Safety of the Blood Supply

IN THE YEARS following the emergence of the human immunodeficiency virus type 1 (HIV-1) infection as a transfusion-transmitted disease, both the general public and the medical profession have voiced great concern about the safety of the blood supply. Although improved donor screening and testing have greatly increased blood safety, a 1993 Gallup survey1showed that concern about acquired immunodeficiency syndrome (AIDS) far exceeded that for heart or lung disease, despite the greater health risk these latter pose. Widely publicized shortcomings in the conduct of several blood collecting agencies in Europe and the United States have only heightened public fear. As the number of measures to promote safety increases, their value must be weighed against many other considerations, such as wastage of discarded blood and unnecessary loss of potential donors due to false-positive results, direct costs of additional or more technologically demanding tests, the increased risk of errors with additional