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FreeRepublic , LLC PO BOX 9771 FRESNO, CA 93794
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Posted on 01/17/2003 6:17:06 PM PST by Copernicus
American Red Cross
January 6,2003
Dear (Former Donor)
RED CROSS WANTS TO WELCOME YOU BACK AS A BLOOD DONOR!
We wrote you after your last donation to advise you of a mild alanine aminotransferase (ALT) elevation discovered when we tested your blood. ALT is an enzyme found in the liver as well as other parts of the body. ALT may be elevated for a variety of reasons,which may include exercise, moderate alcohol consumption or being overweight. Even some types of over-the-counter medications may cause elevated ALT levels. Scientific information recently presented at a National Institutes of Health conference demonstrated that ALT testing no longer contributes to the safety of the blood supply.
Therefore, you are now eligible to donate blood again. As always, your donations will be lifesaving for patients undergoing surgery and children battling Leukemia. I invite you to give, once more, the gift of life.
If you wish to make an appointment to donate, please call your local Red Cross chapter or 1-800-GIVE-LIFE. For more information about ALT you may call a counselor at XXX- XXX-XXXX.
Thank you for saving lives...again!
(signed)
Medical Director/Designee
The recipient attached the following note to the above letter:
Well, vindication comes slowly, but it does come.
You may not remember all the details but about ten years ago I was summarily and somewhat cavalierly told I could no longer donate blood to the Red Cross because of elevated ALT levels.
There was no appeal, discussion, or even coherent explanation given for the letter sent me or my status.
I was forever marked as someone unfit to give blood.
The Gods of the Red Cross had spoken.
Somewhat alarmed I had a complete physical check up and received a clean bill of health from my Doctor who assured me the ALT test meant nothing.
It was in the early days of the Internet and search engines so I sporadically attempted to learn about ALT and blood testing.
To avoid boring you with unnecessary details let me summarize my conjecture after sifting through available literature:
The Red Cross had somehow managed to combine junk science with junk mathematics to develop a test which would with undoubted certainty eliminate the most eligible donors from the donation group over time.
I don't know whether the current "blood shortage" is a direct result of this particular fandango or some other goof ball technique they developed concurrently with this one, but here is the funny part:
They have not learned a thing after ten years of declining donations!
I called the numbers listed and asked a few simple questions based on their letter such as:
What is the name of the Paper that was presented at the National Institutes of Health Conference?
Who was the author?
When was the conference held?
What is the procedure by which the Red Cross acts on information presented at a conference and translates it into Blood Collection Policy?
It was like an episode of Hogan's Hero's with the Sgt. Schultz character: "I know nothing" was the boilerplate response of everyone on the other end of the phone, including the Medical Director whose signature was on the letter!!
How they expect anyone to trust anything they say or do with this kind of performance beats the heck out of me.
Sooner or later the lid has to finally blow off this SNAFU.
What it will take or when it will happen is a mystery to me, but go ahead and crosspost this on your travels on the Internet.
Maybe something will shake loose somewhere at long last.
I'd love to know how many people were ejected from Blood Donation because of elevated ALT over the last ten years and how many they are trying to retrieve now.
Anyway, since they had the good grace to send me this letter I might try to find a private blood donation center somewhere and contribute there.
In the meantime the Red Cross has some 'splaining to do.
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FreeRepublic , LLC PO BOX 9771 FRESNO, CA 93794
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Best regards,
Do you know anyone who may know something about this?
Many thanks.
Best regards,
I am completely asymptomatic and have never suffered even one moment of CJD or other prion-related illness. Up until a couple of years ago, when I was refused from donating blood due to this new mandate, I had never heard of the condition and had donated at least 5 gallons of blood previously. Further, there is no record of any prion-based illness ever being transmitted via blood transfusion, I had received no reports of anyone becoming ill as the result of using my blood, and there is not even any test for the condition that I know of.
I find it very hard to believe that any disease could allegedly have an incubation period of 23 years.
No wonder the blood banks are so chronically short of product - the chicken**** rules and hassle laid down by some wizened bureaucrat somewhere prohibit many otherwise willing potential donors from helping out.
I can state with some confidence that if I drop dead tomorrow, it won't be because of CJD.
ALT (Alanine Transferase)
Increase in serum ALT is primarily associated with liver damage. Red blood cells and striated muscle cells contain small amounts of ALT and damage to these may cause relatively minor increases in serum ALT, as may exercise.
Liver cells (hepatocytes) contain substantial amounts of ALT, and when damaged, the ALT leaks out of the cells and into the blood. Increases of three, or more times normal indicate hepatocellular leakage but do not always signify primary or irreversible liver disease.
You can see normal ALT levels in various types of liver disease. You can see significantly elevated ALT in other sorts of liver disease.
In short, elevated ALT says to the clinician that something may be going on with the liver. You run other tests, consider the history and presenting symptoms and physical exam, and make further determinations as to the relevance of an increased serum ALT.
ONCE AGAIN, THIS INFO IS APPLICABLE TO DOGS AND CATS. I am not a human doctor and don't pretend to be. I don't know the relevance of increased serum ALT in the human.
I'm guessing the Red Cross is using basic screening modalities to try to keep the blood supply as safe as possible. I assume that's what they were doing when they sent you that letter years ago. I have no way of knowing why they've apparently reversed their position on potential donors who had an elevated ALT in the past. It might be worth it to you to contact them and ask them about it.
In the case of HIV (a disease documented to be vectored via blood), common sense indeed. In the case of CJD/mad cow disease/etc., patent nonsense and the apparent desire to strain at gnats while ignoring the beam in one's own eye (how's that for a mixed metaphor).
Thank you for your observation. The letter recipient spent hundreds of dollars in medical tests to avoid exactly the situation you describe.
He is vindicated ten years after the fact apparently by the Red Cross itself because they appear to have reviewed the records and determined nothing in his blood would contaminate the blood supply.
The issue here is the Mathematical and Scientific Incompetence of the Red Cross in screening the blood supply.
While it is possible ALT levels are elevated because of non-A, non-B hepatitus such as C,D (I think it runs to H at this point) they can also be elevated because of the ingestion of common products such as aspirin or licorice.
One primary error in the chain of reasoning here comes from the very word hepatitus -which means "swelling of the liver".
In other words a symptom is treated and not the disease.
When someone exercises by jogging their calf muscles swell as the blood stream eliminates toxins generated from the exercise.
It would be a symptom of disease if no swelling occurred.
As it happens swelling in this case means the muscles are functioning exactly as designed and any test to measure elevated levels of toxins would merely confirm that the exercise of jogging recently occurred.
There is some reason to believe the current "blood shortage" has been manufactured by an ascientific culture within the medical community in charge of stewardship of the blood supply.
That is the chief purpose of this thread.
Best regards,
Best regards,
Do you know of anyone who might be interested in or can comment on this topic?
Many thanks for any help.
Best regards,
-ccm
-ccm
Typically this is defined as two standard deviations from the mean. For a standard 'bell curve' distribution, this works out so that about 95 percent of people fall in the main bulk of the bell curve-- the 95% confidence interval-- while 2.5% will lie in each of the tails at the high and low end.
This means that around 5 percent of disease-free normal patients who take practically any test can be expected to have an 'abnormally' high or low result, just because of the way statistical definitions work. (i.e. those in the green range in the image above.)
And if you take a CHEM-20 blood test, with 20 different measured variables, statistically you can expect one of them (i.e. 5% of 20) to be out of whack. Maybe this is your one. (Of course, it's not quite that simple, as the values measured on the CHEM-20 are not necessarily independent of each other.)
Hope this helps.
-ccm
It should demonstrate the misdirected nature of the entire ALT screen.
I hope to have a copy in hand in the next few days.
Many thanks.
Best regards,
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