Some hospitals turning to transfusions less often

2013-06-09T00:00:00Z 2013-06-14T16:53:05Z Some hospitals turning to transfusions less oftenBy Vanessa Renderman vanessa.renderman@nwi.com, (219) 933-3244 nwitimes.com

The lazy days of summer bring extra pleas from blood centers, as regular donors go on vacation and school lets out.

But some local hospitals are being more judicious in deciding when a patient needs a transfusion. 

Dr. Judy Lyzak, vice president of medical affairs with Alverno Clinical Laboratories in Hammond, said there's a push in Franciscan Alliance hospitals to use blood products more safely -- which can mean less often.

Franciscan Alliance, with which the lab is affiliated, has reduced the use of blood products by 20 percent to about the high-30 percent range, she said.

"We're transfusing smarter and differently than we used to," she said. "We still see a need for trauma and certain oncology patients. There will always be a need for blood and blood products."

Indiana Blood Center, which serves 60 hospitals elsewhere in the state but not in Northwest Indiana, announced it is closing a donation center, freezing management salaries and eliminating 45 positions.

The nonprofit projected blood component demand by hospitals decreased 24 percent over the previous year, citing a "changing health care environment." 

Demand for blood products is about the same as last year in Community Healthcare System, said Arist Sgouroudis, director of the Central Laboratory for the health care system. The hospitals, as well as those in the northern region of Franciscan Alliance, use Heartland Blood Centers for their blood.

Jill Moeggenberg, of Heartland Blood Centers, said the organization has no plans to scale back operations, especially because it recently added 10 hospitals to its client list.

Methodist Hospitals use American Red Cross for its blood products, said Mushtaq Ahmed, director of laboratory services for the hospitals.

"Methodist Hospitals has not seen a downward trend in blood utilization," he said. "In fact, due to a higher volume of surgeries, our blood utilization is anticipated to go up."

American Red Cross also supplies blood and blood products for Porter Regional Hospital, said Dianna Downham, blood bank supervisor for Porter Regional Hospital.

"Porter has maintained or may have slightly increased its need for blood and blood products from 2009 through 2012," she said.

The hospital issued more than 5,000 units of red blood cells in 2012, she said.

"American Red Cross still does several local blood drives that are very important for us to maintain enough supply throughout the year," Downham said.

Transfusions still have some health risks. Enhanced screening methods have lessened the chance of transmitting HIV and hepatitis, but other risks remain, Lyzak said.

"What we worry about now are things newer on the scene," she said. "It's not what we know. It's what we don't know." 

Some patients, such as those with colon cancer, may experience an immune suppressant effect from a transfusion, Lyzak said.

"Those transfused have lower survival (rates) than those who aren't," she said.

Proving causation is hard, and it's hard to study.

"Trying not to transfuse patients in those cases is better medicine," she said. 

Transfusion related acute lung injury and transfusion associated circulatory overload are two complications of blood product transfusion that can cause a patient's lungs to fill up with fluid or cause their heart to go into cardiac failure.

"There's all these newer things we're becoming aware of," Lyzak said. "Nobody's going to argue that, in a trauma situation, it's still needed. There will always be a need."

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