Abstract:
:The use of blood products to support patients undergoing the large variety of medical and surgical interventions requiring such support has continued to escalate very significantly over time. Relevantly, significant practice variation in the use of blood products exists among practitioners and institutions, largely because of the lack of robust clinical trial data, in many instances, which are critical for providing practitioners with evidence-based guidelines for appropriate blood product utilization. Recognizing this gap, the National Heart, Lung, and Blood Institute recently established a State-of-the-Science Symposium to help define areas of clinical trial research that would enhance the opportunity for developing appropriate practice guidelines for both Transfusion Medicine and Hemostasis/Thrombosis. Such a Symposium was held in September 2009 to identify important clinical trial research issues in these 2 subject areas of endeavor. The aims of this Symposium were to specifically identify phase 2 and 3 clinical trials that, if conducted over the next 5 to 10 years, could impact the treatment of patients with hemostatic and other disorders as well as to optimize the use of blood products in patients who need such interventions. This article reports on the deliberations that were held relating to the various clinical trial concepts developed by 7 Transfusion Medicine subcommittees. This Symposium generated a rich assortment of clinical trial proposals that will undergo further refinement before final implementation into pilot or full randomized clinical trials. The various proposals identified many opportunities for clinical trial research and most importantly underscored the ongoing need for well-developed evidence-based clinical trial research in the field of Transfusion Medicine.
journal_name
Transfus Med Revjournal_title
Transfusion medicine reviewsauthors
Blajchman MA,Glynn SA,Josephson CD,Kleinman SH,State-of-the Science Symposium Transfusion Medicine Committee.doi
10.1016/j.tmrv.2010.05.002subject
Has Abstractpub_date
2010-10-01 00:00:00pages
259-85issue
4eissn
0887-7963issn
1532-9496pii
S0887-7963(10)00030-1journal_volume
24pub_type
abstract::Over the last 20 years, the Canadian Blood Services' (CBS) Donor Health Assessment Questionnaire (DHAQ), used to screen prospective blood donors to determine their eligibility, has grown in complexity and length. Its growth is inextricably linked to the evolution of the environment within which CBS operates from unreg...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2007.03.002
更新日期:2007-07-01 00:00:00
abstract::Population-based investigations suggest that red blood cells (RBCs) are therapeutically effective when collected, processed, and stored for up to 42 days under validated conditions before transfusion. However, some retrospective clinical studies have shown worse patient outcomes when transfused RBCs have been stored f...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章
doi:10.1016/j.tmrv.2014.01.003
更新日期:2014-04-01 00:00:00
abstract::Significant progress has been made in reducing the risk of pathogen transmission to transfusion recipients. Nonetheless, there remains a continuing risk of transmission of viruses, bacteria, protozoa, and prions to recipients. These include many of the viruses for which specific screening tests exist as well as pathog...
journal_title:Transfusion medicine reviews
pub_type: 共识发展会议,杂志文章,评审
doi:10.1016/j.tmrv.2007.09.001
更新日期:2008-01-01 00:00:00
abstract::Several public policy decisions in transfusion medicine require information on the long-term (> or =10-year) survival of transfused patients. This information is needed (1) to estimate the number of surviving transfusion recipients who have contracted a particular infection through transfusion, (2) to assess the cost-...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(03)00019-1
更新日期:2003-07-01 00:00:00
abstract::Cardiac surgery affects both coagulation and platelet function. Revision of surgery due to bleeding has to be performed in 2% to 6% of patients undergoing cardiac surgery and is generally associated with a marked deterioration in prognosis. Factors contributing to acquired hemostatic abnormalities in cardiac surgery i...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2006.03.003
更新日期:2006-07-01 00:00:00
abstract::A number of molecules on the surface of red blood cells (RBCs) and platelets express antigenic activity. Various biochemical and molecular approaches have been used to determine the structure and possible function that these molecules have for their respective cell types. The existence of variant molecules and null ph...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2004.03.006
更新日期:2004-07-01 00:00:00
abstract::The fibrinolytic system, known for its ability to regulate the activation of the zymogen plasminogen into active plasmin, has been primarily associated with the removal of fibrin and blood clots. Tissue-type plasminogen activator, the most well-recognized plasminogen activator, was harnessed for therapeutic benefit ag...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2014.09.006
更新日期:2015-04-01 00:00:00
abstract::In summary, it is impossible to reconcile the contradictory results of the studies of the association between previous blood transfusion and subsequent development of NHL (Figs 1 and 2). Most of the studies were of high quality, and the authors discussed the possible sources of bias that might have generated a spuriou...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1053/tm.20000.7395
更新日期:2000-07-01 00:00:00
abstract::Knowledge of the molecular basis of the blood group systems has enabled the development of assays for blood group genotyping. At this time, polymerase chain reaction (PCR)-based assays validated on fetal material obtained by invasive means (chorionic villus sampling or amniocentesis) are available for all clinically r...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1053/tmrv.2003.50001
更新日期:2003-01-01 00:00:00
abstract::Metabolic studies have revealed a gradual impairment in platelet integrity during storage, a process termed the platelet storage lesion. Recent evidence shows that stored platelets also lose signaling responses to physiological agonists with impaired integrin activation, secretion, and aggregation of the cells. On the...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2007.05.004
更新日期:2007-10-01 00:00:00
abstract::Allergic transfusion reactions (ATRs) are the most common adverse reactions occurring during transfusion of blood components. Although most reactions are mild and involve cutaneous manifestations, severe ATRs including life-threatening anaphylaxis may also occur. The mechanisms of ATRs are largely unknown because they...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2017.09.002
更新日期:2018-01-01 00:00:00
abstract::Low levels of C1 inhibitor, the main inhibitor of the classic complement system, result in paroxysmal angioedema attacks that can be incapacitating or even life-threatening in affected individuals. Molecular defects in the gene for C1 inhibitor cause hereditary angioedema. In recent years, new insights in the pathways...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2019.08.002
更新日期:2019-10-01 00:00:00
abstract::An international multidisciplinary panel of 15 experts reviewed 494 published articles and used the RAND/UCLA Appropriateness Method to determine the appropriateness of allogeneic red blood cell (RBC) transfusion based on its expected impact on outcomes of stable nonbleeding patients in 450 typical inpatient medical, ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,多中心研究,评审
doi:10.1016/j.tmrv.2011.02.001
更新日期:2011-07-01 00:00:00
abstract::The use of prothrombin complex concentrates (PCCs) and fibrinogen concentrates (FIBCs) to achieve hemostasis in the perioperative setting as alternatives to allogeneic blood products remains controversial. To examine the efficacy and safety of PCCs and FIBCs, we conducted a systematic review-in accordance with the Pre...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2013.01.002
更新日期:2013-04-01 00:00:00
abstract::Although James Blundell is rightly acknowledged as the father of modern transfusion therapy, a review of the events surrounding the initial human-to-human transfusions in the first decades of the 19th century reveals substantial contributions by Blundell's collaborators. Bundell's uncle John Haighton provided substant...
journal_title:Transfusion medicine reviews
pub_type: 传,历史文章,杂志文章,评审
doi:10.1016/j.tmrv.2018.08.003
更新日期:2018-10-01 00:00:00
abstract::The virucidal properties of photoactive phenothiazine dyes, such as methylene blue, have been known approximately 70 years. The mechanism of virus inactivation involves binding of the dye to nucleic acid, absorption of light, generation of reactive oxygen species, guanine oxidation in the viral genome. The first pract...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1053/tmrv.2002.29405
更新日期:2002-01-01 00:00:00
abstract::This guideline for the use of immunoglobulin (IG) for sensitized patients undergoing solid organ transplantation (SOT) is an initiative of the Canadian Blood Services and the National Advisory Committee on Blood and Blood Products of Canada to (1) provide guidance for Canadian practitioners involved in the care of pat...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2009.09.010
更新日期:2010-01-01 00:00:00
abstract::Autoantibodies against red cells optimally reacting at 0 degree C, ie, CA, are normally found with low titers in the serum of human adults. High-titer CA may be induced by certain infectious agents, including M pneumoniae, EBV, CMV, and rubella virus, or may develop on the basis of chronic (malignant) B cell lymphopro...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(89)70075-4
更新日期:1989-04-01 00:00:00
abstract::ABO is the most important blood group system for transfusion and solid organ transplantation, but it is only over the past 15 years that the techniques for studying its molecular basis became mainstream. Many of its common and rare alleles are now well characterized and by using various expression systems, their effec...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2005.02.003
更新日期:2005-07-01 00:00:00
abstract::Blood services around the world face increasing challenges in recruiting voluntary blood donors. With increasing donor restrictions and ageing populations, it is essential to look for any existing restrictions that may be relaxed in the light of currently available evidence. We propose that one such restriction is the...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2010.03.005
更新日期:2010-07-01 00:00:00
abstract::Millions 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 r...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2011.09.003
更新日期:2012-07-01 00:00:00
abstract::The development and expansion of the CTS in Pittsburgh shows the feasibility of this transfusion medicine delivery system. Few of the changes driven by health care reform both improve patient care and reduce costs. When properly implemented, a CTS achieves these objectives, benefits the community as a whole, and enhan...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(05)80051-3
更新日期:1995-04-01 00:00:00
abstract::Although the role of platelets as central mediators of hemostasis and thrombosis has been the primary focus of research into platelet biology for more than a century, over the last decade, nonhemostatic functions of platelets have been increasingly defined. As such, a large body of experimental evidence now exists, wh...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2014.11.006
更新日期:2015-04-01 00:00:00
abstract::Some have suggested that "blood is different," and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning beh...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2008.09.001
更新日期:2009-01-01 00:00:00
abstract::Two complex protein defense systems-complement and coagulation-are based on amplifying enzyme cascades triggered by specific local stimuli. Excess systemic activation of either system is pathologic and is normally prevented by a family of regulatory proteins. The 2 systems are ancient biological processes which share ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2019.08.004
更新日期:2019-10-01 00:00:00
abstract::Although remarkable advances have been made in the prevention of the major transfusion-transmitted diseases, long intervals have transpired between the first recognition of transfusion risk and the implementation of a preventive strategy. For hepatitis B virus, that interval was 30 years; for non-A, non-B/hepatitis C ...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章
doi:10.1016/j.tmrv.2008.01.001
更新日期:2008-04-01 00:00:00
abstract::Until recently, atypical hemolytic uremic syndrome (aHUS), conventionally defined in the pediatric literature as a syndrome of the triad of renal failure, microangiopathic hemolytic anemia, and thrombocytopenia without a prodrome of hemorrhagic diarrhea, has received little attention in adult practice because the pati...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2014.08.004
更新日期:2014-10-01 00:00:00
abstract::The regulation of complement at the surface of cells is mediated by both plasma and membrane proteins. These molecules act in concert to prevent the accelerated catabolism of complement proteins and the concomitant lysis of homologous blood cells. The deficiency of either a plasma or membrane protein predisposes to th...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/s0887-7963(91)70199-5
更新日期:1991-04-01 00:00:00
abstract::Roger Irving Lee (1881-1964) played significant scientific and leadership roles in overcoming the clinical impediments to blood transfusion in the 1910s. He developed the first successful anticoagulant system, paraffinized glass, and the first sterile system for indirect transfusion without defibrination, the Lee-Vinc...
journal_title:Transfusion medicine reviews
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.tmrv.2004.09.003
更新日期:2005-01-01 00:00:00
abstract::Immunization against human platelet alloantigens (HPAs) is associated with a number of clinical complications. The detection and identification of clinically relevant platelet antibodies are important for the diagnosis and management of patients affected with immune-mediated thrombocytopenias. Human platelet alloantig...
journal_title:Transfusion medicine reviews
pub_type: 杂志文章,评审
doi:10.1016/j.tmrv.2016.12.001
更新日期:2017-04-01 00:00:00