2,500 to Be Told of AIDS Risk From Donated Blood

Nearly three years after undergoing open heart surgery, Wendell Glessner recently learned that the blood he received during that 1983 operation had come from a donor who had been exposed to the AIDS virus.

The 70-year-old Milwaukee resident is among the first of perhaps 2,500 to 5,000 Americans who have been--or soon will be--told that they stand some chance of getting AIDS because they have received blood that, it now turns out, contained antibodies to acquired immune deficiency syndrome.

Public Information

The information is of great importance for public health reasons,” said a national Red Cross official. “It is information that belongs to the public.”

Such donations had come from blood banks before April, 1985, when a test became available to screen donated blood for contamination by AIDS antibodies. A person with AIDS antibodies in his blood is considered to have been exposed to the deadly virus and may develop the disease.

The blood test has allowed blood bank officials to weed out potentially contaminated blood, and health officials insist that the nation’s blood supply now is essentially free of AIDS virus contamination.

In addition, the test is enabling health officials, reviewing blood bank records, to track down donors who, it is now known, have been exposed to the virus and donated blood before April, 1985.

Yet even when recipients like Glessner are located and informed, there is nothing that can be done for them except to regularly test their blood and to monitor their health because there is no cure for AIDS.

In Los Angeles, as many as 500 people among the 500,000 who received donated blood products in 1983 and 1984 may have received contaminated blood, according to local Red Cross officials.

Details of a notification program still have not yet been worked out--partly because blood banks, hospitals and physicians cannot agree who should actually notify the recipients of potentially contaminated blood.

Throughout the country, local branches of the American Red Cross and two other major blood-gathering agencies are in the process of identifying people who tested positive for AIDS antibodies at blood centers in the last year and have donated before the availability of the screening test. It is recipients of such blood who now are at risk.

Once identified, the donors’ names are to be sent to the hospitals that received their pre-April, 1985, blood--so that hospital blood bank administrators can then identify recipients of that blood, according to Dr. Gerald Sandler, associate vice president of the headquarters office of the American Red Cross in Washington.

Once informed, a standard blood test will reveal whether the recipient has developed antibodies to the virus. A negative test would indicate that the blood donor probably had become infected after that donation--and therefore the blood poses no threat of AIDS to the recipient.

Program Extended

For several years, Red Cross and other blood-gathering agencies have been notifying recipients of blood from donors who actually had contracted AIDS that they have received contaminated blood. But the new “look-back” program extends that activity to recipients of blood from donors who now have tested positive for the presence of antibodies to the virus but do not have the disease.

Dr. Joseph O’Malley of the medical operations division at the Red Cross’ national headquarters estimated that no more than 2,500 Red Cross blood recipients are expected to be notified within the next few weeks that they received possibly infected blood from transfusions performed during the last three years. But that figure could be 5,000 because non-Red Cross blood banks supply about 50% of the nation’s blood supply.

In Los Angeles, Dr. Steven Kleinman, associate medical director of the local Red Cross Blood Center, said it will be July or August before his agency will send the list of antibody-positive donors to the hospitals who received their blood.

Informing the Recipient

“We are in the formative stages of implementation of this program. I think that very careful thought must go into planning how the recipients are informed,” he said.

As an indication of the magnitude of the job, Kleinman said that the Los Angeles-Orange County Red Cross Center dispensed blood products--whole blood, red blood cells and platelets--to 500,000 people over the two-year period before the introduction of the test in April, 1985. He estimated that about 500 of those people eventually will be identified as being recipients of suspect blood.

Between June, 1983, and March, 1985, there were 268 donors who later tested positive and their blood had been given to 293 recipients, according to a limited analysis of Los Angeles donors, Kleinman said. The process of determining which hospitals received those donations has not yet been completed, he said.

Kleinman expressed irritation with the national Red Cross for having thrust local agencies “into the position of having to implement a program in which what happens to the recipients has not been adequately addressed by the three blood agencies” on a national level.

“I think there is the potential to cause more anxiety among the recipients than need be,” he said. The other two blood agencies are the Assn. of American Blood Banks and the Council of Community Blood Banks.

No Agreement Yet

So far, he said, there is no agreement between blood agencies, hospitals and physicians on how recipients are to be informed--by telephone or letter--or the wording of such information.

Nor are there any provisions for psychological counseling for recipients of possibly contaminated blood. Such information must be dispensed with “a great deal of backup support,” said Stephen Gamble, president of the Hospital Council of Southern California.

He called it a monumental job for hospitals to trace records to see who received the blood from the list of suspect donors that will be provided by the blood agencies.

Kleinman suggested that a procedure that has been used by Dr. James Mosley of the USC School of Medicine to notify local recipients of AIDS antibody-positive blood may be adapted for the larger effort. It involves a combination of letters and telephone calls and a prepared text that the physician or other person can use to inform patients.

Mosley said the anxiety level of people who have been so informed in a research study that he is conducting has varied widely.

Varied Reactions

“Some are acutely anxious. Some are quite hostile about having this happen to them,” Mosley said. “Often the recipient is more concerned about having exposed a spouse than they are for themselves.”

In Milwaukee, Glessner has not developed any symptoms of AIDS. “It is an extremely devastating thing for him, as it would be for any person so informed,” George Kersten, Glessner’s attorney, said Monday in a telephone interview. Glessner received the news from his personal physician.

Kersten said he has filed an administrative claim against the Milwaukee County Hospital for providing Glessner with “impure and defective blood.”