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Blood shortage, blood waste


THE RECURRENT blood shortages in the United States, including the one in January 1999, which create periodic medical crises when the nation's blood supply falls perilously short, is a problem with a simple solution. Don't throw away good blood!

The blood banking industry influenced the FDA to stigmatize and promote discarding the greatest source of donated blood in this country, namely that of Americans with iron overload, or hemochromatosis. Blood industry leaders allege (with no confirming data) that this iron-rich blood is unsafe, whereas, in fact, most Americans who need blood would benefit from iron-rich blood.

Canada's federal authorities terminated the stigmatization of blood from donors with iron overload in 1991, after determining their blood is perfectly safe. I petitioned the FDA in September 1996 to end the stigmatization of blood of U.S. donors with iron overload, as Canada had done five years earlier. Bowing to pressure from the American Red Cross and the American Association of Blood Banks, the FDA has refused.

For genetic reasons, 12 percent of Americans absorb daily from their food 50 percent more iron than the rest of us and need to donate blood every few months so as not to gradually develop iron overload organ damage. One in 100 Americans absorbs daily 300 percent as much iron as the rest of us, and must donate blood every week or two to avoid gradual iron overload damage. By stigmatizing the blood of hemochromatosis patients, the U.S. blood banks can charge these patients approximately $200 million annually for "therapeutic phlebotomies. This is based on $50 to $200 per procedure, provided the blood bank discards the blood. If the blood is given to patients, the blood banks cannot charge the donors.

Arguments have been made that this is a safety or financial issue. It is neither. Safety should not be a concern because these donors receive continuing medical care for their condition and, in their frequent donations, receive a battery of tests designed to ensure the safety of their blood. Regarding the financial issue, the argument pales into insignificance when we consider the great addition to the U.S. blood supply these donors could make.

The current reported blood shortage would be over in 24 hours if the blood banks would give, to those who need it, good high-iron blood, instead of throwing it away (or refusing to even draw it). A case in point, a man with hemochromatosis had been giving his blood to Oregon Red Cross Blood Banks monthly for years. He was singled out for his public-spiritedness and honored locally for his contributions. When he was identified in a national news magazine looking into the issue of "Throwing Out Good Blood," national Red Cross headquarters issued an order to each of its Oregon Blood Banks to deny him further access to their facility or accept his future blood donations.

Many medical problems require considerable time, effort and resources to address. Fortunately, there is a quick, easy and cost-effective way to solve the problem of the frequent U.S. national blood shortages -- take advantage of the abundant supply of good, iron-rich blood from the more than 1 million hemochromatosis patients in this country. The problem would be solved overnight.

Victor Herbert is a professor of medicine at Mount Sinai School of Medicine, New York, N.Y., and chief of the Mount Sinai Hematology and Nutrition Laboratory at the Veterans Affairs Medical Center, Bronx, N.Y.

Pub Date: 1/15/99

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