Making the blood supply safe also makes it more expensive

Thanks to an array of tests for HIV, Chagas disease and other conditions, the current blood supply is "extremely safe," said Brick Bunch, laboratory manager at Downey Regional Medical Center.

It is also extremely expensive.

From 1979 to 2000, the average price that hospitals nationwide paid for a unit of red blood cells grew from $32 to $96, an increase of about 5% a year.

By 2004, the most recent year tallied in the U.S. government's biannual survey, the price had more than doubled to $201 per unit, which is roughly one pint.

The Downey medical center uses close to 500 units of red blood cells a month in addition to plasma and platelets.

"When I first got here in 2001, blood products cost between $800,000 and $950,000 annually," Bunch said. "We now have basically the same utilization -- a little bit of an increase -- and the cost is $2.3 million.

"That's just for blood product, not the work that goes into transfusing."

When blood is donated, it is separated into components -- red blood cells, platelets and plasma -- that have different uses.

Iron-rich red blood cells, for example, are used to treat congestive heart failure patients with anemia or trauma patients with acute blood loss.

Platelets, on the other hand, help with clotting. Platelets derived by apheresis, a technique that collects just one component of the blood and returns the rest to the donor, cost $425 a unit in 2002, Bunch said. Today, that cost is $520.

What's more, the new tests for platelets take so much time that they decrease the shelf life.

Though refrigerated red blood cells are good for 42 days, platelets require room-temperature storage and now must be used within 48 hours, down from five to seven days, Bunch said. Anything unused after that becomes a costly write-off.

Two organizations, the Red Cross and America's Blood Centers, a consortium of independent blood banks, collect and distribute more than 90% of the nation's blood supply. (Some hospitals have their own blood banks.)

As nonprofit entities, they don't "sell" blood; they charge hospitals fees to recover the costs of recruiting and screening donors and testing, processing, storing and delivering blood.

Why is something that is donated by volunteers and collected by nonprofit groups so costly?

Before 1985, when the AIDS epidemic prompted the addition of a test for HIV, blood was tested for type (A, B, AB or O), Rh factor (positive or negative) and syphilis.