Peter Lemberger is very knowledgeable about blood donations, the head physician of the department for anesthesia and intensive care medicine in the district clinic is responsible for the entire house as the person responsible for the transfusion. In addition, the Regensburg-born transplant officer is the clinic. In an interview, he explains how the blood supply is doing there.
SZ: Apparently blood supplies are running out in Bavaria. How is the situation in Ebersberg?
Peter Lemberger: Critical. In fact, we are currently getting less blood than before, which is why some operations that have already been planned had to be postponed. Whereby the number of operations has not increased compared to pre-Corona times.
How many are there in a year?
Around 9,000 if you add up the planned interventions and emergencies.
Has the decrease in blood donations also made itself felt in the latter?
No, the emergency care has never been at risk. For this we always have a supply of tinned blood group 0 in stock.
These are the universal donors?
Yes and no. We differentiate between the blood products “EK”, ie erythrocyte concentrate (red blood cells), “TK”, thrombocyte (blood platelet) concentrate and “FFP”. That stands for “Fresh Frozen Plasma”. This is what is left over when you take away the blood cells and is responsible for blood clotting. Universal donors are donors with blood group 0 only with regard to the erythrocyte concentrates. In the case of FFPs, donors of blood group AB are universal donors because their plasma does not contain antibodies against other blood groups. FFPs are frozen and can be kept for years. So here we have the slightest problem with availability.
Do you need the same amount of all three products over the year?
No. We have the greatest need for EK, last year 1907 it was canned food. Here we can compensate roughly twice as much blood loss per dose of a 300 milliliter sachet because the red blood cells are concentrated in the preparation. We used 379 of FFP and 85 of TK.
That sounds like very little …
Platelets are also very rarely given – after massive bleeding or in the case of educational disorders in the bone marrow, such as leukemia. With a concentrate you can get into the safe area. However, the product is also very expensive, with a canned product costing several hundred euros. The platelets have to be stored in room air and kept in constant motion. In addition, they can only be kept for five days. Therefore, we cannot store them in our blood depot, but have to request them from the blood donation service immediately if necessary. You will be with us within an hour.
What about the other products, what are they used for?
We rarely need blood for planned operations. It is more often needed in emergency operations, such as after accidents. If, for example, a vessel on the thigh is injured, a few liters of blood can quickly be lost. Often, patients with chronic diseases also need blood, such as those with blood formation disorders. If someone has leukemia, they may need to be transfused over and over again for years. Even after childbirth, massive bleeding can occur, albeit rarely, which requires the administration of blood products.
Do you remember a specific case?
Oh yes, it was two o’clock in the morning, a young woman who was bleeding profusely from her uterus after giving birth. During the operation we had to give several EKs, FFPs and TKs and other coagulation preparations until the bleeding stopped. Thanks to the transfusion, the young mother survived the operation very well and the uterus was preserved.
Up to what amount does one speak of “normal” blood loss?
A hemoglobin value of 13 to 15 grams per 100 milliliters of blood (more in men, slightly less in women) is considered normal. It is a measure of the number of red blood cells. If, as a healthy person, you lose one to two liters of blood (even during childbirth) and the value drops to eight to nine grams per 100 milliliters of blood, you won’t win a gold medal at the Olympics, but you don’t need a replacement.
Compared to the past, how does the use of donated blood look like? Do you need more or less?
The consumption of EKs and FFPs has decreased – despite the fact that our patients are getting older and sicker on average. A few years ago, transfusions were more generous. However, it has been learned that especially patients without concomitant diseases of the cardiovascular system or the lungs also tolerate low Hb values well without taking any risk. In addition, the surgical methods have become more modern with less blood loss. In addition, we avoid some transfusions by promoting blood formation by giving iron when an iron deficiency is the cause. FFP have lost importance in the treatment of coagulation disorders in favor of the targeted use of individual coagulation factors, which often normalize coagulation faster and better. In order to work well, FFP must be given in relatively large volumes (at least one liter), which some patients cannot tolerate. In addition, the FFPs are difficult to handle because they first have to be thawed.
Are you a blood donor yourself?
Not regularly, but I’ve donated several times.
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