Watching What You Eat

In case you hadn’t noticed, the world did not come to an end on May 21st.  Most of us, so we’re told, were not eaten by zombies. However, we did learn of one 6-year-old boy who nearly lost his life because of something someone else ate.

No, we’re not making this up.  In fact, this story comes from the highly respected New England Journal of Medicine, no less. The article reveals that the boy suffered a severe allergic reaction following a blood transfusion from people that had consumed peanuts in the hours before donating their blood.

Dr. Johannes Jacobs, one of the study coauthors, described how three of the five blood donors in this case reported eating peanuts on the evening before they gave blood. It had been a Sunday evening, the night of a big soccer game, and the three donors had been snacking on peanuts as they watched TV.

The boy who received the nut-tainted blood was being treated for acute lymphoblastic leukemia.  During a platelet transfusion he experienced an anaphylactic reaction in which he developed a rash, angioedema, hypotension, and difficult breathing.  Fortunately doctors recognized his symptoms and treated him with epinephrine (adrenaline) and he recovered within 30 minutes.

The patient’s mother stated that her son had had a similar reaction after eating peanuts at the age of 1 year. Since that time, peanuts had been excluded from his diet.

The authors of the report say the boy experienced an allergic reaction because peanuts contain a protein known as Ara h2, which is extremely resistant to digestion and can stay in the blood for up to 24 hours. While such a scenario had been presented as a theoretical possibility in the past, this is the first clinical report of this phenomenon.

Speaking exclusively to Word on Health, Dan A. Waxman MD, President of America’s Blood Centers said “Donor screening measures are quite effective in terms of detecting infectious agents and donor questionnaires tell us if donors need to be excluded because of medicines they are taking such as aspirin or antibiotics.  But, when it comes to what they’ve eaten, we really don’t ask”.

According to the latest Food Allergy Guidelines,  peanut allergies are known to affect about somewhere between 0.6 and 6% of the population.

While the researchers involved with this study are not recommending that blood donors avoid all foods known to be associated with systemic allergic reactions, they caution that more research must be done to determine the level of risk.

In the meantime, SRxA’s Word on Health suggests it may be time to adapt the phrase “Think before you drink, before you drive” to “Think what you ate before you donate.”

The skinny on blood transfusions: a modern day miracle?

Most of us have read the biblical accounts of water being turned into wine.  Now Canadian scientists have discovered how to turn skin into blood.  This miraculous breakthrough could revolutionize cancer treatments and solve the blood donor shortage.

What is more because the blood is made from the patient’s own cells, there is no danger of either rejection or infection.

The team from McMaster University, Ontario say that the process has been so successful that treatment could be available within two years.

Dr Mick Bhatia who headed the team said “People will effectively become their own donors. We are very excited and very enthusiastic about it. There is a lot of work to be done but I would be disappointed if we were not trying it on patients by 2012.”

The research, published in Nature, is part of ongoing attempts across the world to revert adult cells back to their original stem cell form. Stem cells are “master cells” which can potentially be manipulated in a laboratory to become any other cell in the body.

Human Skin Cells

What’s unique about this process is that it misses out the “in-between” stage of turning the skin cells back to stem cells and then converting them to blood cells. Instead, the cell is reprogrammed directly by inserting a specific transcription factor – a protein that interacts with DNA to activate genes – and applying cytokines or signaling molecules.

The result – within a month the skin is converted to blood.

Leukemia patients are likely to be the first to receive transfusions of perfectly matched blood generated from their own skin. In future, laboratory manufactured blood could help to plug the gap caused by donor shortages. The technique also holds out the promise of making other kinds of cell, including neurons with the potential to treat brain diseases such as Parkinson’s and Alzheimer’s.

Skin cells from both young and old people were used in the research to prove that age of donor made no difference to the process.

Next the team plans to assess what kind of production capacity might be possible with the cells, and whether they can successfully be stored in deep freeze.

As always, SRxA’s Word on Health will be watching these developments and bringing them straight to you.

Lack of Trust deters African Americans from Blood Donation

As reported previously by Word on Health, racial disparities in healthcare are rife in the United States. Even though most of these show that ethnic minorities have poorer outcomes, we were surprised by a newly published study in Transfusion that explored why African Americans donate blood at lower rates than whites.

The findings revealed that there is a significant distrust in the healthcare system among the African American community, and African Americans who distrust hospitals are less likely to donate.

Led by Beth H. Shaz, MD, Chief Medical Officer of the New York Blood Center in New York, New York, researchers created a survey to explore reasons for low likelihood of blood donation in African Americans. 930 people  from 15 African American churches in metropolitan Atlanta participated the survey.

The most frequent reported motivators were:

  • donating to help save a life (96%)
  • donating because blood is needed (95%)

…while the most frequent barriers were that they rarely think about it and they were afraid, nervous, or anxious to give blood (35%). The association of barriers with donation status, age, gender, and education level was stronger than for motivators.

The study’s results also showed that about 1 in 5 African Americans (17 %) do not trust hospitals. This lack of trust was positively correlated with not donating blood even compared against other risk factors. Lack of trust in hospitals was also associated with not wanting to participate in research and less knowledge about the blood supply.

Respondents who did trust hospitals had more knowledge of the blood supply, less fear of donation, and were more likely to respond to blood needs of the community.

Clearly, blood centers and hospitals need to build trust with the African American community. SRxA’s transfusion medicine experts can help.

Contact us today to learn how.