Blood

Autologous blood donation

Fear of infection from blood transfusions is driving more patients to donate their own blood for use during or after their elective surgery. In a study comparing transfusion practices among 176 cardiac surgery patients who predonated and 176 cardiac surgery patients who did not, researchers found that exposure to allogeneic transfusion was more likely among nondonors than among autologous donors. However, autologous donors were more likely than nondonors to receive a transfusion, suggesting that physicians use more liberal criteria for the transfusion of autologous blood. [CMAJ 1999;160(7):989-95]

Bacteria in blood

About one in 500,000 units of transfused whole blood and one in every 2,000 units of platelets is contaminated with bacteria from the donor. Although the effects are difficult to measure, the mortality rate associated with contaminated blood may be as high as 75%. New procedures instituted by blood-collection agencies (leukoreduction) will not solve this problem but may make it easier to identify. Physicians need to be increasingly alert to this problem and when patients receiving transfusions develop fever - a sign of bacterial infection - they should culture samples from the transfusion bag. [CMAJ 1999;160(4):535-6]

Canadian Blood Services

Lynda Cranston, a nurse and administrator, was named head of Canadian Blood Services, which replaced the Red Cross as the agency responsible for blood collection. Cranston had spent most of the past 18 years in senior administrative posts at Canadian hospitals and, more recently, as president and CEO at the Children's and Women's Health Centre in Vancouver. "A safe blood supply is our only agenda," she said. "There are no other issues for us." [CMAJ 1999;160(2):244-5]

Cord blood storage questioned

Many Canadian parents are paying hundreds of dollars to store their baby's cord blood at four private facilities. These banks have no regulated standards and some Canadian specialists question their value. [CMAJ 1999;160(4):551-2]

Krever 2008

An editorial offered a stinging critique of local, provincial and federal officials' decision not to institute needle-exchange and opiate-substitution programs to combat the spread of HIV/AIDS among injection drug users. The authors use the example of the final report of the Krever inquiry into the blood system and present a hypothetical transcript of a similar inquiry that takes place in 2008. This time, the authors say, officials will be taken to task for ignoring the evidence of efficacy of harm-reduction programs for drug addiction. [CMAJ 1999;160(8):1179-80]