The University of Southern California University Hospital promotes a transfusion avoidance and blood conservation program for eligible patients. One of the strengths of this program is that it dovetails with conventional transfusion practice and is represented at regularly scheduled Blood Utilization (Transfusion) Committee meetings. In actuality, the hospital has a Tissue and Transfusion Committee that splits its discussion between Pathology and Transfusion Medicine, and transfusion avoidance and blood conservation is not infrequently a front and center topic. The Webmaster wonders if other institutions include representation from transfusion avoidance and blood conservation programs on their Transfusion Committees? If so, how is this helpful? If not, why not?

The following comments have been received.

ADDENDA Nov. 24, 2004

1. The chair of a Blood Usage Committee (BUC) at an acute care hospital in Southern California reports that their BUC's agenda includes discussion about the hospital's Blood Conservation Program, including reports on hemodilution, blood salvage, and the possible implementation of thromboelastography (TEG). Each of the aforementioned activities is overseen by a clinician who provides a report to the committee.

2. A transfusion medicine physician in Ohio is of the opinion that synergy between transfusion medicine programs and blood avoidance/conservation programs might be the exception rather than the rule. She thinks that it will be interesting to see what sort of responses are received to this discussion. At her facility, the folks leading the blood conservation/avoidance program do attend transfusion committee meetings from time to time - however, their activities for the most part are outside the scope of this committee.  It seems that the paradigms of blood transfusion and blood avoidance are very separate at her facility - almost as if they cannot comfortably coexist. It sometimes seems that philosophically those advocating blood avoidance view the use of transfusion as a failure. In any event, .... it seems clear that professional associations that focus on transfusion practices should encompass both use and non-use of transfusion therapy to achieve optimization of clinical care.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator