The Yin and Yang of Blood Transfusion.

Few physicians will argue against the statement that blood transfusions carry certain risks. There is also little debate over the fact that they can benefit those with hemorrhage or non-functioning bone marrow. Most of the salient debate in the literature centers on the benefits/risk ratio of blood component therapy. Besieged with repeated studies on restrictive vs. liberal transfusion, the clinician is left with only one treatment modality for the patient. By centering on transfusion, other more effective or less risk-associated therapies are ignored. This is problematic, as transfusions may prove to be associated with risks higher than that posed by the anemia, especially if there is no clinical or physiological concern (1). The quest for safe and effective blood transfusions is the opposing debate, and that side of the argument has no place in the treatment of anemia in majority of hospitalized and non-hospitalized patients with anemia.