Benefit of using polymerase chain reaction to test blood donations will be considerable

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7099.60a (Published 05 July 1997) Cite this as: BMJ 1997;315:60
  1. John Barbara, Microbiology consultant to the National Blood Authoritya
  1. a North London Centre, London NW9 5BG

    Editor—It is unfortunate that in attempting to summarise a complex situation regarding the potential role of the polymerase chain reaction in blood transfusion Adam Legge has overinterpreted my views.1 Although undoubtedly more costly than serological testing, use of the polymerase chain reaction does not involve a “quantum leap” in cost, but more a quantum leap in the organisation, logistics, and operational aspects of transfusion microbiology.

    The benefit of testing blood donations with the polymerase chain reaction is not “dubious.” On the contrary, because of the current streamlining of the blood service, better microbial surveillance and collation of data have enabled us to calculate residual microbial risk more accurately than ever before. The benefit will indeed be small in terms of extra infectious units detected because we are fortunate in already having an extremely safe blood supply.

    A subtle but important further point is that the introduction of the polymerase chain reaction has not been predicated in the first instance by a perceived need to test individual labile blood components. Instead, the requirement is regulatory and relates to fractionated pooled plasma products. Since the blood service will be undertaking this it is obviously appropriate to apply any benefit of enhanced blood safety to individual components. We are fully aware that this will be a challenging process. Because of improvements in the consistency and organisation of operational procedures nationwide, however, the blood service is confident that the challenges will be met cost effectively by testing of computer based automated pooled blood samples with the polymerase chain reaction.


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