Blood: Safety vs. Supplies

At a time when the U.S. blood supply barely meets demand, some safety experts say the government, Red Cross and other blood suppliers are too cautious, excluding too many donors and adding too many safeguards.

Blood safety and blood supply debates have heated up in recent years as shortages have become more common. Blood bank officials warn that in a crisis, hospitals could run out altogether.

Critics say the "European deferrals" of 2002 -- barring anyone who lived in Europe for five years since 1980, or who lived in England for more than three months between 1980 and 1996 from donating out of fear that a human variant of mad cow disease could contaminate the U.S. blood supply -- are arbitrary and unscientific.

University of Pennsylvania medical ethicist Arthur Caplan, who recently served on the Food and Drug Administration's blood supply advisory committee, said there is no evidence that mad cow disease can be transmitted via human blood. But the FDA and Red Cross argue that uncertainty over how mad cow disease is transmitted makes the deferral -- which has excluded at least 5 percent of donors who normally give -- necessary.

Dr. Jay Epstein, director of the FDA Office of Blood Research and Review, pointed to the transfusion crisis 20 years ago, when tainted blood infected 20,000 Americans with HIV. At the time, blood suppliers ignored early warning signs of a problem; Epstein and others do not want to repeat the mistake.

"In the '80s, we were concerned about [keeping] donors. And we ended up with thousands of patients who became infected with HIV through transfusions. We had the opportunity to reduce the exposure significantly and we didn't do it. We listened to the economists," said Michigan State University hematologist Dr. John Penner.

Others say the AIDS disaster has made regulators and blood banks too skittish. "The FDA is still feeling the sting from HIV," said Dartmouth Medical School pathologist Dr. Jim AuBuchon. AuBuchon argues that reducing the number of donors may ultimately do more harm than good.

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