Refusals to accept blood products increasing, says board

THERE is growing evidence that patients are increasingly reluctant to accept blood products, even in life saving procedures because of concerns arising from the hepatitis C scandal.

The Blood Transfusion Service Board and consultant haematologists have confirmed the problem has been exacerbated by the latest controversy which arose after a woman was approached to give blood even though she was infected with hepatitis C - despite assurances that the incident posed no threat to health.

Recent political comment and a poll in a Sunday newspaper which found most respondents had serious qualms about receiving a blood transfusion had compounded the difficulty, according, to the BTSB.

Its chief executive, Mr Liam Dunbar said he had been alerted last week to a case where a Dublin based consultant haematologist had "a very difficult problem" in persuading a patient to take blood. "It was life or death. He was going to die otherwise."

This case and others, Mr Dunbar said, suggested that the debate was getting out of hand.

There was the potential for "a catastrophe" if the public perception was not corrected as it could lead to people dying as a consequence of refusing blood. "Why not seek the opinion of people who have received blood. Talk to the parents of a child with leukaemia ... Blood is a very serious issue. You cannot play political games with blood supply."

He could understand how adults and children awaiting serious surgery, and those undergoing some forms of cancer treatment "must be frightened", but blood was as safe as it could be and the record of blood donation to the seriously ill or whose life was endangered over the past three years had confirmed this.

Dr Donald McCarthy, a consultant haematologist at St Vincent's Hospital, Dublin, confirmed that patients were reluctant to have blood. He would not be surprised if someone refused blood in the current climate.

"Most of the patients I deal with have to have blood. It's a life saving process," he said. "Largely the fear is unfounded. The blood, is as safe as anywhere else."

Mr Hugh Bredin, president of the Irish Medical Organisation, said the reluctance was due to intensive publicity over the past, few years, especially the past few weeks. "A lot of things have to be exposed if there is to be change. There has to be correction. We would appeal to the media to be responsible."

Blood, however, was a vital asset for patients. Supply needed to be maintained despite a crisis phase, and people had to continue to support donation. The IMO's advice on receiving blood was to accept doctors' recommendations - adult patients of sound mind could refuse blood but it was important to base a decision on individual advice from doctors.

The current difficulty has increased interest in autologous transfusion, where patients donate their blood in advance of an elective procedure such as a scheduled operation that may require transfusion. "You cannot guarantee safety in that case but it's a lot safer from the virus point of view, he noted.

Doctors and patients were thinking twice before considering a blood transfusion as a consequence of the current concerns, said Prof Ernest Egan of University College Hospital, Galway. This was no harm as there was always, the potential for a post transfusion complication. He was not aware, however, of any critical concern about people reluctant to accept blood.