Serious hazards of transfusion (SHOT) initiative

doi:10.1136/bmj.320.7241.1075

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Conclusion was not supported by data presented

Paul Nederlof, senior house officer in obstetrics and gynaecology (paulesteruk@paulesteruk.demon.co.uk)

Gloucestershire Royal Hospital, Gloucester GL1 3NN
Winchfield, Hook RG27 8SP
On behalf of the SHOT Steering Group, SHOT Office, Manchester Blood Centre, Manchester M13 9LL

EDITOR—Williamson et al report on the safety of transfusions in the first two annual reports of the serious hazards of transfusion (SHOT) initiative.1 Although they found 366 cases of serious complications after transfusion, they conclude that transfusions are extremely safe. This conclusion is not supported by their data because they do not mention the total number of transfusions. A rate of complications would be useful for junior doctors, who usually have to seek patients' consent to procedures. Do any such data exist?

References

1.↵
1. Williamson LM,
2. Lowe S,
3. Love EM,
4. Cohen H,
5. Soldan K,
6. McClelland DBL,
7. et al
. Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports. BMJ 1999; 319: 16–19. (3 July.)
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Autologous transfusion would avoid many of the problems of blood transfusion

Michael J G Thomas, colonel (retired), Royal Army Medical Corps (MichaelJGThomas@compuserve.com)

Gloucestershire Royal Hospital, Gloucester GL1 3NN
Winchfield, Hook RG27 8SP
On behalf of the SHOT Steering Group, SHOT Office, Manchester Blood Centre, Manchester M13 9LL

EDITOR—Two articles in the BMJ last year highlight important issues in blood transfusion—namely, safety and autologous transfusion—and emphasise the need for education and standardisation of procedures.1 2 Provan raises the issues of availability and cost.1 The requirement for red cells is increasing annually by 2-3% against a static or even falling number of donations. One solution, suggested by both Provan1 and the NHS Executive, 3 is to increase the use of autologous transfusion. The safest and …