Effectiveness and safety of blood transfusion: have we lost the plot?

Blood  safety  is  a  high  priority.  As  a  result  of  many  additional  safety measures  the  risks  of  transmitting  known  infective  agents  is  remarkably  low. However, some  blood  safety  measures  are  quite  remarkably  expensive  by  an conventional health economic standards.  It is therefore surprising that much of our  current  blood  prescribing  is  not  founded  on  any  reliable  evidence.   We question the logic of spending even more on safety measures that offer marginal benefits  unless  we  also  invest  more  to  understand  rather  better  when, and  for who, transfusion  is  really  beneficial.   On  1  March  2005, the  Royal  College  of Physicians of Edinburgh is holding a one-day meeting to investigate this balance of priorities.