Dr. Golinski,

The current issue on transfusion is absolutely outstanding. I really do not think most anesthesia providers think much about the implications of transfusion, nor do we necessarily do everything we can to minimize the risks.

I would add one more important risk to transfusions that many people do not know about. Although the American Red Cross (ARC) is not the only service that provides blood products in this country, it is by far the most active in blood collection and distribution. Few people know that in 1993, the ARC had such extensive safety problems with its blood products that a court order was issued to force ARC to clean up its act. Although a reorganization was complete in 1997, an FDA inspection in 2002 found that the ARC continued to have major safety issues with blood collection and distribution. Subsequent efforts have been made to correct these issues, but it must be kept in mind that the collection and distribution of blood products have potential safety issues beyond the physiologic risks described in your abstracts.

Every effort should be made to use tranfusion only as a last resort in my opinion.

Thanks again for these outstanding abstracts and your wonderful contribution to the evolution of Anesthesia Abstracts.

Steve Wooden, CRNA MS