The anatomy of Kentucky’s blood supply, and why more need to donate

Cecily Cornett grabs bags of blood to include in a shipment from the Kentucky Blood Center to a Lexington-area hospital on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes) 

Quintissa Peake, like many people, doesn’t like needles. But the Letcher County woman can’t choose to avoid them.

She lives with sickle cell anemia, a genetic blood disorder that is painful and primarily affects people of African descent.

People with sickle cell often need blood transfusions to replace their damaged hemoglobin cells  – which are in the shape of a C — with normal hemoglobin — in the shape of a disk. (Hemoglobin is the protein that carries oxygen to tissue). 

Quintissa Peake (photo provided)

In her 43 years of life, Peake has had more than 500 units of blood transfused into her body.

As it goes into her veins, she feels the cold. 

The blood she receives, which comes from and entirely depends on donors, helps her manage what can be excruciating pain throughout her entire body. 

Many people need blood for various treatments and operations. Those include people like Peake who have sickle cell disease, cancer patients, gunshot victims. It’s also needed for surgeries, organ transplants, childbirth and more. A quarter of the blood supply goes to cancer patients. 

Traumas like mass shootings deplete supply quickly. The Old National Bank shooting in Louisville in 2023, for example, required 80 donations. 

One in four people will need blood at some point in their lives, according to the Kentucky Blood Center (KBC).

And while the need is ongoing, Kentucky has a shortage of blood. Nationally, not nearly enough people donate — only 3% of people who are eligible. 

“The need for blood is always there,” Peake said. “I would just like to encourage people to donate … especially when (there’s) a shortage.”   

Quintissa’s story

Peake, who is from and lives in Neon, was diagnosed with sickle cell anemia at 11 months old. Her mother tells her that, as a baby, she cried a lot and wouldn’t move her arms and legs. 

Both her parents were sickle cell carriers, though they didn’t live with the disease. 

As a child, Peake bounced back from transfusions and hospital stays quickly. But, as more time passes, she deals with more nagging chronic pain. 

Peake’s pain ranges from mild and unrelenting to sharp and throbbing. Both are unpredictable. They interrupt her ability to hold a job and to enjoy carefree travel.  

She has a daily prescription for morphine but still feels pain. Sometimes, she has to go to the emergency room for hydration treatments and pain management by IV. She never knows when doctors are going to tell her it’s time for another blood transfusion. 

When that happens, she needs blood already on the shelf. She is A positive, but can receive blood from A positive, A negative, O positive, and O negative donors. Because she has received so much donor blood in her life, she also needs blood with specific antigens, which KBC tests for in its Reference Laboratory. 

An antigen is a “substance that causes the body to make an immune response against that substance,” according to the National Cancer Institute. If a person who needs specific ones gets a transfusion with the wrong ones, their immune system will attack the donor cells. This can lead to serious negative reactions and even death, according to Eric Lindsey, the KBC spokesman. 

Jessica Schmiers tests blood samples in the Reference Lab at the Kentucky Blood Center on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes)

Amanda Clark, the tech-in-charge at the KBC reference lab, said every month her team sends out about 40 units of special blood for sickle cell patients who need to exchange their whole body’s supply. (An adult who weighs 150 to 180 pounds has about 10 units of blood in their body, according to the American Red Cross).  

Once KBC comes across donors who have antigens that match specific patient needs, the reference lab holds onto those products. 

“These units are held back for … most of the time, cancer patients or sickle cell patients,” Clark said. “Patients that are transfused very often … make antibodies, and they require special blood.”  

Such is Peake’s situation. If she has to wait a few days for the blood, she’s forced to linger in pain. She usually gets her transfusions in Lexington at UK Healthcare, which is a three-hour drive each way, adding yet another complication to her care. 

For the last 16 years, she’s lived with a port that’s implanted under her collar bone on the right side. This ensures she gets stuck only once every time she needs a transfusion or other IV treatment. Before that, her small veins meant she suffered through multiple sticks before getting relief. One time, she stopped counting at 25 needle pricks. 

Her chronic pain — and the extraordinary financial weight of her necessary care — takes a toll on her mental health. She has Medicare, which covers 80% of her medical bills. While that is helpful, she said, her 20% out-of-pocket portion can still reach $60,000, which she tackles through payment plans. 

This “astronomical” burden is a close second stresser to her physical health. 

She tries to focus on the positive and “practice gratitude,” she said. 

“In an ideal world, I would love to not have chronic pain or not deal with it daily,” she said. “However, it’s … something that I’ve just had to come to the realization that: I may not have another 100% pain-free day.” 

Kentucky’s blood shortage 

The COVID-19 pandemic sent blood donations plummeting, which caused a shortage. During a time when highly infectious variants spread quickly — and before vaccines hit the market — many were reluctant to donate. 

Mobile drives, too, could no longer go into schools and collect from much-needed young donors. 

As a result, the blood supply dwindled. Hospitals dipped into the reserve supplies, leaving shelves sparse. 

Kentucky still hasn’t fully recovered. 

For KBC, every day is a juggling act to balance public appeal for donations with hospital demand for products and rotating expiration dates.  

Often right after an emergency — like the 2023 mass shooting in Louisville — donations pour in. While this is always welcome, it’s the supply already processed and on the shelves that is most useful. 

That’s why regular donation is so important, according to Liz Becker, the vice president of donor services at KBC. 

“You never know when it’s going to be you or a family member or a loved one that’s going to need it,” she said. “It’s the blood that’s already on the shelf that’s going to  make the difference.” 

KBC is primarily focused on keeping blood in Kentucky, though it has helped other states in cases of severe emergencies, like a recent school shooting in Iowa that depleted the Hawkeye State’s local supply. 

KBC uses giveaways to incentivise people to donate, including an ongoing lottery for Taylor Swift Eras Tour tickets in Indianapolis this fall worth thousands of dollars. The giveaways are funded with the money hospitals pay for the blood products on their shelves. 

Giveaways like this work for the Kenner family, who recently donated blood in Lexington in exchange for Kings Island tickets. They’ve donated for nothing before, but said they’ll schedule their donations around a good giveaway. 

Adam Kenner, 19, started donating at 16 and tries to donate a couple of times a year. His parents, he said, instilled in him a desire to help others. 

“I just want to help,” said Kenner, who has the type of blood Peake often gets transfused — O-positive. “I can be the person who helped someone.” 

His father, Andrew, is a Lexington firefighter and paramedic. He sees up close when people need blood. 

He’s also donated blood since he was 16, as often as he can. He learned about the need for regular blood donations years ago in a class, and has seen loved ones need blood for cancer treatments and other illnesses. 

“I kind of got to practice what I preach, you know?” 

Adam Kenner, left, talks with his father, Andrew after they both donating blood at the Kentucky Blood Center on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes)

The anatomy of the blood supply 

The blood supply is, itself, like a human body. At the KBC headquarters in Lexington, dozens of moving parts pump the supply out to hospitals and other facilities. The moments a donor spends on the table are just the beginning of an intricate process of testing, separating, creating products and infusing. 

Depending on the donor’s demographics, lab technicians will decide what products they can make out of a blood donation, according Liz Counts, KBC’s vice president of technical services. 

“Generally, there’s going to be a red cell product, and then there’s going to be a plasma or platelet product,” she explained. 

Bennie Tackett places blood donations in a centrifuge in the components lab at the Kentucky Blood Center on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes)

Kentucky scientists place whole blood units in centrifuges to separate red cells from plasma. Test tubes are driven to Cincinnati every day and put on a commercial flight to Atlanta, where a different lab tests for West Nile virus, syphilis and other infectious diseases. 

If donated blood tests positive for any virus or disease that makes it unusable, it’s incinerated. 

Pre-donation screening questions catch a lot of potential issues, Counts said, though staff do get positive results, especially for syphilis and hepatitis C. Some test results go “hand in hand” with Kentucky’s high rate of substance use, she said, which is the reason phlebotomists do a track mark inspection of donors’ arms.  

Within 24 hours — unless there are unforeseen delays with the testing process — donor blood is ready for distribution. 

Plasma, created in the Components Lab in the Kentucky Blood Center, can be various colors dependent on different characteristics of the donor. May 22, 2024 in Lexington. (Kentucky Lantern photo by Arden Barnes)

“Every day we have to make sure that we’ve collected … 250, if not more, blood products,” Counts said. “We rotate the blood through the hospitals — they’re constantly transfusing. So there’s always a constant need for fresh blood and to keep the inventory robust.” 

In order to make up for the shortage COVID-19 caused — and to account for donors who come in but aren’t able to give blood that day — KBC needs 400 donors a day, said Lindsey, the center spokesman. 

KBC is currently not bringing in those 400 donations a day. This means the supply on the shelves is easily depleted from day to day. This is especially true for the O-negative supply, which is the universal type and can go to anyone. This blood type is often used in emergencies when a patient’s blood type isn’t known. According to the American Red Cross, just 7% of Americans have an O-negative blood type. 

Sometimes people don’t donate because they are scared of needles, Counts said. 

But: “That is such a small part of blood donation,” she said. “And the number of people that you’re helping — it just doesn’t even match up to the little bit of pain you could possibly feel.”  

Moving parts 

Scott Arnold delivers blood to the UK Chandler Hospital from the Kentucky Blood Center on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes)

Among the blood supply’s moving parts are blood couriers like Scott Arnold, who is in his seventh year driving for the Kentucky Blood Center. He’s worked at KBC in other roles for 16 years. Each day he drives to six local hospitals and drops off coolers full of human blood. KBC supplies more than 70 facilities around the state in 90 counties, and couriers drive as far as Pikeville every day. 

Around 9 a.m. on a recent Tuesday, Arnold packed the back of his van full of human blood, packaged in coolers with ice. 

Once he arrives at the hospitals on his route, Arnold walks to lab after lab to hand-deliver coolers. If facilities have blood on their shelves that’s about to expire, they send it with him to whichever facility in his route that can use it. 

Usually it goes to UK Healthcare, which receives 40% of KBC’s blood supply. 

The job gives him “inner peace,” he told the Lantern as he drove down Harrodsburg Road. “Not a lot of people have a job where you can actually serve others.”  

Arnold said he feels “a sense of pride for helping somebody survive.”

Nadia Ahmadzai receives a box of blood to prepare in the components lab at the Kentucky Blood Center on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes)

In addition to her gratitude practice, Eastern Kentucky’s Peake finds comfort in her online sickle cell support groups and her faith. She also speaks to medical school students about her disease and promotes blood donation. She encourages others to face their fears of needles that may keep them from donating. 

“It’s something that helps me and it has helped my life. … I know it’s something that can help others,” she said. “Your fears are valid, and it’s hard to get over some things. But if you can get over your fears, just think of how much life you can be adding to someone that you don’t even know. And the person who’s on the receiving end, I can guarantee, is very thankful and grateful for your time and your effort.” 

Donors can give whole blood, double red cells and platelets. Whole blood donations take 45 minutes and donors can give every 56 days. Double red donors can give every 112 days, and each donation takes about 30-40 minutes. Platelet donors can give every 14 days, and each donation takes between 45 minutes and an hour and a half. 

Blood samples at the Kentucky Blood Center on May 22, 2024, in Lexington. (Kentucky Lantern photo by Arden Barnes)

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