In April 2013, we began performing a Human Leukocyte Antigen (HLA) antibody test on each of our current platelet donors who has ever been pregnant. That’s a change from our previous testing of platelet donors with three or more pregnancies. In addition, we modified our Medical History Questionnaire to ask female donors whether they have been pregnant since their last donation. Platelet donors who respond yes will be screened for HLA antibodies. We will also retest platelet donors after any subsequent pregnancies. These adjustments reflect our ongoing efforts to minimize occurrences of Transfusion-Related Acute Lung Injury (TRALI).

TRALI is a rare but serious complication of blood transfusions most commonly thought to be caused by a reaction to white blood cell antibodies present in the donor’s plasma. When transfused, these antibodies can sometimes cause plasma to leak into the patient’s lungs, creating fluid accumulation — a condition referred to as acute pulmonary edema.

Female donors who have been pregnant and developed antibodies as a result of exposure to fetal blood are most likely to have these antibodies in their plasma. Once the antibodies develop, they are present in the blood forever. The antibodies are perfectly healthy for an individual to have in their blood, but could be harmful if transfused into certain patients. The antibodies are present in plasma — and platelet donations actually contain a high volume of plasma, so our current efforts are directed at adjusting the eligibility requirements for platelet donors.

We will notify donors of positive results by a phone call and a follow-up letter. If you test positive for these antibodies, you will not be eligible to donate platelets in the future, but we strongly encourage you to continue giving back to our community by donating whole blood or red cells instead, which are just as important to patients in need. And, as a whole blood donor, you will continue to build donor recognition points as you help people who need you.

“Blood is a very special juice.”

Goethe didn’t know the half of it when he penned this line for Mephisto more than 200 years ago.

In those days people believed blood held mystical qualities and was a potent life force. No wonder Mephisto wants the contract for Faust’s soul signed in this “special juice.”

But what exactly does blood do?

Blood transports oxygen to all of our body’s cells, which use it as fuel. Blood sweeps away wastes. Blood conveys messages, in the form of hormones, from one organ to another. Blood hosts the immune system — carrying it where it’s needed.

There’s also blood’s dark side. It can turn against us, afflicting us with cancers of the blood cells, sickle cell anemia, hemophilia and many other diseases, and it can carry infection.

Because of blood’s many roles, a few drops can serve as a window on the state of our health, making it the go-to material for diagnostic tests.

Our view of blood has greatly altered in the last century, when transfusion was perfected. Earlier, bloodletting — draining and discarding a portion of blood — was a standard treatment. Today blood is a valuable treatment itself, with nearly 5 million people in the United States each year needing a blood transfusion.

Medical science continues to expand our understanding of what goes on in blood and how best to marshal its power.

Last year brought some significant changes for Stanford Blood Center that we can reflect back on with a sense of great accomplishment. Our hard work and collaborative efforts came along with many successes and achievements. We welcomed several new team members including three managers, two directors, one senior operations director, and one assistant medical director. In addition, we opened up a brand new donation center in Menlo Park, taking with us fond memories of our Campus center as we closed its doors.

As many of you know, Vince Yalon, SBC’s administrator for 24 years, retired last year. Vince built a legacy that made a substantial impact on the organization over the years. I am grateful that I had the privilege of working closely with him and that I have now been given the opportunity to take on the joys and challenges of my role as the new Administrator.

During the hiring process of our seven leadership positions, we were highly selective with each candidate, all of whom come from very different backgrounds and bring years of experience with them. I have 100% confidence that their skills will play a powerful role in the ongoing success of our organization.

As I mentioned above, we said farewell to our campus presence in December after 32 years as a result of the expansion and renovation of Stanford’s Medical Center. With our facilities team working diligently on the project for months ahead of time, we made a smooth transition to our brand new center in Menlo Park. We received a very warm welcome from the community and continue to meet many friendly new neighbors. Thank you to all of our existing donors who have switched over and settled into the new center. We look forward to seeing many new faces there as well!

Not many second-graders manage to clear the school with a single show-and-tell project. But 8-year-old Holbrook Kohrt had a knockout demonstration. Literally.
Kohrt, a hemophiliac, was showing his class how he had learned to give himself lifesaving injections of a blood-clotting factor that his body was unable to make naturally. Engrossed in the performance of what was for him a routine occurrence, he was startled by the reaction of others in the room.

“Halfway through, my teacher passed out, as did many of the other students,” he says. Because his rural Pennsylvania school was both remote and minimally staffed, the entire school was dismissed for the afternoon.

Kohrt, now an assistant professor of medicine at Stanford with an MD and a PhD to his name, is keenly aware of the importance of healthy blood — mostly because he doesn’t have any. He tells the show-and-tell story in a wry tone, acknowledging the inherent comedy in the scene. But it’s a rare light-hearted moment in a childhood that was, by any measure, harrowing. As a child in the early ’80s, he, like other hemophiliacs, was forced to rely on transfusions from apparently healthy donors to prevent bleeding to death from even minor injuries. But these treatments carried a significant risk of lethal infection.

“From when I was about 10 until I was about 15 or 16, I was very aware that my risk of contracting HIV and other pathogens increased with each transfusion,” recalls Kohrt. “I was also very aware, though, that without the transfusion, I would die. I watched some of my best friends become infected in this way, and saw them go through the process of dying from AIDS and the stigma the disease carried at that time. The whole experience was very shaping.”

All told, about 80 percent of people with severe hemophilia during the early 1980s were infected with HIV, according to the National Hemophilia Foundation. Many of these people died as a result. In 1998, the federal government set up a system of restitution through the Ricky Ray Hemophilia Relief Fund Act for those affected by the slow or inadequate screening of the nation’s blood supply.

Kohrt’s story is a scrapbook of how treatments for a blood disease have gone from being nearly universally fatal to treatable with routine, safe injections of a recombinant form of the clotting factor. Recent advances in gene therapy, including an ongoing clinical trial at Stanford and elsewhere, have researchers cautiously optimistic that it may one day be possible to provide a permanent cure for patients like Kohrt.

One day in 2011, an ambulance pulled up to the Stanford emergency room and paramedics unloaded a man in his 30s who had crashed his motorcycle. He was in critical condition: Tests showed dangerously low blood pressure, indicating that around 40 percent of his blood was lost. And an ultrasound revealed that the blood was collecting in his belly, suggesting that one or more of his abdominal organs was the source of the blood loss.

Paul Maggio, MD, a trauma surgeon and co-director of critical care medicine at Stanford Hospital & Clinics, sped the patient into the operating room. But he made sure that the technicians prepping his operating room took the time to set up one key piece of equipment, called an intraoperative cell salvage device, which is now commonly used in trauma cases. As the patient lay on the operating table and Maggio made the first cuts into his abdomen, suction devices slurped up the loose blood, directing it away from the surgery site through tubes. But instead of leading to a container bound for disposal, the tubes led to the salvage device.

The ATM-sized machine spun the blood to separate its components, cleaned it of any debris that had been suctioned up from the abdomen and sent it back out into fresh bags. From there, the blood was shunted right back to the patient’s body, through intravenous tubes poking into his veins. The cell salvage device has been around for decades, but only recently has evidence emerged that autotransfusion — giving patients their own blood instead of blood from donors — leads to better surgery outcomes. As a result, the use of the machines has gone from extremely rare to commonplace. Today, hospitals that have the machines use them in many scheduled abdominal and heart surgeries and routinely in trauma cases involving massive bleeding.

Continue to the full article by clicking here.

Most donors give blood only a few times a year, if that. But for Linda Johnson, it’s a routine part of life. On this fall day in 2012, Johnson reclines in a comfy chair at the Stanford Blood Center, wrapped in a soft, powder-blue blanket, while two pints of blood drain from a vein in her arm. Right next to her, a machine snatches the tiny cell fragments called platelets from her blood and returns the rest of the fluid back into her vein. She’s a very familiar face here: This is her 561st donation.

Though Johnson has been donating at the Stanford Blood Center for 25 years, her history of giving blood starts even earlier. She donated in college and — like many who give of themselves to help others — found the experience rewarding. Wanting to make a bigger impact, she got tested to see if she’d be eligible to donate platelets, a blood component crucial for clotting. Because only platelets are removed from their blood, these donors can give more than the usual pint at a time, and can do so more often. Johnson donates twice a month, whereas whole-blood donors are limited to once every eight weeks.

“I donate because I can. My fortune is good health,” says Johnson. “I know many people who are not healthy, and there is no substitute for blood.”

Johnson, the only woman to surpass 500 donations at the Stanford center, admits she’s also in the game for a little friendly competition with her fellow donors: At her current pace, she’ll hit 600 donations in June 2014.

“I get the satisfaction of knowing I helped save somebody’s life, and I’ve done that more than 500 times,” Johnson says. “It’s extremely heartwarming. Plus I get cookies — at least two.”

Each of us has about 10 pints of nature’s life-giving concoction flowing through our arteries and veins — delivering oxygen to vital organs, fighting infection and healing wounds. In spite of striking advances in our understanding of how blood works, no one has come up with a substitute that re-creates all its virtues. To date, the only replacement for lost or damaged blood comes in the form of a gift from a willing donor, which is why donors are vital.

I awoke close to midnight. It was the middle of August, in 1992, and the windows were open in the room of the Paris hostel where I was staying. The air was warm and still. My chest felt moist with — sweat? I touched the substance with an index finger and pressed it to my thumb. It felt tacky. Blood!

I put on shorts and flip-flops and walked down a flight of stairs to the men’s bathroom. There, I stood in front of a mirror and contemplated the thin, crimson paste that covered my chest. I ran a hand through it like finger paint, searching for the source. Had I scratched a mole? I was starting to feel nauseated. I opened a faucet and splashed water on my neck, shoulders and torso. I patted myself dry with a paper towel, which soon was covered in damp, pink blotches. Pale and sweating, I turned toward the door, grasped the handle and twisted it. Stepping into the hallway, I collapsed.

A specific phobia is an anxiety disorder in which the presence or anticipation of an object, animal or situation provokes intense and irrational fear. Approximately 12.5 percent of American adults will suffer from at least one such phobia at some period in their lives, according to the National Institute of Mental Health. Where I work, one of my colleagues suffers from a phobia of spiders. (She underwent therapy for the condition several years ago, which helped.) Another colleague has a phobia of riding in elevators and, whenever possible, will take the stairs. Yet another is phobic about driving over bridges.

A phobic reaction starts in the brain but instantly affects other parts of your physiology: Heart rate and blood pressure increase as the sympathetic nervous system activates the body’s fight-or-flight response. Some people may sweat, tremble and feel their muscles tense and heart palpitate.

But blood phobia and its next of kin, injury phobia and injection phobia, are different. (The Diagnostic and Statistical Manual of Mental Disorders groups these phobias together as blood-injection-injury phobia, or BII.) Observing blood seep from a wound, flow into a syringe or spatter on the ground, blood phobics initially will respond like other phobics — that is, their heart rate and blood pressure will increase. But then something else will happen: Their heart rate and blood pressure will suddenly drop, causing dizziness, sweatiness, tunnel vision, nausea, fainting or some combination of these symptoms. This is a vasovagal response. The vagus nerve, a component of the parasympathetic nervous system, meanders from the brain stem through the neck, chest and abdomen. It helps to control involuntary “rest and digest” functions, such as lowering heart rate and promoting the secretion of gastric juices. But when it overreacts — in response to hunger, dehydration, standing up quickly, standing too long, intense laughter, sudden fright, severe coughing, pain, vomiting and, of course blood, among other triggers — it causes a vasovagal response, which does not generally occur with other phobias.

Blood-injury-injection phobia is a fairly common psychiatric disorder: Studies estimate 3 to 4 percent of the population suffers from it. But why would the sight of blood, or for that matter the sight of being stuck by a hypodermic needle, trigger a physiological response that is so different — practically diametric — to that of other phobias? This is the mystery.

Ed Engleman, MD, Stanford Blood Center’s director, strode briskly into the large lecture hall at UC-San Francisco, eager to describe the screening test he and his colleagues had just developed — a test they thought could help save the nation’s blood supply from a looming threat.

It was October 1983, Engleman was 29, and a bizarre, deadly agent was percolating in the population. It had first surfaced among gay men, leading to uncommon cancers, pneumonias and other infections, some of which had rarely been seen before in humans. But the mysterious microbe would soon invade the broader population and present a massive public health threat, becoming an epidemic for all time. The source later came to be known as the human immunodeficiency virus, or HIV — the cause of AIDS.

Faced with the unknown, blood bank officials nationwide resisted Engleman’s plea to test blood donors, with the result that at least 20,000 transfusion recipients — surgery patients, hemophiliacs, new mothers and their babies — would become infected with HIV. Few, if any, would be patients who received blood at Stanford, where the screening test likely saved at least 33 people from an AIDS death.

The experience would make him a pariah in the blood banking community and reset the course of his career, which would shift to AIDS. It would also lead to a transformation of the blood banking industry. The blood supply, then vulnerable to potentially dangerous agents, would ultimately become much safer, though much more costly to maintain, as a result of the crisis, Engleman says.

Since 2009, student leaders nationwide have been participating in the National Cesar E. Chavez Blood Drive Challenge to promote civic engagement in honor of the Latino American civil rights activist. Campus-wide blood drives are organized at colleges and universities, with about 250 participating this year; an impressive number considering its recent establishment. This health service learning event as it’s called, “integrates meaningful community service with instruction and reflection. The community benefits while students learn civic responsibility, leadership, and teamwork.”

Topic of Discussion
We are living in the genome age, where the productivity of DNA sequencers is advancing faster than Moore's Law. Dr. Quake will describe one contribution of biophysics to this field - the development of the first single molecule DNA sequencer. He will then go on to discuss several applications of high throughput DNA sequencing in medicine, ranging from non-invasive diagnostics to the first clinically annotated human genome.

About Dr. Quake
Stephen (Steve) Quake, PhD, is Professor of Bioengineering and Applied Physics at Stanford University. He pioneered the development of Microfluidic Large Scale Integration (LSI), demonstrating the first integrated microfluidic devices with thousands of mechanical valves. This technology is helping to pave the way for automation of biology at the nanoliter scale, and in recent years Quake and his collaborators have used it for applications as diverse as discovering a new drug for hepatitis C, mapping the genomes of environmental microbes, and measuring gene expression in individual cancer stem cells. Commercial versions of microfluidic LSI are now used in hundreds of laboratories around the world for diverse purposes.

Quake demonstrated the first successful single molecule DNA sequencing technology, which has been commercially developed and is a leading candidate to deliver the first $1,000 genome. In 2009 he and two coworkers sequenced his genome using the commercial version of the single molecule sequencing technology that he developed, an event that was widely reported in the popular press. He has received numerous awards from the NIH, MIT, Forbes, and Popular Science among others. He is a founder and scientific advisory board chair of Fluidigm, Inc. and Helicos Biosciences, Inc. (NASDAQ: HLCS).

He is the holder of more than 80 patents, has founded at least four companies based on his conceptions, and has invented technologies that have transformed science and medicine in fields ranging from genomic sequencing and microfluidics to infectious disease and medical diagnostics.

Please take a moment to read this article, written about Dr. Quake after receiving a $500,000 research prize.

Certain patients receiving blood transfusions require specific compatibility testing beyond the ABO type and Rh factor that we commonly hear about, (A+, A-, B+, etc.). This is typically the case with those who have been transfused many times, such as sickle-cell anemia patients.

When a hospital’s transfusion services department can’t find compatible blood for a patient, they send a sample of the blood to a blood bank reference lab. These labs have many tests they use to help identify the antibodies that are causing the incompatibility.

I was always terribly afraid of needles. But in the mid-1990s when my friend Evelyn was diagnosed with leukemia and needed apheresis donors, I went with a group of coworkers to the Welch Road facility to donate and be tested as a potential donor. Though I was not able to donate for her, I realized that my fear of needles was completely unfounded, and have been donating regularly ever since.

If there’s one thing we know about hockey fans, it’s that they aren’t generally squeamish about blood. That’s a great thing for Stanford Blood Center (SBC), who hosted its seventh annual “Save a Life” blood drive with the Sharks Foundation on Saturday, March 2. One of the most well-attended drives each year, dedicated Sharks fans combined to donate 261 units of blood. Some donors were lucky enough to be thanked personally for their donations by Sharks players Tommy Wingels, Matt Irwin, and Jason Demers.

The Sharks drive always brings out a combination of repeat donors and first-timers. This year, 74 donors registered with Stanford Blood Center for the first time! One hardcore fan at this drive is a regular SBC platelet donor at our center locations, but donated at the drive for the opportunity to watch the team’s morning skate.