The Dark Side of Blood

What Doctor's Don't Tell You About Blood Transfusions

Nov 16, 2009 Joanna Karpasea-Jones

Blood undoubtedly saves many lives each year but it also carries risks, some life threatening, that recipients are rarely informed of.

Did you know that 82% of the world's population live in third world countries, yet they receive less than 40% of the world's blood donor supply? Many hospitals in poorer countries do without blood, or frequently cancel operations that require it. If you were to have a serious accident in one of these countries, your chances of survival would be much less than if you lived in a developed nation.

Donated blood has saved the lives of traffic accident victims, women in childbirth and people with blood diseases, to name a few, but most people assume that blood is always safe and that it has been thoroughly screened prior to use. It is true that it is now screened for Hepatitis B and HIV and other infections not previously screened for, but new diseases are developing all the time.

Peter Carolan, from the International Federation of Red Cross and Red Crescent Societies, said,

"Absolute guarantees on blood supplies can never be given. There will always be new infections for which at the moment there is no test."

Variant Creutzfeldt-Jakob Disease (vCJD).

An example of this risk is vCJD. The progressive, fatal brain disease in which your brain turns to a sponge-like consistency, was first discovered in the UK in 1985 when a cow at Pitsham Farm in Sussex, exhibited strange coordination problems and confusion. It became a notifiable disease in 1988 and scientists had admitted by 1995 that it could transmit to humans. So far, 171 young people in Britain have died of vCJD.

On the 2nd May 2007, the first case of BSE appeared in a cow in British Columbia, Canada and two Canadians have since died of vCJD.

The disease is transmittable by eating infected meat, and by the use of blood products in medicines and vaccines, as well as by blood transfusion itself.

18 blood donors were later found to have vCJD, and their blood was used all over the world for the following products:

• Ireland: Polio vaccine - 83,500 doses
• Brazil: Albumin - 44,864 vials, immunoglobulin 80 vials
• Dubai: Albumin - 2,400 vials
• India: Albumin - 953 vials
• Turkey: Ammunoglobulin - 840 vials
• Brunei: Albumin - 400 vials
• Egypt: Albumin - 144 vials
• Morocco: Albumin - 100 vials
• Oman: Immunoglobulin - 100 vials
• Russia: Factor VIII - 23 vials
• Singapore: Immunoglobulin - 3 vials

As human albumin is a common ingredient in most vaccines, there may have been other vaccines affected, in addition to the doses for Ireland.

Currently, the government do not screen UK blood donors for vCJD and as victims are asymptomatic for years, this is a concern.

The Haemophila Society said,

"The Haemophilia Society is fundamentally opposed to not testing for vCJD and believes that failure to deploy the tests would repeat the mistakes which led to 1,757 people with haemophilia dying of Hepatitis C and HIV. "

Despite the risk to haemophila sufferers and the fact that there is a test available, the UK government is refusing to screen the blood supply for vCJD.

Transfusion Related Acute Lung Injury (TRALI)

Transfusion-related acute lung injury (TRALI) was first reported in 1951 and occurs one in every 5000 transfusions. A person suddenly has a life threatening immune reaction after receiving donated blood, characterized by respiratory distress and a build up of fluid in the lungs. Fifty percent of transfusion related deaths are due to TRALI. The exact cause is unknown, but patients who have been given blood containing pooled plasma (a blood component taken from several different donors and mixed together) are at higher risk, due to being exposed to more than one blood type.

Women who have had several babies are also at higher risk because they may have had exposure to fetal blood that is different from their own blood type.

People who regularly receive donated blood are also at risk because the more times you receive donated blood, the more chance you have of an immune reaction. This is called sensitization.

Mismatching and other Mistakes

Thousands of blood transfusions involved "near misses," where the blood is labelled incorrectly and nearly given to the wrong patient, or the patients themselves are mixed up and someone recieves one when they don't need one.

In the USA, between the years of 1995 and 2001, 441 people died from transfusion mistakes.

Dr. Brian McClelland, Director of the Edinburgh and Scotland Blood Transfusion Service, asks doctors to remember that a transfusion is a transplant with risks:

"It's not a trivial decision," he said. "Doctors should ask, if this was myself or my child, would I agree to the transfusion?"

Ways to Reduce the Risk of Blood Transfusions

The risks associated with blood transfusions can be reduced in the following ways:

1. Don't have a transfusion unless you are in a life threatening situation. They are frequently given for low iron counts, and this isn't a life threatening reason.
2. Consider storing some of your own blood to use in an emergency. This is called auto-transfusion and means you wouldn't be at risk for contracting other people's diseases.
3. If your blood transfusion is for a surgery, investigate whether you can have "bloodless" or "keyhole" surgery. Many hospitals now do this type of surgery, but it would depend on the nature of your illness or disability.
4. Write to your government representative to ask that they start screening for vCJD - the tests are already available but so far, governments have not used them.

Sources:

www.justice4andy.com

Public Health Agency of Canada

The Haemophila Society, UK,

Bux J. Transfusion-related acute lung injury (TRALI): a serious adverse event of blood transfusion. Vox Sang. 2005 Jul;89(1):1-10. PMID 15938734

Awake! "Blood: Why is it so valuable?," p. 3-12, August 2006,

The copyright of the article The Dark Side of Blood in General Medicine is owned by Joanna Karpasea-Jones. Permission to republish The Dark Side of Blood in print or online must be granted by the author in writing.

Andrew Black Died of vCJD