NoBlood

Ongoing blood shortages have been common place with continuing requests for blood donations from Blood Centers. This worry over blood availability, critical blood shortages, concern for safety, and rising costs have lead members in the healthcare industry to rethink its once more liberal use of blood to one of conservation. The statistical data regarding transfusions is quite impressive.

Each year in the United States, approximately 14 million units of blood are donated by 8 million volunteers. This, in turn, is transfused into approximately 4 million patients. For safety measures and to improve the quality of the United States blood supply, the pool of eligible blood donors has been decreased considerably. In addition, less then 5% of the eligible population donates blood. Globally, 17% of the populations in developed countries benefit from approximately 60% of the 75 million units donated annually.

In the US, blood products are needed every three seconds, breaking down to an average of 34,000-40,000 units each day. One person in 20 will require a blood transfusion sometime in their lifetime. People older than 65 use 43% of all blood donated, leading to an increased need for blood as the population base ages. One out of every 10 people enter entering a hospital requires blood. So why is this blood transfused? Consider the following: [*]Examples of Blood Use and Average # of Units Required:

1. Automobile Accident: 50 units of blood
2. Heart Surgery: 6 units of blood; 6 units of platelets
3. Organ Transplant: 40 units of blood; 30 units of platelets; 20 bags of cryoprecipitate; 25 units of fresh frozen plasma
4. Bone Marrow Transplant: 120 units of platelets; 20 units of blood
5. Burn: 20 units of platelets

* bloodtransfusion.com/stats.asp retrieved Nov 1, 2006

One unit of blood is equivalent to approximately one pint. The average adult has approximately 10-12 pints of blood within his circulatory system. Blood is composed of water, plasma, cellular components (red blood cells, white blood cells, and platelets), nutrients, proteins minerals and hormones. Blood may be transfused as “whole blood”, or may be broken down into its individual components (plasma, red blood cells, platelets, cryoprecipitate) and transfused into several individuals. Blood may further be broken into blood fractions including but not limited to interferons, interleukins, albumin, and clotting factors.

In recent years, the cost of blood has increased by as much as 35%. Depending on the region, a unit may average $215. With further processing and additional screening costs, one unit of whole blood can cost as much as $485. As reported by St. Vincent Charity Hospital, many insurance companies do not cover the first two or three units needed in a medical procedure; hence the cost is transferred to the patient.

The decision to transfuse blood over the years has been predominantly left up to the discretion of the physician who is treating the patient, but physicians' transfusion practices can vary widely depending on their level of knowledge and interest (many physicians receive little academic training in blood component therapy), area of specialty (e.g., a hematologist vs. other specialist), and, possibly, the setting in which they practice. In addition, no clear-cut guidelines exist as to when blood transfusions should be considered. Physicians are, however, recognizing the need for more conservative transfusion practices and in many cases, based on prudent medical practices or patient decision, avoiding blood exposure all together.