Proceedings of the 2022 NHLBI and OASH state of the science in transfusion medicine symposium

Abstract

Background: State of the Science (SoS) meetings are used to define and highlight important unanswered scientific questions. The National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, and the Office of the Assistant Secretary for Health (OASH), Department of Health and Human Services held a virtual SoS in transfusion medicine (TM) symposium. Study Design and Methods:In advance of the symposium, six multidisciplinary working groups (WG) convened to define research priorities in the areas of: blood donors and the supply, optimizing transfusion outcomes for recipients, emerging infections, mechanistic aspects of components and transfusion, new computational methods in transfusion science, and impact of health disparities on donors and recipients. The overall objective was to identify key basic, translational, and clinical research questions that will help to increase and diversify the volunteer donor pool, ensure safe and effective

Assessment of stored red blood cells through lab-on-a-chip technologies for precision transfusion medicine

“…However, these studies were retrospective and hence lacked proper randomization. Nevertheless, their findings prompted agencies such as the US National Heart, Lung, and Blood Institute (NHLBI) to reexamine the suitability of the current practices ( 25 , 60 ).…”

“…Therefore, the focus when using stored RBCs should be on assessing the quality and thus the transfusibility of each stored unit for the particular patient in need, whether the storage lesions be due to donor, time, or processing factors. These considerations have fueled the debate on personalized transfusion medicine approaches, a key goal in the agenda of the NHLBI, as discussed in the State of the Science in Transfusion Medicine Workshop ( 60 ). Thus, rather than an overly simplistic “first-in-first-out” or “last-in-first-out” approach, a data-driven selection of stored RBC units for each patient will prove superior ( Fig.…”

Biological and Genetic Determinants of Glycolysis: Phosphofructokinase Isoforms Boost Energy Status of Stored Red Blood Cells and Transfusion Outcomes

“…Despite the importance of metabolism and glycolysis in health and disease, and decades of research on the biochemical determinants of glycolytic fluxes in mammals 18 , understanding glycolytic regulation in mature RBCs holds relevant implications for systems physiology and clinical practice. Indeed, in addition to the central role RBCs play in mediating systemic gas and metabolite exchange throughout the body, understanding erythrocyte metabolism holds the key to optimizing storage conditions and predicting post-transfusion performance of blood products 19 .…”

“…[34][35][36] Finally, neither of these "quality" testing parameters provides any insights regarding preservation of RBC "function" upon storage, which is a critical unmet clinical need. For these reasons, both the National Heart, Lung and Blood Institutes 37 and the Food and Drug Administration (FDA) 38 have listed the identification of new functional biomarkers of RBC storage quality and post-transfusion performances as central to their programmatic agenda.…”

“…Indeed, understanding erythrocyte metabolism holds the key to optimizing storage conditions and predicting post-transfusion performance of blood products. 16…”