In an attempt to account for the discrepancies between whole blood collected and transfused in the U.S. in 1956 the Joint Blood Council made an analysis of units collected and units transfused by regional breakdowns and per 1000 population. The Report came to the conclusion that, in total, of the 4,470,000 whole blood units collected 2,517,000 (or 56 per cent) were used for purposes of transfusion (p. 17).1 This left 44 per cent of whole blood to be accounted for. Of this proportion, less than 1 per cent of fresh blood was converted into plasma (p. 30).

The balance of 43 per cent could be accounted for in the following ways:

• (i) Outdated blood converted into plasma

• (ii) Blood used for research and testing control purposes

• (iii) Blood wasted for:

• (a) technical reasons (contaminated, haemolysed, ‘short’ bottles)

• (b) administrative reasons (see Chapter 1).

• (iv) Errors in response for collections and use.

The Report made estimates under (i) and arrived at the following proportions (p. 34): American Red Cross 8.2 per cent; Community Blood Banks 4.4 per cent; short-term hospitals 3.6 per cent; long-term hospitals 3.0 per cent. The total of units of outdated blood converted into plasma was 264,000 or 5.9 per cent.

No precise estimates were made for (ii) and (iii).

To compare these proportions and to obtain estimates for (ii) and (iii) a statistical study was made of the 1956 monthly regional reports for the National Blood Transfusion Service in England and Wales. The region selected for study was the largest, the Sutton (the South-East and South-West) region. To summarize the results:

As a check on the plasma figure, it should be noted that, for England and Wales as a whole, the ratio in 1956 of blood issued to dried plasma issued was 18.8:1. Allowing for the fact that each plasma bottle contained the plasma from slightly more than two bottles of whole blood the proportion works out at 9.4 per cent—about 1 per cent lower than the proportion for the Sutton Regional Centre.