Transfusion Medicine Reviews RSS feed: Articles in Press. Transfusion Medicine Reviews provides an international forum in English for the publication of scholarly work devoted to the various sub-disciplines that comprise Transfusion Medicine including hemostasis and thrombosis and cellular therapies. The scope of the journal encompasses basic science, practical aspects, laboratory developments, clinical indications, and adverse effects. http://www.tmreviews.com//inpress?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. Transfusion Medicine Reviews0887-79632012-05-07 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.tmreviews.com/article/PIIS0887796312000223/abstract?rss=yesJournal Club - Corrected ProofSimon Stanworth, Richard Haspel, Jeannie Callum10.1016/j.tmrv.2012.04.001Transfusion Medicine Reviews (2012)2012-05-07Transfusion Medicine Reviews2012-05-07http://www.tmreviews.com/article/PIIS0887796312000247/abstract?rss=yesFigs. 1 and 3 were interchanged in the above article; the legends are correct. Thus, the figure on page 183 is actually Fig. 3 and shows the bleeding time in 15 patients presenting with severe anemia due to various causes., while the figure on page 184 is actually Fig. 1 and shows the correlation between the logarithm of the bleeding time and the hematocrit in 33 patients with a chronic renal insufficiency, subjected three times a week to hemodialysis.The Role of the Hematocrit in Bleeding (1987;1:182-5) - Corrected ProofBernard Boneu, Francoise Fernandez10.1016/j.tmrv.2012.04.003Transfusion Medicine Reviews (2012)2012-04-25Transfusion Medicine Reviews2012-04-25ERRATUMhttp://www.tmreviews.com/article/PIIS0887796312000211/abstract?rss=yesTransfusion-related acute lung injury (TRALI) is a major cause of transfusion-related morbidity and mortality. Although the pathogenesis of TRALI is incompletely understood, substantial data from hemovigilance systems, large case series, clinical trials, and animal models have identified antileukocyte antibodies as a major precipitant and have contributed to the development of concrete interventions to reduce the risk of TRALI. This review presents the clinical data supporting specific donor management strategies to reduce TRALI risk and their observed clinical efficacy. Novel strategies that use the donor health questionnaire combined with testing are discussed, and important challenges that remain going forward are explored.Reducing Transfusion-Related Acute Lung Injury Risk: Evidence for and Approaches to Transfusion-Related Acute Lung Injury Mitigation - Corrected ProofRobert S. Makar, Amy Powers, Christopher P. Stowell10.1016/j.tmrv.2012.03.001Transfusion Medicine Reviews (2012)2012-04-20Transfusion Medicine Reviews2012-04-20http://www.tmreviews.com/article/PIIS0887796311001222/abstract?rss=yesPaul Schmidt was born in 1925 into the Greatest Generation. Events during military service decided him on the study of medicine. Early research training in red cell preservation that continued during his medical studies opened a 20-year career at the National Institutes of Health (NIH). Beginning in 1954 at the Blood Bank of the NIH Clinical Center, he had exposure to the pioneers who had translated transfusion's wartime beginnings into civilian applications. Work inside the unique NIH clinical research atmosphere together with many of his students provided a fertile field for the growth of what has become transfusion medicine. Topics described range from early studies on platelets and on hepatitis to the background in Washington health politics leading to the National Blood Policy. National and global organizational activity and a second career in community blood service added to his 65 years of experience. The story as transfusion history is presented as a template for future progress.Sixty Years of Blood Transfusion: A Memoir - Corrected ProofPaul J. Schmidt10.1016/j.tmrv.2011.12.002Transfusion Medicine Reviews (2012)2012-02-10Transfusion Medicine Reviews2012-02-10http://www.tmreviews.com/article/PIIS0887796311001210/abstract?rss=yesLarge scale red blood cell (RBC) antigen genotyping of donors is currently well developed. There is scarce information, however, to select patients who might benefit from preemptive extended RBC antigen-matched transfusions. Female sex has been proposed as a risk factor for RBC alloimmunization after transfusion. To asses whether females respond differently to RBC alloantigens compared with males, we conducted a literature review on RBC alloimmunization. Clinical studies on RBC alloimmunization incidence were searched for in databases from 1950 through 2011. Studies were included when data were available to calculate the female-to-male risk ratio for alloimmunization. Based on the reported age, adult patients (>18 years) were distinguished from pediatric patients (≤18 years), and articles were analyzed according to disease categories. Thirty articles fulfilled the inclusion criteria. The Mantel-Haenszel risk ratio estimate of combined adult studies showed that women with sickle cell disease had an increased relative risk (27%) on RBC alloantibodies compared with men. Other groups showed equal alloimmunization risk in women and men. Women slightly more often than men possess RBC antibodies. This is likely explained by more exposure to immunizing events through pregnancy and/or transfusions in females with sickle cell disease. The results support the current policy implemented in many countries for Rhesus/Kell matching in patients with a hemoglobinopathy irrespective of sex. Thus, based solely on sex difference, the results do not justify recommending additional matching for women, besides preemptive K and c antigen matching for women during the (pre-) fertile age, as already applied in many European countries for the prevention of fetal morbidity.Is Female Sex a Risk Factor for Red Blood Cell Alloimmunization After Transfusion? A Systematic Review - Corrected ProofEsther P. Verduin, Anneke Brand, Henk Schonewille10.1016/j.tmrv.2011.12.001Transfusion Medicine Reviews (2012)2012-01-16Transfusion Medicine Reviews2012-01-16http://www.tmreviews.com/article/PIIS0887796311001234/abstract?rss=yesBenchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept of benchmarking forward in the field of transfusion medicine. A systematic review of published literature was performed to identify transfusion medicine–related studies that compared at least 2 separate institutions or regions with the intention of benchmarking focusing on 4 areas: blood utilization, safety, operational aspects, and blood donation. Forty-five studies were included: blood utilization (n = 35), safety (n = 5), operational aspects of transfusion medicine (n = 5), and blood donation (n = 0). Based on predefined criteria, 7 publications were classified as benchmarking, 2 as trending, and 36 as single-event studies. Three models of benchmarking are described: (1) a regional benchmarking program that collects and links relevant data from existing electronic sources, (2) a sentinel site model where data from a limited number of sites are collected, and (3) an institutional-initiated model where a site identifies indicators of interest and approaches other institutions. Benchmarking approaches are needed in the field of transfusion medicine. Major challenges include defining best practices and developing cost-effective methods of data collection. For those interested in initiating a benchmarking program, the sentinel site model may be most effective and sustainable as a starting point, although the regional model would be the ideal goal.Benchmarking: Applications to Transfusion Medicine - Corrected ProofTorunn Oveland Apelseth, Laura Molnar, Emmy Arnold, Nancy M. Heddle10.1016/j.tmrv.2011.12.003Transfusion Medicine Reviews (2012)2012-01-11Transfusion Medicine Reviews2012-01-11http://www.tmreviews.com/article/PIIS0887796311001209/abstract?rss=yesSevere sepsis and septic shock are the most common reasons for admission to an intensive care unit; and the risk of death is substantial, estimated at approximately 40%. Evidence suggests that early resuscitation strategies that include the use of resuscitation fluids, antibiotics, blood, and inotropes reduce death. Although fluid resuscitation is an immediate life-saving intervention, a fundamental question that remains unanswered is whether the type of resuscitation fluid impacts survival when it is initiated very early in the course of septic shock. A randomized controlled trial published in 2008 confirmed that hydroxyethyl starch fluids cause acute renal failure defined by the requirement for renal replacement therapy. In contrast, a subgroup analysis from a randomized controlled trial suggests that 4% albumin fluid may reduce death from severe sepsis; however, these findings require confirmation in a large randomized trial. Our team is planning a pragmatic early septic shock fluid resuscitation trial that will compare the effectiveness of 5% albumin vs normal saline on 90-day mortality (PRECISE). In this article, we summarize the scientific rationale and inherent challenges associated with the conduct of PRECISE, the background work and planning elements that have been undertaken, and the PRECISE RCT protocol with rationale and justifications provided for the chosen population, the interventions, and the outcome measures.The PRECISE RCT: Evolution of an Early Septic Shock Fluid Resuscitation Trial - Corrected ProofLauralyn McIntyre, Dean A. Fergusson, Brian Rowe, Deborah J. Cook, Yaseen Arabi, Sean M. Bagshaw, Marcel Emond, Simon Finfer, Alison Fox-Robichaud, Alasdair Gray, Robert Green, Paul Hebert, Eddy Lang, John Marshall, Ian Stiell, Alan Tinmouth, Joe Pagliarello, Alexis Turgeon, Timothy Walsh, Andrew Worster, Ryan Zarychanski, for the Canadian Critical Care Trials Group10.1016/j.tmrv.2011.11.003Transfusion Medicine Reviews (2012)2012-01-05Transfusion Medicine Reviews2012-01-05http://www.tmreviews.com/article/PIIS0887796311001003/abstract?rss=yesFor general health care, the difference between quality and safety has been unclear for measurable patient outcomes. In contrast, in the transfusion service (TS), the relationship between quality and safety has been direct and demonstrable. Case studies are summarized to illustrate the relationship between operations, quality management, and risk management in the TS. In blood availability for elective surgery over 3 audited intervals, the incidence of patients undergoing elective surgery without available crossmatched blood that had been requested was 1:333, 1:328, and 1:225 for pre-quality improvement, post-quality improvement, and subsequent postintervention audit assessment, respectively. In event discovery reports (EDRs) over 2 years, incidence of biologic product deviation reports (Food and Drug Administration reportable) was successfully reduced from 60 biologic product deviation reports (12%) of 507 EDRs in 2009 to 42 (12%) of 336 EDRs in 2010. In wrong blood in tube, 102 specimens were identified (by a change in patient's ABO/Rh) from 176 711 type and screen/cross-match specimens received over a 5-year interval, detected either by previous patient record of ABO/Rh or by a second specimen for blood type confirmation implemented in our TS for the last 3 years. No known cases of “mismatched” red blood cell transfusion have occurred during this interval. There is an inverse relationship between resources/time expended on quality and risk management relative to volumes of operations in the TS. Laboratory-based initiatives that improve patient safety and clinical outcomes need to have resources aligned with the personnel and time required for quality management and risk management.Operational, Quality, and Risk Management in the Transfusion Service: Lessons Learned - Corrected ProofLawrence Tim Goodnough10.1016/j.tmrv.2011.10.002Transfusion Medicine Reviews (2011)2011-12-05Transfusion Medicine Reviews2011-12-05http://www.tmreviews.com/article/PIIS0887796311000915/abstract?rss=yesMillions of patients in the UK benefit from the use of both plasma derivatives and blood components that are seen as critical interventions in current medicine. Measures are in place to significantly reduce the risks associated with blood transfusion and plasma derivatives; however, these measures themselves are not risk free. Over the past 20 years, advances in technology and regulation have seen major reductions in the risks associated with transfusion. International blood services, industry, and regulators strive to maintain safety levels through constant monitoring, assessment, and response to changing risk factors. Regulation of screening tests together with the development and introduction of nucleic acid technique tests for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus has improved blood safety. However, other risks, including the changing epidemiology of transfusion-transmitted infections, bacterial contamination of platelets, incorrect blood component transfusion, and variant Creutzfeldt-Jakob disease, require further attention. Risks such as these are often complex, and there is a difficult balance to be struck between donors/recipients' benefit and adequacy of blood supply. The introduction of any new safety measure therefore requires robust, evidence-based evaluation of associated benefit, both clinical and economical. This review presents a UK perspective on how the safety of the blood supply is maintained in the face of uncertain risks.The Management of Blood Safety in the Presence of Uncertain Risk: A United Kingdom Perspective - Corrected ProofNicholas A. Watkins, Stephen Dobra, Peter Bennett, John Cairns, Marc L. Turner10.1016/j.tmrv.2011.09.003Transfusion Medicine Reviews (2011)2011-11-30Transfusion Medicine Reviews2011-11-30http://www.tmreviews.com/article/PIIS088779631100099X/abstract?rss=yesFindings about the efficacy of interventions promoting blood donation are scattered and sometime inconsistent. The aim of the present systematic review was to identify the most effective types of interventions and modes of delivery to increase blood donation. The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL, EMBASE, and Proquest Dissertations and Theses. Additional studies were also included by checking the references of the articles included in the review and by looking at our personal collection. The outcomes of interest were either blood drive attendance or blood donations. A total of 29 randomized controlled trials or quasi-experimental studies were included in the review, detailing 36 interventions tested among independent samples. Interventions targeting psychosocial cognitions (s = 8, s to represent the number of independent samples; odds ratio [OR], 2.47; 95% confidence interval [CI], 1.42-4.28), those stressing the altruistic motives to give blood (s = 4; OR, 3.89; 95% CI, 1.03-14.76), and reminders (s = 7; OR, 1.91; 95% CI, 1.22-2.99) were the most successful in increasing blood donation. The results suggest that motivational interventions and reminders are the most effective in increasing blood donation, but additional studies are needed to evaluate the efficacy of other types of interventions.Efficacy of Interventions Promoting Blood Donation: A Systematic Review - Corrected ProofGaston Godin, Lydi-Anne Vézina-Im, Ariane Bélanger-Gravel, Steve Amireault10.1016/j.tmrv.2011.10.001Transfusion Medicine Reviews (2011)2011-11-30Transfusion Medicine Reviews2011-11-30http://www.tmreviews.com/article/PIIS0887796311000939/abstract?rss=yesThe objective of this systematic review was to identify and analyze the evidence base supporting the “30-minute” and “4-hour” rules in transfusion medicine. The 30-minute rule states that red blood cell (RBC) units left out of controlled temperature storage for more than 30 minutes should not be returned to storage for reissue; the 4-hour rule states that transfusion of RBC units should be completed within 4 hours of their removal from controlled temperature storage. Eligible studies were identified from searches (to October 2010) of a range of electronic databases (including The Cochrane Library, MEDLINE, EMBASE, and the National Health Service Blood and Transplant's Transfusion Evidence Library) and contact with transfusion medicine and blood bank experts. Twenty-three studies were identified that measured the quality of the RBC unit (n = 19), bacterial contamination in the RBC unit (n = 4), or both (n = 2) after exposure to greater than 4°C ± 2°C from between 20 minutes to 42 days. The overall finding was that temperature exposure did not adversely affect the quality of the RBC units or result in significant bacterial contamination. However, the variation in the temperature of exposure, its duration, the amount of data reported by the individual studies, and the age of the studies (and thus their comparability to current clinical practice) make it difficult to draw significant conclusions. To reliably determine whether these time “rules” could be extended without an adverse risk to the RBC unit requires robust, modern studies using multiple combinations of blood, anticoagulant, and additive solutions with defined temperatures and times of exposure.What Is the Maximum Time That a Unit of Red Blood Cells Can Be Safely Left Out of Controlled Temperature Storage? - Corrected ProofSusan Brunskill, Stephen Thomas, Emma Whitmore, Carl P. McDonald, Carolyn Dorée, Sally Hopewell, Julie Staves, Rebecca Cardigan, Michael F. Murphy10.1016/j.tmrv.2011.09.005Transfusion Medicine Reviews (2011)2011-11-28Transfusion Medicine Reviews2011-11-28http://www.tmreviews.com/article/PIIS0887796311000988/abstract?rss=yesAutologous blood transfusions (ABTs) has been used by athletes for approximately 4 decades to enhance their performance. Although the method was prohibited by the International Olympic Committee in the mid 1980s, no direct detection method has yet been developed and implemented by the World Anti-Doping Agency (WADA). Several indirect methods have been proposed with the majority relying on changes in erythropoiesis-sensitive blood markers. Compared with the first methods developed in 1987, the sensitivity of subsequent tests has not improved the detection of blood doping. Nevertheless, the use of sophisticated statistical algorithms has assured a higher level of specificity in subsequent detection models, which is a crucial aspect of antidoping testing particularly to avoid “false positives.” Today, the testing markers with the best sensitivity/specificity ratio are the Hbmr model (an algorithm based on the total amount of circulating hemoglobin level [hemoglobin level mass] and percentage of reticulocytes, ) and the OFF-hr model (algorithm based on hemoglobin level concentration and percentage of reticulocytes, ). Only the OFF-hr model is currently approved by WADA. Recently, alternative indirect strategies for detecting blood doping have been proposed. One method is based upon a transfusion-induced immune-response resulting in specific changes in gene expression related to leukocytes such as T lymphocytes. Another method relies on detecting increased plasticizer metabolite levels in the urine caused by the leakage of plasticizers from the blood bags used during the blood storage. These methods need further development and validation across different types of transfusion regimes before they can be implemented. In addition, several research projects have been funded by WADA in recent years and are now under development including “Detection of Autologous Blood Transfusions Using Activated Red Blood Cells (the red blood cells eNOS system)” and “Detection of Autologous Blood Transfusion by Proteomic: Screening to find Unique Biomarkers, Detecting Blood Manipulation from Total Hemoglobin Mass using 15-nitric Oxide as a Tracer Gas, Storage Contamination as a Potential Diagnostic Test for Autologous Blood Transfusion and Test for Blood Transfusion (Autologous/Homologous) based on Changes of Erythrocyte Membrane Protome” (WADA, WADA Funded Research Projects. http://www.wada-ama.org/en/Science-Medicine/Research/Funded-Research-Projects/. 2010). Although strategies to detect autologous blood transfusion have improved, a highly sensitive test to detect small volumes of transfused autologous blood has not yet been implemented.Detection of Autologous Blood Transfusions in Athletes: A Historical Perspective - Corrected ProofJakob Mørkeberg10.1016/j.tmrv.2011.09.007Transfusion Medicine Reviews (2011)2011-11-28Transfusion Medicine Reviews2011-11-28