Stanford Blood Center officials say SJSU ban on blood drives could hurt supply

Stanford Blood Center officials say the recent decision by San Jose State University to suspend blood drives on campus is a seriously misguided effort to influence national policy and could have a devastating effect on the local blood supply.

SJSU President Don Kassing sent a letter Jan. 27 to all 37,000 faculty, students and staff on the San Jose campus, saying blood drives would be suspended because of a federal policy on blood donation that discriminates against gay men. The federal Food and Drug Administration's policy, which goes back to 1983, prevents men who have sex with men from donating blood because of their risk of HIV, which can be transmitted through transfusion.

In his letter, Kassing said he perceives the federal policy to be in conflict with San Jose State's own policy, which views discrimination on the basis of sexual orientation as 'an affront to the entire university.' Though the federal policy has long been the subject of debate in educational and scientific circles, this is believed to be the first time a university has moved to ban blood drives in protest. San Jose State says students can still donate blood in off-campus drives.

'It's entirely appropriate to try to influence the FDA based on scientific data, but while you're trying to influence the FDA, you should not be putting patients at risk,' said Susan Galel, MD, director of operations at the Stanford Blood Center. 'And by withholding blood donations, that's exactly what's happening. Our concern is that this is going to have a ripple effect through California which could dramatically impact the blood supply.'

Stanford receives 20 percent of its blood supplies through drives at high schools and colleges, Galel said. These drives are critically important because they establish a pattern of giving among students that continues throughout their lifetime. Now, officials fear that the move by San Jose State may spread to other campuses, thus depriving blood banks of a critical source of blood at a time when supplies are perennially at risk.

'The only people who are going to suffer are patients,' said Galel, an associate professor of pathology at the School of Medicine. 'If the same people canceling blood drives had a loved one who needed a transfusion, they would expect blood to be on the shelf. Where do they think the blood is going to come from?'

Over the last decade, Stanford's center and other blood-bank organizations have lobbied for a change in the FDA policy that would relax the restrictions on donations by gay men.

In response to San Jose State's action, the nation's three major blood organizations last week issued a joint statement reiterating their position that FDA policy 'is no longer medically and scientifically valid,' particularly in light of new, highly sensitive genetic tests for detecting HIV in blood. The three groups - the AABB (formerly the American Association of Blood Banks), America's Blood Centers and the American Red Cross - advocate a policy change in which gay men would be deferred from giving blood for one year. This is similar to the deferral policy for other risk groups, such as those who have traveled to malaria-prone areas or received a tattoo, which puts them at risk for contracting hepatitis C.

'If there were a one-year deferral, we have great confidence that the tests would identify anyone who is HIV-positive,' said Vince Yalon, director of the Stanford Blood Center, who has lobbied legislators for the change.

Blood centers nationwide now routinely use two tests for HIV detection. In addition to the long-standing serologic tests, which screen for antibodies to the virus, blood banks now apply a nucleic acid test that can detect the presence of viral RNA on average at 10 days after an individual's exposure. Within the first 10 days of exposure, no test will reliably detect infection, so questioning potential donors is the only way to protect the blood supply.

'The issue is, is there a way to modify the questioning strategy so that more people could donate without adversely affecting safety?' said Galel. 'We've tried to influence the FDA on many fronts. The FDA's response is always, our top priority is safety, and we need to be convinced by the data before we modify the exclusion.'

On its Web site, the FDA notes that the current risk of contracting HIV through transfusion is one in 2 million. The agency remains concerned that if the donation policy on gay men were relaxed, HIV-tainted blood could slip through the testing system or be accidentally given to a patient as a result of human error. It says it won't modify the policy unless presented with scientific data showing that the change would not present a 'significant and preventable risk to blood recipients.'

Galel said the Stanford center will work collaboratively with San Jose State in seeking to change the federal policy, possibly by advocating for funds for a federally sponsored study to provide sufficient data to support the change.