Risk Management in Blood Transfusion: The Virtue of Reality
Proceedings of the 23rd International Symposium on Blood Transfusion
edited by
C.Th. Smit Sibinga
Red Cross Blood Bank Noord-Nederland, Groningen, The Netherlands
H.J. Alter
National Institutes of Health, Bethesda, MD, USA
Book Series: DEVELOPMENTS IN HEMATOLOGY AND IMMUNOLOGY : Volume 34
Since the outbreak of the AIDS epidemic, public and political perception of blood transfusion has been negatively colored. As a result, blood banks and transfusion services have been forced into defensive positions. The balance has tipped to criticism, suspicion and mistrust, where the overwhelming positive and blessed effects of blood transfusion seem to have been forgotten or grossly neglected.
Risk Management in Blood Transfusion is unique in providing a fairly complete overview of the various aspects of risk perception in relation to blood transfusion. Inspired by an unequalled authority as Dr. Harvey Alter, an extremely competent and talented panel of authors provides a balanced opinion on how to manage risk in blood transfusion; a true virtue of reality.
This book is composed of four major sections:
The perception of risk, where authorities from the field of environmental psychology and risk analysis describe the backgrounds and mechanisms of cognitive behavior and the effects of emotional and publicity factors on perception and acceptance of risk. Such information has only scarcely been touched upon in the medical world and in particular in transfusion medicine. Much can be learned about these mechanisms that define how the media, the public and politicians react to information and scientific data. These grossly exaggerate and lose touch with reality.
Realistic cost-benefit analysis explains the reality of the magnitude that social and political behavior seems to reflect.
The management of infection-defined risk, the core of public and political anxiety. Here the book illustrates how safe the current blood supply has become over the past decade in at least the majority of industrialized countries in the world. Aspects of further prevention and management of infection-defined risks related to blood transfusion illustrate the virtue of reality today and for the future, as discussed in the chapter on the application of genome amplification testing of donor blood. The expert panel of authors in this section alone makes reading the book worthwhile.
The management of immune-defined risks has been the Cinderella of blood transfusion and transfusion medicine up till now. Here, routine transfusion practice seems to focus on the all or nothing principle, without many evidence-based principles being applied. The authors illustrate new views and hypotheses on the function and behavior of the human cellular immune system. Fascinating information, further elaborated on in the discussion part, enriches this section.
Risk management in clinical practice: optimal versus maximal is the section where the real virtue of reality comes to life through valuable contributors by authors from the field of clinical blood banking, heavily involved consumers organizations (WFH), the Cochrane Institute of Medical Sciences and National Health Services Center for reviews and dissemination, and international policy makers and regulative bodies like the Council of Europe and the European Commission.
The edited discussion on the chapters adds specific value, because of the references made by the discussants quoted. Without losing touch with daily realities in practical and clinical blood transfusion, the authors provide a unique and comprehensive overview and perspective of this important matter in health care. When the reader is first confronted with a poem illustrating the reality of virtue, written by one of the editors noted for his talent in anecdotal medical poetry, the scene is set for the virtue of reality in the management of risk in blood transfusion.
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