Cellular therapy services provided by blood centers and hospitals in the United States, 1999: an analysis from the Nationwide Blood Collection and Utilization Survey

Blood collection and transfusion in the United States in 2001

BACKGROUND

Collection, processing, and transfusion of blood and blood components in the United States in 2001 were measured and compared with prior years.

STUDY DESIGN AND METHODS

The survey was completed by 1443 blood centers and hospitals. Statistical procedures were used to verify the representativeness of the sample and to estimate national totals.

RESULTS

The total US blood supply in 2001 was 15,320,000 units (before testing), 10.4 percent greater than in 1999. It included 14,259,000 allogeneic units, 619,000 autologous units, and 273,000 red cell (RBC) units collected by apheresis. Transfusion of whole blood (WB) and RBCs increased by 12.2 percent to 13,898,000 units. Platelet (PLT) transfusions totaled 10,196,000 units, an increase of 12.6 percent in comparison with 1999. The use of single-donor apheresis PLTs increased by 26.0 percent to 7,582,000 PLT concentrate equivalent units. The use of PLTs from WB (PLT concentrates) continued a downtrend, declining 13.9 percent to 2,614,000.

CONCLUSIONS

The margin between transfusion demand and the total allogeneic supply in 2001 was 1,162,000 units, 7.9 percent of supply. By comparison, the 1999 margin was 9.1 percent. The rate of blood collection per 1,000 donor-eligible population in 2001 was 8.9 percent higher than in 1999, due largely to additional donations following the September terrorist attacks. During the same period, however, the rate of transfusion per 1,000 total US population increased by 9.9 percent to 50.0 units, the highest in 15 years of measurement. The steady increase in demand continues to challenge the US blood community.

Blood collection and transfusion in the United States in 1999

BACKGROUND

Collection, processing, and transfusion of blood and blood components in the US in 1999 were measured and compared with prior years.

STUDY DESIGN AND METHODS

Questionnaires were completed by 2040 blood centers and hospitals. Statistical procedures were used to verify the representativeness of the sample and to estimate national totals.

RESULTS

The total US blood supply in 1999 was 13,876,000 units (before testing), 10.1 percent greater than in 1997. It included 13,109,000 allogeneic units, 651,000 autologous units, and 116,000 red cell (RBC) units collected by apheresis. Transfusion of whole blood and RBCs increased by 7.6 percent to 12,389,000 units. Platelet (PLT) transfusions totaled 9,052,000 PLT concentrate equivalent units, of which 66.5 percent were PLTs from apheresis. In comparison with 1997, the total number of PLT units transfused was unchanged, whereas single-donor PLT units transfused increased by 6.7 percent and the transfusion of PLTs from whole blood (PLT concentrates) declined by 10.6 percent (a difference of approximately 400,000 units in each case).

CONCLUSIONS

The margin between transfusion demand and the total allogeneic supply in 1999 was 1,203,000 units, 9.1 percent of the supply. By comparison, the margin in 1997 was 7.2 percent, whereas in 1989 it was 13.8 percent. Similarly, the rate of blood collection in 1999 per 1000 population was 11.9 percent higher than the 1997 rate. During the same period, however, the rate of transfusion per 1000 population increased by 5.8 percent. Risk in the future lies primarily in the increasing demand for RBCs and further shrinkage of the supply-and-demand margin.

Current and future commitment to hematology research

This article provides an overview of the National Heart Lung and Blood Institute's (NHLBI) current and future commitment to hematology research. The paper comprises nine sections: (1) a brief history of how NHLBI incorporated blood research in its mission; (2) a summary of the traditional areas of research interest for blood diseases and resources; (3) a description of how NHLBI has assured and continues to assure a safe blood supply; (4) the current and future plans for transfusion medicine and cellular therapy research; (5) research support for hemoglobinopathies and red cell disorders; (6) research support for thrombosis and hemostatic disorders; (7) current and future research of hematopoietic stem cell biology, and aplastic and preneoplastic conditions; (8) future training for hematologists, and (9) a concluding summary.