Intended for healthcare professionals


Do liberal blood transfusions cause more harm than good?

BMJ 2014; 349 doi: (Published 05 December 2014) Cite this as: BMJ 2014;349:g6897
  1. Lawrence Tim Goodnough, professor of pathology and medicine1,
  2. Michael F Murphy, professor of blood transfusion medicine23
  1. 1Transfusion Service, Stanford University Medical Center, Stanford University, Stanford, CA, USA
  2. 2NHS Blood and Transplant, Oxford, UK
  3. 3Oxford University Hospitals, University of Oxford, Oxford, UK
  1. Correspondence to: L T Goodnough, 300 Pasteur Drive, Room H-1402, Stanford CA 94305-5626, USA ltgoodno{at}
  • Accepted 10 November 2014


Guidelines and evidence from randomised controlled trials and meta-analyses increasingly support restrictive blood transfusion, but it is being implemented only slowly, explain Lawrence Tim Goodnough and Michael Murphy. They argue that electronic systems for clinical decision support could improve blood use


  • Contributors and sources: The authors both have considerable experience in clinical and laboratory transfusion practice and research into optimising the care of patients who might need transfusion. This article arose from sharing experience in implementing restrictive transfusion strategies and electronic clinical decision support systems for blood ordering at Stanford and Oxford.

  • Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

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