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Friday January 26 12:35 PM EST
Red Cross: Make Blood Filtering Universal
By E'Louise Ondash
HealthScout Reporter
THURSDAY, Jan. 25 (HealthScout) -- Every unit of blood that patients receive
should be filtered to remove all white blood cells, urged the American Red Cross
today at a Health and Human Services hearing in Washington, D.C.
Advocates argue that taking out white blood cells from the whole blood may cut the
number of bad reactions when people get transfusions. The HHS Advisory
Committee on Blood Safety is hearing testimony through tomorrow on the safety of
the nation's blood supply. The committee will then make a recommendation to the
U.S. Food and Drug Administration on whether such filtering should be federally
mandated.
Called universal leukoreduction (ULR), the process is necessary, says the Red
Cross. Although a person's own leukocytes (white blood cells) protect against
infection and foreign organisms, leukocytes serve no purpose in a blood transfusion,
according to the Red Cross, but they can cause problems. For instance, leukocytes
can cause the formation of antibodies in the recipient that make future transfusions
less effective and more likely to cause bad reactions.
Filtration of blood supplies in the United States nearly doubled in 1999-2000,
according to the ARC, and it is estimated that more than 60 percent of all blood is
currently being filtered. And as of December 2000, the ARC filters 77 percent of its
blood.
ULR of blood began about 15 years ago, explains Dr. Scott Murphy, chief medical
officer for the Pennsylvania-New Jersey region of the ARC.
"It was initially [done] by adding a filter to the unit of blood as it was being
infused," he explains. "Now we do it at the blood center shortly after collection. The
advantage is that we can control the filtration for things like temperature and speed,
which you can't control at the bedside."
As it stands now, it is up to the doctor or hospital as to which patients receive
filtered blood. In general, it is used for high-risk patients, like those who are easily
susceptible to infection. Rhode Island is the only state that provides filtered blood to
all patients.
"Leukocyte-reduced blood is a better product for the patients because it reduces
transfusion reactions," says Jacquelyn Fredrick, executive vice president of
Biomedical Services for the Red Cross in Washington, D.C. "We're hearing about it
now because of the focus on using new technology to advance safety. There are many
countries, like Canada and those in Western Europe, where filtration is mandatory.
The United States has been discussing this issue through the FDA for a couple of
years now."
Those opposed to universal leukoreduction -- doctors and hospitals -- say that the
process makes blood even more expensive. Unfiltered blood costs about $100 a unit;
leukoreduction would add another $25 to $45 a unit.
"One study estimates that hospitals will spend more than $600 million per year on
leuko-reduced blood," says Dr. Lawrence Petz, former director of transfusion
medicine at the UCLA Medical Center in Los Angeles, who represents the American
Hospital Association, which has about 5,000 members. Providing this blood to all
patients would be "at the expense of other hospital departments, programs and
patients. I believe these resources could be better spent on other transfusion safety
measures that I know will save lives."
Petz argues that research has failed to show "a substantial health benefit" that
justifies giving filtered blood to all patients, and that the doctor should decide
whether the patient will benefit.
Despite the added cost, Murphy counters, "the Red Cross feels there's an ethical
obligation to implement advances that improve the safety of the blood supply. As a
doctor who takes care of patients, I believe you can't predict 100 percent as to
whether the patient can benefit or not from filtered blood, so all patients should have
access to it."
What To Do
To learn more about blood safety, visit the American Red Cross, and the University of
Tennessee Medical Center.
Or, you may want to read previous HealthScout articles on the safety of the blood
supply and blood transfusions. |
