# Why are autologous transfusions illegal?



## trhoppe (Dec 21, 2009)

Honest question, as I don't quite get it. 

Understand why injecting extra EPO isn't legal. Understand why homologous transfusions are illegal (it's not your blood), but why are autologous transfusions illegal?

After all, it's your own blood? Not trying to start anything, but genuinely curious. 

-Tom


----------



## ttug (May 14, 2004)

*well*



trhoppe said:


> Honest question, as I don't quite get it.
> 
> Understand why injecting extra EPO isn't legal. Understand why homologous transfusions are illegal (it's not your blood), but why are autologous transfusions illegal?
> 
> ...


My understanding is that you are doping just with your own blood. Extending your logic, we could also in theory, use Hgh or Insulin etc etc if you were of course able to harvest your own from your body.

Sounds kind of icky.......


----------



## mohair_chair (Oct 3, 2002)

Because they enhance performance artificially.


----------



## trhoppe (Dec 21, 2009)

But "how" are you doping? You have the same levels of everything as your regular blood. How does that enhance performance "artificially"? Seems to me it's "natural" as it's your own blood. 

Maybe I don't get it?

-Tom


----------



## SilasCL (Jun 14, 2004)

It's doping because the people who make the rules say so. Caffeine is a drug with proven performance enhancing effects. Yet it's not on the banned list, while other drugs are.


----------



## Gatorback (Jul 11, 2009)

Maybe because it can be dangerous?

I wouldn't call it natural. Granted, you can get in some tricky arguments when you start debating what is natural and what is not. It is easy to create a lot of gray area. Is it natural to ingest whey protein powder? How about a sports drink as opposed to fruit juice and salt? How about EPO or growth hormone from a non-human animal? 

The bottom line is you've got to figure out where to draw the line somewhere. Blood products are regulated by the FDA in the U.S. And that is likely the case elsewhere. Sticking a big needle into a vein a draining a blood bag, even if your own, clearly falls into the "it shouldn't be allowed" category in my assessment when we are talking about enhancing athletic performances. If you have lost blood due to trauma or are anemic, then yes it is good. But to climb Alp d' Huez faster in a sporting event? I'd say clearly no.


----------



## Gatorback (Jul 11, 2009)

In terms of the enhancing performance, some others can answer better, but there are two clear benefits I can identify: 

1. You increase your blood volume, which increases your ability to transport oxygen to your muscles for athletic performance; and

2. In long, rigorous events--and due to hard training leading up to an event--your hematocrit and/or hemoglobin drops due to the significant stress on your body. Adding "good blood" helps so that you can perform closer to your peak as opposed to in a chronically fatigued/stressed state.


----------



## rydbyk (Feb 17, 2010)

Is using a hyperbaric chamber illegal? Seems like it is sort of similar..


----------



## mohair_chair (Oct 3, 2002)

rydbyk said:


> Is using a hyperbaric chamber illegal? Seems like it is sort of similar..


Getting your body to create new red blood cells through a natural process is a lot different than injecting them.


----------



## mohair_chair (Oct 3, 2002)

SilasCL said:


> It's doping because the people who make the rules say so. Caffeine is a drug with proven performance enhancing effects. Yet it's not on the banned list, while other drugs are.


Up to 2004, caffeine was on the list. And recently (August 2010), WADA mentioned putting it back on.


----------



## rydbyk (Feb 17, 2010)

mohair_chair said:


> Up to 2004, caffeine was on the list. And recently (August 2010), WADA mentioned putting it back on.



Caffeine is over the counter, so it should remain legal imo.. Are there any over the counter products that are currently banned?


----------



## Alaska Mike (Sep 28, 2008)

rydbyk said:


> Caffeine is over the counter, so it should remain legal imo.. Are there any over the counter products that are currently banned?


Over-the-counter where? Mexico? China? The standards vary greatly from country to country.

There are substances on the WADA list that are part of common US cold medicines, and yes, they are performance-enhancing.


----------



## Gatorback (Jul 11, 2009)

But coffee, expresso, and caffeine are just part of the cycling culture. You can't ban them.

Oh wait, maybe I don't want to pursue that line of reasoning too far...


----------



## baker921 (Jul 20, 2007)

Its illegal because it is potentially lethal.
It started in athletics when athletes, most famously the Finn Lasse Viren, would train at high altitude and transfuse blood for use before a race. Because of the reduced oxygen at altitude the body compensates and naturally produces more red blood cells.
Scientists soon realised that extended holidays in the Andes were expensive and it was simpler just to spin out the red blood cells and re-inject them. 
The downside was that this quite literally thickened the blood and young healthy cyclists died in their sleep since their hearts couldn't pump around the thickened blood.
Thgis is a layman's answer. Others will be able to explain it more accurately


----------



## pretender (Sep 18, 2007)

trhoppe said:


> Why are autologous transfusions illegal?


Because 
(1) it works and
(2) it's dangerous.

http://en.wikipedia.org/wiki/Blood_doping#Negative_effects
_The simple act of increasing the number of RBCs in the blood stream makes blood thicker, which can also make it clot more readily.[15] This increases the chances of heart attack, stroke, and pulmonary embolism, which has been seen in cases where there is too much blood reintroduced into the blood stream.
Blood contamination during preparation or storage is another issue. Contamination was seen in 1 in every 500,000 transfusions of RBC in 2002.[16] Blood contamination can lead to sepsis or an infection that affects the whole body_


----------



## ZoSoSwiM (Mar 7, 2008)

I'd sleep in a altitude chamber if I could afford one! However I wouldn't want to inject my own blood into my body because thats just freaky. Plus the increase in blood volume is bad for your body. I wanna live forever not just win a few races.


----------



## HikenBike (Apr 3, 2007)

trhoppe said:


> But "how" are you doping? You have the same levels of everything as your regular blood. How does that enhance performance "artificially"? Seems to me it's "natural" as it's your own blood.
> 
> Maybe I don't get it?
> 
> -Tom


It's not "natural" because our bodies do not have centrifuges inside of them. The blood is "artificially" manipulated.


----------



## Doctor Falsetti (Sep 24, 2010)

rydbyk said:


> Is using a hyperbaric chamber illegal? Seems like it is sort of similar..


The increase in Hct from living at altitude is marginal. If your Hct is 40 the average person would see an increase to 41.5. Many people see no increase at all and a small percentage would see an increase to 42.5. 

Contrast that to a bag of RBC's, quickly can take you to 49,9 without having to sleep in a tent. drink water and take a bag of saline in the morning before the Vampires show up to bring it down enough to not trigger the biopassport


----------



## Doctor Falsetti (Sep 24, 2010)

HikenBike said:


> It's not "natural" because our bodies do not have centrifuges inside of them. The blood is "artificially" manipulated.


Bingo, it is banned under the "Methods" part of the WADA code

M1. ENHANCEMENT OF OXYGEN TRANSFER


----------



## Doctor Falsetti (Sep 24, 2010)

There is little natural about an auto-transfusion. It also can cause some serious health issue. 

Ricco was hospitalized yesterday

https://www.cyclingnews.com/news/ricco-hospitalized-for-possible-kidney-ailment

Due to an bad auto transfusion

https://www.gazzetta.it/Ciclismo/08-02-2011/ricco-nottata-tranquilla-8084685384.shtml

Ricco is not the only one. Here is Jesus Manzano after a bad transfusion


----------



## pedalruns (Dec 18, 2002)

Does the OP get it now? I hope so. 

Here is a google translation from the Italian source:


MODENA, February 8, 2011 - The health of Riccardo Ricco improve. But the story is complicated by concerns that the legal point of view and sports. The prosecutor of Modena has opened a file (at the time against the person to be identified) for suspected violations of the anti-doping law 376/2000. The Attorney Pasquale Mazzei placed on record the medical report submitted by the Hospital on Sunday morning Pavullo provided first aid to Riccò, presented himself to the emergency room in critical condition, so as to encourage the transfer of emergency hospital Baggiovara (Modena). According to the testimony of the doctor, the rider from Modena was in a state of shock and said, "in the presence of his wife" (in reality 'girlfriend Vania Rossi, ed) that they had "made himself a self-transfusion of blood preserved in the refrigerator home for 25 days, "fear" for the poor storage of blood that had been put back. " The prosecutor's office received the news of crime only yesterday evening at 19.30. It has required Hospital Baggiovara can acquire the medical records of Riccò, still in hospital under observation in the Department of neurorianimazione, but in steady state. Almost certain that the prosecutors will proceed, as soon as circumstances allow, the interrogation of Riccò, to search for support for claims made by the doctor Pavullo. They will also order medical examinations and hematological. Ricco, who for now is not entered in the register of suspects, assuming the offender liable to 3 months to 3 years for doping violation of the law. For the sports justice radiation risk, having already served a 20-month ban for doping (Cera) Tour 2008.


----------



## zoikz (Sep 5, 2003)

rydbyk said:


> Caffeine is over the counter, so it should remain legal imo.. Are there any over the counter products that are currently banned?


Numerous over the counter products are banned most fall under the category of stimulants (ephedrine, pseudo-ephedrine) likewise DHEA is a legal supplement. Many states you can get insulin without a prescription, likewise albuterol. Being over the counter really has no bearing as to whether the substance in question can be used as a performance enhancing drug, it has to do with consumer safety.


----------



## rydbyk (Feb 17, 2010)

Doctor Falsetti said:


> The increase in Hct from living at altitude is marginal. If your Hct is 40 the average person would see an increase to 41.5. Many people see no increase at all and a small percentage would see an increase to 42.5.
> 
> Contrast that to a bag of RBC's, quickly can take you to 49,9 without having to sleep in a tent. drink water and take a bag of saline in the morning before the Vampires show up to bring it down enough to not trigger the biopassport



Wow. That is really a big difference in Hct. I kind of always thought the "bag of RBCs" was just like living at elevation for months sort of thing...amazing! A lot of people DO train at higher elevations for an event at lower elevation (usually a ONE day event). Boxers, MMA fighters, cyclists, runners (Tanner Hall lives at elevation for this reason I believe?)

That small jump from 40 to 41.5 is enough for many to train at elevation. I can't imagine going from 40 to 49ish...holy cow!


----------



## crazyc (Jun 5, 2008)

there are 3 main reasons i can think of off the top of my head why autologous blood transfusions are dangerous

1) increased blood viscosity - the fluidity of the blood is decreased leading to increased cardiac muscle strain, increased incidence of strokes, heart attacks, and pulmonary embolisms

2) risk of bacterial infection from stored blood

3) risk of mislableled blood (might be the #1 causes of transfusion reactions in the general public), you think you are getting your blood and you get someones elses leading to a transfusion reaction.


----------



## 88 rex (Mar 18, 2008)

rydbyk said:


> Wow. That is really a big difference in Hct. I kind of always thought the "bag of RBCs" was just like living at elevation for months sort of thing...amazing! A lot of people DO train at higher elevations for an event at lower elevation (usually a ONE day event). Boxers, MMA fighters, cyclists, runners (Tanner Hall lives at elevation for this reason I believe?)
> 
> That small jump from 40 to 41.5 is enough for many to train at elevation. I can't imagine going from 40 to 49ish...holy cow!



I don't know where the good Dr got his numbers, but 1 unit will approximately raise your hgb 1g/dl ( or a hct of 3%). To go from 40 to 50 you'd need 3 units. If living at altitude or training with a HYPObaric chamber potentially raises your lever 2.5%, then you'd be pretty close to a person that just took 1 unit.

EDIT:

http://www.cptips.com/alt2.htm

In this study, tHb went from an avg of 14.0 to 15.3 in males from altitude training.


----------



## Doctor Falsetti (Sep 24, 2010)

88 rex said:


> I don't know where the good Dr got his numbers, but 1 unit will approximately raise your hgb 1g/dl ( or a hct of 3%). To go from 40 to 50 you'd need 3 units. If living at altitude or training with a HYPObaric chamber potentially raises your lever 2.5%, then you'd be pretty close to a person that just took 1 unit.
> 
> EDIT:
> 
> ...


My numbers come from dopers. 

Yes, the common figure is a 3% increase per unit (450 ml) of Packed blood and 6% per liter. A few points to remember on this


PRBC in a hospital are normally 60-70% RBC. If there is a resident hemotogist here they can correct me but Fuentes would spin his out to a much high concentrate. 

The variance on the 3% study was large -/+ 4% per liter. This means a 130 pound climber could see up to 10 point change from 1 liter, moving from 40 to 50

2 units (1 Liter) was the common amount used by Blood dopers and is mentioned by Manzano, Landis and others. Recently there has been talk of a using much smaller amounts, 300 ml, but more often in order to fool the passport with stable numbers. 

A key point to remember is that a bag of blood is something you can take at anytime. For example the average Hct decrease in the 3rd week of a GT is 12%. A bag of PRBC can turn this decrease into a 10% increase, that is a massive swing. 

Note the % discussed in most altitude studies refers to the percentage increase in Hct, not the basis points that the unit studies refer to. There are also large variances so you would need more then 10 people, some see huge gains and others see nothing. Some even decrease their Hct. The common numbers I have seen over the years is 3-5%


----------



## Hula Hoop (Feb 4, 2009)

They are illegal in the context of a multi-stage race because they artificially
increase hemocrit relative to other riders who have also expended the same
effort relative to the blood doper. I don't understand why this is a hard question
to answer, seems relatively simple to me, it is an attempt to skew the
playing field.


----------



## 88 rex (Mar 18, 2008)

Doctor Falsetti said:


> My numbers come from dopers.
> 
> Yes, the common figure is a 3% increase per unit (450 ml) of Packed blood and 6% per liter. A few points to remember on this
> 
> ...


I suppose it's naive of me to think that Dr's who help cheaters follow normal SOP.  Thanks for the further explanation.


----------



## Snpiperpilot (Feb 13, 2011)

trhoppe said:


> Honest question, as I don't quite get it.
> 
> Understand why injecting extra EPO isn't legal. Understand why homologous transfusions are illegal (it's not your blood), but why are autologous transfusions illegal?
> 
> ...


Because it creates a state in the body which isn't natural. Consider the body a fuel tank. Training uses fuel, you refill by eating and resting. Eating refuels the fat and muscle, the resting refuels the red blood cells which carry oxygen. Resting, however allows muscles to atrophy while the red blood cells regenerate. Adding fresh blood eliminates the need for rest which keeping the muscles at their higher trained state. That is unnatural, and hence, is considered cheating.


----------

