March 16, 2020   Urgent Notice - Blood Utilization

Dear Faculty and Staff,

Please see below for a notification from the Director of Transfusion Medicine and the attached letter from the American Red Cross.

More updates later on other issues,

David Roth
Chair, Pathology and Laboratory Medicine

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The American Red Cross has just notified its transfusion service partners throughout the country on the adverse effects the COVID-19 pandemic is having on its ability to maintain normal blood supplies - in large part due to the massive cancellations of blood drives.  The ARC’s notification (see below) provides some detail to those of us who run blood banks and transfusion services as to how it will be modifying some of its operational procedures for how we procure blood components from the ARC.  Independent of these actions, however, there are things we can do as clinicians within our hospitals to deal with this precarious situation.  Many of the ARC’s suggestions are things we already employ to conserve blood – and to some extent, our recent efforts to cancel elective surgeries will help ease the situation, though elective surgeries do not comprise the bulk of our blood orders.

In response to likely blood shortages, please be very prudent when ordering red cell and platelets.  Our blood bank medical, housestaff, and technical staff will be reviewing many of the blood orders prospectively, e.g. orders for 2 or more units of red cells in stable/non-emergent patients and contacting you to considered transfusing 1 unit first and then waiting to reassess the need for additional unit(s).  In non-bleeding oncology patients in particular, we will work with you to limit the transfusion of multiple units of apheresis platelets when a single unit may be sufficient for the time being.

Please encourage those of us who have to be out and about and feeling well to consider donating blood now.  As detailed in the March 3rd American Association of Blood Banks statement on COVID-19 and blood safety (http://www.aabb.org/advocacy/regulatorygovernment/Pages/Coronavirus-and-Blood-Donation-Talking-Points.aspx ), there is no evidence that COVID-19 is a transfusion-transmitted infectious disease.  There have been no reported or suspected cases of COVID-19 transmission through transfusion, and past experience with other coronaviruses (SARS and MERS-CoV) has never shown any cases of transmission by transfusion.

Don L. Siegel, PhD, MD
Medical Director, Blood Bank, HUP
Professor of Pathology & Laboratory Medicine
Director, Division of Transfusion Medicine & Therapeutic Pathology