These discussions are attempts at recreating genuine interactions from my encounters with intriguing individuals. They are sourced from Zoom records, scribbled notes, emails and voice recordings, then whimsically reshaped through AI.
Joshua: Hi Adriaan, given my consistent interest in non-invasive methods to understand physiology, I wanted to discuss the criteria you use to evaluate the physiological fitness of blood donors. I’m aware of your unwavering support for the blood donation drives, and considering the continuous strain on our blood supplies, I thought it would be invaluable to delve deeper into this topic with you today. How are donors assessed today?
Adriaan: Great to chat, Joshua. Currently, donors are assessed based on two primary factors before they can donate: their blood pressure (BP) and hemoglobin (Hb) levels. The acceptable ranges for BP are a diastolic BP of 100-140 and a systolic BP of 60-100.
Joshua: And what are acceptable Hb levels?
Adriaan: We determine Hb levels using a finger prick method. The blood obtained is then tested on-site with a benchtop Point-of-care (POC) machine. The acceptable Hb levels are 13.5 for males and 12.5 for females. If the first finger prick test fails, we do a second one. If both results are unsatisfactory, the person is not allowed to donate.
Joshua: I’ve heard that these finger prick tests for Hb sometimes suffer from reliability issues, can you expand on this?
Adriaan: You’re right. The finger prick method has its challenges. One of the main issues is that we’re drawing blood from the periphery, which can give variable readings. In some cases, these readings can mislead us about the donor’s actual physiological state. In addition to the Hb tests, we’ve started incorporating ferritin testing to monitor the iron store levels of donors. However, ferritin can’t be tested on the spot like Hb. It’s included in the routine blood testing performed at our laboratory.
Joshua: And that’s done every donation?
Adriaan: Not quite. It’s done on the first donation and then every fourth donation after that. It helps us track long-term ferritin trends in donors. However, these protocols are subject to change as more ferritin study data and trends are processed which could modify the appropriate algorithm.
Joshua: Anecdotally, fear of needles during finger pricks and donation seems to be a big deterrent for donation. Do you also observe this?
Adriaan: Absolutely. It’s a notable concern for many potential donors. And you might be surprised at the number of feedback we receive regarding the discomfort of the finger prick.
Joshua: So, ideally, what would be a more optimal solution for these pre-donation checks? Considering the rapid adoption of non-invasive smartphone-based applications to measure physiological states and infer biomarkers of interest, do you think this could work in your setting?
Adriaan: Well, a non-invasive solution would be ideal. If we could leverage technology, say a smartphone-based application, it could potentially allow donors to check their readiness at home. But the challenge would be ensuring that the results are accurate. We’ve noticed some donors might not always be entirely truthful if they’re very eager to donate.
Joshua: It’s a difficult balance, ensuring accuracy while also making the process more donor-friendly. But with technology advancing as rapidly as it is, I’m optimistic we can find a middle ground. Thank you for sharing all this valuable information; it really sheds light on the challenges you face.
Adriaan: Of course, Joshua. It’s essential to keep evolving and improving. Thanks for your interest in understanding our processes better!
Thanks to Adriaan for always schooling me in hematology and virology and for allowing our notes to be the feedstock for our AI overlords.
Joshua Wallace 
Leave a comment