What Ukraine's wartime blood supply transformation can teach the US

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What Ukraine's wartime blood supply transformation can teach the US

'Your blood can fight' slogans and 24-hour blood centers increased donations in Ukraine

• U.S. could adopt best practices on expanding blood collection to prepare for mass casualty events
• Study offers a rare look at how a national blood system can remain operational during a prolonged crisis
• Study published amid the American Red Cross' second-ever national blood crisis

CHICAGO --- At the start of the Russia-Ukraine War, Ukraine was hit with a 40% surge in demand for blood for its civilians and military personnel.

Despite damaged healthcare facilities, supply-chain disruptions and population displacement, the country maintained a self-sufficient blood supply by centralizing operations and expanding donor recruitment, according to a new international study that included scientists from Northwestern University.

While Ukraine's experience occurred during wartime, the study offers a rare real-world example of how a national blood system can remain operational during a prolonged crisis. The findings come as the American Red Cross recently declared its second-ever national blood crisis, underscoring the importance of resilient blood collection and distribution systems. The study authors noted that Ukraine's experience offers lessons for other countries, including the U.S., where strategies such as extended blood center hours and social media-based donor recruitment could help maintain blood supplies during emergencies.

Ukraine's trip to the Midwest

Early in the war, with facilities non-operational, supply chains disrupted and heightened demand from military and civilian trauma, Ukraine's blood system faced critical challenges in meeting transfusion needs nationwide. In October 2022, Ukrainian blood bank and blood system leaders visited several Midwestern U.S. blood banks, including one at Northwestern Memorial Hospital, to gain insights from how other blood centers operate. They exchanged information on blood system organization, transfusion practice, disaster preparedness and how to best meet European Union standards.

Drawing on ideas exchanged during the U.S. visit and its own innovations in donor recruitment and blood collection, Ukraine shifted from a decentralized hospital-based system to a coordinated national network, without relying on imports. For instance, Ukraine implemented a 24-hour operation of blood collection centers as needed, created public campaigns with patriotic slogans like "Your blood can fight!" and launched a specialized donor platform that shows blood type-specific demand.

Today, Ukrainian blood establishments report blood stocks daily, and have demonstrated sustained resilience during full-scale conflict. The study was published last week in Transfusion.

"They have this great story to tell. They basically reorganized their whole national blood service from hospitals to a national system, and their ability to pass inspections was very impressive," said senior author Dr. Glenn Ramsey, director of transfusion medicine in the department of pathology at Northwestern University Feinberg School of Medicine.

Ukraine's transition mirrors a transformation the U.S. underwent decades ago - from a scattered, hospital-based blood system to the coordinated national blood-collection system that emerged after World War II and was led by organizations such as the American Red Cross and regional blood centers - offering a rare modern look at how a nation builds a coordinated blood system under crisis.

How the U.S. can learn from Ukraine

Beyond annual blood shortages, the study authors said the U.S. could borrow from Ukraine's experience to prepare for large-scale emergencies of any kind.

"For instance, in the case of being at war, our military has their own system, but we could potentially need to make arrangements with the civilian blood supply to have blood collected, and hopefully there would be an outpouring of collection," Ramsey said. "That's where we could learn a lot from Ukraine. Their public campaigns advertised blood needs while assuring donors of safe practices, which countered Russia's strategy to undermine morale."

The U.S. also could adopt best practices on expanding the country's donor base and collection to prepare for mass casualty events, said corresponding author Dr. Yevgen Chornenkyy, assistant professor of transfusion medicine at University of Washington.

"Say it's a mass casualty event that we can anticipate, such as a large event like an international soccer game happening in the city, then we could increase our blood bank stock of units and products ahead of time," Chornenkyy said. "If it's an unanticipated event, that will be more in the line of a disaster response, and there we would again try to do what Ukraine is doing with recruiting donors, try to open our blood donor centers longer. And importantly, reach out to those interested in donating through social media channels."

Additionally, he said donor centers could possibly implement a public dashboard indicator for a specific region or city to predict how much and what type of blood is needed in that area.

The study is titled, "The Blood System in Ukraine: Experience in Martial Law Conditions."