Detection of autologous blood transfusions in cross-country skiers.

Transfusion of autologous blood (blood doping) has been used by athletes to improve performance in sports events. This practice has been banned by the International Ski Federation (FIS) and the International Olympic Committee (IOC). So far, no reliable method for detection of blood doping has been available. In the present study, a group of six elite cross-country skiers, who were phlebotomized and retransfused with 1350 ml of blood 4 weeks later, was compared with a control group (n = 7) in whom no blood doping was performed. The blood was stored at +4 degrees C for 4 weeks. Hemoglobin increased by 7.9% from the prephlebotomy level and by 14% from the preinfusion level. The reinfusion of blood caused a 60% reduction (P less than 0.001) in serum erythropoietin in 24 h and a sharp increase (P less than 0.05) in serum iron and bilirubin after a test race performed on the day of reinfusion. It is therefore concluded that a combination of measurements of hemoglobin and bilirubin, iron, and erythropoietin in serum could detect 50% of the blood-doped athletes by a single test sample during the 1st week after reinfusion. If two test samples were used, an increase in Hb of more than 5%, and a decrease in serum erythropoietin by more than 50%, would be discussed in 50% of the blood-doped athletes throughout the first 2 weeks after reinfusion and without implicating any of the controls.