Dr. Merlyn Sayers Addresses the 19th Annual Bill T. Teague Lectureship: Old Donors, Old Blood, Old Guidelines: What is New?
Dr. Merlyn Sayers, president and CEO of Carter BloodCare in Bedford, Texas, was honored May 6, 2015, with the 19th annual Bill T. Teague Lectureship in Transfusion Medicine by Gulf Coast Regional Blood Center in Houston. The award is named for Bill T. Teague, The Blood Center’s founding CEO, who served in that capacity for more than 30 years.
Blood bankers, until relatively recently, were mainly concerned about transfusion-transmitted infection. With improvements in infectious disease test sensitivity, priorities have changed. This lecture addressed challenges that blood programs need to address in their relationships with donors, regulators, hospitals and patients.
Sayers began the lecture by discussing “old donors.” Changes in the population pyramid reveal increasing numbers of people over the age of 65, who are less likely to be donors. Recruiting teenage donors and ensuring their safe donations have become important strategies.
Sayers then discussed the morphologic and functional changes of the red blood cell storage lesion that occur during refrigerated storage. While some retrospective reports suggest that old red cells are associated with increased morbidity and mortality in transfusion recipients, the results of recent prospective randomized trials, however, show that older blood does not impair patient outcomes.
Next, Sayers discussed iron nutrition of blood donors. While prolonging the donation interval might reduce the incidence of iron deficiency in regular donors, it could significantly affect inventories. For example, doubling the donation interval to 112 days could decrease annual group O, D-inventory by more than 10 percent.
Another group O inventory consideration is the influence of the changing demographics in Texas. It is estimated that by 2030, there will be a majority of Hispanic individuals in every age group. Since approximately 57 percent of Hispanics have type O blood, 10 percent more than the 45 percent in the Caucasian population, a strategy is necessary to ensure that Hispanic donors are well represented as contributors to the community blood supply.
Sayers concluded the lecture pointing to the important public health role that blood centers can perform by supplementing donor testing with, for example, total cholesterol and HgbA1c screening for evidence of cardiovascular disease and diabetes risk.