Strategies for the review of transfusion practices

Several new methods have been developed recently in an attempt to more carefully screen blood to minimize transfusion- associated diseases. Increased awareness of the transmission of the human immunodeficiency virus (HIV), the virus thought to be responsible for the development of AIDS (acquired immunodeficiency syndrome), through the transfusion of blood has prompted some peer review committees in health facilities to monitor more closely the appropriateness of transfusions. Transfusion policies differ from one institution to another according to the types of patients treated and the availability of blood products and supporting laboratory services. Despite this variation in levels of need and usage, it is recommended that all health care institutions establish specific criteria for developing and auditing procedures to determine when therapeutic transfusions should be administered. Because of the relatively recent increase in concern regarding the HIV infection, many healthcare facilities have not yet developed new guidelines to respond to it. It is suggested that more specific indications and audit criteria be developed for each type of blood component that is transfused and that any areas of controversy be examined. A method for assessing the need for transfusion should be clearly outlined and all health care professionals should be made aware of the procedures to achieve a more thorough and more coordinated effort in preventing unnecessary blood transfusions.