Promoting safe and effective use of blood products

Science is ever changing and so is medicine. Some certainties today may not be valid tomorrow. New research, observations and outcomes can turn widely used current practices into no longer acceptable ones. Additionally, and especially in medicine, one may find more than one right answer to the same problem. Different physicians, with different backgrounds, may choose different ways to address a clinical situation. Through medical conferences and peer reviewing, these 'uncertainties' can evolve into safer practices, as one's experience can add to others'. Blood transfusions have never been safer. Through the addition of new and powerful technologies and practices, the use of human blood is an efficient and safe therapeutic option, as long as it is correctly applied. But what can be considered the " correct use " of such a tool? Since the 1960s it is current practice in different medical centers, particularly in the US, to have a medical committee to review the indications and usage of blood products: the Transfusion Committee (TC). This is also recommended by different institutions, including Advancing Transfusion and Cellular Therapies Worldwide (AABB-formerly American Association of Blood Banks) (1) , and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) both in the USA. More recently, it has also become a demand of the Brazilian Ministry of Health and was included in the latest " Technical Regulations in Hemotherapy Practice " (2). The precise objectives and composition of the TC may vary between institutions and governmental regulating agencies. For AABB, it should be " a peer reviewed program that monitors and addresses transfusion practices for all categories of blood products ". For the Brazilian Ministry of Health, it should be " a multidisciplinary committee that monitors hemotherapy practice, including education, hemovigilance and the definition of protocols for transfusion practices ". Mintz states that " the clinical staff governing body from each hospital must decide how it wishes to assess transfusion practices " (3). The benefits of blood transfusions are well established. Inappropriate use, however, should be reduced to a minimum, as the inventories are permanently on the edge, the products are finite and hard to obtain, and making human blood a safe product for therapeutic use is a very expensive process (4). It should also be remembered that adverse effects are still present and should be carefully considered when physicians prescribe blood. A multi-specialty medical group allows teamwork, open and transparent communication and …