Hospitals found to mishandle autologous blood.

U.S. hospitals are suffering from what some might call a blood disorder.

According to a recent study, hospitals are making mistakes in transfusing autologous blood - blood donated by individuals for their own use. The health risk was discovered by a Bethesda, Maryland-based educational association, the American Association of Blood Banks (AABB), which counts many hospitals among its members.

In a survey in which 1,829 of its 2,400 members responded, 22 reported that they knew of incidents when blood donated by individuals for their own use was given to someone else for transfusion. In nearly one-quarter of these cases, the blood had not been screened for HIV, which causes AIDS, or other viral infections.

Nearly 20 percent of the respondents also reported that they had seen patients erroneously receive conventional blood before receiving a transfusion of their own blood, which can defeat the purpose of autologous blood donations. (See G. Pascal Zachary, Hospitals Found to Mishandle Blood Donated by Patients for Their Own Use, Wall St. J., May 25, 1995, at B11.)

Karen Shoos Lipton, the AABB's chief executive officer, acknowledged that "a 1 percent error rate is a problem. It is significant."

But she added that the percentage has to be put into context, which some people have trouble doing. "When you start talking about your blood, a lot of people stop listening after they hear the word `risk,'" she said.

"The scenario that has to come together to make this type of error happen is rather complex," Lipton explained. "You would have to collect an infected autologous unit, not test the unit, and then give that unit to the wrong person."

When the AABB read the survey results, Lipton said, some members "roughly calculated" the odds of a person mistakenly, receiving a transfusion of HIV-infected blood. Since only about 1 million autologous units are donated each year, Lipton said, the error would occur rarely - about once every 250 years.

"When you figure it that way," she said, "what you realize is that it's not so much of a safety, issue as it is an operations issue. The hospitals have to focus their attention on the procedures for handling autologous blood."

Lipton said that is why her group believes testing autologous blood does not significantly alter a person's chances of getting an infected unit.

The AABB and many hospitals oppose mandatory testing of autologous blood. They cite the added expense, as well as the right of patients to set aside their blood for their own use and the importance of making the option of autologous donation as widely available as possible.

"The association strongly believes that a person's own blood is the safest blood for them," Lipton said. Bethesda attorney Robert Jenner, former chairman of ATLA's AIDS Litigation Group, said that no one really knows what the chances are of receiving the wrong blood. But he said he does not think expense should stand in the way of testing. "I think that a testing surcharge of $20 or so is a cost most consumers would bear without complaint for peace of mind," Jenner added.