Blood transfusions found to harm some patients

April 24, 2008

a.. 26 April 2008

b.. NewScientist.com news service

c.. Nowak

" For the life of the flesh is in the blood. No soul of you shall eat blood. " So

says the Bible's book of Leviticus, and it is for this reason that Jehovah's

Witnesses shun blood transfusions. They do not, however, shun surgery. As long

as surgeons use special techniques, Jehovah's Witnesses can have surgery -

including operations with the greatest potential for blood loss, such as

open-heart surgery - without ever receiving a drop of someone else's blood.

Now some surgeons and anaesthetists are questioning whether every patient

shouldn't get the same treatment. Over the past decade a number of studies have

found that, far from saving lives, blood transfusions can actually harm many

patients.

The problem is not the much-publicised risk of blood-borne infectious agents,

such as HIV, but the blood itself. Study after study has shown that

transfusions, particularly those containing red blood cells, are linked to

higher death rates in patients who have had a heart attack, undergone heart

surgery, or who are in critical care. The exact nature of the link is uncertain,

but it seems likely that chemical changes in ageing blood, their impact on the

immune system, and the blood's ability to deliver oxygen are key.

In fact, most experts now agree that the risk posed by the transfused blood

itself is far greater than that of a blood-borne infection. " Probably 40 to 60

per cent of blood transfusions are not good for the patients, " says Bruce

Spiess, a cardiac anaesthesiologist at Virginia Commonwealth University in

Richmond.

Such claims have led this week to the US National Institutes of Health issuing a

call for proposals to study the problem. Also this week, the Joint Commission in

Chicago, which accredits US hospitals, is holding the first of several meetings

to look for ways to reduce the risks. It is expected to at least conclude that

hospitals should be more selective in the use of transfusions.

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