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As Red Cross moves to pricey blood treatment method, hospitals call for more choice

Julie Appleby, Kaiser Health News on

Published in News & Features

Americans generally don’t spend much time thinking about the nation’s blood supply.

That’s mainly because the collection and distribution system is safe and efficient. But there’s a new behind-the-scenes challenge, according to some hospital officials, who fear a change in how blood platelets are handled will sharply increase the cost — and, in some cases, the number of transfusions needed — to treat cancer patients, trauma victims, and those undergoing surgery.

The concern revolves around the American Red Cross, the nation’s single-largest provider of blood products, which will exclusively use an expensive technology to reduce the risk of dangerous bacteria tainting platelets. But the move limits hospitals’ choice of less expensive testing options, which are also effective. “We are very concerned the blood collection centers have decided what is best for our patients when we are on the front line,” said Dr. Aaron Tobian, director of the transfusion medicine division at Johns Hopkins Hospital.

His concerns are echoed by some in Congress, including Rep. Earl “Buddy” Carter, R-Ga., who in February joined 12 other congressional Republicans in signing a letter to the Department of Health and Human Services asking whether something could be done to boost hospital choices for complying with blood safety guidelines.

“This has impacted rural hospitals in particular,” which have tight budgets, he told KHN.

The switch by the Red Cross, which it expects to be fully implemented by next year, stems from a recommendation by the FDA in late 2020 to use any of three methods to reduce the risk of bacterial contamination in the blood platelets.


Under those recommendations, hospitals can buy platelets specially processed to reduce pathogens, which is the method the Red Cross and some other, smaller suppliers are moving toward. Or blood centers can test samples of each unit of platelets, looking for bacterial contamination, at least 36 hours after the blood is collected. The other option is to use a rapid test for bacteria shortly before the platelets are transfused, which occurs in addition to a primary screening for bacteria after collection.

The FDA did not rank the options. And many hospitals and blood centers already employ one or more of them. No test or process is 100% effective.

“Each of those methods has pluses and minuses,” said Dr. Claudia Cohn, chief medical officer for the nonprofit Association for the Advancement of Blood and Biotherapies, which represents health care providers involved with transfusion medicine. She is also a professor of laboratory medicine and pathology at the University of Minnesota.

The FDA offered the guidance because platelet transfusions are associated with a higher risk of sepsis and fatality than any other blood component, with some research estimating the chance of a serious infection at 1 in 10,000. Platelet transfusions are important to prevent or treat bleeding in some patients, such as those who have certain types of cancer, are trauma accident victims, or are undergoing surgical procedures that can result in a large loss of blood.


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