The New York Times - November 9, 1986
Sandra Friedland

Known as Operation Lookback, the effort will track units of blood and blood components from donors who gave blood before the AIDS screening test was instituted last spring and who now show evidence of exposure to the deadly virus.

The Lookback program will examine transfusion records back to Jan. 1, 1983. Since then, nearly two million units of blood and blood components have been transfused in New Jersey, but state officials estimated that only about 250 people would need to be notified that they might have received the now-suspect blood.

Those recipients will be urged to have their blood tested. If they received a transfusion that actually contained the AIDS virus, an unknown percentage now could be symptom-free AIDS carriers. They could be unwittingly spreading the virus to their sexual partners or unborn children.

In New Jersey, 3 percent of the adult AIDS victims, or 46 of the 1,530 cases, and 11 percent of the children with AIDS - 7 of the 60 cases - have been linked to transfusions.

In a statement introducing the guidelines, Dr. Ronald Altman, director of the state's AIDS program, stressed that, although the number of transfusion-related AIDS cases had been small, the fatal nature of the disease and questions about its transmission warranted an aggressive Lookback effort.

"It is entirely appropriate to do all in our power to insure the safety of the public," Dr. Altman said.

In a recent interview, he explained that the blood-collection agencies would start the Lookback process. Those agencies, which keep detailed records of the disposition of blood, will notify any hospitals that may have received suspect blood.

The hospitals then would try to trace recipients of any units of the blood that actually were transfused (some units may have been used for research or discarded).

Because most recipients of blood transfusions are critically ill, Dr. Altman said that a certain percentage of the patients who got the suspect blood probably had died during that hospital admission. Other patients may have died later.

Dr. Altman has asked hospitals to designate an infectious-disease specialist to coordinate efforts to contact any living recipients. The patient's attending doctor, if available, would also be consulted.

The hospital would offer an AIDS blood test to any patients and their sexual partners who can be found and, if the results were positive, counsel them on how to reduce the risk of spreading the infection.

If the recipient of the suspect blood died after the hospital admission, then the physician coordinating the Lookback effort would try to contact the patient's spouse or regular sexual partner and recommend a blood test.

The state's Department of Health will oversee this process and will, Dr. Altman said, act as the "tracer of last resort" if hospitals cannot find a patient or if the patient now lives outside the hospital's service area.

Ron Czajkowski, a spokesman for the Princeton-based New Jersey Hospital Association, said that the Lookback program was a product of cooperation between hospitals, physicians, the Department of Health and the blood banks.

He said that the hospital industry viewed AIDS as a public health problem and pushed to have the Health Department notify and counsel recipients of suspect blood.

However, Mr. Czajkowski said that the state's hospitals had accepted the role after state officials agreed to supply support with laboratory and counseling services.

Part of the Lookback program will involve data collections, Dr. Altman said.

"If we find a high percentage of recipients who test positive," he said, "then we may go back further than 1983. First, we want to see if this effort does any good."

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