‘Life or death’: The impact of blood donations across UK HealthCare

Video produced by Hillary Smith with UK Public Relations and Strategic Communications. To view captions for this video, push play and click on the CC icon in the bottom right-hand corner of the screen. If using a mobile device, click on the “thought bubble” in the same area.

LEXINGTON, Ky. (Sept. 11, 2024) — One in four people will need a blood transfusion in their lifetime. Christine Murphy knows that firsthand.  

The 17-year UK HealthCare nurse spent more than a decade working on the trauma surgical unit. She’s seen the lives of several patients depend on the transfusion of massive amounts of blood.  

“It really is life or death,” Murphy said. “I can’t imagine somebody not having the blood they need.” 

Unlike many other key ingredients for modern medicine, blood can’t be manufactured. The sometimes-scarce supply of blood that helps keep thousands of Kentucky patients alive is dependent on the kindness and trust of willing donors.    

Murphy, whose Type O negative blood makes her a universal donor, has donated blood 30 times so far. Trauma patients aren’t the only ones who need blood. Everyone from pregnant mothers to cancer patients receives blood transfusions.  

“I see blood transfusions in a different light,” said Murphy, who now cares for patients in the UK Markey Cancer Center. “Cancer patients need infusions as well, so I try to stay on top of it whenever a blood drive is offered.”  

UK HealthCare uses 40% of the blood supply maintained by the Kentucky Blood Center, which serves more than 90 counties. The KBC has eight donor centers in six different cities that collect blood six days a week alongside the thousands of mobile blood drives that occur in communities around the state.  

Unlike Murphy, most blood donors don’t get to directly see how their donation saves lives. But getting a peek behind the curtain could help others understand how much a small donation of their time and blood can make a difference, she says. 

The thought of a needle or the sight of blood can make some people nervous, says Eric Lindsey, the director of media and branding at the KBC. Those fears are real, and some folks simply can’t donate. If you’re feeling squeamish but still want to donate, trust that you’re in safe hands.  

“We work every day with people just like you,” Lindsey said. “This is what our staff does. They are trained to make you feel comfortable, safe and if you have questions, ask them. Once you get that text that your blood has been used, many people realize their minor inconvenience had a major impact.” 

The work of a blood donor ends once the bag is full and complementary snacks are in hand, but for the KBC’s hardworking couriers and blood bankers, the journey has just begun.  

That bag of blood, whether it’s coming from a mobile blood drive or one of the KBC’s eight donor centers, goes through rigorous laboratory testing to ensure its safety. Meanwhile, the blood is separated into several different products like plasma, platelets and red blood cells. 

The blood components are stored at different temperatures — not unlike groceries you may find in your freezer, refrigerator or pantry — where the Commonwealth’s finite supply of donated blood is made obvious.  

Once donated blood is deemed safe by lab testing, it’s made ready for distribution to the more than 70 hospitals the KBC serves. Lindsey says hospitals constantly coordinate with the KBC to let them know what their current blood needs are.  

“It’s a 24/7 operation,” Lindsey said. “People need blood at all times. It doesn’t matter if there’s two feet of snow on the ground or there’s a nasty thunderstorm. We’re always working with folks to make sure that the blood is being used.” 

Couriers with coolers and refrigerated boxes regularly deliver blood to medical facilities like UK HealthCare. Though blood needs fluctuate, longtime KBC courier Scott Arnold estimates that they make eight to 10 restocking runs to UK every day.  

“Prior to working here, I had no idea what all was involved in the process. It’s pretty amazing,” he said. “We’re kind of behind the scenes, but we’re someone saving a life on occasion.” 

The heart of the hospital — the UK HealthCare Blood Bank 

When a courier arrives, the blood products are quickly ferried up into the Blood Bank inside UK Chandler Hospital, where highly trained medical laboratory scientists perform another set of checks to ensure that the donated blood is safe for patients. The new blood is loaded into a large, organized refrigerator, but it doesn’t stay there for long. From newborns to the elderly, expectant mothers to children with cancer, car accident victims to transplant recipients, there’s no shortage of patients at UK HealthCare who need blood products to survive and thrive. 

“A blood transfusion is actually one of the most — if not the most — common procedures performed at the hospital,” said Aaron Shmookler, M.D., medical director of UK HealthCare’s Blood Bank. “Any or all of these people may need blood; the list is endless. But we’re here to make sure that anyone who needs that transfusion can get it as part of their care.” 

Shmookler likens the Blood Bank to a regular bank — it receives regular deposits, it safely stores the product and it issues the product as health care providers make requests. It even uses a pneumatic tube system, just like a bank, to take in specimens and send out requested blood. But importantly, no blood products go to waste. If UK happens to have an excess of any product and another hospital needs it, a KBC courier quickly gets that blood where the demand is. 

“I always want to make sure we’re giving the right blood to the right patients at the right time, which is the bedrock principle of patient blood management,” Shmookler said.  

Donated blood can be transfused whole as a complete blood replacement, or it can be broken down into three components and transfused separately to address specific concerns.  

Red blood cells are responsible for carrying oxygen throughout the body and are often used for patients with sickle cell disease or trauma patients who have experienced great blood loss. Anemia, a common blood disorder where a person does not have enough functioning red blood cells, can occur on its own or as a result of another disease or treatment (such as chemotherapy or radiation).  

Another component of blood, plasma, helps with overall blood volume and carries water, nutrients and other blood components throughout the body as well as ridding the body of waste products. Plasma also helps with clotting, and is often used for patients in shock, with burns or with severe liver disease, among other conditions. 

Platelets, the smallest component of blood, have one primary function: to prevent and stop bleeding. In addition to traumas, they are frequently used for those undergoing cancer treatments, solid organ transplants, surgeries and more. This component of blood also has the shortest shelf life, making the need for this particular product even greater. 

“Just like a carton of milk that has an expiration date, our blood components have expiration dates,” Shmookler said. “Platelets have an expiration date that’s only five to seven days. We’re constantly short on platelets. We need as many platelet donors as we can get, regardless of type, because we can definitely help anyone who needs it.” 

The most commonly transfused blood type, as one might expect, is Type O. Anyone can safely receive Type O negative blood, making it the most commonly used blood in emergencies when a patient needs blood right away, but their blood type is unknown. Additionally, Shmookler points to the plasma of AB blood type donors, which happens to be the most rare, but also the most compatible plasma for all patients.  

However, he also wants everyone to understand that all blood types are critical. While anyone can receive Type O, the best option is always to give patients their own blood type. 

“We can run into a situation where we can lose a lot of our Type O blood, so we want to try to reserve Type O for those who have Type O blood,” he said.  

When blood is needed in the hospital, the Blood Bank gets a notification, and the medical laboratory scientists begin preparing and checking the blood one more time before it’s sent off. Blood then makes its way to patients across UK HealthCare via in-house couriers carrying coolers and through the tube system. 

Shmookler himself is a “rare blood donor,” a term for a donor who has missing antigens in their blood. It’s something that occurs in less than 1 out of every 1,000 people and means that type of blood can be difficult to stock. After his first experience donating blood as a teenager, he was struck by the realization of what that simple act was doing for someone else.  

“I just felt this rush of, ‘Oh my gosh, I’m giving blood, and it’s actually going to somebody, and it could save not one, but potentially three lives,’” he said. “How cool is that?” 

Preparing for the unexpected — the UK HealthCare Trauma team 

UK HealthCare has the only Level 1 Trauma Center in the region, meaning the most severely injured patients in Central and Eastern Kentucky are usually sent to UK, explains Zach Warriner, M.D., a trauma surgeon and UK HealthCare associate trauma medical director.  

“About every other day, someone comes into this emergency department who’s badly injured and needs blood immediately to correct whatever problem they have,” Warriner said. “If we don’t have blood available, then those patients are unlikely to survive. Our outcomes here are quite good because of the donations that people in the community make.” 

The average severely injured patient might need 10 units of blood — which equals the amount of 10 different donors, says Andrew Coleman Bernard, M.D., the trauma medical director at UK HealthCare. 

“Just in the last year, we had one woman receive 105 units, and she survived,” Bernard said. “She wouldn’t have survived if it wasn’t for those 105 people who made that donation.”   

Given the nature of their work, UK HealthCare’s close relationship with Kentucky Blood Center cannot be overstated, Warriner says.  

“I cannot do the job here that I do without donations from the community. We get a lot of credit as a trauma program, but it takes the whole community coming together to provide blood to save lives,” he said. “When people ask me, ‘What can I do to help? How do we support the trauma program?’ The blood resource is a tangible way to do that, and you can rest assured knowing that your donation is going to impact patients right here every day.” 

Providing strength for cancer patients — the UK Markey Cancer Center 

Although it’s easy to understand trauma patients needing blood, they’re not the only ones. Cancer patients going through chemotherapy, bone marrow transplants and other common treatments may suffer from low red blood cell counts and need blood before continuing their potentially lifesaving treatment. Additionally, some types of cancer — such as colon or stomach cancer — can cause internal bleeding in patients, requiring transfusions. According to America’s Blood Centers, a quarter of the nation’s blood supply goes to cancer patients. 

Kentucky has the highest rates of cancer incidence in the country, and the UK Markey Cancer Center cares for thousands of Kentuckians with cancer every year. In the past decade, Markey’s outpatient visits have increased by 57%. 

Last year, oncology patients at the UK Markey Cancer Center received over 4,000 blood products. That demand continues to go up as the center continues to treat more patients, said Amanda Martin, D.N.P., nursing operations director for inpatient oncology, medicine and acute pain service. 

“We see patients from every county in Kentucky and some from surrounding states,” Martin said. “So, there is a high possibility that if you’re donating blood, it could be going to someone in your community that is getting cancer treatment.” 

From the lab to the Labor Hall — UK HealthCare Obstetrics & Gynecology 

Though pregnancy and childbirth are common occurrences — more than 3.5 million babies are born every year in the U.S. — there are some inherent health risks for pregnant women. In the U.S., maternal mortality is the No. 1 preventable cause of death. Donor blood can help prevent issues or save the lives of both a new mother and her baby.  

Blood transfusions are occasionally used before childbirth to help boost red blood cell counts, which can help the baby get proper oxygenation and prevent complications during delivery. However, blood is much more frequently used after childbirth, when mothers can be at risk for postpartum hemorrhage.  

When complications arise, “a woman can lose up to half a liter of blood per minute during a C-section or childbirth,” Flowers said. And many women who experience uterine atony — when the uterus fails to contract and compress blood vessels during delivery — showed no risk factors for such a complication prior to labor.  

“Someone’s life could be on the line tomorrow when they’re going in to give birth,” Flowers said. “But mother or baby — or both — could be saved and have a long, productive, joyful life because of the donation of one particular individual.” 

Aiding life-saving surgery — UK Transplant Center 

Essentially any patient who undergoes a major surgical procedure — from knee replacements to open heart surgery and more — is likely to need blood to make up for blood loss during the surgery. As the major academic health system for Kentucky, UK HealthCare performs many complex surgical procedures that other hospitals do not — such as solid organ transplants. 

Blood transfusions are also sometimes used proactively — nearly half of transplant patients will need a blood transfusion as part of their care, said Matthias Loebe, M.D., the lung transplant program’s surgical director. Those transfusions can help support a patient through intensive procedures that may start on short notice.  

“You have to remember that many of these patients have a long history of disease, have had previous surgeries, or may be on blood thinners for heart disease,” Loebe said. “They might be called in for a transplant that happens in the middle of the night, and blood transfusions help us ensure the best outcomes for our patients when it’s time for surgery.” 

Helping the youngest Kentuckians — Kentucky Children’s Hospital 

Like adults, pediatric patients ranging from small babies with complex congenital heart disease to children with cancer need blood transfusions, said Scottie Day, M.D., physician-in-chief for Kentucky Children’s Hospital.  

Some children may need transfusions of platelets to help them heal after an intense procedure, while a child with leukemia at the DanceBlue Clinic may need red blood cells to continue their treatment, Day said. Kentucky Children’s Hospital is also home to the only Level IV NICU in the region, treating the most complicated cases in the youngest of the young. 

For some of the most complex cardiac cases, like a patient born with a single ventricle, getting a blood product is “the difference between life and death,” Day said.  

“Sometimes blood is something we take for granted, but there are times when we have to wait because there are shortages of certain blood types,” Day said. “As a physician, as a caregiver, it truly is lifesaving. There’s just a drastic difference when it’s not available.”  

UK HealthCare cares for about 100 children and young adults with sickle cell disease — a blood disease that can cause patients chronic pain and damage to their internal organs.  

Many sickle cell patients have a life expectancy roughly 20 years shorter than the general population, said Vlad Radulescu, M.D., the medical director for pediatric hematology and oncology. Most patients with this disease will need several transfusions during their lifetime. Those who face more severe complications may require at least five units of blood every month to keep them alive.  

“By donating blood, you save the life of a child, you prevent debilitating complications and you allow a family to realize their dreams. And for that, I thank you from the bottom of my heart,” Radulescu said. “Medicine is a team sport. We really rely on many people to participate in the care of our patients, and by donating blood you are a member of this team.” 

Putting a face to your donation 

The kindness of Kentucky blood donors keeps Noah West’s smile wide and spirits high. The 7-year-old has beta thalassaemia major, a rare blood disorder that essentially makes his own blood unusable and requires Noah to receive blood transfusions every few weeks at Kentucky Children’s Hospital’s DanceBlue Clinic.  

Noah has received 102 transfusions over his lifetime, said his dad, Samuel. 

“There’s 102 people out there that have donated blood to help save his life,” Samuel said. “If he didn’t have the blood, he would not be here with us. We want to thank everybody for the donations, but also try to encourage others to donate.” 

The hope is that one day, Noah will be able to get gene therapy that could possibly cure the disorder, but until then he’s dependent on the generosity of Kentucky blood donors. To pay it forward, Samuel tries to donate blood every chance he gets, even if it does make him queasy. To remember the impact his donation is making, he tries to put a face to his donation.  

“If I can look at him, and he goes through 102 of these transfusions and doesn’t have a problem with it,” Samuel said, Noah playing with Legos next to him, “then it gives me courage and strength to do try to do better, try to do more.”