Marian T. Sullivan, MS, MPH
National Blood Data Resource Center
Committee on Commerce of the United States House of Representatives Subcommittee on Oversight and Investigations
September 23, 1999
Good morning, My name is Marian Sullivan. I am the Executive Director of the National Blood Data Resource Center (NBDRC) in Bethesda, Maryland. I am pleased to have the opportunity to speak to you about the NBDRC. After briefly introducing you to the NBDRC and our activities, I would like to outline for you our most recent findings regarding the U. S. blood supply and our plan for monitoring it in the next sixteen months.
The NBDRC is an independent, not-for-profit, corporation, conceived and founded by the American Association of Blood Banks (AABB) in July of 1997. The mission of the NBDRC is to collect, analyze, and distribute data on all aspects of blood banking and transfusion medicine. Prior to the founding of the NBDRC, there was no existing organization dedicated to the collection of blood supply monitoring data.
The goals of the NBDRC are to assist members of the blood community at large in identifying and assessing existing and emerging issues, validating new technologies, improving operations, promoting the highest standards of care for patients and donors, and making policy at the national, regional, and local levels. In short, we strive to provide whatever information is needed by the community to ensure a safe and efficient modern blood system.
We rely on the AABB and our own limited membership for the financial support of our operations. Our small staff has worked hard to meet our goals in the brief 25 months since we opened our doors. Our accomplishments include the 1998 Nationwide Blood Collection and Utilization Survey- a comprehensive survey of blood services activities completed by 2,360 blood centers and hospitals. Data from this project have assisted numerous federal agencies and advisory committees in recent policy discussions, and been quoted in the media by the Surgeon General, yet not one dollar of federal funds supported this ambitious NBDRC project.
The NBDRC has also contributed directly to the safety of the blood supply by continuation of the long-term Creutzfeldt-Jakob Disease Lookback Study, now funded by the Centers for Disease Control and Prevention, and the Survey of Donation Incentives, supported by a grant from the National Blood Foundation.
The results of our previous Nationwide Blood Collection and Utilization Survey indicated that 700,000 fewer units of whole blood were collected in the United States in 1997 than in 1994, a statistically significant decrease of 5.5%. It is important to note that 205,000 of these units were directed donations (intended for a specific patient) and 643,000 units were autologous donations (for the donor's own use). Although we recognize that both directed and autologous donations have been on a steep downward trend since they peaked in popularity in 1992, we cannot disregard the fact that these donations combined to account for 0.6 million transfused units; units which would have otherwise come out of the community supply.
On the other hand, the total number of transfused whole blood and red blood cell units increased by 4% in 1997 in comparison to 1994, to 11.5 million units. If the rates of overall whole blood collection and transfusion that occurred between 1994 and 1997 are continuing, the United States may experience a national blood shortage as early as next year.
The NBDRC is committed to conducting another Nationwide Blood Collection and Utilization Survey in 2000, even if it must be supported entirely by internal funds and report sales, as it was last year. The previous survey captured blood collection and transfusion data for the calendar year 1997. In February 2000 we will distribute the next nationwide survey to 3,000 hospitals and blood centers.
The results of the 2000 survey, which will be available to NBDRC members and customers approximately twelve months from now, will provide data for 1999, and enable us to extend the historical trends analysis through 1999 as well. However, in the interim between surveys, there is little information available regarding the adequacy of the blood supply, other than anecdotal. Some blood centers have recently reported significant increases in 1998 and 1999 collections, while other centers have issued repeated appeals for blood, beginning well in advance of the anticipated summer shortages this year. The impact of this on the national supply cannot be carefully assessed without current nationwide data for comparable time periods and donation types.
In order to better estimate the adequacy of the recent supply, and to enable us to more accurately project the available supply for the year 2000, the NBDRC is currently conducting a "QuiKount" of the whole blood donations made at every U. S. blood center. The short survey was mailed out last week and will capture blood collection data for all of 1998 and the first six months of 1999 by calendar quarter. The QuiKount project is supported entirely by internal funding, and the results will be shared with all interested parties in early November.
Finally, I am very pleased to tell you that we will begin to collect supply data on a monthly basis in approximately two months, under a short-term financial arrangement with the National Heart, Lung and Blood Institute (NHLBI). Initially, we will enlist the participation of a representative sample of blood centers willing to report their monthly distribution figures very rapidly. Later on, next year, we hope to bring the corresponding national hospital sample on-line in order to capture timely and detailed blood utilization data.
Congress has rightly recognized that the safety of our blood supply is a national public health priority. However, patients cannot benefit from safe blood if it is not readily accessible. Moreover, long-term blood collection and usage data are needed in order to detect and avoid potential blood shortages. The NBDRC urges Congress to support the collection of blood supply monitoring data.
We are proud that in our short tenure, the National Blood Data Resource Center has established a reputation as the premier source of reliable, national blood data, and we sincerely appreciate the recognition of this subcommittee, the NHLBI, and the various advisory committees, task groups and agencies which have relied on our data to characterize the U. S. blood supply. You have our commitment to continue to provide accurate and timely data to meet the needs of the U. S. Public Health Service, both routine and urgent, as long as sufficient financial support is available. Thank you for the opportunity to testify today. I would be pleased to answer any questions.