Impact of Nucleic Acid Testing for Human Immunodeficiency Virus and Hepatitis C Virus on Blood Product Availability, Outdating, and Patient Safety

Context.—Limited data are available about the impact of nucleic acid testing for human immunodeficiency virus and hepatitis C virus in donated blood as part of a nationwide investigational study that affected greater than 90% of the blood supply. Objective.—To assess the impact of nucleic acid testing on supply, outdating, and patient safety. Design.—Participants in the College of American Pathologists 2001 American Association of Blood Banks/College of American Pathologists Viral Marker C survey were asked questions about supply, outdating, and implementation of a full quarantine of blood pending nucleic acid testing results. The number of respondents for each question ranged from 197 to 219 for blood centers and from 462 to 504 for hospitals. Results.—Shortages were more common for platelets (29% and 23% of blood centers and hospitals, respectively) than for red blood cells (13%, 11%). Similarly, outdating of platelets (13%, 11%) was more common than outdating of red blood cells; outdating of red blood cells was negligible for both blood centers and hospitals. Forty-two percent of blood centers did not meet the mid 2000 target date for quarantining red blood cells, and 18% were not quarantining as of September 2001. The hospital figures were 66% not quarantining in mid 2000 and 39% not quarantining as of September 2001. Higher proportions of centers and hospitals were not quarantining platelets at these 2 dates. Conclusions.—Unfavorable trends in both blood shortages and outdating were attributed to nucleic acid testing. Greater effects may have been masked by delayed implementation of full quarantine nationwide. This delay meant continued patient risk, and lack of full benefit, in a trial that was in effect a national standard. In the future, added systems will be needed for similar new endeavors to ensure uniformity of care and to avoid shortages.