A new generation of blood components and transfusion modalities aimed at further reducing real or hypothetical risks threatening the blood supply is available. Since the risk of infection with transfusion-transmitted viruses is already very low, many of these new interventions provide a minimal health benefit at a very high cost. It is even possible that risks inherent to the new technologies themselves could surpass the current risk of transfusion-transmitted viruses. For some of the new blood components, such as leukoreduced products, the poor cost-effectiveness projections may be substantially improved if the purported health benefits are eventually proved in appropriate randomized, controlled clinical trials. Meanwhile, cost-effectiveness analyses show that allocating more resources to improve the safety of donated blood may actually decrease the overall transfusion safety by subtracting resources from other areas of the health care system, so a realignment of costs with health benefits seems necessary.
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