By Matt Leingang
Enquirer staff writer

A stepped-up marketing campaign aimed at first-time donors has helped the Hoxworth Blood Center set a record for blood collection in Greater Cincinnati.

Hoxworth, which is the only supplier of blood for the region's 25 hospitals, collected 87,910 pints in fiscal year 2004, which ended June 30.

Fern Browning, RN with the Hoxworth Blood Center's downtown location, prepares Katie Hannum for a blood donation. (Gary Landers photo)

Of the 50,645 people who donated last year, 13,331 were first-timers, a 7 percent increase from 2003.

The previous collection record was 86,661 pints in 2002, a number that was skewed because of an influx of donors after the Sept. 11 terrorist attacks.

But despite the center's success, hospitals in Greater Cincinnati are using more blood than ever, offsetting the region's ability to maintain a significant stockpile.

Low reserves did not force any surgeries to be postponed or canceled last year.

But on several occasions, Hoxworth officials made emergency transfers of whole blood from one hospital to another to avoid a shortfall. The agency also was forced to purchase platelets - cells that help the blood to clot - from other cities.

Nationwide, most blood banks face similar struggles.

Blood collecting is increasingly difficult thanks to high hospital demand, safety regulations that prohibit certain people from donating and a general apathy or unawareness among the public, experts say.

About 60 percent of Americans are eligible to donate blood, but of those, only 5 percent do it each year.

"We are not good at this," said University of Pennsylvania bioethicist Arthur Caplan, a former member of the federal government's advisory committee on blood safety and availability. "Part of the problem with getting people to donate is that we tend to take the blood supply for granted."

Running low

Hoxworth officials attribute the 2004 record to a new marketing campaign that included, for the first time in many years, paid television commercials, newspaper ads and outdoor billboards.

The center also pushed for more collections in rural areas, including Brown, Highlands and Adams counties.

But hospitals are demanding more and more blood, a reflection of the growth in medical services and advancements in technology, hospital officials say.

For example, hospitals are doing more open-heart surgeries and more organ transplants. Cancer therapies are improving, as well as treatments for premature infants and techniques in trauma care.

Hoxworth must collect a minimum of 325 pints of blood every day in order to meet daily hospital demand and to keep the shelves stocked with a five- to seven-day reserve.

Hitting that mark isn't easy. Summer vacations, holiday weekends, winter storms or a flu outbreak can reduce donor turnout, pushing blood inventory to low levels throughout the year.

GIVING BLOOD

Who can donate? Donors may give as often as every eight weeks or 56 days. Requirements: • I.D.: All donors are required to have identification at the time of donation. • Age: Must be at least 17 years old. There is no upper age limit. • Weight: Men and women - minimum of 110 pounds • Eating: Donors should eat a meal within four hours before donating. • Fluids: Drink plenty of water before donating. Most in need: Type O blood Hoxworth regularly has shortages of type O blood. Because type O is the most common blood type, hospitals use it more than any other blood type. About 44 percent of the population is either O-positive or O-negative. If you don't know your blood type, there is a good chance you have O type blood. Platelet donation is needed, too. Unlike red blood cells that last for 42 days, platelets last for only five days. Platelets aid in clotting to prevent or stop bleeding, and are vital in helping a patient with leukemia or other cancers. Collection sites Hoxworth operates eight neighborhood donor centers in Greater Cincinnati. Centers are located in Anderson Township, Blue Ash, UC Medical Center, downtown Cincinnati, Fort Mitchell, Fort Thomas, Springdale and Western Hills. Call the appointment center at (513) 451-0910 or (800) 830-1091 to speak with a recruitment representative.

The inability to consistently stockpile blood is like a household that lives paycheck to paycheck - bills somehow get paid, but there's little money left over for emergencies.

Hoxworth officials worry that a mass-casualty event - a plane crash or bus wreck - could critically tax Greater Cincinnati's blood supply.

"We are a barely self-sustaining community," Hoxworth spokesman Michael Anderson said. "It takes two days for blood to be collected and tested before it can go to a hospital, so we can't just set up a camp on the day of a disaster and ask for donations. An adequate reserve has got be on hand."

Dr. Steven Rudich, director of liver transplant services at the University of Cincinnati, said he occasionally feels the pinch.

"There are times when we're told that there aren't enough blood platelets in the community," said Rudich, whose department performed 84 liver transplants last year, a record for the university. "So we have to be very careful about how much we use."

A civic duty

Katie Hannum donates blood every eight weeks. The Bridgetown resident said it is her way of giving back to the community.

"There always seems to be a need for it," Hannum, 32, said.

But not everyone is aware of the blood shortage, so they don't think to donate, experts say.

Other reasons people give: fear or a lack of time. Donating blood can take up to an hour.

But ironically, medical science, which has made the nation's blood supply safer than ever, has also contributed to the overall blood shortage by reducing the donor pool.

Here's how:

• Hoxworth and other blood banks test for HIV, hepatitis B and C and syphilis - discarding any positive hits. In addition, questions about health and sexual history can automatically disqualify donors at the door.

• Hoxworth also won't collect blood from prospective donors who have recently had headaches or a fever - possible signs of a West Nile virus infection.

• Travel history cuts off some potential donors.

Recent regulations by the U.S. Food and Drug and Administration disqualify donors if they lived in the United Kingdom for three months or more from 1980 to 1996 or spent five years or more in Europe since 1980.

The reason: "mad cow" disease. While there is no evidence that the disease is transmitted through blood, it is theoretically possible, so the FDA decided to err on the side of caution.

As a result, Hoxworth annually turns away hundreds of people with ties to Western Europe: former military personnel, European immigrants, international college students and business travelers, Anderson said.

But a lot of the blame for the nation's blood shortage falls at the feet of eligible Americans who simply don't donate, Caplan said. Yes, Americans are great at responding to crises, such as 9-11, but we otherwise tune out the call for more blood in nonemergency situations, he said.

Caplan also criticizes blood collection agencies for not doing a better job of appealing to the public.

"You can't always cry wolf," Caplan said.

Instead of making urgent appeals during dire shortages, blood banks should market the act of donating blood as a civic duty.

"Every company and civic agency ought to be talking about donating blood as part of what it means to be a good citizen," Caplan said.

---

E-mail mleingang@enquirer.com