Doctors unaware of 'bad blood' risk

Hidden danger: Doctors are calling for screening test

Many doctors do not understand the dangers posed by a rare condition caused by blood transfusions, say experts.

New Scientist magazine reports that TRALI - or transmission-related acute lung injury, affects thousands of patients in the US each year.

It is an immune reaction which happens when antibodies in the donor blood come into contact with the recipient.

Donors who have been pregnant with more than three children - or who have had transfusions themselves - are most at risk of giving "bad blood" which can cause the reaction.

It can cause extreme shortness of breath, and in one in 10 cases may progressively get worse and even kill the patient.

However, its early symptoms are the same as a non-lethal condition caused by transfusing the new blood too quickly.

Doctors who mistake TRALI for this, less serious condition, may treat it with diuretic drugs, which could actually make it worse.

A simple blood pressure reading could spot the difference between the two.

Screening call

Mark Popovsky, of Haemonetics, a Massachusetts based company that makes blood collection machines, said that it was likely that TRALI was under-recognised and under-reported by doctors.

He would like to see all donated blood screened for these antibodies in the same way that it is screened for HIV.

He told New Scientist: "These are not difficult tests to do. They are also not cheap, but we're not talking about so many donors."

Trial of danger

A recent report in the Journal of the American Medical Association told the story of a donor whose blood triggered a TRALI death.

The history of her donations was traced back - and researchers found it had caused 14 other reactions in the past.

Only two hospitals involved had reported the incidents to their local blood bank.

Mr John Heyworth, chairman of the British Association of Accident and Emergency Medicine, said that the problem could well be relatively unrecognised in the UK.

He said: "It could be a problem - and it should be researched further."