Minimal-Exposure Transfusion: A New Approach to Homologous Blood Transfusion

Abstract

Despite the recommendations by the American Association of Blood Banks, the Community Council of Blood Centers, and the American Red Cross to discourage the use of directed donations (choosing and recruiting of a specific blood donor by or for a specific recipient of a transfusion), many blood banks continue to accept directed donations. In 1986, 391 blood donor centers ac­ credited by the American Association of Blood Banks (centers that collect more than 100 units of blood per year) accepted directed donations (Kehoe P, American Association of Blood Banks: Personal communication). Despite the increased numbers of these donations, objective evidence about directed donations remains scanty and contradictory. In particular, questions about both the serologic and the biologic safety of these donations, hoarding of blood by donors, and the veracity of donor responses remain unresolved. Clearly, many blood banks have yielded to pressure from patients, their family members, and their friends to accept directed donations, despite the recommendations to the contrary. Family members and friends should be com­ mended for their willingness to make a directed donation; however, we think it is our role as physicians to counsel patients' friends and rel­ atives and channel these energies into a more rational approach to donation in order to obtain the greatest benefit at the least cost (medical, financial, and emotional) for our patients.