AABB24: Blood Donation, Race and Transfusion Medicine: Looking Back to Move Forward

The Sunday afternoon session “Blood Donation, Race and Transfusion Medicine: Looking Back to Move Forward” focused on the history of racial segregation of blood products in the United States and examined the association between blood group serology and race. The speakers also emphasized the importance of better practice race-conscious, as opposed to race-based, transfusion medicine. 

The first speaker, Patricia Brunker, MD, DPhil, discussed how modern population genetics provides an important context for understanding the intersection of race and blood donation. She opened the session with a definition of race and ethnicity and highlighted the fixation index, which measures the genetic differentiation between populations based on genetic structure. Brunker also emphasized that race is a sociopolitical and not biological construct. 

Yvette M. Miller, MD, ABIHM, executive medical officer of the American Red Cross in North Carolina, began her presentation with a black-and-white group photo of Black community leaders gathered with American Red Cross leaders for one of several meetings held at the Red Cross National Headquarters in 1942 to discuss social policies and issues. Miller explained that the Red Cross decided to segregate blood based on race in 1942. The organization discontinued the discriminatory blood banking policy in 1948.  

“It has been a difficult life for me as a Black physician in the American Red Cross with knowing its history of segregating blood. But it’s something I’ve come to terms with because this is the job I love,” Miller told the audience. “The Black community knew there was no biological basis to segregate blood, but it was the policy of the U.S. military, and the Red Cross eventually complied,” Miller stated. 

The legacy of the practice of segregating blood has led to continued mistrust and pain for the Black community, Miller noted. Miller also talked about pioneer Dr. Charles R. Drew. Drew, who became the first medical director of the Red Cross in Feb 1941, openly disagreed with the policy of segregating blood based on race. 

Miller highlighted the American Red Cross Sickle Cell Initiative, which launched in 2021 to grow the number of blood donors who are Black to help patients with sickle cell disease (SCD). “We are doing everything we can to partner with trusted organizations that have always served the Black community so that trust can be opened, and the Red Cross can be invited in. We need a diverse pool of donors to meet the transfusion needs of the diverse community,” Miller told the audience.  

Attendee Sunitha Vege, from New York Blood Center, said the session highlighted the importance of knowing one's history. "Understanding the history of transfusion medicine is important to improving practices and gaining trust in underrepresented communities," she said. "This trust is essential to diversify the donor population to provide better and more precise match for patients, especially those with sickle cell disease."