The practice of storing and re-infusing blood to boost oxygen-carrying capacity, exposed in major scandals like Operation Puerto.
Blood bag doping involves withdrawing an athlete's blood, storing it, and re-infusing it before competition to increase red blood cell count and oxygen-carrying capacity. This autologous transfusion method was central to cycling's doping scandals.
• Blood is withdrawn weeks before competition • Red blood cells are separated and stored • Athlete's body naturally regenerates blood supply • Stored blood is re-infused before key races • Results in temporarily elevated hematocrit
• Increased hemoglobin levels • Higher oxygen-carrying capacity • Hematocrit increase of 5-10% • VO2 Max improvement of 5-10% • Enhanced endurance performance
• 2-4 units (450ml each) withdrawn over weeks • Done during training periods • Performance temporarily reduced during withdrawal • Body takes 4-6 weeks to fully regenerate
• Blood stored in refrigerated conditions • Red blood cells can be preserved 35-42 days • Freezing extends storage to years • Requires medical equipment and expertise
• Typically 1-3 days before major competition • Done via intravenous injection • Takes 1-2 hours per unit • Effects last 2-4 weeks
Operation Puerto (2006): • Spanish doping network exposed • Dr. Eufemiano Fuentes at center • Hundreds of blood bags seized • Labeled with code names • Multiple cyclists implicated • Jan Ullrich, Ivan Basso suspended • Led to major reforms in anti-doping
• Systematic blood doping program • Blood stored in refrigerators • Re-infused during Grand Tours • Detailed in USADA investigation (2012) • Lance Armstrong and teammates involved • Use of team doctors and support staff
Festina Affair (1998): • Team car stopped with EPO and equipment • Revealed systematic team doping • Led to police investigations • Changed Tour de France forever • Sparked anti-doping reforms
• It's the athlete's own blood • No foreign substances introduced • DNA testing cannot distinguish it • Direct detection nearly impossible
• Monitors hemoglobin and reticulocyte levels • Detects abnormal spikes in red blood cell count • Tracks OFF-score (combination of markers) • Flags suspicious patterns for investigation
• Detects chemicals from blood storage bags • DEHP and other plasticizers leach into blood • Can remain detectable for weeks • Introduced around 2010 • Several cyclists caught via this method
• Random no-notice testing • Looking for fresh needle marks • Catching athletes with equipment • Requires physical evidence
Pre-2000: • Hematocrit limits (50% rule) • Easy to work around • No effective detection • Widespread use
Post-2008 (Biological Passport): • Individual baselines tracked • Abnormal fluctuations flagged • Much harder to transfuse undetected • Significant deterrent effect
Post-2010 (Plasticizer Testing): • Direct evidence of bag storage • Multiple positives resulted • Additional deterrent • Combined with Passport data
Alexander Vinokourov (2007): • Homologous transfusion detected • Different blood DNA markers found • Used someone else's blood • Two-year ban
Tyler Hamilton (2004): • Homologous blood transfusion • Mixed blood populations detected • Stripped of Olympic gold medal • Later admitted to years of transfusions
• Plasticizers detected in sample • Evidence of blood bag storage • Two-year ban
• Naturally stimulates red blood cell production • Legal and widely used • Training camps at 2,000-3,000m elevation • Heat acclimatization camps
• Sleep at simulated altitude • Legal performance enhancement • Used by many WorldTour teams
Blood bag doping represents the most systematic and organized form of cycling doping. Operations like Puerto showed it wasn't just individual cheating but team-organized programs. This led to major reforms including team licenses, biological passports, and stricter penalties.
The biggest misconception is that blood doping is a thing of the past. While much less common due to detection methods, the biological passport and plasticizer testing make it extremely high-risk but not impossible. The other myth is that all blood transfusions are the same - autologous (your own blood) is much harder to detect than homologous (someone else's blood).