The Johns Hopkins Hospital and a handful of other medical centers around the country are set this week to begin collectively monitoring and tracking dangerous reactions to blood transfusions, the first piece of a nationwide "biovigilance" program that is arriving in the United States years later than in most other developed nations.
The ultimate goal of the project, a collaboration between federal agencies and private medical associations, is to reduce the number of infections, allergic reactions, clerical errors and other complications related to blood transfusions. Such complications resulted in at least 46 deaths in the U.S. last year.
But physicians also call it a long overdue effort to better understand the risks of a common medical practice - more than 30 million blood products are transfused in the United States each year - that has scarcely been evaluated on a large scale.
The monitoring system also comes as civilian hospitals have increased use of plasma - among the riskiest blood components - to treat injured patients, based on treatments used by military doctors in Iraq.
"We've sort of fallen behind efforts in the rest of the world," said Dr. Paul Ness, director of transfusion medicine at Hopkins, one of nine institutions participating in a pilot study that organizers hope to implement nationwide in the fall.
"We'd like to be able to educate recipients about potential risks, but what, really, is the incidence of these reactions? We don't know," Ness said.
Blood transfusions are fairly routine treatments for cancer patients, trauma victims, surgery patients and other hospital patients. At Hopkins, Ness said, doctors transfuse roughly 45,000 units of the most common blood component each year.
Serious complications are rare. The number of annual deaths attributed to transfusion reactions nationwide declined to 46 last year, from 52 the year before and 63 in 2006.
But deaths, which are required to be reported to the Food and Drug Administration, are only one measurement of safety, said Dr. Matthew Kuehnert, director of the Centers for Disease Control and Prevention's Office of Blood, Organ and Other Tissue Safety. Things like allergic reactions or treatable infections can have a huge effect on the cost and the outcome of a patient's medical treatment, Kuehnert said, yet doctors know very little about the scope or the frequency of such reactions because there is no nationwide monitoring program.
