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Jeffrey L. Carson, MD

JAMA. 2002;288:2884-2886.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Reducing the frequency of red blood cell transfusion is a goal of modern blood management. The primary driving force during the past 15 years has been safety. In the mid 1980s the HIV (human immunodeficiency virus) epidemic and frequent transmission of hepatitis C led to careful examination of transfusion practices.¹ A review of the data available then showed no evidence for maintaining hemoglobin concentrations at 10 g/dL or hematocrit at 30%,¹ the so-called 10/30 rule. Subsequent new guidelines urged a lower threshold and consideration of symptoms and other clinical parameters,² although clinical judgment was the cornerstone of many of the recommendations.

Blood transfusion has many known adverse effects aside from the potential transmission of infectious disease, including allergic reaction; febrile, nonhemolytic transfusion reactions; red blood cell alloimmunization; and leukocyte/platelet alloimmunization.³ In most patients these events have few clinical consequences. Less common but more serious adverse effects . . . [Full Text of this Article]

Author Affiliations: Division of General Internal Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick.

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