Abstract
R. K. Spence, New Jersey, NY, USA: Let me ask a prerogative question. Since the title of this discussion was to optimise haemotherapy let me ask you to make an assumption that the optimal approach to transfusion would be to eliminate all risk. Since we know that we can never completely eliminate all risk from allogeneic transfusion does it make sense then that all our efforts should be focused on eliminating allogeneic transfusion completely because that is where mostly the risk lies. I wonder what the panel’s comments might be on that. If we will look at evidence based medicine there is no level 1 evidence based medicine that allogeneic transfusion is a benefit and I doubt if I will ever see a randomised controlled trial of allogeneic transfusion. So, if we are going to optimise transfusion therapy should not we get rid of blood completely?
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Notes
Carson JL, Spence RK, Poses RM, Bonavita G. Severity of anaemia and operative mortality and morbidity. Lancet 1988;i:727–729.
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Requirements for the collection, processing and quality control of human blood and blood products. WHO Technical Reports Series 626, Geneva 1978.
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Fratantoni, J.C., Sibinga, C.T.S. (1998). Discussion. In: Sibinga, C.T.S., Das, P.C., Fratantoni, J.C. (eds) Alternative Approaches to Human Blood Resources in Clinical Practice. Developments in Hematology and Immunology, vol 33. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5619-0_5
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