Blood Traffic

Blood, just as it comes from a donor's vein, is worth more than fine old cognac; but unlike brandy, blood is harmed by aging. Faced with the necessity of throwing this costly liquid away after its effective life of 21 days has passed, a crooked dealer may break the rules and sell it anyway. A fortnight ago, the U.S. Attorney for the Southern District of New York alleged that a firm called Westchester Blood Service, Inc. had changed the dates on bottles of expired blood and then sold them to hospitals. It was the first such indictment ever made under the labeling provision of the Public Health Act of 1902.

Until federal investigators stepped in, the firm had been shipping 4,000 pints of blood a month to Puerto Rico and about 100 hospitals in New York, New Jersey, Rhode Island, Massachusetts and Pennsylvania. Some hospitals received blood that had been "updated" by as much as 42 days.

Better Red than Dead. Blood may save lives wholesale if fresh, and each year more than 2,000,000 Americans get a total of some 5,500,000 transfusions of it. But after three weeks, as more and more of its red cells die, it may do more harm than good, and its use is prohibited. Time-expired blood can be salvaged up to the 26th day by removing the cells, which are thrown away, and saving the virtually imperishable plasma, used for burned patients and patients who are in shock.

The organization of the blood-banking business traces back to the days right after World War II when the American Red Cross was regearing its blood-donor program for peacetime. When it got rolling again, it had to compete with the American Association of Blood Banks, set up in 1947, mainly by community groups for private nonprofit hospitals. The two waged sanguinary warfare for a decade. Not until last year did they put into effect a sense-making national clearinghouse system, so that a patient who gets a transfusion in any of about 5,500 hospitals can receive credit for blood that either he or his family donated elsewhere, whether through Red Cross or an AABB bank.

Through its 55 regional donor centers, the Red Cross now drains off 2,500,000 pints of blood a year, or 45% of the national consumption. The Red Cross pays donors nothing and does not sell its blood; the only charges it permits are for processing ($3 to $8 a pint) and for actual transfusion by the hospital ($10 to $15 a pint).

Two Pints for One. Most of the 812 blood banks enrolled in AABB are in hospitals, though some are community and private (but nonprofit) ventures. They collect more than 2,000,000 pints, mainly from family and friends of patients, but partly from paid donors who get an average of $15 a pint. Unlike the Red Cross, which exacts no more than pint-for-pint replacement, some hospital banks demand two pints for one. A common compromise is to take two pints for the patient's first transfusion pint, to cover waste and spoilage, and then accept pint for pint. A few community blood banks, organized by civic groups but not in AABB, also furnish blood to hospitals in their areas.

An estimated 10% of U.S. transfusion blood is drained from paid donors by commercial supply houses, which sell the blood for profit. They need a license from the National Institutes of Health for interstate shipments. They flourish in the Midwest and the South. One such is the Community Blood and Plasma Service Inc. of Birmingham, Ala., which sold blood to the indicted Westchester dealers, but, far from being implicated, helped Public Health Service officers open up the case. It pays donors an average of $9 but may go to $20 for rare types. In segregated Alabama, its blood is labeled by donor's race.

Federal inspectors may drop in at any time on blood-donor services and banks under their control, and AABB has an inspection service to make sure that the blood they supply is not only fresh but, so far as possible, free of disease. Even so, donors out to make blood money will sometimes lie about whether they have had malaria, which is hard to check in the laboratory, or hepatitis, which is impossible to check. These diseases are a small but real peril in blood transfusion. Though no case of injury to a patient had been traced to blood supplied by the West-Chester firm, officials are still checking.

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