What is blood tested for?
Every pint of blood collected by the Florida's Blood Centers undergoes 18 hours of processing, testing and labeling. During this testing, every pint goes through 10 screening tests before being transfused. Blood drawn is usually transfused within 36 hours of collection. After blood is drawn, it is tested for ABO group (blood type) and Rh type (positive or negative), as well as for any unexpected red blood cell antibodies that may cause problems for the recipient. Screening tests performed are listed below:

• Blood group and Rh type
• Blood group antibody screening
• Serological test for syphilis
• Hepatitis B surface antigen
• Hepatitis B core antibody
• HIV 1/2 antibody (AIDS)
• HIV-1 antigen
• Hepatitis C virus antibody
• ALT - alanine amino transferase (liver function test)
• HTLV-1/2 antibody test for leukemia virus
• Total serum cholesterol
• NAT - nucleic acid amplification test (NAT)
  

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What is autologous donation?
Blood donated by an individual for his or her exclusive use is referred to as an autologous or self-donation. The primary advantage of autologous donations is simple: your own blood is an exact blood match with no crossmatching issues.

Florida's Blood Centers provides both short-term and long-term blood storage. Short-term donated blood is kept refrigerated (maximum of 42 days) while long-term blood is frozen (up to 10 years).

Individuals preparing for elective surgery are primary candidates for autologous donations. In this case, the individual's physician must sign a request for the autologous donation procedure, which may allow the person to donate as frequently as every two weeks. The donated blood will then be stored in liquid form and be delivered to the hospital for use during the patient's surgery.

Long-term frozen storage enables a donor to build up a reserve of their blood over time. Because of the length of time to thaw and process frozen blood, it is not suitable for emergency situations.

Frozen blood storage requires special care and monthly storage charges, which can be costly for donors. People with reoccurring ailments such as bleeding ulcers are good candidates for long term frozen storage.

Recent data indicate that autologous blood accounts for 4.6 percent of all donated blood. Almost half of all autologous donations are not used by the donor, and many of these units are discarded because this autologous blood may not be suitable for transfusion to another patient.

A written order from the patient's physician is required prior to autologous blood collection.

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What is a directed donation?
Donating for someone specific is termed a directed donation. Directed donations occur when a family member or close friend with compatible blood is asked to donate for someone having elective or scheduled surgery. The same screening and tests are required as a regular donation. If the blood is not used by the person it was designated for, it CAN be returned to the regular inventory.

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How is blood used?

• Accident Victims Anywhere from four to more than 100 units, depending on the injury. People who have been in a car accident or suffered mass blood loss need an average of 50 pints of blood.
• Cancer Patients Need blood and blood products on an ongoing basis while they undergo chemotherapy and/or radiation. Ten donors are needed for one pool of platelets, the most common blood product used in cancer treatment. Each patient can need one to two pools of platelets per week.
• Open Heart Surgery Uses an average of six pints of red blood cells and six units of platelets.
• Neurosurgery (spinal/brain surgery) Uses two to four units of red cells.
• Premature Babies One donation can transfuse a premature baby, who often use blood once a day until they are strong enough to go home, for weeks.
• Burn Victims Severe cases can need 20 units of platelets during treatment
• Bone Marrow Transplant Average transplant requires 120 units of platelets and about 20 units of red blood cells.
• Sickle-Cell Anemia Some patients with complications from this disease receive blood transfusions every month.
• Liver Transplants Average patient needs 40 pints of red blood cells, 30 pints of platelets, 20 bags of cryoprecipitate and 25 pints of plasma.
  

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Type A
Type A is the second most common blood type; so many trauma patients will need your blood. Your blood is most valuable when donating platelets that are given to cancer patients undergoing chemotherapy. You can help a cancer victim! Platelet donors can give every two weeks.

Type B
Type B is a somewhat rare and often needed blood type. Your blood is used to treat trauma patients and children with sickle cell anemia. Give a child a second chance! Donate every eight weeks.

Type AB
Type AB is the universal plasma donor. Your blood is most valuable when giving plasma because it can be given to patients with any blood type. Your plasma is most commonly used for burn patients, patients requiring massive transfusions and patients with bleeding disorders. Provide someone a lifeline! Plasma donors should donate every four weeks.

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What is anemia?
Anemias are conditions in which the number of red blood cells or amount of hemoglobin (the protein that carries oxygen) in them is below normal. If you have anemia, you cannot donate blood.
Red blood cells contain hemoglobin, which enables them to carry oxygen from the lungs and deliver it to all parts of the body. Because anemia reduces the number of red blood cells or the amount of hemoglobin in them, the blood can't carry an adequate supply of oxygen. Symptoms, caused by the inadequate oxygen supply, are varied. For example, anemia can cause fatigue, weakness, inability to exercise, and light-headedness.

Simple blood tests can identify anemia. The percentage of red blood cells in the total volume of blood (hematocrit) and the amount of hemoglobin in a blood sample can be determined. These tests are part of the complete blood cell count (CBC). (see box, page 736)

Many nutrients are needed for red blood cell production. The most critical are iron, vitamin B12, and folic acid, but the body also needs trace quantities of vitamin C, riboflavin, and copper, as well as a proper balance of hormones, especially erythropoietin (a hormone that stimulates red blood cell production).

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What foods will help correct my anemia?
Anemia is often a temporary condition that can be corrected with diet. Through a change in diet, many of the aforementioned nutrients can be replaced.
The best sources for iron: Iron fortified cereals and liver (chicken, beef or pork).
Good sources of Iron: Lean meat, greens (turnips, mustard, collard, spinach), liverwurst, oysters, clams, prunes (prune juice), raisins, dried apricots, dried peaches, dried beans and green lima beans.
Fair sources of Iron: Eggs, enriched cereals, enriched bread, blackberries, strawberries, watermelon, black-eyed peas and green peas.
Vitamin C is needed by your body to help you use the iron you eat. The best sources for Vitamin C: 0ranges (orange juice), grapefruits (grapefruit juice), tomatoes (tomato juice), greens, broccoli, watermelon, raw cabbage, cantaloupe and strawberries.

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What is Sickle Cell Anemia?
Sickle cell disease is an inherited condition that is most common among people whose ancestors come from Africa, the Middle East, the Mediterranean basin, and India. In the U.S., it affects primarily African Americans, about 0.3% of whom have some form of sickle cell disease, and approximately 10% of whom carry the sickle cell trait. There are approximately 80,000 individuals in the United States with sickle cell disease.

The red blood cells of people with sickle cell disease contain an abnormal type of hemoglobin, the oxygen-carrying pigment, called hemoglobin S. The deficiency of oxygen in the blood causes hemoglobin S to crystallize, distorting the red blood cells into a sickle shape, making them fragile and easily destroyed, leading to anemia.

The "sickled" blood cells then are unable to squeeze through the smaller blood vessels (arterioles and capillaries). When the tissues are deprived of an adequate blood supply, painful symptoms occur. Complications can include stroke, bone pain, kidney damage and breathing problems. The recurrent pain caused by the disease can interfere with many aspects of the patients' lives including education, employment, and psychosocial development.

Normal Hemoglobin & Sickle Hemoglobin:
While sickle hemoglobin and normal hemoglobin carry the same amount of oxygen, two major differences exist between the two kinds of cells. First, they differ in the way they flow through the blood vessels. Normal hemoglobin is found in disc-shaped red blood cells that are soft (like a bag of jelly), which enables them to easily flow through small blood vessels. Diseased red blood cells which are sickle-shaped and are hard (like pieces of wood), often get stuck in small blood vessels and stop the flow of blood.

The second difference between the two types of cells is their longevity. Sickle cells do not live as long as normal cells. Normal, healthy cells can survive for about 120 days, while the more fragile sickle cells can survive for about 60 days or less. Unfortunately, the body cannot make new red blood cells as fast as it loses sickle blood cells. As a result, a sickle cell patient has fewer red blood cells and less hemoglobin than normal red blood cells. This decreased hemoglobin (called anemia), in turn, results in less oxygen being available for use by the cells of the body.

How Do You Get Sickle Cell Disease?
The only way you can get sickle cell disease is by genetic inheritance. You cannot get sickle cell disease by contact or by blood transfusions.

There are many forms of sickle cell disease. These occur whenever the gene for abnormal hemoglobin S combines with any other gene for abnormal hemoglobin, (e.g., C, O, E, Beta-Thalassemia, etc.). The resulting types of sickle cell disease in the above examples would be SC, SO SE, and S Beta-Thalassemia, respectively. However, when one hemoglobin S gene combines with a second hemoglobin S gene, the result is a particular type of sickle cell disease known as sickle cell anemia, or SS disease. This is probably the most well known form of sickle cell. Even though we often see the term sickle cell anemia used to refer to all types of sickle cell disease, technically, SS disease is the only form of sickle cell disease that is correctly referred to as sickle cell anemia. The umbrella term, "sickle cell disease" does, however, refer to any of the above conditions.

As sickle cell is a genetic disorder, in order to have sickle cell disease, you must inherit a hemoglobin S gene. Inheriting the hemoglobin S gene from only one parent and a normal hemoglobin gene from the other parent means you only have the trait, and not the disease. Anyone who has the trait has the potential for passing it on to his or her child.

Sickle Cell Disease & Sickle Cell Trait
People who have inherited a hemoglobin S gene from one parent and a second abnormal hemoglobin gene from the other parent manifest symptoms of sickle cell disease by having sickled cells in the bloodstream. People with sickle cell trait usually do not manifest any of the problems associated with sickle cell disease. However, there have been cases that show people with sickle cell trait can exhibit sickle cells under extreme conditions of physical stress or low atmospheric oxygen.

More of What Happens When You Have Sickle Cell Disease
Clogged blood capillaries can lead to different types of problems, depending upon where the blockage occurs. The outcome of this blockage may lead to problems such as kidney infections; intense pain in the chest, arms and legs; death and decay of tissues, especially in the joints; disease of the retina of the eye; slow healing sores or ulcers; gallstones; and cerebral vascular accidents, or "strokes." The health problem known as anemia may result because the sickle cell does not last as long as the normal red blood cell. Normal red blood cells last 120 days; sickle cells last, at the most, 60 days. This shorter lifespan means fewer circulating red blood cells and, therefore, a smaller amount of hemoglobin at any given time compared to normal. Low hemoglobin (anemia) is manifested as fatigue and weakness.

Is There A Cure?
Presently, there is no cure for sickle cell disease. However, there is treatment for the pain and other aspects of the disease. Pain medication, antibiotics, rest, good nutrition, supplementation with folic acid and high fluid intake are all helpful treatments for aspects of sickle cell disease. At times, invasive procedures such as blood transfusions and surgery may be needed. Recently, treatment with hydroxyurea has been shown to increase the production of fetal hemoglobin, which does not sickle like normal sickle cells. Other experimental drugs are currently being used in clinical trials with promising results. Bone marrow transplantation has proven to be a cure in a very limited number of cases, yet only a few people are eligible for this extremely risky procedure (which, if successful, requires a lifetime of post-surgical maintenance with anti-rejection drugs). Many people are also exploring alternative types of treatments such as bio-feedback, acupuncture, herbal medicine, and meditation.

How Do You Know If You Have Sickle Cell Trait?
The easiest way to find out if you have the trait is to be tested by a simple blood test. This test is available in several hospitals, clinics, and in some university health centers. If you and your partner test positive for hemoglobin S or another abnormal form of hemoglobin, and you wish to become pregnant, it is imperative that you have genetic counseling to determine your risks for having a child with sickle cell disease.

Tips For People In High Risk Groups
For those population groups known to be susceptible to sickle cell disease, it is recommended that they read or strive to know more about the disease manifestation. Genetic counseling and screening for preventive measures is highly recommended. Also, information on genetic transmission of the disease is highly advisable before making reproductive decisions. For those who have been identified as having sickle cell disease, they should be aware of situations that can lead to crisis. These situations include bacterial infections, stressful environments at home and in the workplace, dehydration, sudden temperature variations, and overexertion.

Adapted from material produced by the NIH, 1996

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ALYX
Realize the potential...touch more lives! ?The ALYX Component Collection System can help make your donation go even further. With ALYX, we can specifically collect red blood cells, which are the most frequently used for transfusion, while leaving your platelets and plasma behind. By collecting only red blood cells, donors can give more of the component in greatest demand.

Donating on the ALYX System takes 10-15 minutes longer than a whole blood donation. However, you can donate just as many red cells in half as many visits!

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