Transfusion Medicine Reviews RSS feed: Current Issue. Transfusion Medicine Reviews delivers authoritative reviews of important advances in the basic science and clinical aspects of transfusion medicine -- ranging from blood products to blood banking and laboratory medicine. Each issue offers information that is useful to hematologists, nurses, technicians and other scientific personnel involved in the provision of blood products. http://www.tmreviews.com/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. Transfusion Medicine Reviews0887-7963261January 2012 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.tmreviews.com/article/PIIS0887796311001076/abstract?rss=yesMasthead10.1016/S0887-7963(11)00107-6Transfusion Medicine Reviews 26, 1 (2012)2012-01-01Transfusion Medicine Reviews2012-01-01261S0887-7963(11)X0005-6IFCIFChttp://www.tmreviews.com/article/PIIS0887796311000642/abstract?rss=yesIn the recent years, thromboelastography has become a popular monitoring device for hemostasis and transfusion management in major surgery, trauma, and hemophilia. Thromboelastography is performed in whole blood and assesses the viscoelastic property of clot formation under low shear condition. Thromboelastography can be performed with a variety of activator and inhibitors at different concentrations representing the most important factors for different intervals and clot formation variables reported in multiple studies and algorithms. Furthermore, fibrinogen levels and platelet counts have a major influence on thromboelastographic variables. In addition, differences in patient populations, devices, and preanalytical conditions contribute to some conflicting findings in different studies.Principles and Practice of Thromboelastography in Clinical Coagulation Management and Transfusion PracticeDaniel Bolliger, Manfred D. Seeberger, Kenichi A. Tanaka10.1016/j.tmrv.2011.07.005Transfusion Medicine Reviews 26, 1 (2012)2011-08-29Transfusion Medicine Reviews2011-08-29261S0887-7963(11)X0005-6113http://www.tmreviews.com/article/PIIS0887796311000678/abstract?rss=yesYoung blood donors between the ages of 16 and 18 years contribute substantially to the blood supply in the United States, accounting for about 14% of the allogeneic whole blood collected by the American Red Cross in 2010. However, studies have consistently demonstrated that the donors' age, total blood volume, and first-time donation status independently contribute to the risk of syncopal reactions after whole blood donation. Efforts to improve the donation experience are crucial not only to ensure the health and well-being of blood donors but also to sustain an adequate blood supply. Even minor reactions or temporary deferrals discourage individuals from donating blood again. Shifting population demographics and advances in medical care in the United States and other countries predict that the need for blood will increase, whereas blood donation by the older generations declines each year. Broad deferral strategies and precautionary measures have further winnowed the eligible donor pool, but their contribution to transfusion safety remains controversial. Consequently, blood centers that depend on recruiting and retaining adolescent blood donors have made concerted efforts to improve safety, especially on high school blood drives. Population-based operational tactics to improve donation safety focus on donor education, the drive environment, or recruiting individuals who are less likely to have reactions. Physiologic strategies modulate the donors' response to blood loss, decreasing their susceptibility to a donation-related reaction. This review examines the published data supporting the measures recently taken by blood centers to reduce the risk of syncopal reactions among young, whole blood donors.Improving Safety for Young Blood DonorsAnne F. Eder10.1016/j.tmrv.2011.07.008Transfusion Medicine Reviews 26, 1 (2012)2011-08-29Transfusion Medicine Reviews2011-08-29261S0887-7963(11)X0005-61426http://www.tmreviews.com/article/PIIS0887796311000563/abstract?rss=yesPolyvinylchloride (PVC) is used in blood component containers as well as in many other medical devices because it shows optimal inertness, durability, and resistance to heat and chemicals. However, the polymer itself does not provide good handling characteristics or the necessary properties for red blood cell (RBC) survival. PVC thus needs to be plasticized, and di-(2-ethylhexyl)phthalate (DEHP) has been the most common plasticizer to produce the required flexibility to PVC. However, DEHP has been found to leach out from the containers, causing toxic effects, as demonstrated mainly in rodents. It is considered to be a possible carcinogen and suspected to also produce endocrine effects especially in young males. Although controversial, it is commonly accepted that in vulnerable patients such as newborns, trauma patients, or pregnant women, high exposure to DEHP should be avoided.The replacement of the common PVC + DEHP blood bags poses technical challenges due to the positive influence of the DEHP molecules on the red blood cell (RBC) membrane, and thus it has been shown to affect RBC storage and survival after transfusion. Different approaches are thus being taken to find a suitable alternative to DEHP for blood components bags. Environmentalists even favor the substitution of the PVC to avoid not only the plasticizers but even the other residues contained in the polymer material. Consequently, whereas the simplest solution is the substitution of the DEHP by other plasticizers, alternative plasticizer-free materials are becoming explored. Even modifications of existing materials are being presented by some research groups, ranging from covering of the DEHP-containing materials to alloys or special additive solutions. Different strategies as well as the most promising approaches are presented in this review. In any case, the degree of stabilization of RBCs undergoing prolonged storage will dictate the final acceptance for such alternatives.Progress in the Removal of Di-[2-Ethylhexyl]-Phthalate as Plasticizer in Blood BagsJuliane Simmchen, Rosa Ventura, Jordi Segura10.1016/j.tmrv.2011.06.001Transfusion Medicine Reviews 26, 1 (2012)2011-08-08Transfusion Medicine Reviews2011-08-08261S0887-7963(11)X0005-62737http://www.tmreviews.com/article/PIIS0887796311000605/abstract?rss=yesMost industrialized countries maintain surveillance programs for monitoring transmissible infection in blood donations, revising approaches to methodology and risk assessment as new threats emerge. A comparison of programs in the United States, Canada, France, the UK, and Australia indicates that they have similar function, although the structure of blood programs vary as does the extent and nature of formal ties with public health. The emergence of HIV in the late 1970s and early 1980s was key in recognizing that surveillance systems specific to blood transfusion were essential. Hence, most industrialized countries monitor transfusion-transmissible infections in donors and evaluate the impact of new testing and of predonation screening strategies. Emerging infections since HIV have had different transmission pathways and challenged blood programs to draw upon resources for a rapid and effective response, with recognition that the original focus on sexual/drug-related risk of HIV and hepatitis was inadequate. The focus of surveillance programs on new and emerging pathogens fulfills a key role in risk assessment and policy formulation. The precise nature of such activities varies by country because of the structure of the blood programs and surveillance systems, the strategic focus of the blood programs, and the epidemiology of disease in each country.Surveillance of Transfusion-Transmissible Infections: Comparison of Systems in Five Developed CountriesSheila F. O'Brien, Shimian Zou, Syria Laperche, Lisa J. Brant, Clive R. Seed, Steven H. Kleinman10.1016/j.tmrv.2011.07.001Transfusion Medicine Reviews 26, 1 (2012)2011-09-26Transfusion Medicine Reviews2011-09-26261S0887-7963(11)X0005-63857http://www.tmreviews.com/article/PIIS0887796311000617/abstract?rss=yesBlood centers have a central role in the community through recruitment and donation, and these community interactions enable blood centers to have a critical role in public health. Some public health initiatives are inherent in the blood center, such as providing human immunodeficiency virus educational material, whereas other initiatives have been actively created, such as cardiovascular screening, as a means to increase blood donor rates and increase the blood center's community interaction. These public health initiatives have been inconsistently practiced by blood collection centers over many years. An understanding of the current literature and exploring the potential role of blood centers in public health, while considering cost and value of these programs, are necessary for blood centers to evaluate the value of implementing these programs. The studies do not support a significant improvement in donor health or significant increase in donation rates through these public health initiatives. However, no study published thus far has been comprehensive enough or carried out long enough to adequately evaluate the value of providing health initiatives to donors.Evaluating the Role of Blood Collection Centers in Public Health: A Status ReportBeth H. Shaz, Debra Kessler, Christopher D. Hillyer10.1016/j.tmrv.2011.07.002Transfusion Medicine Reviews 26, 1 (2012)2011-08-26Transfusion Medicine Reviews2011-08-26261S0887-7963(11)X0005-65867http://www.tmreviews.com/article/PIIS0887796311000629/abstract?rss=yesFor centuries, man has been trying to figure out how to revive sick and traumatized individuals using fluids of various types, even from animals. In the 17th century, it was determined that blood was the best fluid to use and, in the early 1900s, after the discovery of the ABO blood groups, human blood was found to provide significant benefit for patients with shock and/or anemia. In the 1950s and 1960s, various ways to obtain, process, and store human blood were developed. It soon became apparent that storage of human blood for transfusion was problematic because red cells, as they aged in vitro, underwent a multitude of physicochemical changes that greatly affected their shelf life, the so-called storage lesion. More recently, the question has arisen as to the potential detrimental effects of the storage lesion and suggestions that older blood may induce increased morbidity and even mortality despite its acceptable in vivo survival. To address this issue of the efficacy and safety of transfusion of aged stored blood, a number of controlled clinical trials have been instituted to determine if older blood is significantly detrimental compared with fresher blood in transfusion recipients.Red Blood Cell Storage Lesions and Related Transfusion Issues: A Canadian Blood Services Research and Development SymposiumKaterina Pavenski, Elianna Saidenberg, Marianne Lavoie, Melanie Tokessy, Donald R. Branch10.1016/j.tmrv.2011.07.003Transfusion Medicine Reviews 26, 1 (2012)2011-08-26Transfusion Medicine Reviews2011-08-26261S0887-7963(11)X0005-66884http://www.tmreviews.com/article/PIIS0887796311000782/abstract?rss=yesOften, I have been asked by “junior faculty”—who are usually burdened by substantial responsibilities in service and teaching—how they can launch their career in research as a means to succeed in academic medicine. Obviously, the answers/solutions are as diverse as are the circumstances of each questioner. In the following article, I offer the approach that I applied to my career—acknowledging that “one shoe doesn't fit all” and that others will advise differently. However, one truism exists whenever one seeks excellence in anything—the opportunity must be present to commit uninterrupted time for thought/concentration, organization, training/mentoring/study, and effort/hard work. Without such an opportunity, success in research will be elusive.One Pathway to Academic Success: Autobiography of Dr Ronald G. StraussRonald G. Strauss10.1016/j.tmrv.2011.08.001Transfusion Medicine Reviews 26, 1 (2012)2011-09-26Transfusion Medicine Reviews2011-09-26261S0887-7963(11)X0005-6Pioneers and Pathfinders8589http://www.tmreviews.com/article/PIIS0887796311000575/abstract?rss=yesThe review by Strauss and Widness (2010) about the role of placental blood for autologous red blood cell (RBC) transfusions in prematures addresses an important issue for neonatal transfusion practice. Newborns are currently transfused with RBCs from adults, which mainly contain adult hemoglobin (HbA). HbA has a lower affinity for oxygen than fetal hemoglobin (HbF); therefore, adult RBC transfusions could be responsible for increased oxygen delivery to the immature retina. Repeated RBC transfusions in the first month of life of prematures presently are one of the major risk factor for developing retinopathy. Strauss and Widness suggest that umbilical cord blood RBCs represent the only alternative source for newborn transfusions. Previous studies, however, have demonstrated that autologous cord blood transfusions in newborns, although feasible, are not sufficient to entirely cover the early neonatal blood requests. Because no experience with allogeneic cord blood (ACB) RBC transfusion has been described so far, we would like to report the preliminary results of our study carried out to assess the feasibility of an ACB transfusion program for prematures in terms of preparation and yield of valid transfusion ACB RBC units.Allogeneic Cord Blood Red Cells for TransfusionMaria Bianchi, Alessandra Landini, Carmen Giannatonio, Patrizia Papacci, Giuseppe d'Onofrio, Gina Zini10.1016/j.tmrv.2011.06.002Transfusion Medicine Reviews 26, 1 (2012)2011-08-10Transfusion Medicine Reviews2011-08-10261S0887-7963(11)X0005-6Letters to the Editor9091http://www.tmreviews.com/article/PIIS0887796311000587/abstract?rss=yesThe following is our reply to the letter by Bianchi et al that was prompted by our earlier article reviewing use of autologous/placental red blood cell (RBC) transfusions for the anemia of prematurity.Autologous or Allogeneic: Cord Blood Red Blood Cells Still Are InvestigationalRonald G. Strauss, John A. Widness10.1016/j.tmrv.2011.06.003Transfusion Medicine Reviews 26, 1 (2012)2011-07-08Transfusion Medicine Reviews2011-07-08261S0887-7963(11)X0005-6Letters to the Editor9192http://www.tmreviews.com/article/PIIS0887796311000976/abstract?rss=yesSegura J, Ventura R, Pascual JA. Forensic Sci Int 2011; epub ahead of print Jelkmann W, Lundby C. Blood 2011;118:2395-2404.Journal ClubJeannie Callum, Richard Haspel, Sunny Dzik10.1016/j.tmrv.2011.09.006Transfusion Medicine Reviews 26, 1 (2012)2011-11-02Transfusion Medicine Reviews2011-11-02261S0887-7963(11)X0005-693101http://www.tmreviews.com/article/PIIS0887796311000873/abstract?rss=yesIn the above article, we correct the spelling of collaborator Elliott Bennett-Guerrero. Clinical Trial Opportunities in Transfusion Medicine: Proceedings of a National Heart, Lung, and Blood Institute State-of the-Science Symposium, 24/4 (October 2010) pp. 259-285Morris A. Blajchman, Simone A. Glynn, Cassandra D. Josephson, Steve H. Kleinman, for the State-of-the-Science Symposium Transfusion Medicine Committee10.1016/j.tmrv.2011.08.003Transfusion Medicine Reviews 26, 1 (2012)2011-09-20Transfusion Medicine Reviews2011-09-20261S0887-7963(11)X0005-6102102http://www.tmreviews.com/article/PIIS0887796311001088/abstract?rss=yesEditorial Board10.1016/S0887-7963(11)00108-8Transfusion Medicine Reviews 26, 1 (2012)2012-01-01Transfusion Medicine Reviews2012-01-01261S0887-7963(11)X0005-6FrontmatterA1A1http://www.tmreviews.com/article/PIIS088779631100109X/abstract?rss=yesWill Publish in Future Issues10.1016/S0887-7963(11)00109-XTransfusion Medicine Reviews 26, 1 (2012)2012-01-01Transfusion Medicine Reviews2012-01-01261S0887-7963(11)X0005-6FrontmatterA2A4http://www.tmreviews.com/article/PIIS0887796311001106/abstract?rss=yesContents10.1016/S0887-7963(11)00110-6Transfusion Medicine Reviews 26, 1 (2012)2012-01-01Transfusion Medicine Reviews2012-01-01261S0887-7963(11)X0005-6FrontmatterA5A5http://www.tmreviews.com/article/PIIS0887796311001118/abstract?rss=yesInfo for Contributors10.1016/S0887-7963(11)00111-8Transfusion Medicine Reviews 26, 1 (2012)2012-01-01Transfusion Medicine Reviews2012-01-01261S0887-7963(11)X0005-6FrontmatterA7A10