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Diagnosis, treatment, & prevention: patient care at Bloodworks

The Pacific Northwest knows Bloodworks as the go-to resource for all things blood. While this may feel like a limited scope—the red stuff that comes out of your arm when you donate–blood impacts all aspects of life.

When it comes to patient care and the number of services offered, conditions treated, diagnostics performed, and research conducted, Bloodworks is a diverse organization, spanning the spectrum of medicine from diagnosis through specialized testing to treatment by our clinical programs to prevention via blood research.

Blood is complex.

Take platelets, the part of the blood that controls bleeding. If a patient’s platelet counts becomes low, they are at risk of uncontrolled, unwanted bleeding. This is bad. Bloodworks collects and distributes platelets to help these patients control bleeding.

If this goes in the opposite direction — platelet counts become too high or can’t properly regulate their function — the patient may experience unwanted blood clotting. This is also bad.

Thrombotic thrombocytopenic purpura (TTP) is one example of unwanted platelet activity and demonstrates how Bloodworks works together to treat patients.

“TTP is a rare disorder, but it’s a devastating disorder,” said Dr. Jose Lopez, Chief Scientific Officer. “If someone gets TTP and it’s left untreated, it’s almost universally fatal. So it’s really important to get a diagnosis and get it treated promptly.”

However, TTP research and care has broader impact.

“In trying to help patients with a very rare disease, we quite often learn about diseases that are very common,” added Dr. Lopez.

It’s a collaboration.


Bloodworks laboratories performs the diagnostic studies that can determine TTP and clotting and bleeding disorders.

 “The beauty of these small labs is that they are very flexible and we can kind of add tests as necessary,” said Gayle Teramura, manager of Bloodworks’ Genomics Testing, Platelet Immunology and Hemostasis Reference Laboratories.

One of these tests measures ADAMTS13 activity.

ADAMTS13 is an enzyme involved in blood clotting. When working as it should, ADAMTS13 keeps the body’s clotting mechanisms in balance. TTP occurs when something, like antibodies from an infection, autoimmune disorder, or medication, inhibits ADAMTS13 activity, though only about half of TTP cases have a clear trigger.

When TTP is suspected, Bloodworks receives samples from local hospitals, runs tests to determine ADAMTS13 activity, and then sends them back to the hospitals once we know the results.

But that’s not where it stops.


If a test results indicate TTP, “we notify WACAT that there’s a patient with low protease activity,” said Gayle. “We do that to allow them some time to prepare as a possibility of having to perform a procedure on this patient.”

She adds, “That requires that the whole team at Bloodworks has to kick in: we need blood products and a variety of things for us to do the procedure, and it has to be perfectly orchestrated because this disease is life-threatening.”

This procedure, therapeutic plasma exchange, is similar to a platelet, plasma, or red cell donation via apheresis.

“During the treatment, we sure use a ton of plasma to replenish fresh ADAMTS13 that the patient is deficient,” said Dr. David Lin, medical director of Washington Center for Apheresis Therapy (WACAT).

An apheresis machine uses a centrifuge to separate and remove unwanted blood components, in this case the plasma containing harmful antibodies, then returns the rest of the blood components and replacement plasma to the patient.


Sometimes, however, the test results in Gayle’s labs do not fit the symptoms or the diagnosis.

“We’re finding out through all our expert research that it could be the sensitivity of the assay (analytic test) we’re running, or it could be that there are different epitopes (the part of an antigen that an antibody attaches to) that possibly could be a target that we’re missing,” she explained.

Twenty years ago,Dr. Dominic Chung, a senior scientist at Bloodworks Research Institute was in the group that first identified the ADAMTS13 enzyme and its role in blood clotting – including working on diagnostic assays.

 “In our ongoing efforts to understand TTP, we have leveraged our understanding of protein chemistry, and actually developed several new assays that are relevant to TTP,” he said.

These compliment the clinical tests. Whenever a clinical test gives results that aren’t clear, we can use the tests that Bloodworks Research Institute developed to get a better picture of the patient’s situation to help their physicians improve their outcome.

One of these tests is a reagent that can measure protein levels. Another is an immunological assay to look at ADAMTS13 antibodies; Dr. Chung’s lab isolated these antibodies and turned them into a simple dipstick test.

“The enzyme that is missing in TTP turns out also to be involved in many other conditions, including severe trauma or severe sepsis – yes, including COVID-19 – so there is an increasing need of measuring this enzyme,” he said.

Simpler, easier tests, like the ones Dr. Chung is developing in his lab, will address this need in the future.

There’s no substitute for donated blood – unless…

Bloodworks always has a need for donated platelets and, like blood centers across the country, has seen a decrease in blood and platelet donors in the past decade, leading to shortages.

Bloodworks’ Cord Blood Program banks donated umbilical cord blood for stem cell transplantation. However, not every cord that is collected has enough cells to be banked for transplant, and those that do not make the cut may be used for research.

Bloodworks Research Institute, in partnership with Bloodworks Bio, is currently embarking on research to try to make platelet-like cells from cord blood. Time will tell if this is an effective source of platelets for transfusion, but one thing is for sure: we have the science to determine either way.

This is just one of the many ways we work across disciplines to save lives in the Pacific Northwest and beyond.

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When Donating Blood Comes Full Circle – Bloodworks Northwest Blog

When teacher and improv performer Jaclyn Schuenzel gave birth to her daughter Zelda in June 2020, life with her husband Marc Guy and the new baby was joyous. But just one month later, the longtime blood donor found out why those donations are so important.

Just standing in her kitchen and without any warning, she started hemorrhaging blood and struggled to call out to her husband for help before collapsing and passing out. Marc administered CPR until an ambulance arrived and whisked her to Evergreen Hospital in Kirkland. WA.

Jaclyn had suffered a ruptured uterine artery, one of the biggest blood vessels in the body, so her blood loss was severe and her condition, tenuous. Doctors immediately transfused three units of blood, and they started a fourth, they rushed her into surgery. Luckily, a specialist was on hand to find and repair the bleed in the operating room in the span of just one hour. But she still needed 10 units of blood on the operating table.

“If I had not had that blood, I wouldn’t have made it.” 

-Jaclyn Schnuezel

Happily reunited with her daughter and husband, Jaclyn has recovered fully and is grateful. Her husband and many of her family and friends immediately made blood donation appointments in gratitude for all the help Jaclyn received, and in October 2020, her employer Unexpected Productions Improv (UPI), a local theatre in the heart of Pike Place Market, hosted a virtual blood drive to highlight the need for donations in our community.

It was midnight and Jaclyn Schuenzel was simply standing in her kitchen like any other night when she suddenly needed vast quantities of blood to live. It can happen in an instant. And for that reason, our community’s need for blood never stops. Please make an appointment to donate blood today. Someone, somewhere, is counting on you.

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“I’m So Fortunate to be Able to Donate, So I Do.” – Bloodworks Northwest Blog

Leo Notenboom with one of his Corgis, Walter. Photo credit Leo Notenboom.

For National Blood Donor Month 2022, we’re highlighting one of our most dedicated – and most eclectic – platelet donors.

Leo Notenboom is so busy, he sometimes uses a tagline. “Coffee, computers, and Corgis,” he says, “and not necessarily in that order.” He is also self-employed (but was the 342nd employee at Microsoft), an avid volunteer with Washington State Animal Response Team, an amateur radio operator, and an over-200-unit blood and platelet donor.

Like many blood donors, Leo’s first donation happened when Bloodworks came to him. In his case, it was at work, with a bloodmobile, and more than 30 years ago. He can’t say why he made that first donation that day, but his wife was then a Licensed Practical Nurse, so he understood “what would happen with blood, what it was used for, why it was important, and how donations end up helping the people in need. So it just sort of fit.” And over the years, his dedication grew:

“This is one of those very easy and obvious ways for me to give back in a way that I think a lot of other people might not be able to.”

After donating whole blood a few times, Leo became a platelet donor since he had flexibility in his schedule to accommodate the longer donation time. Not one for doing anything on a small scale (he hosts the annual Pacific Northwest Corgi Party at his house every year with dozens of them in his back yard; yes, there are photos), he just completed his 105th platelet donation.

Leo teaching radio fundamentals at Washington State Animal Response Team, where he’s a volunteer. Photo credit: Leo Notenboom.

We asked Leo for his thoughts on the pandemic-era that has halted the kind of workplace blood drives that introduced him to blood donation, and he said it better than we could. “This is one of the safest environments I can think of during the pandemic to be able to do something like this. Especially now, because there aren’t any blood drives going on at the workplace, it’s that much more important for those of us who can to take that extra effort to come in, make the appointment, donate whole blood, donate platelets, whatever it is you can do. You can do it; perhaps other people can’t. And we know that there’s a huge, huge need.”

When Leo isn’t donating platelets, rescuing stricken animals from perilous situations, writing books that make technology more accessible, or managing the oldest and largest internet mailing list for Corgi lovers, Leo hosts a few of his own websites, each centered on his optimistic spirit. With names like Heroic Stories and Not All News Is Bad, Leo spends time each day scouring the internet for stories of human kindness and hope. We asked him why he strives to be so optimistic:

“It’s helped me not fall into the abyss. And the ability to share good news with others makes me feel like I’m making the world a little bit of a better for people who need that reminder.”

Leo said he didn’t know what pulled him through that bloodmobile’s door all those years ago, but we think in that statement, he found the answer. Spreading optimism, human kindness and hope is clearly in Leo’s blood. It’s why he maintains those websites, helps rescue stricken animals, and herds Corgis in an explosion of cuteness every summer. And we think it’s why he donates platelets too. Because that’s what blood and platelet donation is – hope offered when nothing else will do.

So Happy National Blood Donor Month to one and all! We’re grateful to you all every day, and stay tuned for a new episode of our podcast, Bloodworks 101, featuring Leo!

We may be a regional blood center supporting 90+ hospitals throughout the Pacific Northwest, but we’ll never pass up an opportunity to share a photo of a Corgi in flight. Photo credit: Leo Notenboom & Freddie.

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My Blood Type is AB+

Although it may look identical, not all blood is the same. The small, but vitally important difference can be found at the surface of the red blood cells. The presence, or absence, of A and B antigens at this level determines your blood type. The antigens help identify to whom your donated blood can be transfused and what types of blood you can receive if you ever require a blood transfusion. Differentiating blood in this way is important, because without it, careful matching to ensure safe transfusions would not be possible. This matching process is especially important for those with AB+ blood, a blood type with a very specific antigen make-up that appears less frequently in the U.S. population.

So what makes AB+ different from the other blood types? AB+ blood has both A and B antigens at the surface of the red blood cells, while other blood groups (A and B) only have one, or lack them altogether (group O). Because of this unique combination, AB+ donors’ blood can only be given to others with AB+ blood. However, AB+ is the universal recipient blood type, meaning that patients with AB+ blood can receive blood from donors of any blood type if they require a transfusion.

Antigens present in AB+ also play a vital role in plasma donations. While AB+ blood has both A and B antigens on the red blood cells, neither of the antigens are present in the plasma. This makes AB+ the universal plasma donor, meaning that AB+ plasma can be transfused into patients who have any other ABO blood type. The AB blood group is believed to be the newest blood type. The AB blood group is the result of the intermingling between Caucasian (commonly group A) and Mongolian (commonly group B) people. For these reasons, the AB blood group is found in low percentages throughout the European population, but appears more commonly within the sub-continental Indian population.

Only about 3 percent of the U.S. population is AB+, making AB+ blood donors all the more valuable. Although people with AB+ blood can receive from any blood type, it is always preferred to receive blood from a person with the same blood type. If your blood type is AB+, we hope you will consider giving life to your community by donating blood and/or plasma as often as you can. You can give whole blood donations every 56 days and plasma donations as often as every four weeks. You can even give us a call at 1-800-366-2834 to see when your donation is most needed.

If you’re not AB+, you can learn more about how your blood type helps save lives here (link to “Donate to Meet the Needs” blog post). Don’t know your blood type? You can still give blood! When you donate with Carter BloodCare, we’ll test your blood and let you know your type so you can research more about who your blood helps, what types of blood could help you, and when your blood type is needed most.

Knowing your blood type and what makes it different from the others can give you a greater understanding of the blood donation process, the blood cross-matching process, and the need for blood donations of your type in your community.

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