In the latest installment of "How New York City Works," NY1's Roger Clark takes a look at the blood donation process and how a donor's generosity saves lives every day.
Danny Ramdular is a busy 23-year-old. He's a student at Baruch College and has an on-campus job as an internship coordinator. He is also a paid intern himself at MTV.
But at 7 a.m. on a Thursday, Danny is not on his way to work or school. Twice monthly, he has an appointment to get the blood transfusion that keeps him alive. He has needed transfusions since he was eight months old, when doctors discovered he has a rare blood disorder called Thalassemia.
The process that allows him and so many others to get the blood they need for transfusions, surgeries and sudden emergencies is one that depends not only on medical science, but on the kindness and generosity of others.
Let's find out how it works.
It all starts with us, donating at blood drives run by organizations like the nonprofit New York Blood Center. They’re held at places like Grand Central Terminal, where commuters add some time to their trips to help out, at schools like Hunter College, where students pitch in, and at those mobile donation vans we see parked around town. NY1 visited a drive at the U.S. Postal Service's Morgan Processing Plant.
Donating blood is pretty easy. It all starts with a quick screening process to make sure you meet all the federal regulations for being a blood donor.
The whole thing takes about 20 minutes and is more comfortable than you might think. First, some samples are set aside for later screening to make sure your blood is safe. Then, it's time for your donation, about a pint. When the collection's over, it's all packed up in coolers, loaded into a Blood Center van and driven to their processing center in Long Island City to be separated into its various components. The organization distributes to nearly 200 hospitals in the region, serving more than 20 million people. Two-thousand units, or pints, of blood are collected each day to keep up with the demand. But before any of it is used, those samples are set aside and flown to a lab in Arizona.
"There, they'll get tested for the infectious diseases that we need to test for such as HIV, Hepatitis B, Hepatitis C," says Donna Strauss, executive director of core operations for the New York Blood Center.
Results are available in about 48 hours. During the wait, work begins to ready each donation for potential recipients.
Blood has four main components: red blood cells, which carry oxygen, white blood cells, which help fight infections, plasma, a fluid that transports blood cells through your body, and platelets, cell fragments that help control bleeding.
Platelets are usually donated using a special machine, so in the component lab, the focus is on separating out plasma and red cells using a large centrifuge. Next, a special device removes the plasma portion. White blood cells are discarded because they can fight the recipient's system. Red blood cells are stored in a refrigerator. The plasma is frozen.
It's a lot more comfortable where platelets are stored, agitating at room temperature to guard against clotting. Platelets have a five-day shelf life. For red cells, it's 42. Frozen plasma can be stored for up to a year.
In another room, techs receive the test results from Arizona. If someone's blood tests positive for an infectious disease, it's discarded. Blood deemed safe is labeled with a re-confirmed blood type. You may know yours, you may not, but it's one of these: A, B, AB or O. It all depends on antigens, or substances in your body that can fight disease, classified as A and B.
Some people have one type on their blood cells, some have both, and some neither. That's type O. If antigens are also in your plasma, you're RH positive, if not, RH negative. Get the wrong type, and the antigens can attack your body. Since type O negative has none on the cells or in the plasma, these donors are considered universal.
"That person can give blood to anybody. If you're A, you're B, you're AB, you can still receive blood from somebody who's O," says Dr. Sujit Sheth, director of pediatric hematology/Oncology at New York Presbyterian/Weill Cornell.
You can't downplay the importance of any blood, but some is more valuable because it is so rare. The New York Blood Center's facility has the largest inventory of rare blood in the entire world.
There are actually 600 possible antigens that can be found in blood, but most are extremely rare. For carriers of those antigens, a frozen reserve, where blood can stay for up to 10 years, is essential.
"The problem with when you freeze a unit of blood is when you thaw it, the hospital has to get it and use it within 24 hours,” says Strauss.
But for most, it's off to the Blood Center's hospital services department, where it's prepared for delivery to hospitals.
The Blood Center gets a variety of orders, some for next day delivery, some for same day, and for life-threatening situations, there are two-hour emergency orders.
"It happens up to 30 times a day, if not more. It's a little stressful, but at the end of the day, you go home and you know you've done something well," says Michael Wurst, hospital services supervisor for New York Blood Center.
Central dispatch sends the blood products to hospitals like New York-Presbyterian Weill Cornell on the east side. There, it's kept in a highly secured "blood bank." Transfusion Medicine and Cellular Therapy Manager Kathleen Crowley undergoes an eye scan to enter. Inside, techs test their patient's blood type, identify a potential donor match and mix a sample of both to ensure compatibility. It's one of at least 20 checks to ensure the right blood is going to the right patient.
"Because if we were to mistransfuse someone, give them the wrong bag of blood or the wrong blood type, it could cause a severe reaction in the patient, and that could cause death," Crowley says.
The blood is now ready for the patient. Techs do a final series of checks before it heads upstairs, where it will be put to good use.
A few minutes later the blood arrives in Danny's room, where he waits for his transfusion. Currently, the only cure for Thalassemia is a stem cell transplant, but a match is difficult to find, so this blood is critically important for Danny and others like him.
"It keeps these individuals in good health. It allows them to have a normal quality of life, go to work, go to college, and do all of the things that everybody else would do," Sheth says.
You don't have to remind Danny, who can spend an entire day waiting for the 90-minute transfusion.
"When I get a small cut on my finger and I see some blood, I always think, 'That's not mine, it's someone else's blood that's kind of surging through my body,'" he says. "I try not to dwell on it or anything like that, but every time I come here, it definitely crosses my mind to kind of think about those who are donating and how it is helping me."
And it continues to be up to you, and me, so I decided to roll up my own sleeve, all part of making sure this system based on the power of giving keeps pumping.
So that's how your blood donation saves lives, and that's how New York City works.