The widespread concern about blood safety triggered by the AIDS epidemic has caused the number of blood transfusions in the United States to decline since 1986, according to a new Harvard Medical School study.
At the same time, the number of blood donations that individuals make in advance of surgery for their own use increased sharply.
Otherwise-serious blood shortages were forestalled by "the unprecedented decline in transfusions of whole blood and red cells," the growing popularity of blood predeposits, and the continued importation of blood products from Western Europe, scientists at the Center for Blood Research in Boston, a Harvard affiliate, report in today's New England Journal of Medicine.
"We see evidence of a major adjustment on the part of physicians, patients, blood donors and the public at large to the AIDS crisis," said Douglas Surgenor, the principal author of the study. "AIDS has been the primary stimulus in beginning to raise questions about the appropriateness of many transfusions."
Since 1985, blood has been screened for the human immunodeficiency virus, the cause of AIDS. In May, an improved screening test was introduced for hepatitis C, a liver ailment which is the most common serious infection spread by blood transfusions.
The risk of becoming infected with AIDS through a blood transfusion is currently considered about one per 150,000 units transfused, according to Dr. Jay Menitove of the Blood Center of Southeastern Wisconsin in Milwaukee. By comparison, Menitove estimated that the new hepatitis C test would reduce the risk of contracting that infection from one per 300 units transfused to one per 1,500 units transfused.
The Harvard researchers compiled data on blood donations and transfusions from many sources, including the federal government, national blood bank organizations and their own surveys.
Among their specific findings:
Total collections of blood in the United States increased from 10.9 million units in 1980 to 13.4 million units in 1987. The 1987 totals included 12.1 million units collected at blood centers, 1.3 million units collected at hospitals, 274,000 units imported from Europe, and 397,000 units that were predeposited, mostly by elective surgery patients.
The total amount of blood collected did not change between 1986 and 1988.
