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Experts find little evidence for transfusions improving health; much for potential harm

  [ 21 votes ]   [ 4 Comments ]
www.ProHealth.com • April 23, 2009


“It has been known for some time that blood undergoes many physical and chemical changes during storage, losing its ability to supply oxygen to vital organs and triggering inflammatory and immune reactions when transfused.”

There is little evidence to support a beneficial effect from the majority of transfusions currently being given to patients, concludes an exhaustive review and analysis of the medical literature by a panel of experts - reported at an International Consensus Conference on Transfusion and Outcomes (ICCTO), held this month in Phoenix to address the issue.

The vast majority of studies show an association between red blood cell transfusions and higher rates of complications such as:
• Heart attack,
• Stroke,
• Lung injury,
• Infection and kidney failure,
• And death.

The ICCTO conference brought together leading international physicians and scientists in the fields of anesthesiology, intensive care, hematology, oncology, surgery, and patient blood management, and was monitored by:
• The Food and Drug Administration,
• The American and the Australian Red Cross,
• The Joint Commission,
• Along with government health officials, and other organizations.

"The results of the conference firmly establish the view that, rather than being a benign procedure, blood transfusion is associated with increased risk of medical complications," said Aryeh Shander, MD, Chief of the Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine at Englewood Hospital and Medical Center in Englewood, NJ, and a founding member of the Society for the Advancement of Blood Management (SABM).

"The evidence tells us to restrict the practice of transfusion and to avoid unnecessarily transplanting stored blood that could harm a patient's recovery."

About formation of the ICCTO:

Safety concerns with blood initially came to the public's awareness with the realization that infectious agents such as HIV could be transmitted via blood transfusion. Careful screening and testing have resulted in the risk of known infectious agents being transmitted via blood being reduced to extremely low levels.

Since then, concern has emerged amongst many in the medical profession that transfusion itself may be a risk factor for adverse patient outcomes.

It has been known for some time that blood undergoes many physical and chemical changes during storage, losing its ability to supply oxygen to vital organs and triggering inflammatory and immune reactions when transfused. It is now thought by some that these storage-related problems may result in negative outcomes to patients.

ICCTO was convened by two professional medical societies, the USA-based Society for the Advancement of Blood Management (SABM) and the international Medical Society for Blood Management (MSBM), out of concern for the lack of evidence supporting transfusion effectiveness and the growing number of studies reporting the association between transfusion and negative patient outcomes.

Because blood transfusion came into medical use decades ago, it has never been subject to the same rigorous safety and efficacy assessment process applied today to other drugs and treatments before they are approved for use.

This has resulted in a great deal of uncertainty and lack of knowledge among physicians as to whether a patient should or should not be transfused. As a consequence, there is enormous variation in transfusion practice between countries, states within countries, hospitals and even between clinicians within the same institution.

The accepted "consensus conference" process using the RAND-UCLA method was chosen to unravel some of this uncertainty. This method involves:
• A comprehensive review of all published scientific studies on a treatment,
• After which a panel of experts assesses a series of patient scenarios using the scientific literature to determine whether the treatment has evidence to support that it will improve the patient's outcome.

The ICCTO panelists also considered what has come to be known as the Bradford Hill Criteria for establishing causation, the process Sir Austin Bradford Hill and Sir Richard Doll used in the 1960s to establish that cigarette smoking caused such diseases as lung cancer and emphysema.

The ICCTO literature review searched for all studies on blood transfusion and outcomes published in the last 13 years. 555 studies met study inclusion criteria and were analyzed by each panelist in preparation for the conference.

A great majority of these studies were initiated to investigate the benefits of transfusions, and instead either found no benefit or identified negative outcomes associated with blood transfusions.

Only a small minority of clinical scenarios, were associated with suggested improved outcome.

The panel confined this initial ICCTO analysis to stable non-bleeding patients. Approximately sixty percent of the 90 million units collected around the globe each year (14 million units annually in the USA) are given to such patients.

"Given what we now know, donor transfusions should be limited only to surgery patients who are experiencing major bleeding that is difficult to control quickly," said James Isbister, MD, Clinical Professor of Medicine at the University of Sydney, and a founding member of MSBM.

"We hope the conference will help all physicians and the public become aware of the many negative outcomes associated with transfusion, and call for blood management strategies to improve patient outcomes."

Source: News release on behalf of International Consensus Conference on Transfusion and Outcomes (ICCTO), Apr 22, 2009




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Article Comments Post a Comment

Blood Transfusions,, not so positive
Posted by: beachgirl61
Apr 29, 2009
I found this article very interesting,, its something I personally thought about myself over the years,, how reliable and how many lives have been affected negatively in having a blood transfusion? I know a lot of Jehovah Witnesses have had sucessful surgeries and even survived back to optimim health after refusing blood at all,,, I think a lot could be learned from a study on these people against studies on others who have had transfusions,,,Its a thought BUT I do think for our future this would be a good starting point on an very previlent posssibly life saving issue that could make such a huge difference to the health and future disease risk of Tranfusion patients,
Reply Reply

 
Transfusion-alternative research
Posted by: Kelly Vaneman
May 11, 2009
There is a video entitled "No Blood-Medicine Meets the Challenge" and it allows individuals to become fully informed about the options that are available in the field of bloodless medicine. Leading experts in the medical community are interviewed and explain why some have called bloodless medicine the new standard of health care. A free copy can be obtained at http://www.watchtower.org/e/vcnb/article_01.htm

There is also a video regarding tansfusion alternatives available at this same website. No charge.

 


Transfusions
Posted by: grace54
Apr 29, 2009
The religious cult sited is not worth studying in refference to this subject.They have lost far more than they saved by their refusing blood transfusions. Do a Google on this group and see how many innocent children and mothers and fathers have died because they refused blood, even their own for that matter. Someone twisted enough to watch their loved one literally bleed to death is something to study. I believe the article advises limiting transfusions when at all possible.But Emergency medicine of this nature saves un-told numbers every day.
Reply Reply

Big News
Posted by: Svette_Palme
May 14, 2009
This article is big news to me... I've long wondered if there was not some kind of "hush hush" attitude to questions about blood transfusions. I had a huge blood transfusion given to me many years ago [1976], and I became very ill after - fever etc. They said it was "mismatched antibodies - there are 100s of them and they cannot all be the same as in your blood". I wonder what kind of person I got the blood from? Come to think of it, that was about the time my earliest Fibromyalgia symptoms started up. Nawww... could it be the cause? Doctors should hold off on giving transfusions unless it is urgently needed.
Reply Reply


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