Wednesday, January 14, 2009

Can blood expire?

Recent research in the New England Journal of Medicine found that heart surgery patients who received blood that was more than two weeks old were more likely to have potentially serious post-operative complications.  Another study done at Cooper University Hospital found that intensive-care patients transfused with blood that had been stored for 29 days had a greater chance of infection including pneumonia, urinary tract, or other life threatening infections than when given blood stored for 28 days or less (Carr, 2008).  With this in mind is it alright that the U.S Food and Drug Administration uses donated blood on patients for up to six weeks after it's been collected?  

If giving older blood does pose health risks than perhaps the FDA should rethink it's blood storage policies.  However, in order for any policy changes to occur more studies would have to be conducted in order to have any substantial credibility.  For now, I think there should be no reason for people to panic if they are receiving older blood but there's always going to be that thought in the back of my mind if I ever do go into a hospital to receive blood.  I wonder if it's alright to ask hospitals how old the blood is before they put it in me.  This question alone just reveals the panic and worry I have of this topic.  It's stories like this that come out in the news that just freak out the public when it's just a theory and not a substantial finding or fact.

Perhaps for those patients who did get infection or problems after receiving the blood they just naturally rejected the foreign liquid in their body even though it's the same blood type.  Every person is different and I wouldn't be surprised if some people are more hypersensitive to new things going into their body.  Standard practices of blood storage have been going on for several years now and the percentage of related fatalities is extremely low. (8 million transfusions/year, only 75 related fatalities/year).  Maybe those 75 fatalities per year were because their bodies were unique for receiving blood because they were hypersensitive.  But what do I know, I'm not a doctor in the field.
As of right now the newest blood brought in is used on newborns.  The fact that this is a standard practice suggests that newer blood is better for you because it's used on an important specific age group.  So then what happens to the blood after a certain amount of time?  These recent findings have only been observations in the outcomes of certain patients.  In no way, biologically, does anyone know why the blood would expire in terms of red blood cells or white blood cells, etc.  This is why it's crucial that there should be more research done to come up with any sort of answers. 
Let's just say that there was some truth to this theory.  If
 blood storage practices were changed to the FDA only carrying blood for 28 days or less than the blood supply would diminish extremely fast not having enough to care for the patients in the U.S.  Basically, we have a choice.  We could use older blood and take the risk of having a small amount of people reject it or we could shorten the amount of time that blood is held in storage and run out of our supply extremely fast.  If we decrease the amount of time that blood is good than A LOT more people would have to give blood way more regularly, especially the more rare types of blood.  Also, if they found this to be true of expired blood than there would be a lot of ethical issues as far as deciding who gets the "best" blood.  We would have to categorize patients based on age and type of condition to see who gets what.  This will be incredibly tough for hospitals to have a limited amount of blood and have to decide which patients are more deserving of it.  
Currently, there are a number of new studies being tested to see if this is actually true.  I think this is the best, necessary next step in seeing if this is legitimate or not.  All we can do is wait.  In the meantime, we must trust the FDA's stand that the blood is just as good after 28 days.  I hope this blog post has not freaked out anyone too much incase you are going into the hospital anytime soon.  I'd like to know people's reactions.  What's your health input?

1 comment:

  1. Gundo,

    Well, the USA's system is designed to be profit-oriented not patient-centred.

    I have lived with fantastic private health care, both in Switzerland and here in Hong Kong, and both places also have a base of fantastic public health care which sets a standard of treatment for the private actors to meet and beat.

    Full private... I was never so happy with when I lived in the USA.