Patients with sickle cell disease need frequent blood transfusions. Medical Laboratory Scientists ensure their safety.
The COVID-19 pandemic has impacted every aspect of society. People dealing with serious health issues have felt its impact far more. However, the American Red Cross declared a blood crisis in early 2022, noting that blood donations had declined 10 percent since March 2020—and that’s especially worrisome for those dealing with sickle cell disease (SCD).
Sickle cell disease affects the red blood cells and is more common among African American and Latino people. Blood transfusions are extremely important in helping individuals with sickle cell disease manage their illness.
“During the pandemic, nationally we saw a 50-percent reduction from African American donors,” notes Kimberly W. Sanford, MD, MASCP, MT(ASCP), immediate past president of The American Society for Clinical Pathology (ASCP) and medical director of transfusion medicine at Virginia Commonwealth University Health. “This depleted our blood supply for our patients with sickle cell anemia.”
The blood shortage has also brought to the forefront the crucial work performed by healthcare professionals who are involved in sickle cell disease: Medical Laboratory Scientists, who are also referred to by the acronym MLS.
“SCD patients are transfused frequently; finding compatible blood can be difficult, and alloimmunization from transfusions are highly probable,” explains Tiffany Channer, MPH, MLS(ASCP)CM, a laboratory leader and ASCP Board Member in the New York City area. (Alloimmunization refers to an immune response to foreign substances from another human, most commonly occurring after pregnancy or blood transfusions.) Laboratories have seen firsthand the dire consequences the blood shortage has had on SCD patients.
Challenges of blood transfusion
The blood needs for SCD patients are complex. Generally, patients with sickle cell disease receive transfusions of red blood cells. In individuals with SCD, their red blood cells expire after 10 to 20 days, rather than the 90 to 100 days the red blood cells would ordinarily last. While donating blood is relatively painless, the process of receiving blood is more complex. Three primary types of transfusion for SCD patients include a simple transfusion, in which donated blood is added to the patient’s system; a partial exchange where small amounts of the patient’s blood are removed while donated blood is added, so that a patient never misses more than a few ounces of blood at a time; and erythrocytapheresis, where blood from an SCD patient is removed and run through an apheresis machine which removes and discards the red blood cells. The patient’s plasma, platelets, and white blood cells are then mixed with the donated blood. An anticoagulant is added to the mix, which is then put back into the patient’s body. There is always a risk of adverse reactions following a transfusion.1
“In general, we find that patients are able to receive donated blood from any race or ethnic groups,” Dr. Sanford says. “However, owing to the presence of some unique red cell antigens that people of African heritage share, it is preferable for patients fighting sickle cell disease to receive donations from individuals who are Black; they are likely to produce better health outcomes.”
The challenge, says Channer, is that “less than four percent of the blood donor population is African American. This unfortunate circumstance creates a strain on the system and thereby impacts individuals with SCD.”
Channer notes that blood supply typically fluctuates as people go on vacation or during holidays. However, during the pandemic, the blood supply has remained at a low ebb. These blood shortages are worse for SCD patients because finding compatible blood can be very challenging. SCD patients can develop multiple antibodies due to being transfused repeatedly. “Once an antibody has been formed, that individual can never receive blood with that corresponding antigen,” explains Channer. “Therefore, antigen-negative blood should always be given. Our blood supply is very low, and it should be everyone’s civic duty to take this call to action,” she says. “So please—please!—donate.”
Medical Detectives
Medical laboratory scientists play a critical role with SCD patients. They are part of the team of laboratory professionals who safeguard each unit of blood for all patients, ensuring all blood transfused is safe and compatible or approved for transfusion by the medical director prior to issuing blood.
Medical laboratory professionals definitely don’t get the attention they deserve—both in terms of helping people dealing with blood disorders like SCD and in terms of the career and life it affords. “Medical laboratory scientists complete all laboratory testing, which provides vital information for diagnosis and treatment,” Channer says. Medical laboratory scientists are essential to hospital systems and healthcare organizations, from community hospitals to the Centers for Disease Control and Prevention or the National Institutes of Health.
Channer is proud to be a medical laboratory scientist and a problem solver in the healthcare profession. “Laboratory professionals save lives every day by carrying out their passion for science and enforce quality measures to ensure the public’s health is protected,” she says.
Even if they are under-recognized, medical laboratory scientists can take enormous pride in knowing that they are having a positive impact on patients with sickle cell disease and so many other illnesses.
“I definitely know that I’m saving lives every single day,” notes Channer. “We’re all on a team, and it’s a well-oiled machine. Every single specimen—we know and regard each person.”
Interested in learning more about careers in the medical laboratory? Check out the American Society for Clinical Pathology’s What’s My Next program! Click here.
References:
- Dresden, Danielle, What to know about blood transfusions and sickle cell disease,” Medical News Today, June 17, 2020. https://www.medicalnewstoday.com/articles/blood-transfusions-sickle-cell-disease Accessed May 25, 2022.