Science commentary: Why is it important to reduce the need for blood transfusion, and how can it be done?

doi:10.1136/bmj.324.7349.1302

BMJ 2002;324:1302 ( 1 June )

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Science commentary

Why is it important to reduce the need for blood transfusion, and how can it be done?

The first 150 words of the full text of this article appear below.

Reducing the need for blood transfusions is desirable for several reasons. Since 2000 in the United Kingdom it has been mandatoryto remove all white cells from donated blood to reduce the smallbut theoretical risk of prion disease (variant Creutzfeldt-Jakobdisease). This has trebled the cost of providing donated blood.Transmission of hepatitis B, hepatitis C, and HIV by transfusionoccurs in 1 in 300 000 cases, despite screening programmes.¹However, non-fatal but serious transfusion errors occur in 1 in16 000 transfusions.¹

Critically ill patients are now known to do just as well with a lower haemoglobin concentration than previously thought, thusreducing the need for top-up transfusions.² There is also someevidence that homologous blood transfusions increase the ratesof recurrence of some cancers (tumours of the bowel and oesophagus,in particular) and can increase the incidence of wound infections.³It is unclear why these phenomenaoccur.

A number of mechanical methods . . . [Full text of this article]

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Relevant Article

Reducing blood transfusion: Alain Vuylsteke, Caroline Gerrard, Michael H Cross, Christopher M Munsch, Derek R Norfolk, Vipin Zamvar, Nicola Payne, Ivor Cavill, Gregor Caspari, Wolfram H Gerlich, and Lutz Gürtler
BMJ 2002 325: 655. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Vuylsteke, A., Gerrard, C., Cross, M. H, Munsch, C. M, Norfolk, D. R, Zamvar, V., Payne, N., Cavill, I., Caspari, G., Gerlich, W. H, Gurtler, L. (2002). Reducing blood transfusion. BMJ 325: 655-655 [Full text]