Ensuring the Safety of our Community’s Blood Supply

One of the criteria for blood donation is that a prospective donor should not have had infectious hepatitis after the age of 12.  In addition it must have been a year since the prospective donor had close contact with someone who has infectious hepatitis   It is easy to get confused about who should donate and who should not because the term hepatitis is usually associated with a viral infection.

The word “hepatitis” comes from the Greek word for the liver, “hepat” plus the Greek suffix for inflammation, “-itis”.  So, hepatitis simply means inflammation of the liver.  Liver inflammation can have many causes - chemicals (drugs), autoimmune diseases, and surgical conditions to name a few.  Viruses, however, target the liver cells.  They are designed to attack the liver cells in order to make new viruses.  When there are too many viruses in the cell, it bursts releasing millions of new viruses to infect other liver cells.  This process results in the liver inflammation, hepatitis. The reason why we defer donors with infectious hepatitis or exposure to infectious hepatitis is because, unlike other causes, the viruses can be transmitted through the blood. 

Chemicals associated with hepatitis include alcohol, carbon tetrachloride, vinyl chloride, the herbicide paraquat and polychlorinated biphenyls.  Over the counter pain relievers such as aspirin, ibuprophen (Advil, Motrin), naproxen (Aleve) and acetaminophen (Tylenol) can cause liver inflammation, especially when combined with alcohol.  Prescription medications such as halothane (a general anesthetic), isoniazide (antibiotic for TB), valproic acid (Depecote), phenytoin (Dilantin) most cholesterol lowering agents and other drugs can cause hepatitis.  Some herbal medicines also can cause liver inflammation including cascara, chaparral, comfrey, kava, and ephedra.  Hereditary metabolic disorders, such as Wilson’s disease, hemochromatosis or non-alcoholic fatty liver disease, cause liver inflammation because of abnormal accumulation of material (copper, iron or fat) in the liver cells causing them to rupture.  Autoimmune disease can attack the liver cells, or ducts of the liver causing inflammation. Stones in the gallbladder can cause bile to back up into the liver causing hepatitis.  None of these causes of hepatitis are due to a viral infection, and once the donor is recovered, evaluation for blood donation should be permitted, as long as the donor is otherwise in good health.

A number of viruses have been associated with hepatitis.  Hepatitis A is usually acquired from ingesting contaminated food.  Hepatitis B is transmitted through contact with contaminated blood or body fluid, as is Hepatitis C.  Much rarer are Hepatitis viruses E, D and G (I don’t know where hepatitis F went). Usually when a person gets hepatitis A or B they develop flu-like symptoms.  Less often, the person becomes very sick needs to be hospitalized.  However, most often when the person recovers the virus is gone and no longer infectious.  Today, even hepatitis C responds pretty well to treatment and the virus becomes undetectable. So, even though a donor can be exposed to someone who had hepatitis, because the exposure was not to someone who has hepatitis it is ok to evaluate the donor for blood donation at the time they present to donate.  

Hepatitis viruses can be a little tricky.  They can cause a low level infection, “chronic hepatitis.” People with chronic hepatitis have hepatitis.  These individuals cannot donate. A prospective donor who has been exposed to a person with chronic hepatitis or active hepatitis can become infected by the virus and transmit hepatitis through the blood.  It is permissible to evaluate these donors one year after the most recent exposure to someone who has hepatitis, either acute or chronic. 

In summery:

1. Hepatitis is not always caused by a virus.

2. A person may donate without deferral if the person is in good health and had hepatitis due to a non-infectious cause.

3.A person may donate without deferral if exposed to a person who had viral hepatitis more that a year ago, but no longer has hepatitis. 

4. A person who has ever had viral hepatitis after age 12 may not donate.

5. A person who has viral chronic hepatitis still has hepatitis.

6. A donor who was exposed to a person with virus caused hepatitis or chronic hepatitis may be evaluated to donate one year after the most recent exposure.

D. Kip Kuttner, D.O. holds a BA in Molecular, Cellular and Developmental Biology from the University of Colorado, and his D.O. from the College of Osteopathic Medicine of the Pacific. Dr. Kuttner completed his internship at the Tulsa Regional Medical Center, his residency at the Harbor-UCLA Medical Center, and Fellowships at Harbor-UCLA Medical Center, Long Beach Memorial Medical Center, and the American Red Cross Blood and Tissue Services. He is certified by the National Board of Osteopathic Medical Examiners and the American Board of Pathology in Anatomic and Clinical Pathology, as well as Transfusion Medicine and Blood Banking. He has served as Miller-Keystone Blood Vice President/Medical Director since 1995. 

Relying on the Generosity of Others

As a not-for-profit 501(c)(3) organization, Miller-Keystone Blood Center relies on the generosity of community businesses, government resources, foundations and individuals to help us achieve our goals and remain true to our mission of ensuring a safe, stable and constant blood supply in the 10 counties we serve.

We face an enormous challenge of maintaining a safe and adequate community blood supply to serve the hospital patients in our region. Much of that challenge is inherent in that there is no substitute for blood; the only source is the volunteer blood donor.

Blood that is donated has a short shelf life – 5 days for platelets and 42 days for red blood cells. That is why a constant stream of blood donors is necessary to ensure an ongoing supply of lifesaving blood products is available for the hospitals in our region.

The Food and Drug Administration (FDA) mandates that all blood centers implement new laboratory technology and blood collection equipment as they become available. In addition to this mandate, we face strict Quality Assurance regulations and out-of-date equipment that must be replaced on a relatively continual basis. New equipment guarantees the safety of the blood supply and allows us to operate in the most cost-effective and productive manner possible.

We are privileged to have volunteer blood donors who roll up their sleeves to provide the community with the gift of life, and we remain grateful to all the volunteers who donate their time, talent and philanthropic support.  It is only with their ongoing assistance that we can continue to ensure a safe and productive blood center.

Sandra D. Thomas, Director of Development

Sandra D. Thomas holds a Bachelors Degree in Social Work from Cedar Crest College, and a Masters Degree in Social Work from Marywood University. Ms. Thomas also serves as a Lieutenant with the U.S. Navy. She has served as Director of Development for Miller-Keystone Blood Center since 2001.

Today’s Students are Tomorrow’s Lifesavers

I often use the word “community” in our advertisements, in the scripts that our recruiters use when calling on potential donors, and with our blood drive coordinators.  Sometimes when a word is heard regularly it can lose its value.  I wanted to take this opportunity to reinstate what “community” means to Miller-Keystone Blood Center.

The MKBC Community is made up of 10 counties and 21 hospitals.  Even more, it is made up of thousands of local hospital patients, who rely on those of us who are healthy to donate blood.  When I drive into work and hear on 99.9 The Hawk or WEEU about an accident on Rt 22 or I-78, I immediately wonder how bad the accident is and if those involved will need blood.  The Blood Center will then receive a call from St. Luke’s Hospital, St. Joseph’s Medical Center, Lehigh Valley Health Network – stating that they need a rare blood type or four times their normal order of platelets for the day to treat the accident victims.  This push for additional blood products is above and beyond the hospital’s normal orders for scheduled, elective surgeries.  In some cases we are even more connected to the accident.  In the past it has been one of our own employees driving to work… one of our neighbors…. a local high school student.

I have a vested interest in this community.  I went to high school and college here, I had both my children at St. Luke’s Hospital, and I am proud to work for an organization that has created a family of employees who help to save the lives of those living right here in our community.

As our population ages it places an increased demand on the need for blood, and this demand is already exceeding the number of active blood donors within our community. Without the support of our community’s high schools and colleges, we would not be able to meet the demands of our local hospitals, and we may not have the opportunity to create a life-long donor.  Today's high school and college students are tomorrow's lifesavers, and we must engage them now to become regular blood donors, instilling in them the foundation for a lifestyle of community giving. 

Catherine Palumbo, Director of Donor Recruitment and Marketing

Catherine Palumbo holds a Bachelors Degree in Marketing/Management from DeSales University.  She has over 15 years of sales and marketing experience, and has served as Miller-Keystone Blood Center’s Director of Donor Recruitment and Marketing since 2008.  

Larry’s Story

In 1967, I drove my motorcycle to the Auburn Dam to go waterskiing with a friend. When the boat motor failed to start, I volunteered to ride my bike to get a new spark plug. I had gone a mile or so on a narrow, rough macadam road when I came to a hill with a sharp right curve. That is the last thing I remember.

Several days later, I finally awoke in a revolving hospital bed. The doctors were trying to get circulation into my left leg, in order to save it from amputation. I also learned the doctors were considering amputating my right arm because it was missing tendons and muscle. Eventually the doctors had to amputate my left leg. Not being aware of too much through six (6) operations and a 104-degree fever, I finally awoke to some form of reality. That is when I found out that I almost died in the emergency room.

I had had an almost head-on collision with an Oldsmobile 88. Witnesses said I was thrown 45 feet into the air. When I landed, I was disemboweled and bleeding profusely from my abdomen, my left arm and right leg. My left leg was smashed.

Back in the mid-60's, there was no EMS service as we know it today. It took over an hour and a half for the volunteer ambulance to get me to the hospital, and because of the long delay, I had no pulse, only a heartbeat. I was later told that I had lost 90% of my blood, and that my surviving was nothing short of a miracle. I was told that I received more than 40 pints of life-sustaining blood.

I had often donated before my accident, but after the accident I learned first-hand how important donating blood really is. Once I regarding my health, I began donating on a regular basis, and am still doing so today. Every single day, I am grateful to those who gave their blood. In doing so, they saved my life. They are heroes.

Lawrence Alati, Shoemakersville, PA