Behind the Scenes at the UH Blood Bank

UH Clinical Update | April 2025

Blood banks at every hospital in the UH system provide life-saving products for patients in need. And the need is growing.

“At UH Cleveland Medical Center in 2024, for example, the blood bank received an additional 4,300 samples over 2023, representing a 7% increase,” says Christine Schmotzer, MD, System Pathologist-in-Chief, Executive Vice Chair, Pathology and holder of the Linda Sandhaus, MD, and Roland Philip, MD, Chair in Pathology and Laboratory Medicine. “This resulted in the performance of 12,000 additional tests. Staff supported the activation of 323 Massive Transfusion Protocols (MTPs), a 5% increase. These MTPs involved well over a thousand units of blood products.”

“When I started here 15 years ago, if we got 140 samples, that was a busy day,” adds Victoria Cary, MLS (ASCP)(CM), SBB(CM), Manager, Transfusion Medicine. “As of yesterday afternoon, at 3 o'clock, we were already up to 189. Our numbers of daily specimens processed through this lab has grown significantly.”

But while this increased volume has required greater efficiency and hard work, UH blood banks have also been busy innovating to improve patient care. One recent effort has focused on adding more safeguards to prevent wastage of platelets. These crucial blood components have a limited five-day shelf life and are donated by a just a small subset of blood donors, making them uniquely valuable. Working with OR staff, the Pathology team designed a storage solution for platelets called a “blue bag,” preventing them from inadvertently being put on ice. Since the initiative began in March 2024, wasted platelets have decreased from nine to two as of January 2025, saving both money and treatment options for patients. Platelets are now also being more efficiently reallocated through the system to cut down on waste, with 28 platelets having been moved through the system for transfusion since the sustainability initiative began in November 2024.

UH blood banks are also in the process of digitizing 30 years’ worth of paper-based antibody panels, currently stored in dozens of file cabinets around the system. Association for the Advancement of Blood and Biotherapies (AABB) standards dictate that patient antibody panels need to be kept accessible indefinitely, so the UH Pathology team has developed a way to digitize these panels using the already-established OnBase software.

“If we have a patient who's a little more complicated, our transfusion medicine attendings, residents, and we in the blood bank will be able to go into OnBase and pull up their panels and see any trends or gradual antibody identifications to confirm or deny, especially when we deal  with our stem cell transplants, bone marrows transplants and our sickle cell patients,” Cary says. “Those patients can have a very complicated antibody history. Being able to just pull all that up without digging through a paper file will be really helpful.”

Outside the four walls of the hospital, the UH blood bank team is also helping guide Ohio’s growing movement toward pre-hospital transfusion, managed by paramedics. In July, the state of Ohio established that paramedics can be trained to initiate transfusions. The UH blood banks are working with Cuyahoga County to get this up and running locally. In addition, a similar program for Tactical EMS blood product retrieval is also being developed, to be supported by the St John Medical Center’s blood bank. The paramedics are trained appropriately per AABB standards to initiate a transfusion. If a situation poses a high risk of violence, warrant arrests or SWAT team activation, the squad acquires emergency release red cells for the event – to be quickly available if needed.

Blood bank leadership at UH is also integrally involved in one of the most exciting research breakthroughs in a very long time – the development of a gene therapy treatment for sickle cell disease. Robert Maitta, MD, PhD, is Section Director of Transfusion Medicine, Medical Director, Apheresis/ FACT/ Stem Cell Collection Center at UH Cleveland Medical Center and Vice Chair of Clinical Pathology Research. His group oversees collection of the stem cells that will be gene-edited by outside laboratories once cell targets are reached.

“The FDA-approved product is Lyfgenia (lovotibeglogene autotemcel) and those in clinical trials are RUBY and BEAM -- both gene editing,” he says. “We have already treated a handful of patients who have been collected and are in red cell exchanges waiting for their cells to be edited. A few of them have already received their cells, are doing well and have no disease post-transplant.”

Dr. Maitta also oversees a chronic red cell exchange program for sickle cell patients in both adult and pediatric settings. In addition, his team offers other apheresis procedures, such as therapeutic plasma exchanges, leukocytapheresis (removal of white blood cells from the bloodstream) and thrombocytapheresis (selective removal of platelets from the bloodstream), as well as stem and mononuclear cell collections for transplantation.

Like the Pathology department itself, the UH blood bank touches nearly every UH patient in some way. Aware of their crucial role, the team reiterates its by-now-familiar core message: Donate blood if you are able.

“Donations are always needed,” says Victoria Cary, who manages the system’s largest blood bank. “There’s always somebody else in this hospital who needs donations. And I think we sometimes forget that. Patients need donations every day.”