Is Our Blood Supply Safe?

On the heels of the Food and Drug Administration’s decision to uphold a 1983 ban on gay men donating blood, asks, how safe is America’s blood supply?

The answer is very safe, according to the FDA and Dr. Louis Katz, a past president of America’s Blood Centers.

“If you look at the risk of contracting HIV or hepatitis C, for example, from a blood transfusion, the risk is one in 2 million or less,” said Katz, who is also an infectious disease specialist with the Mississippi Valley Regional Blood Center in Davenport Iowa. “In fact, the rates are so low, we can only do statistical models to determine the odds.”

Katz said blood transfusion recipients are much more likely to suffer complications from the transfusion, such as a lung injury or fluid overload, than contract a disease.

“We’ve really solved the product issues,” Katz said. “We have two huge laboratories dedicated to catching new infectious diseases and we have pretty decent interceptions in place to do that. When West Nile was identified as an infectious disease in 2002, tests were implemented at astounding speed. Our biggest challenge now is determining who should and shouldn’t be transfused and making sure the units get to the right people.”

FDA spokeswoman Karen Riley defended the government agency’s decision to uphold its ban on gay men, saying that epidemiological data from the U.S. Centers for Disease Control and Prevention indicates “men who have sex with other men have the highest risk of transfusion-tramsmitted diseases like HIV and hepatitis.”

“We acknowledge that not everyone in a high risk group is indeed at risk and, as science advances, we periodically review our policy,” she said. “We continue to be open to reviewing new information and any new scientific studies that would support a change in policy.”

Here are some other questions that asked:

Who is responsible for the safety of America’s blood supply?

The FDA is responsible for ensuring the safety of our nation's blood supply. The Center for Biologics Evaluation and Research (CBER) regulates the collection of blood and blood components used for transfusion or for the manufacture of pharmaceuticals derived from blood and blood components, such as clotting factors, and establishes standards for the products themselves. CBER also regulates related products, such as cell separation devices, blood collection containers and HIV screening tests that are used to prepare blood products or to ensure the safety of the blood supply.

What measures are in place to ensure the safety of our blood supply?

“We start out with how we recruit donors and have a 49-question form that we use to determine who is and isn’t eligible,” said Katz. “We ask about their sexual history, what kinds of medications they’re on, and where they’ve traveled to. We look for signs of drug use. That eliminates 80 percent of the infections in our blood supply.

“We also use computers and automation to take manual handling of the product out of the process as much as possible,” Katz continued. “Hospitals are also starting to use automation to unpack and catalog the units and to make sure the right unit gets to the right person.”

To maintain the safety of the blood supply, who should not give blood?

“Basically, people should just make sure they’re feeling well on the day that they decide to give blood,” Katz said. “With our questionnaire and the physical exam that we give prior to the donation, we can weed out any other problems that would result in a deferral.”

How often do blood centers turn away potential donors because of concerns?

“We defer about 13 out of every 100 people that come to us,” Katz said. “So about 13 percent, which I think is about average. That’s a lot of people. Especially when you think that in the U.S. there’s probably 110 million people who are potentially eligible to donate and only 3 or 4 percent actually give.”

Given what the medical community knows today, do you think the FDA is being overly cautious in upholding its 1983 ban on gay men?

“I support a less stringent deferral,” Katz said. “I think deferring blood donation to six months or one year after male-to-male sexual contact is reasonable and would not have a negative impact on the current safety of our blood supply. I understand their thought process. But the other issue is fairness. Not all men who have sex with men are at high risk for HIV. I’m not violently angry about it, but I think they could have dealt with the concern a little differently.”

This article was reviewed by Dr. Manny Alvarez