While the American Red Cross encourages any healthy person meeting the requirements to give blood as often as possible, minority donors are especially in high demand. No one knows this better than the children across the country, most of them African American, who rely on frequent blood transfusions for sickle cell anemia.

"It's scary to think about a day when the blood won't be there," says Autumn, an 11-year-old soccer goalie and monthly blood transfusion recipient. With blood levels as cyclical as they have been over the past year, her fears are not unwarranted.

According to the Sickle Cell Disease Association of America, sickle cell is an inherited red blood cell disorder that affects more than 70,000 people nationwide. Under normal circumstances, red blood cells in our bodies are doughnut-shaped and can easily float through the blood vessels to deliver oxygen. Patients with sickle cell disease have red blood cells that are hard and pointy and do not pass through the body easily, leading to severe pain, anemia, and the potential for blood infection.

Recent research has demonstrated that there are ways to reduce pain from sickle cell, as well as prevent strokes in children with sickle cell, one of the most common and serious side effects of the disease.

"Since 1997, doctors have been advised to treat kids with sickle cell disease with rapid blood transfusions every three to four weeks," said Melissa McMillan, a spokesperson for America's Blood Centers. "This treatment has been shown to reduce the risk of stroke in children with sickle cell disease by as much as 90 percent."

When any patient receives repeated blood transfusions, the body begins to see the proteins in donated blood as foreign bodies, often leading to a "rejection" reaction, said Dr. Donald Siegel of the University of Pennsylvania Medical Center. When patients with sickle cell disease receive transfusions of blood from a donor that is non-Caucasian, a rejection reaction is less likely since donor and recipient blood proteins will be more alike.

"When you try to find compatible blood for people, you must take into account the ethnic and racial background of both the donor and the recipient," Dr. Siegel said. "If there were more donations from minority groups, it would be easier to find matches."

Lagging Behind

Claire Gemme, director of donor services for the American Red Cross Western Massachusetts Blood Region, agrees with Dr. Siegel. She said that of the 5 percent of the population that donates blood, only 0.5 percent are African American and Hispanic donors, meaning that there is less blood available to effectively treat all of the children with sickle cell in the United States.

"The African American and Hispanic population has grown tremendously in our country," Gemme said. To increase the number of minority blood donors, she said, "We have to go out into the community and get to know our [African American and Hispanic] neighbors."

This mindset is exactly what is driving several American Red Cross programs geared toward collecting more blood to use in treating children with sickle cell disease. Merle Schneider, diversity officer for Red Cross biomedical services, said that increasing demand for blood for elective surgeries and other medical advances has really put a strain on the amount of blood available for sickle cell transfusions.

"We need much more blood than we currently collect," she said. "We get six million units a year and it's not enough—we need to keep up with the requests."

Spotlight on St. Louis

Several American Red Cross blood regions with strong ties to hospitals with sickle cell treatment centers have begun to reach out to their minority communities, Schneider said. In just ten months, the Missouri-Illinois Blood Services Region of the American Red Cross has collected 3,000 units of usable blood from the African American community in the St. Louis metropolitan area. Much of this blood has gone to benefit children receiving regular transfusions for sickle cell disease at nearby St. Louis Children's Hospital.

The leaders of the minority recruitment initiative in St. Louis, called the Charles Drew Community Blood Donation Campaign, have used an effective strategy to market blood donation to African Americans in the city. "We've found that a combination of 'personal ask' tactics and education is the best way to recruit [minority] donors," said Schneider.

As Project Manager of the Missouri-Illinois Charles Drew Community Blood Donation Campaign, Michael Yarbrough has made blood donation personal for a number of African Americans in St. Louis. After more than 50 blood drives in churches, schools and community centers, the Campaign has helped to identify "donor partners" for many of the sickle cell patients at St. Louis Children's Hospital.

Following each Charles Drew blood drive in St. Louis, American Red Cross labs test the collected blood to see if any closely matches the blood of one (or more) of the sickle cell patients, explained Yarbrough. When matches are identified, the donors are notified and asked to be a sickle cell partner. While these partners don't know who their blood is going to, they do know that each time they donate, their blood will be used to a specific patient at St. Louis Children's Hospital.

"These matching donors will have the unique ability to say to themselves, 'I am directly involved in someone's life'," said Yarbrough. "Ultimately, we want to designate ten or twelve donors for each child receiving transfusions for sickle cell [at St. Louis Children's]." Since people can only donate blood every fifty-six days, this would provide insurance that matching blood would always be available for each sickle cell patient whenever he or she needed a transfusion.

Philadelphia: Designated Donations

In Philadelphia, another city with a large African American population, the American Red Cross Penn-Jersey Blood Services Region has partnered with the Children's Hospital of Philadelphia Comprehensive Sickle Cell Program to provide transfusion support for sickle cell patients.

Susan Sponar, communication director for the American Red Cross Penn-Jersey Blood Services Region, said that Children's Hospital treats about 600 kids with sickle cell disease each year. To prevent strokes and organ damage, sickle cell patients as young as two receive repeated blood transfusions at Children's.

"While it is everybody's responsibility to donate blood, most of the children with sickle cell disease are African American and the best matches for them will come from African American donors," Sponar said. Through education and specially targeted blood drives, the Penn-Jersey region has collected blood from African American donors that is designated specifically for a child with sickle cell disease.

When Philadelphia-area donors learn about the program that the American Red Cross runs in conjunction with Children's Hospital, officially called the Cooperative Program for Sickle Cell Disease, they can request that their blood be flagged to go to Children's Hospital for sickle cell treatments. Sponar said that several hundred donors in the Penn-Jersey region currently make the personal choice to participate in the program by designating their blood.

"The American Red Cross has been able to provide better matches for the children with sickle cell disease and, while all the scientific data are not in yet, medical staff at Children's report that over the last two years the children who are receiving transfusions are doing very well," she said.

Whether or not minority blood donations are designated to go to a child with sickle cell disease needing a transfusion, the blood is adding to the supply in all of the American Red Cross blood regions—one that always benefits from replenishment. "In minority populations in general, there is a greater preponderance of Type O and Type B blood—exactly what we are always lacking in our blood systems," said Schneider.

As long as American Red Cross donor recruitment programs continue to educate and inform our country's quickly-growing minority population, children like Autumn, the 11-year-old soccer player, can rest assured that their medical care is not in jeopardy.