Blood transfusions have saved countless lives. But blood transfusions can be risky. Emily Anthes writing in Nature gathers the evidence that the procedure is one of the most overused treatments out there, an expensive, but more importantly, potentially dangerous, problem.

It’s intuitive to understand why blood transfusions are good. When blood banks that arose out of World War II proved their use, doctors began adopting transfusions widely—without randomized clinical trials to back up many of the practices. “I think we were kind of brainwashed into thinking that blood saves lives, and the more you give the better,” anesthesiologist Steven Frank told Nature.

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Lately, doctors have been trying to curb the practice. At Stanford Hospital and Clinics, doctors were prompted to reduce the number of transfusion requests, which ended up cutting costs by by $1.6 million and reducing length of hospital stays and mortality for patients.

More compelling than the money saved is the the fact that blood transfusions can do serious damage: There is the low, but not zero, risk of receiving infected blood, and then there is the complicated way in which foreign blood interacts with the immune system. Categorizing blood into different types (A, B, AB, O and positive/negative) is supposed to prevent harmful immune reactions, but it doesn’t always. Read more about the overuse of blood transfusions in Nature.

[Nature]

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