Consumer Reports on Blood Transfusions

The "Your Health" Department (page 61) in the September 1999 issue of Consumer Reports deals with the question: 'Premium' plasma -- Isn't 'regular' blood safe enough?

The article includes a very noteworthy graphic depicting the relative risk of dying from various causes. It states (highlighting added):

What's the risk?

This chart compares the average chances of a hospital patient's being infected from a transfusion against the annual risk of other life-and-death events. Transfusion data are for two units of blood, the amount often given during routine surgery such as knee replacement. (However, some complicated cases--such as heart surgery, care for car-crash victims, or organ transplantation--may require far more units than that.) The transfusion risks shown here should become even slimmer as nucleic-acid testing is phased in (see story).

As the chart shows, the likelihood of infection from a two-unit blood transfusion is substantially less than the chance of being murdered or of being killed in an auto accident during the year. Indeed, for a hospital patient, the greatest risk shown here is dying from an unexpected adverse reaction to some medication.

The story discusses a number of recent innovations in blood therapy and testing, including something called nucleic-acid testing (NAT). It says: "The new test can detect the virus itself, not just the telltale signs of the virus, which can take weeks or months to appear. So NAT should radically shrink the old testing loophole--the chance of missing a delayed sign of the virus..."

Lest any should think the above-mentioned developments support the Society's claims about the present dangers associated with blood transfusion, I hasten to add that the article also states:

In the 1970s high rates of hepatitis from transfusions triggered a sweeping re-examination of blood banks' procedures. Most important, the banks stopped collecting blood from paid donors, who were more likely than unpaid donors to be sick.

The advent of AIDS in the early 1980s forced further reforms.... The payoffs were huge.

In 1984, the year before blood banks got an AIDS-virus test, 714 transfusion recipients were infected with the disease, according to a 1997 government report. Over the next 12 years, a total of just 38 cases of AIDS were linked to transfusions of blood that had tested negative for the virus--and the vast majority of those cases occurred in the early years, before the test was refined.

That change reflects an impressive improvement in the blood supply. In 1983 the AIDS virus was present in as many as 1 out of 100 units of blood. Today the odds are an estimated 1 in 676,000. Hepatitis C contamination has fallen from a similarly high prevalence to about 1 in 103,000 units....

Dr. F. Blaine Hollinger, chairman of the Food and Drug Administration's Blood Products Advisory Committee (a group of outside experts), says that even the above estimates of the AIDS and hepatitis C risk from transfusions may paint an overly pessimistic picture of blood safety. Not everyone exposed via transfusion to various blood-borne illnesses get sick, Hollinger notes .... And the introduction of nucleic-acid testing should make the already tiny risk much tinier.

Your risk of dying while in hospital, the article then points out, "may be hundreds of times greater" from other causes, including allergic reaction to drugs administered.

Under "Recommendations", the story reports:

Transfusions save nearly 10,000 lives a day: trauma and burn victims, surgery patients who lose lots of blood, cancer patients who undergo blood-depleting chemotherapy and radiation, and people with deadly anemias and clotting disorders. On average, that benefit far outweighs the extremely small risk of getting a serious disease from tainted blood.