Dear Addy: Nation's Blood Supply

Dear Addy,
How is the nation’s blood supply managed, and how do we know if it’s safe?
Searching for the Best Blood

Dear Searching,
The US blood supply system is managed by a number of major organizations, including federal agencies. They oversee two types of blood collection activities: (1) the collection of the cellular elements and plasma from whole blood and (2) the large-scale collection of plasma from whole blood.
Ninety-eight percent of the nation’s blood supply comes from donors in the US. To protect the US blood supply, donors are screened using a standard set of questions. The questions are intended to help determine whether the donor is in good health and free of disease that could be transmitted through blood transfusions or blood-derived products. All blood collected from donors is screened for the following infectious diseases. If one of these diseases is found in the donated blood, the infected blood is discarded.

Infectious Disease Pathogen Laboratory Tests Used
Bacterial Contamination Bacterial culture
Hepatitis B Virus (HBV) Hepatitis B surface antigen (HBsAg) detection
Hepatitis B core antibody (anti-HBc) detection
Hepatitis C Virus (HCV) Hepatitis C virus antibody (anti-HCV) detection
Nucleic acid amplification testing (NAT) for HCV
Human Immunodeficiency Virus (HIV)Types 1 and 2 HIV-1 and HIV-2 antibody (anti-HIV-1 and anti-HIV-2) detection
Nucleic acid amplification testing (NAT) for HIV-1
Human T-Lymphotropic Virus Types I and II (HTLV) HTLV-I and HTLV-II antibody (anti-HTLV-I and anti-HTLV-II) detection
Treponema Pallidum (Syphilis) Anti-treponemal antibody detection
West Nile Virus (WNV) Nucleic acid amplification testing (NAT) for WNV

Though no central data repository exists on the amount of blood collected by the Red Cross, hospitals, and blood banks, the US blood supply is one of the safest in the world. The US Food and Drug Administration (FDA) regulates how blood donations are collected and how blood is used in transfusions. The US Centers for Disease Control and Prevention (CDC) monitors the blood supply and investigates any issues. The National Institutes of Health (NIH) conducts research on clinical practices of blood use, epidemiology, and basic science. Oversight for the blood collection management is done by advocacy groups, including HFA and National Hemophilia Foundation (NHF).
There is no absolute guarantee of safety in our blood supply, but the US has stringent rules in place to protect it. HFA and other advocacy organizations will continue their efforts to advocate for blood safety and not allow the nation to forget the tragic contamination of the US blood supply in 1980s and 1990s.
For more information on how the FDA works to keep the blood supply safe, see “The Safety of the Blood Supply.” For more information on blood donation, see the Red Cross’s “Blood Facts and Statistics.” Please contact HFA for information on how we advocate for blood safety.

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HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.