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Enormous strides have been made to reduce the risk of transfusion-transmitted disease. Additional tests to eliminate transfusion-transmitted disease are costly, in terms of both health care resources and availability of volunteer donors. Future improvements in safety probably will require postdraw treatment of blood and components and the use of pharmacologic agents as a substitute for transfusion.

The benefits of transfusion therapy must always be weighed against the unavoidable chance of an infectious complication. Strategies to minimize the infectious risks inherent in the use of human blood and blood components can be categorized under four general headings: donor selection, testing, appropriate use, and follow-up and reporting of complications. The application of these strategies in the context of their role in the prevention of some of the infectious complications of transfusion therapy is discussed in this article.

Cost containment in the blood bank can be achieved by continually re-evaluating the relevance of routine testing on patient and donor samples and the quality control methods used. At all times one should strive for simplification, with patient safety as a primary concern. In addition, certain testing that might otherwise be eliminated must be continued in order to meet the requirements of government agencies and voluntary accreditation programs. Careful monitoring of the practices of ordering blood and components and the patterns of utilization can identify educational objectives that can lead to improved patient care and significant cost savings.