Making risk statements stick

The rights of blood recipients should supersede any asserted rights of blood donors

Some gay men have argued that the laboratory testing of blood is so accurate that continued deferrals based upon sexual activity are unnecessary and unjust. They also assert that they have a right to donate blood. There has been much debate over altering the rule barring donation from men who have had sex with other men since 1977, with blood organizations disagreeing over the best course of action. Two studies have indicated that changing the rule would increase the risk of human immunodeficiency virus (HIV) transmission. This dilemma is part of a broader issue, namely: what are the responsibilities of blood services to blood donors and recipients? Blood services should base decisions regarding donor suitability on science rather than on their donors' desires. Blood services must recognize that the rights of blood recipients should supersede any asserted rights of blood donors.

Rapid screening method for detection of bacteria in platelet concentrates

Public awareness has long focused on the risks of the transmission of viral agents through blood product transfusion. This risk, however, pales in comparison to the less publicized danger associated with the transfusion of blood products contaminated with bacteria, in particular, platelet concentrates. Up to 1,000 cases of clinical sepsis after the transfusion of platelet concentrates are reported annually in the United States. The condition is characterized by acute reaction symptoms and the rapid onset of septicemia and carries a 20 to 40% mortality rate. The urgent need for a method for the routine screening of platelet concentrates to improve patient safety has long been recognized. We describe the development of a rapid and highly sensitive method for screening for bacteria in platelet concentrates for transfusion. No culture period is required; and the entire procedure, from the time of sampling to the time that the final result is obtained, takes less than 90 min. The method involves three basic stages: the selective removal of platelets by filtration following activation with a monoclonal antibody, DNA-specific fluorescent labeling of bacteria, and concentration of the bacteria on a membrane surface for enumeration by solid-phase cytometry. The method offers a universal means of detection of live, nondividing, or dead gram-negative and gram-positive bacteria in complex cellular blood products. The sensitivity is higher than those of the culture-based methods available at present, with a detection limit of 10 to 10(2) CFU/ml, depending upon the bacterial strain.