For six weeks, three-year-old Ivy Exantus was kept alive by blood donations from six dedicated strangers.
Their precious platelets - almost an exact match to her own - were flown from collection points across Australia to Sydney Children's Hospital, where Ivy's family were preparing for a bone marrow transplant donated by her six-year-old donor brother, Jaye.
The wait for the first urgent bag of platelets, the clotting component of blood, was the most anxiety-inducing, Ivy's mother Kimberley Exantus said.
Ivy was diagnosed with Fanconi anaemia after she didn't bounce back from a playground bug in April. Her blood tests showed she was dangerously low in haemoglobin and platelets, the clotting agent in blood.
"Her platelets were so low that nothing would have stopped the bleeding if she got a bump on the head or a bad cut. She would have bled out," Mrs Exantus said of her daughter and youngest of three children.
Ivy would need to undergo surgery to insert a central line before her transplant to receive immunosuppressants and cytotoxic medication, but her body had begun to create antibodies to the platelet transfusions she was receiving and threatened to reject the donations.
Her surgery could not go ahead while her platelet count was so low.
"She was so sick. It was so horrible. She had blood blisters all through her mouth and gums. She was bruised all over," Mrs Exantus said.
Ivy's parents had to stop brushing her teeth for fear the toothbrush would nick it and she would start haemorrhaging.
An urgent search began to find donor platelets with proteins called Human Leukocyte Antigens (HLA) that matched Ivy's HLA profile.
The Australian Red Cross Blood Service found two bags of matched platelets in Perth. They were flown to Sydney overnight and arrived just in time for the central line insertion.
Ivy would now need daily transfusions from her six unknown donors with matching HLA, whose platelets were collected specifically for the three-year-old as she waited for her bone marrow transplant.
Mrs Exantus and Ivy's father James don't know who these individuals are, but can't thank them enough.
"They kept her alive. They didn't have to do that. They didn't have to keep donating of their own accord," Mrs Exantus said of the anonymous donors.
"It's hard to explain how much that means to us, when we weren't able to help her. I would love to be able to tell them how much I appreciate it. Hopefully they see this story."
Increase in demand
Supplies of platelets are at risk of being exhausted over the Christmas and New Year period unless an additional 4000 donors roll up their sleeves, the Australian Red Cross Blood Service has warned.
NSW alone needs 1000 extra people to book an appointment from December 26 to January 2 to forestall a shortage of blood products crucial for cancer patients who rely on the platelets to prevent internal bleeding as they undergo treatment, as well as trauma patients, new mothers and people with blood disorders.
The Australian Red Cross Blood Service will need to collect 3500 half-litre bags of red cells and platelets; a total of 12,500 donations nationally to meet the demand Australian hospitals are predicting.
Blood supplies are particularly vulnerable over the festive season, said service spokeswoman Jemma Falkenmire.
Regular donors are away on holidays and stocks are exhausted in the lead-up to Christmas as hospital staff try to get as many patients home to their families for celebrations.
Around one in five people cancelled their blood donation appointment over the same period last year, Miss Falkenmire said. The service predicted the same proportion would cancel this year, exacerbating a 5 per cent increase in demand.
For the first time, blood donor centres will be open on a Sunday (Christmas Eve), but any donations collected before Christmas will have expired by the following week, Ms Falkenmire said.
"If people do need to cancel we ask them to cancel early so we can try to fill that appointment," she said.
A tiny proportion of the Australian population - just 3 per cent, half a million people - keep blood supplies going all year round, despite 8.5 million Australians being eligible to give blood, according to the service.