Arizona Red Cross' communications manager. At the current levels, "a single emergency could exhaust a hospital's supply of O-negative blood," she said.

Numark said that the donor sites in California where drives were cancelled are normally able to handle the summer weather, but that the unexpectedly high temperatures this year have proved to be too much for their existing cooling systems. In light of the high number of cancellations, he said that the Red Cross is currently reassessing which of its Southern California sites can sustain the current temperatures.

"We usually don't see these types of record heats," Numark said. "I'm concerned that given that this is the beginning of the summer it may bode ill for the rest of the summer."

National blood supplies for the Red Cross — one of the nation's largest blood-collection agencies — sit at about two days' worth of blood, which is low but not critically so, according to Stephanie Millian, the Red Cross' director of communications for biomedical services.

There is no specific temperature at which blood centers must shut down a drive, but Deininger said that the Red Cross' policy is to judge situations on ad hoc basis, taking into account the comfort of both donors and staff, who wear protective clothing when they withdraw blood.

According to the most recent blood-collection and -utilization survey by the U.S. Department of Health and Human Services, a total of 135 hospitals — 8.4 percent of all hospitals — had postponed elective surgeries at least once in 2004 because of blood-inventory shortages. Nationwide that year did see a net blood surplus: Approximately 4.7 percent more blood was collected than was transfused into patients, the report said.

This year's heat wave has exacerbated an annual decline of blood supplies each summer, as office workers go on vacation and students are off from school, limiting blood banks' access to some of their largest populations of donors. Furthermore, the rising mercury often dissuades potential donors from leaving their homes to donate blood.

"The summertime is a protracted time where it isn't business as usual," said Harold Kaplan, the director of transfusion medicine at Columbia University Medical Center. "We rely heavily on volunteer donations, and as you might imagine summertime is a time when school's out, families take vacations, people travel and the routines change."

Not all blood centers are facing the shortages of the Red Cross' Arizona and Southern California regions this summer.

The Associated Regional and University Pathologists, which procures blood for the University of Utah, currently has a two-day supply of blood — relatively large for this time of year — thanks to promotional activities including the raffling of a 42-inch plasma television, an iPod and $50 gas cards.

Because of these efforts, "[summer] reserves are the highest they've ever been," group spokesman Lance Bandley said.

And after a Fourth of July drive and an event at US Airway's Center, the home of the Phoenix Suns, the United Blood Services of Arizona also has a relatively strong two-day supply of blood, according to Sue Thew, a spokeswoman for the organization.

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