Cleaning Up the Blood Supply

June 07, 1991

The American Red Cross, throughout its lifetime one of the nation's most respected emergency relief services, is also one of its largest independent health agencies. Among other things, its 53 blood centers collect and process 1 million containers of blood products a month, half of the nation's blood supply. It is a vitally needed resource.

But all has not been healthy in the 53 Red Cross blood centers. The worldwide AIDS epidemic caught blood bank officials everywhere flat-footed, precipitating a vociferous behind-the-scenes debate among doctors concerned about how to detect the insidious virus and stop its spread. Eventually, a "core antibody" test, used to look for hepatitis infections, was found effective for AIDS as well, but blood bank officials at first resisted its use.

The spreading AIDS epidemic, repeated hepatitis outbreaks and burgeoning cases of sexually transmitted diseases focused new attention on the nation's blood supply. Victims of the AIDS virus didn't always turn out to be people whose lifestyles put them at risk. Some were merely hemophiliacs, who contracted the disease during blood transfusions. Sufferers of other illnesses found that the virus could be transmitted along with fractional blood products from infected donors. The result was that, between 1985 and 1990, Red Cross blood centers had to carry out 100 million more tests than in the five previous years.

Federal Food and Drug Administration auditors have harshly criticized blood collection centers for making too many errors in handling contaminated blood and for failing to make timely reports of their errors. An internal review by Red Cross personnel found that, during a six-month period in 1987-1988, of 6 million blood products collected, 2,400 were improperly released. Another 575,000 were tested and destroyed after being found contaminated.

Such criticism is forcing a major shift in the way the Red Cross does business. An amalgam of 2,700 local chapters and 53 blood collection centers is bound to have difficulty operating in a consistent fashion. Thus, Red Cross officials have embarked on an ambitious plan to re-structure their entire operation, dividing the country into 10 regions, shifting to a new, nationally uniform computer system and retraining all employees in new procedures.

It is to be hoped that the reorganization succeeds brilliantly. The Red Cross is looking to raise $100 million to complete it, and the agency needs to convince skeptical donors as well as a shaken public that its worst problems are behind it. No one should forget that the future of the Red Cross blood banks and the continued healthy image of the entire agency rests on public confidence. And it is clear that the safety of the nation's blood supply cannot continue to depend on the creaky system that went before.

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