thesis topics on transfusion medicine

• Frontiers in Medicine
• Research Topics

Transfusion Medicine and Blood

Total Downloads

Total Views and Downloads

About this Research Topic

Transfusion medicine is in perpetual evolution and has faced several challenges from donors screening to clinical practices through blood preparation. Nowadays, blood is mainly processed in its different components that are red blood cells, platelets, plasma and some therapeutics. This incredible story ...

Keywords : Blood, blood products, donors, hematology, transfusion medicine

Important Note : All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Topic Editors

Topic coordinators, recent articles, submission deadlines.

Submission closed.

Participating Journals

Total views.

• Demographics

No records found

total views article views downloads topic views

Top countries

Top referring sites, about frontiers research topics.

With their unique mixes of varied contributions from Original Research to Review Articles, Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author.

Current advances in transfusion medicine 2021: A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee

• Laboratory Medicine and Pathology

Research output : Contribution to journal › Article › peer-review

Background: Each year the AABB Clinical Transfusion Medicine Committee (CTMC) procures a synopsis highlighting new, important, and clinically relevant studies in the field of transfusion medicine (TM). This has been made available as a publication in Transfusion since 2018. Methods: CTMC members reviewed and identified original manuscripts covering TM-related topics published electronically (ahead-of-print) or in print from December 2020 to December 2021. Selection of publications was discussed at committee meetings and chosen based on perceived relevance and originality. Next, committee members worked in pairs to create a synopsis of each topic, which was then reviewed by additional committee members. The first and senior authors assembled the final manuscript. Although this synopsis is extensive, it is not exhaustive, and some articles may have been excluded or missed. Results: The following topics are included: blood products; convalescent plasma; donor collections and testing; hemoglobinopathies; immunohematology and genomics; hemostasis; patient blood management; pediatrics; therapeutic apheresis; and cell therapy. Conclusions: This synopsis highlights and summarizes recent key developments in TM and may be useful for educational purposes.

Bibliographical note

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

• 10.1111/trf.16944

Other files and links

• Link to publication in Scopus
• Link to the citations in Scopus

Fingerprint

• Transfusion Medicine Keyphrases 100%
• Clinical Transfusion Medicine Keyphrases 100%
• Selected Topic Keyphrases 100%
• Committee Member Keyphrases 75%
• Clinically Significant Keyphrases 25%
• Pediatric Keyphrases 25%
• Cell Therapy Keyphrases 25%
• Hemostasis Keyphrases 25%

T1 - Current advances in transfusion medicine 2021

T2 - A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee

AU - Metcalf, Ryan A.

AU - Cohn, Claudia S.

AU - Allen, Elizabeth S.

AU - Bakhtary, Sara

AU - Gniadek, Thomas

AU - Gupta, Gaurav

AU - Harm, Sarah

AU - Haspel, Richard

AU - Hess, Aaron

AU - Jacobson, Jessica

AU - Lokhandwala, Parvez M.

AU - Murphy, Colin

AU - Poston, Jacqueline

AU - Prochaska, Micah T.

AU - Raval, Jay S.

AU - Saifee, Nabiha H.

AU - Salazar, Eric

AU - Shan, Hua

AU - Zantek, Nichole

AU - Pagano, Monica B.

N1 - Publisher Copyright: © 2022 AABB.

PY - 2022/7

Y1 - 2022/7

N2 - Background: Each year the AABB Clinical Transfusion Medicine Committee (CTMC) procures a synopsis highlighting new, important, and clinically relevant studies in the field of transfusion medicine (TM). This has been made available as a publication in Transfusion since 2018. Methods: CTMC members reviewed and identified original manuscripts covering TM-related topics published electronically (ahead-of-print) or in print from December 2020 to December 2021. Selection of publications was discussed at committee meetings and chosen based on perceived relevance and originality. Next, committee members worked in pairs to create a synopsis of each topic, which was then reviewed by additional committee members. The first and senior authors assembled the final manuscript. Although this synopsis is extensive, it is not exhaustive, and some articles may have been excluded or missed. Results: The following topics are included: blood products; convalescent plasma; donor collections and testing; hemoglobinopathies; immunohematology and genomics; hemostasis; patient blood management; pediatrics; therapeutic apheresis; and cell therapy. Conclusions: This synopsis highlights and summarizes recent key developments in TM and may be useful for educational purposes.

AB - Background: Each year the AABB Clinical Transfusion Medicine Committee (CTMC) procures a synopsis highlighting new, important, and clinically relevant studies in the field of transfusion medicine (TM). This has been made available as a publication in Transfusion since 2018. Methods: CTMC members reviewed and identified original manuscripts covering TM-related topics published electronically (ahead-of-print) or in print from December 2020 to December 2021. Selection of publications was discussed at committee meetings and chosen based on perceived relevance and originality. Next, committee members worked in pairs to create a synopsis of each topic, which was then reviewed by additional committee members. The first and senior authors assembled the final manuscript. Although this synopsis is extensive, it is not exhaustive, and some articles may have been excluded or missed. Results: The following topics are included: blood products; convalescent plasma; donor collections and testing; hemoglobinopathies; immunohematology and genomics; hemostasis; patient blood management; pediatrics; therapeutic apheresis; and cell therapy. Conclusions: This synopsis highlights and summarizes recent key developments in TM and may be useful for educational purposes.

UR - http://www.scopus.com/inward/record.url?scp=85132038923&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85132038923&partnerID=8YFLogxK

U2 - 10.1111/trf.16944

DO - 10.1111/trf.16944

M3 - Article

C2 - 35713186

AN - SCOPUS:85132038923

SN - 0041-1132

JO - Transfusion

JF - Transfusion

Transfusion medicine: A research agenda for the coming years

Affiliations.

• 1 Department of Pathology and Laboratory Medicine (Transfusion Medicine), University of Rochester Medical Center, Rochester, NY, USA. Electronic address: [email protected].
• 2 Department of Pediatrics, Division of Critical Care, University of Rochester Medical Center, Rochester, NY, USA; Department of Pediatrics, Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA.
• 3 Department of Pathology and Laboratory Medicine (Transfusion Medicine), University of Rochester Medical Center, Rochester, NY, USA.
• 4 Department of Medicine, Division of Critical Care and Pulmonary, University of Rochester Medical Center, Rochester, NY, USA.
• 5 Department of Pathology and Laboratory Medicine (Transfusion Medicine), University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, Division of Critical Care and Pulmonary, University of Rochester Medical Center, Rochester, NY, USA.
• 6 Department of Pediatrics, Division of Hematology-Oncology, University of Rochester Medical Center, Rochester, NY, USA.
• 7 Department of Pediatrics, Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, Hematology-Oncology Division,Rochester, NY, USA.
• 8 Department of Pathology and Laboratory Medicine (Transfusion Medicine), University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, Hematology-Oncology Division,Rochester, NY, USA.
• PMID: 31402101
• DOI: 10.1016/j.transci.2019.08.015

The important scientific and clinical advances of the last century in transfusion medicine include methods for avoiding hemolytic transfusion reactions and preventing transmission of viral infectious diseases. The next great clinical advances will require improving the efficacy and safety of transfusions, as well as acknowledgement of the now proven serious complications of transfusion, including nosocomial infection, thrombosis, inflammation and multi-organ failure. Possible strategies include (1) universal leukoreduction to mitigate transfusion immunomodulation effects and improve storage conditions, (2) minimizing transfusion of ABO incompatible antibodies and cellular/soluble antigens, (3) substituting use of safer solutions for normal saline during apheresis, component infusion and washing (4) new techniques to improve the efficacy and safety of blood components, including improved storage solutions/conditions, supernatant removal by washing, and rejuvenation and (5) maximizing the risk to benefit ratio of transfusions by employing more restrictive and physiologic indications for transfusion (including patient blood management) and improving clinical decision making through novel laboratory and bedside tests such as thromboelastography.

Keywords: Cellular therapies; Hemostasis; Inflammation; Thrombosis; Transfusion.

Copyright © 2019. Published by Elsevier Ltd.

Publication types

• Blood Component Removal*
• Blood Component Transfusion*
• Blood Group Incompatibility / prevention & control
• Blood Safety*
• Transfusion Medicine / trends*
• Transfusion Reaction / blood
• Transfusion Reaction / prevention & control
• Virus Diseases / blood
• Virus Diseases / prevention & control

Advertisement

Introduction to a review series on transfusion medicine

• Split-Screen
• Request Permissions
• Cite Icon Cite
• Search Site
• Open the PDF for in another window

Mario Cazzola; Introduction to a review series on transfusion medicine. Blood 2019; 133 (17): 1793–1794. doi: https://doi.org/10.1182/blood-2019-01-888248

Download citation file:

• Ris (Zotero)
• Reference Manager

In their review in this journal for the 50th anniversary of the American Society of Hematology (ASH), Alter and Klein underscored that “the beginning of the modern era of blood transfusion coincided with World War II and the resultant need for massive blood replacement.” 1   Initially focused mainly on laboratory activity aimed at testing blood donors and processing blood and its components, transfusion medicine has progressively evolved to become a clinically oriented discipline. 2   This evolution has been characterized by continued innovation that has made blood transfusion increasingly useful. 3   Nowadays, blood transfusions represent one of the most common procedures for patients in the hospital. 4   According to the American Red Cross, ∼36 000 U of red blood cells (RBCs), 7000 U of platelets, and 10 000 U of plasma are transfused daily in the United States. 5   Despite continuous improvements, blood transfusion still involves risks and, therefore, the implementation of best transfusion practices and guidelines is of fundamental importance in clinical practice. 6   The review series in this issue of Blood primarily provides an update on prevention, diagnosis, and treatment of transfusion reactions for practicing physicians. In addition, this series illustrates how genomics and big data analytics are also impacting this area of medicine.

The reviews in this series include the following:

Connie M. Westhoff, “Blood group genotyping”

Christopher A. Tormey and Jeanne E. Hendrickson, “Transfusion-related red blood cell alloantibodies: induction and consequences”

Ruchika Goel, Aaron A. R. Tobian, and Beth H. Shaz, “Noninfectious transfusion-associated adverse events and their mitigation strategies”

John W. Semple, Johan Rebetz, and Rick Kapur, “Transfusion-associated circulatory overload and transfusion-related acute lung injury”

Michael P. Busch, Evan M. Bloch, and Steven Kleinman, “Prevention of transfusion-transmitted infections”

In the first review, Westhoff illustrates the innovation in the field, summarizing the evolving use and applications of genotyping for RBC and platelet blood group antigens. Conventional blood typing by antibody-based methods has been useful for decades but has significant limitations; consequently, routine RBC typing for transfusion has been essentially limited to ABO and RhD determination. Blood group genotyping uses single-nucleotide polymorphisms (SNPs) in genes encoding human blood group antigens and DNA arrays for their evaluation. The advantages of this approach have already been shown in several areas, including prenatal medicine, transplantation settings, and prevention of alloimmunization in patients with sickle cell disease. Although DNA-based genotyping is clearly advantageous compared with antibody-based methods, DNA arrays can interrogate only a limited number of known SNPs. By contrast, next-generation sequencing (NGS) can interrogate the whole exome or genome, and is continuously improving in terms of instruments and costs. In Westhoff’s view, NGS is likely soon to become a tool for immunohematology reference laboratories.

In the second review, Tormey and Hendrickson examine alloantibody formation in response to transfused blood products, a complication that remains a clinically significant problem. They focus on alloimmunization to non-ABO blood group antigens, also known as RBC antigens. Alloantibody formation may have significant clinical consequences, including delayed hemolytic or serologic reactions and difficulties in locating compatible blood for alloimmunized individuals. In addition, alloantibodies can also be clinically significant in settings like pregnancy and hematopoietic stem cell transplantation. To prevent alloimmunization in patients with sickle cell disease, matching for some blood group antigens is now recommended, and DNA-based RBC typing has already become the primary method for extended RBC typing in some institutions. 7  

The Biomedical Excellence for Safer Transfusion (BEST) Collaborative has reported that transfusion reactions occur in up to 1 in 100 transfusions. 4   In the third review, Goel, Tobian, and Shaz focus on features of the most common noninfectious transfusion-associated adverse events, and discuss definitions, diagnostic criteria, treatment, and mitigation strategies. The most common noninfectious reactions include allergic reactions, ranging from mild urticarial lesions to anaphylaxis, and febrile nonhemolytic reactions that occur during or shortly after transfusion. Many countries now have national hemovigilance systems for monitoring, reporting, and analyzing transfusion-associated adverse events with the aim of making blood transfusion increasingly safer. To further improve hemovigilance, vein-to-vein databases are being created and big data applications are being implemented to enable management and analysis of the huge quantities of digital information that accumulate. 8   Although the use of big data in transfusion medicine will hopefully improve patient blood management, Goel et al emphasize that the single best modality for preventing transfusion-associated adverse events is avoiding an unnecessary transfusion. To minimize the hazards related to the administration of blood products, clinicians are expected to follow best transfusion practices that focus on transfusing the right product to the right patient at the right time.

In the fourth review, Semple, Rebetz, and Kapur examine transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI). Both TACO and TRALI are syndromes of acute respiratory distress that occur within 6 hours of blood transfusion and demonstrate infiltrates on a chest radiograph indicative of the presence of pulmonary edema. TACO and TRALI are life-threatening transfusion reactions, and specific therapies are unfortunately lacking. For TACO, supportive measures may include the use of diuretics, oxygen, and intubation, whereas preventive strategies are available for TRALI.

In the final review, Busch, Bloch, and Kleinman discuss the prevention of transfusion-transmitted infections. The classic transfusion-transmitted infectious agents include hepatitis B virus, HIV, human T-cell lymphotropic virus type I/II, and hepatitis C virus (HCV). The recognition that HIV and HCV are transmissible by blood significantly contributed to making transfusion medicine increasingly focused on patient care. 2   Research in this field has provided reliable tests for detecting virus-specific antibodies, antigens, and nucleic acid sequences, so that risks per blood transfusion unit are now <1 in 1 000 000 in the United States and other high-income countries. Agents of recent transfusion-transmitted concern include West Nile virus, Zika virus, and Babesia microti . Busch et al analyze these emerging infectious diseases, previous false alarms, and current approaches to surveillance and response. They also underline the need for global blood-safety programs, as the high level of transfusion safety in high-income countries has not been matched so far in most low- to middle-income countries.

I hope that these articles will help Blood readers improve their knowledge of the optimal use of blood products and the management of transfusion reactions.

This feature is available to Subscribers Only

• Next Article

Email alerts

Affiliations.

• Current Issue
• First edition
• Collections
• Submit to Blood
• About Blood
• Subscriptions
• Public Access
• Permissions
• Blood Classifieds
• Advertising in Blood
• Terms and Conditions

American Society of Hematology

• 2021 L Street NW, Suite 900
• Washington, DC 20036
• TEL +1 202-776-0544
• FAX +1 202-776-0545

ASH Publications

• Blood Advances
• Blood Neoplasia
• Blood Vessels, Thrombosis & Hemostasis
• Hematology, ASH Education Program
• ASH Clinical News
• The Hematologist
• Publications
• Privacy Policy
• Cookie Policy
• Terms of Use

This Feature Is Available To Subscribers Only

Sign In or Create an Account

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Acad Pathol
• v.9(1); 2022

An open-access transfusion medicine course for medical students

The senior author created a two-week online transfusion medicine course for fourth-year medical students to meet an unmet need at our institution. The course includes organized and concise online videos, reading assignments, and 100 quiz questions. Assessments include two oral quizzes via video call with 10 questions per quiz chosen at random from the study questions, and two written assignments to describe transfusion reactions in settings that are relevant to the student's specialty interests. The students were on camera and shared their device screens to minimize the use of external resources. Anonymous course evaluation surveys were completed by 78 of 102 students (77%). Mean ratings ranged from 6.7 to 7.0 on a seven-point scale. We share our experience as well as our complete materials (including quiz questions and free videos) via open access for this two-week online course in transfusion medicine that may be used for medical students, pathology residents, and other learners.

Introduction

Transfusion medicine training is important to many medical specialties, and blood transfusions are the most common procedure completed in American hospitals. 1 However, despite its direct relevance to nearly all medical specialties, transfusion medicine training is often overlooked. One study completed in 2011 found that 17% of medical schools had no transfusion medicine didactic lectures in their curriculum, and other studies have found significant deficits in training and practicing physicians’ knowledge of transfusion medicine citing a lack of learning opportunities. In multiple studies done on internal medicine and hematology residents, scores were consistently below 60% on transfusion medicine-related quizzes and greater than 90% of the participants communicated an interest in increasing transfusion medicine education. 2

Experts in the field have created transfusion medicine curriculum for medical students to improve the safety and efficiency of patient care as well as lower the cost of healthcare for patients and healthcare systems alike by decreasing excessive ordering and misinterpretation of laboratory tests. 3 The success of these curricula has been contingent on the presence of small group and case discussions with low student to faculty ratio focused on clinical correlations and practice problems. There are a variety of different approaches taken by medical schools to include laboratory medicine in their pre-clinical curriculum; some schools have a dedicated block course for the subject, some have laboratory-based teaching and case sessions interspersed throughout the curriculum, and some schools focus on problem-based learning (PBL) exercises.

During clinical clerkships, the greatest exposure to transfusion and laboratory medicine tends to occur during the internal medicine rotation. In a few rare programs, there is a required laboratory medicine clerkship as well with a greater focus on diagnostics and transfusion medicine. Many schools also offer elective courses on laboratory medicine. Beyond core and elective curriculum, there are many online resources to teach and test students' understanding of laboratory and transfusion medicine. Laboratory medicine-related questions are included in the United States Medical Licensing Examination (USMLE) step 2 and step 3; however, subscores for these questions are not provided by the NBME, so it is difficult to gauge medical students’ knowledge level of this vital field.

As is the case with institutions worldwide, the University of Wisconsin Madison School of Medicine had to rapidly change and adapt its curriculum in response to the start of the COVID-19 pandemic and related restrictions. This abruptly created a dire need for effective and efficient online learning for students throughout our medical school's three phases of curriculum: pre-clinical courses, clinical rotations, and advanced clinical experiences and selectives, which are specialty elective courses that all students are required to complete during the third and final phase of medical curriculum. Students are able to choose which selectives to take to fulfill a credit number requirement for graduation. 4 , 5

In response to this new goal and the emergency shift to online learning, the senior author adapted videos for an online transfusion medicine-focused pathology-based selective. The videos already existed before the course was created. The senior author made them for pathology residents’ rotation exam review, as each resident is required to do three transfusion medicine rotations and take a different rotation exam at the end of each rotation.

Some of these resident rotation exam videos were repurposed for use in the medical student course with some material omitted to increase relevance for medical students and keep it at their level of understanding. While the same videos were used, students in the medical school course had access to a question bank, later used for class quizzes, that focused on fewer, higher-yield topics. The course included two transfusion reaction assignments and two ten-question video oral quizzes completed via Zoom, an audiovisual conferencing platform, with a passing score for the course of 70%. Before participating in the course, students must already have all required basic sciences and clerkships completed to ensure comprehension of course material.

Materials and methods

This project is IRB exempt by our institution's standards. The general structure of the course included two written assignments about transfusion reactions and two oral quizzes. Student questions were addressed via Zoom, email, or through the online discussion forum, a unique online message board created for each class using our institution's online learning platform.

The course (and the supplemental materials) included a catalog of free videos adapted from the course creator's pathology residency program. Table 1 summarizes the topics of each video. The course syllabus also contained links to relevant information on websites for the Centers for Disease Control and Prevention (CDC), Association for the Advancement of Blood & Biotherapies (AABB), American Society for Apheresis (ASFA), etc. The course included institutional access to an online textbook. This could be replaced with the student's home institution's access to the same textbook or revised to reference a different book. If no electronic textbook is available through the home institution, the videos could stand alone as the main resource for the course.

Table 1

The course's free video titles, descriptions, and lengths.

Graded assessments for the course consisted of two written assignments and two synchronous video oral quizzes. For the two “transfusion reaction” assignments, students chose two reactions per assignment from a list of transfusion reactions and described the blood product transfused, signs and symptoms, workups, a summary of pertinent negatives, treatment course, and any other important information surrounding each reaction. Each case was worth five points for a total of ten points per assignment and twenty points for the duration of the course with a passing score of fourteen.

The two video oral quizzes were conducted one-on-one via Zoom and consisted of ten questions each that corresponded to the course videos and textbook chapters. The questions were chosen via a random number generator from the list of questions that were provided to the students on the course outline and syllabus. Some of the quiz questions overlapped with the previously published curriculum for anesthesiology residents. 6 Table 2 shows the general topic areas and number of questions for each.

Table 2

Numbers of questions by topic.

The quizzes were closed-note and closed-book, and the students were required to both be on camera for the duration of the quiz and share their desktop screen to minimize any chances for academic misconduct. Each question was worth one point for a total of ten points per quiz and twenty points total during the course with a passing score of fourteen. Both the assignments and the quizzes required a score of 14/20 in each category to pass the course. Some iterations of the course included group discussions Monday through Thursday in an office hour style that were ungraded and not required. These were discontinued due to poor attendance. However, one or more such sessions could be implemented if necessary.

A course evaluation report was compiled using data from a student survey including statements on a number scale from 1 to 7 with 1 being strongly disagreed and 7 being strongly agreed as well as an open comments and suggestions section.

The students who completed the course received a nine-question survey as described in Table 3 . Statements were followed by choices 1–7 with 1 being strongly disagreed and 7 being strongly agreed. Not applicable was also an option but was not used by any participants. Seventy-eight students completed the survey. All statements had a mean between 6.7 and 6.9 on a seven-point scale.

Table 3

Survey response averages from the 2019–2020 and 2020–2021 academic years with a total of 78 participants who were students that took the course and subsequently responded to nine statements regarding the course. Statements were followed by choices 1–7 with 1 being strongly disagreed and 7 being strongly agreed.

In addition, all students passed the course, as they all achieved 70% in each category of assessments.

Some online courses continue to be offered to fulfill requirements for certain non-clerkship courses, such as basic science selectives. They have proven to be popular among medical students because they are compatible with concurrent residency interviews, scholarly projects, family and personal life activities, and travel anywhere there is a sufficient Internet reliability and bandwidth. Online course options have also become increasingly popular and useful during the COVID-19 pandemic as a necessity for improved safety. In an attempt to provide many avenues for instructor contact, optional office hours were included initially, but for most instances of the course, no students attended. Thus, they were discontinued. The main reason for the creation of this course was to provide a short elective course for medical students to gain knowledge of transfusion medicine topics that was in an online, flexible format to increase accessibility during the pandemic and beyond, using preexisting videos originally formatted for pathology residents.

There were many strategies used to ensure that medical students taking the course were able to focus on and understand high-yield concepts while still being exposed to the more complex information in the course material. Firstly, the course book used was a review book instead of a long-form textbook to minimize time spent reading information that was not relevant to course evaluations or on an appropriate level of understanding. Secondly, the course videos clearly identified the biggest learning priorities. Thirdly, students were provided a question bank with 100 questions pertaining to course material that would be selected randomly for the oral quizzes using a random number generator. So, as long as students were able to answer those specific questions successfully, they would have no problem passing the course. Many students commented that they appreciated having a structured course book with a concise review format to focus their learning on high-yield topics, which allowed them to optimize their time spent studying.

The questions were in short answer format instead of multiple choice to encourage recall and application rather than simple memorization or recognition, so that despite the students being provided the questions beforehand, they were still gaining an understanding of the concepts. These course study questions emphasized the high-yield points, and the students were informed that some topics in the videos or presentation slides would not be tested and were included for a broader understanding of the material.

Despite being in an online format, the course was still arranged to prevent any cheating or other academic misconduct that could affect the students' understanding of the material and successful completion of the course. This goal was achieved by including both written assignments and oral quizzes, with the added security of the oral quizzes being completed on Zoom with the course professor, cameras, and microphones turned on, and the student's screen being shared for the duration of the quiz. The written assignments also minimize the risk of plagiarism because, unlike a short answer assignment, written assignments of prose are less amenable to copying.

Including a student presentation was considered for the course for an added element of depth but not breadth in chosen topics; however, presentations would require more faculty time and the current course arrangement allows for significant faculty involvement without imposing a lot of extra work or time commitments. For example, the randomly selected subset of quiz questions allowed students to learn all the high-yield topics while also allowing the proctor to minimize time spent administering and grading.

Additionally, minimal synchronous sessions, limited to the two 10-min oral quizzes, made the course compatible with other activities such as residency interviews and allowed the faculty to minimize repetitive delivery of the same lectures. This format also allowed the course schedule to be compatible with the instructor's schedule.

Furthermore, the reader may customize the course freely. For example, one could customize course logistics, assessments, or change the individuals that grade them. Instead of one faculty member that grades the assignments and administers the video quizzes, these tasks could be delegated to rotating or additional faculty, residents, or fellows as necessary. If the reader has different opinions of topics to include, their relative weights, or other characteristics, then those can be changed.

One major disadvantage of this course is that it is not an in-person patient care rotation in clinical medicine. We concede this point. We do not claim that this learning experience is the equivalent of a clinical rotation or that it can be used as a direct substitution. However, in-person rotations continue to exist, and the online course does not preclude the student from doing an in-person rotation as well. In fact, this course and in-person rotations in clinical and transfusion medicine complement each other well and may culminate in a broader and more in-depth understanding of clinical medicine as a whole. We also note that long-term retention of knowledge from the course has not been tested.

The general flexibility of the course and the generalizability of the material made it very simple to adapt it from material initially aimed at residents to a medical student course. The student prerequisites included the basic science courses and core clinical clerkships to ensure that the students had adequate background knowledge for this course.

Our data are from the medical student course, but the videos were originally created for pathology residents and repurposed for the medical student course. Thus, the videos and the curriculum's study questions could be useful learning tools for pathology residents as well as trainees in transfusion medicine, hematology/oncology, nephrology, nursing, clinical laboratory technology, and other specialties. 7 , 8 All course materials, videos, and supplemental files are provided as Supplemental Material with this article to make the course as open access as possible to allow for future students, residents, and any other individuals interested in transfusion medicine.

The authors declare no relevant funding.

Declaration of competing interest

The authors declare no conflicts of interest.

• Scope of the Problem
• Major Advances
• Current Scientific Foundation
• Current Cutting-Edge Research
• Critical Needs
• Forecast of Major Advances

See More About

Select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing

Others Also Liked

• Download PDF
• X Facebook More LinkedIn

Silberstein LE , Toy P. Research Opportunities in Transfusion Medicine. JAMA. 2001;285(5):577–580. doi:10.1001/jama.285.5.577

Manage citations:

© 2024

• Permissions

Research Opportunities in Transfusion Medicine

Author Affiliations: Harvard Medical School, Boston, Mass (Dr Silberstein), and the Department of Laboratory Medicine, University of California, San Francisco (Dr Toy).

In recent years, the translation of basic research in transfusion medicine has led to development of novel cellular therapies using well-characterized cell populations isolated from either bone marrow or blood (eg, hematopoietic stem and progenitor cells, T lymphocytes, dendritic cells). Refinements in cell therapies will make possible optimal stem cell engraftment, gene therapy, immunotherapy of cancer and infectious disease, and even solid organ regeneration. Moreover, the immune consequences of transfusion therapy are better appreciated and opportunities are at hand to prevent or blunt unwanted immune responses, such as platelet refractoriness and graft-vs-host disease. Transfusion medicine has become a broad, multidisciplinary field that has evolved beyond issues related to blood procurement and storage. The next series of advances in transfusion medicine will complement the current approaches of donor blood screening and viral/bacterial inactivation steps to ensure a safe and adequate blood supply.

The field of transfusion medicine began 100 years ago, in 1900, with the discovery by Landsteiner 1 of the ABO blood group system. This discovery demonstrated that plasma proteins have defined specificities. These plasma proteins, later termed antibodies, recognize epitopes on red blood cells. These discoveries constituted a starting point for blood banking—collection and storage of blood—and for immunohematology, the serological investigation of blood group antigens ( Figure 1 ). During the past 3 to 4 decades, significant advances have been achieved in improving the blood supply with respect to availability, safety, and fractionation into components, such as red blood cells, platelet concentrates, and plasma proteins.

Donors currently donate approximately 12 million units of blood annually in the United States. 2 Without these donations, many procedures and treatments, such as hematopoietic stem cell transplantation, complex cardiac and orthopedic surgery, and organ transplantation, would not be possible. A safe and adequate blood supply is a fundamental necessity to support state-of-the-art medical and surgical therapies. However, resources are now needed to translate advances in the biology of hematopoietic cells into newer cellular therapies and to investigate the unique immunological effects that result from transfusion of blood cells. This article discusses current status and progress in several aspects of transfusion medicine, including adequacy and safety of the blood supply, appropriate use of transfusion therapy, development of novel cellular therapies, and manipulation and prevention of immune responses.

Advances in transfusion medicine that have occurred during the past 25 years include reduction in risk of virally transmitted disease, pharmaceutical production of recombinant clotting factors, isolation and storage of stem and progenitor cell populations for transplantation, and genetic characterization of blood group antigens.

Reduction in transfusion-transmitted viral disease was achieved by a conversion from paid to volunteer donors, by improvement in donor screening, and by improvement of assays that detect viruses in donor blood. Since implementation of nucleic acid testing of donor blood, the estimated risks of hepatitis B (1 per 63 000 units), hepatitis C (1-3 per 1 million units), and human immunodeficiency virus (HIV) (1-2 per 1 million units), are now minuscule ( Figure 2 ). 3 At the same time, pasteurization and solvent-detergent treatment have virtually eliminated risk of HIV and hepatitis transmission through clotting factor concentrates and other plasma derivatives.

Advances have also been made in hematopoietic stem and progenitor cell transplantation for both hematologic and nonhematologic malignancies. The realization that stem and progenitor cells circulate in peripheral blood and that these cells can be mobilized from bone marrow using cytokines has led to outpatient cytapheresis procedures. 4 Transfusion medicine specialists are now involved in collection, in vitro manipulation, and storage of hematopoietic stem and progenitor cells for both allotransplantation and autologous transplantation.

Historically, blood group antigens were defined only by serological means, and their expression was thought to be limited to red blood cells. During the past 2 decades, establishment of the molecular basis for the majority of these blood group antigens has led to the realization that many of these antigens are expressed on other tissue cells. In addition, the biological functions of some of these antigens have been defined (eg, as receptors for pathogens or as ion transporters in the cell membrane 5 ). It is now possible to develop blood group antigen testing by genetic approaches. 6 Genotyping may lend itself to screening larger numbers of units in the blood supply and may be more amenable to laboratory automation. 7 This development could therefore enhance compatibility testing by selecting donor red blood cell units, which genetically match the red blood cells of the recipient. As a result, alloimmunization would be less likely.

The indications for transfusion of blood products continue to evolve. The hemoglobin concentration alone is an inadequate indication for red blood cell transfusion but improved clinical guidelines have not yet been defined. The importance of this issue is underscored by evidence that suggests that more liberal use of red blood cell transfusion may possibly harm younger, less severely ill patients in the intensive care unit. 8 Similar questions pertain to the indications for platelet concentrates, plasma, and specialized blood products (eg, leukoreduced cellular products, cytomegalovirus seronegative blood, washed red blood cells, fresh blood).

Alloimmunization is a major clinical problem in transfusion medicine, particularly in the setting of patients with multiple transfusions who become refractory to both red blood cells and platelet concentrates. For example, patients with hemoglobinopathies, such as sickle cell disease, rely heavily on transfusions for prevention and treatment of stroke, treatment for acute pulmonary disease, and preparation for surgery. 9 Unfortunately, a large percentage of sickle cell disease patients (25%-30%) develop multiple alloantibodies and autoantibody syndromes and become refractory to transfusion. Similarly, patients undergoing stem cell transplantation and aggressive chemotherapy often require frequent and sustained platelet transfusion support. A significant proportion of patients (30%) develop anti-HLA antibodies, resulting in platelet refractoriness. 10 A different aspect of alloimmunization pertains to graft-vs-host disease, in which transfused allogeneic T cells react with antigens on host tissues. These allogeneic T cells are transfused via traditional blood components (eg, packed red blood cells and platelet concentrates) or via stem cell products for hematopoietic stem cell transplantation.

There is also a deliberate use of alloimmunity in transfusion medicine, which involves the transfusion of allogeneic T cells to induce a graft vs leukemia/tumor effect for treatment of residual or recurrent tumor. 11 In addition, transfusion of viable donor leukocytes may induce ill-defined immunosuppression, referred to as the immunomodulatory effect, leading to tumor recurrence and postoperative infections. 12 It has been argued that more research is needed to understand the biology and clinical implications of the immunomodulatory effect before expensive strategies, such as universal leukoreduction of blood products, are instituted. 13

Current research is aimed at reducing viral transmission of blood products. Several viral/bacterial inactivation methods are being investigated for cellular products that are not amenable to solvent-detergent treatment or pasteurization. 14 Also, artificial blood substitutes (now in phase 3 trials) ultimately may have clinical utility, but they are unlikely to replace the volunteer donor blood supply. 15

With respect to cell therapies, attempts are under way to define hematopoietic stem cells and to understand stem and progenitor cell replication and differentiation. 16 These studies may lead to better approaches for ex vivo stem and progenitor cell expansion. Also, stem cell homing (eg, chemokines) and engraftment (eg, facilitator cells) are critical for hematopoietic stem cell transplantation. 17 Other cell therapies in development include T-cell therapies, for their graft vs tumor effect (ie, residual/recurrent chronic myelogenous leukemia), and the ex vivo generation of dendritic cells, for use in tumor vaccines. 18 , 19 Progress also is being made in differentiating the cells (and surface molecules) of the immune system that generate immune responses to foreign and host antigens. 20 , 21 As a result, experimental research and clinical trials are ongoing to find ways to either prevent or blunt autoimmune or alloimmune responses by costimulatory molecules (eg, using anti-CD40, CTLA4-Ig). 22 - 24

Basic principles of quality and risk management support establishment of evidence-based guidelines. A network of clinical research centers in transfusion medicine is essential to improve the effectiveness of the research that this discipline requires. Basic research analyzing the control of hematopoiesis is critical to expansion of hematopoietic cells and important to development of novel cellular therapies. Several issues must be resolved to advance hematopoietic stem cell transplantation. For example, which cells or factors are necessary for long-term engraftment? Which cells exist in the bone marrow environment and how do they influence hematopoietic growth and differentiation? Which factors influence the retention and trafficking of hematopoietic progenitor cells to and from the bone marrow environment?

Alloimmunity is a common consequence of blood cell transfusion. Further studies are needed to elucidate the mechanisms involved in generation of these immune responses. Such studies may focus on definition of target antigens (eg, tumor antigens, antigens in graft-vs-host disease, immune cell types, and the membrane molecules involved), cell origin (eg, host vs donor), the role of cytokines in establishing and perpetuating an alloimmune response, and the role of chemokines and chemokine receptors in homing immune cells. To date, few animal models exist that can be used to study alloimmune responses to blood cell elements. A special need exists to develop murine models to take advantage of existing reagents; the ability to inactivate murine background genes and knock-in human genes may be useful to study the induction, prevention, and modulation of immune-hematological responses. Such models may help define the role of specific immune cells (eg, T cells, dendritic cells), the role of donor vs host antigen-presenting cells, and the role of certain receptors (eg, Fcγ).

Current problems with blood shortages can be solved by finding ways to increase blood donations, by establishing donor criteria that maintain a safe blood supply without turning away safe donors, and by more accurately defining the indications for transfusions. Blood group genotyping will improve compatibility testing and selection of appropriate donor blood. In addition, genotyping will more precisely define fetal risk for neonatal hemolytic disease. Transfusion safety will be further enhanced by improved genetic testing of donated blood for known pathogens and by use of viral/bacterial inactivation steps suitable for cellular products. While reduction in the transmission risk of hepatitis B, hepatitis C, and HIV infection during the past 15 years is a major advantage, it is important to continue surveillance for newly emerging viruses and other pathogens (eg, prions, associated with variant mad cow disease) ( Figure 2 ). 25

Advances in cell and molecular biology of immune and hematopoietic cells will make it possible to isolate and grow cells in vitro for specific cell therapies. 26 Such therapies will include hematopoietic stem and progenitor cell populations with optimal engraftment and minimal graft-vs-host disease, 27 dendritic cells for tumor vaccines, T-cell populations defined for their antitumor/antiviral effects, 28 and stem and progenitor cells that are rendered resistant to infectious disease or genetically modified to correct genetic disorders. Since hematopoietic stem cells are capable of differentiating into cells of different lineage (eg, liver cells), it may possible to generate human tissue and blood cells in vitro for therapeutic applications. 29 ( Figure 3 )

Further understanding of alloimmune responses after transfusion may lead to ways to mitigate or prevent unwanted consequences of transfusion, such as graft-vs-host disease and refractoriness to platelet transfusion. Collectively, this interdisciplinary research effort will translate into safer and more effective transfusion therapy with a wide range of applications.

• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts

• भारत सरकार Government of India
• स्वास्थ्य एवं परिवार कल्याण मंत्रालय Ministry of Health & Family Welfare
• JIPMER INTERNET RADIO

Jawaharlal Institute of Postgraduate Medical Education & Research JIPMER Breaking Boundaries.. Finding Frontiers.. An Institution of national importance

• General Info
• Bone marrow transplantation
• Hand Transplantation
• Liver Transplantation
• Announcement
• Notice Board
• Departmental Administration
• Rooms and Capacity
• Hospital Statistics
• Monthly Report Form IV
• Departmental administration
• Notice & Awards
• Faculty and Staff
• Research and Publication

Extramurally funded

• Understanding the phenotypic and genetic variability in different clinically important blood group systems and its application in development of population specific red cell panels and rare donor registry ( Multicenter study – ICMR funded)
• Extended blood group phenotyping and creating an Institutional based blood donor registry. ( Funded by JAANA (JIPMER Alumni Association of North America) )
• Serological identification and molecular characterization of RhD variants among apparently RhD negative individuals from South India

Intramurally funded

Following Post graduate thesis projects (dissertation works) are being carried out in this department at present.

• Changes in hematological parameters among donors after plateletpheresis
• Is dental care associated with a higher risk of Transfusion transmitted infections?
• To Study the Impact of maternal alloantibody titer on Hemolytic disease of fetus and newborn
• Safety and efficacy of umblical cord blood transfusion in Thalassemia
• Assessment of changes in the levels of anti-A and anti-B antibody titres in ABO incompatible Hematopoietic transplant recipients after transfusion of donor plasma having A and B secretory substances
• Amount and duration of menstrual blood loss and its association with ABO blood groups & non willebrand factor levels among females (18-30 years) - A cross sectional analytical study
• Impact of single alloantibody and multiple antibodies in pregnancy on fetal outcomes

Publications –

• D Basu, R Kulkarni . Overview of blood components and their preparation . Indian journal of anaesthesia 58 (5), 529
• KP Athira, K Vanathy, R Kulkarni , R Dhodapkar. The prevalence of occult hepatitis B infection among the blood donors in a tertiary care hospital, Puducherry . Indian journal of medical microbiology 36 (3), 426-428
• VK Gente, A Basavarajegowda, R Kulkarni , D Basu. Recipient hemovigilance at a tertiary care hospital in Southern India: A cross-sectional study . International Journal of Advanced Medical and Health Research 5 (2), 66
• RG Kulkarni , KB Lakshmidevi, V Ronghe, US Dinesh. Gilbert's syndrome in healthy blood donors what next?? . Asian journal of transfusion science 10 (1), 63
• PL Ambika, R Kar, D Basu, RG Kulkarni . Influence of ABO Blood Group on von Willebrand Factor Antigen Level in Normal Individuals: A Cross-Sectional Study from Southern India . Indian Journal of Hematology and Blood Transfusion 37 (3), 505-506
• Basavarajegowda A , Bajpai M, Arora S, Maheshwari A, Dua S, Sahoo D. Survey based cross-sectional study to analyse the variation of practices at blood centres during COVID-19 pandemic in India. Transfus Apher Sci. 2021 Jun;60(3):103131. doi:10.1016/j.transci.2021.103131.
• Basavarajegowda A , Arjunan C, Nalini Y C, Parameshwaran S, Kannan S. A comparative study of knowledge, attitude, and practices about organ donation among blood donors and nonblood donors. Asian J Transfus Sci 2021;15:37-45 doi: 10.4103/ajts.ajts_9_21.
• V Arunachalam, R Kulkarni, A Basavarajegowda . Adverse reactions to the donation of platelet by apheresis and related factors in a tertiary level care blood center. Global Journal of Transfusion Medicine 6 (2), 135-40
• Nair NP, Alexander A, Abhishekh B , Hegde JS, Ganesan S, Saxena SK. Safety and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial. Int Arch Otorhinolaryngol. 2019 Jan;23(1):77-82. doi: 10.1055/s-0038-1649495.
• Remakanth R, Basavarajegowda A *, Dhodapkar R. Prevalence of dengue NS1 antigenemia among healthy blood donors in a tertiary care hospital in Southern India. Asian J Transfus Sci Asian J Transfus 2021; DOI:10.4103/ajts.ajts_51_21
• Balasubramanyam P, Basavarajegowda A *, Hanumanthappa N, Negi VS,Harichandrakumar KT.Irradiating stored blood and storing irradiated blood: Is it different? ‐ A study of serial changes in biochemical parameters of red blood cell units. Asian J Transfus Sci 2021; DOI:10.4103/ajts.ajts_71_21
• Gnanaraj J, Toora E, Pothen J, Sathish S, Menon V, Basavarajegowda A . Transfusion-associated anxiety: Recognised and overcome in an adolescent child. Transfus Clin Biol. 2021 May;28(2):217-220. doi: 10.1016/j.tracli.2021.02.002.
• Gnanaraj J, Arjunan C, Basavarajegowda A . Hourglass ballooning of the apheresis kit blood filter. J Clin Apher. 2020 Aug;35(4):376-377. doi: 10.1002/jca.21808.
• Mathew J, Gnanaraj J, Basavarajegowda A , Venkateswaran R. Plasmapheresis in lethal yellow phosphorus poisoning: a scope for recovery. BMJ Case Rep. 2021 21 Apr;14(4):e239676. doi: 10.1136/bcr-2020-239676
• Cherukat J, Jacob SE, Kulkarni R, Basavarajegowda A . Seroprevalence of cytomegalovirus among blood donors at a tertiary care hospital in Puducherry, India. Is testing donated blood for cytomegalovirus a viable option? Asian J Transfus Sci 2021;15:113-4. DOI: 10.4103/ajts.AJTS_1_19
• Remakanth R, Abhishekh B. Is it an acute pain transfusion reaction? Asian J Transfus Sci 2021;15:97-9 DOI:10.4103/ajts.AJTS_100_20
• Das S, Priyamvada PS, Basavarajegowda A , Mathur A. Deciphering a delayed hemolytic transfusion reactions nightmare – Case of Chido/Roger antibodies. Asian J Transfus Sci 2019;13:132-5 DOI:10.4103/ajts.AJTS_152_17
• Singh J, Kayal S, Dubashi B, Jadhav N, Basu D, Vijayakumar S, Basavarajegowda A , Vadivel A. Engraftment syndrome, transplant-associated thrombotic microangiopathy and hemophagocytic syndrome following autologous stem cell transplant in multiple myeloma. Transfus Med. 2019 Aug;29(4):290-294. doi: 10.1111/tme.12600.
• Gopal S, Kannan S, Kulkarni R, Basavarajegowda A *.Prevalence of ABO Blood Group Phenotypes and Antibody Titers of the Blood Donor Population in and around Puducherry. Int J Adv Med Health Res 2021;8:28-32. DOI:10.4103/ijamr.ijamr_8_21
• Das S, Basavarajegowda A *. A retrospective study of single-unit transfusion in a tertiary care center of Southern India. Glob J Transfus Med 2021;6:38-42 DOI: 10.4103/GJTM.GJTM_51_20
• Remakanth R, Abhishekh B . Blood utilization quality indicators in a tertiary care center in South India. Glob J Transfus Med 2020;5:206-8. DOI: 10.4103/GJTM.GJTM_67_20
• Kannan S, Kulkarni R, Basavarajegowda A *. Prevalence of high titered anti-A and anti-B antibodies among O blood group individuals and their associated factors. Glob J Transfus Med 2020;5:187-91 DOI: 10.4103/GJTM.GJTM_38_20
• Pokhrel B, Basavarajegowda A *, Chandran S, Basu D, Rehman T. Allogenic blood transfusion requirements and effects of storage age of blood units on postoperative period in cardiac surgeries: An analytical study. Glob J Transfus Med 2019;4:180-5 DOI: 10.4103/GJTM.GJTM_47_19
• R Loganathan, Rajendra G Kulkarni, Rakhee Kar, B Abhishekh and Debdatta Basu. Effects of Site of Blood Collection and Duration of Storage on Coagulation Factor V and Factor IX Levels in Fresh Frozen Plasma. Annals of Pathology and Laboratory Medicine, Vol. 7, Issue 10, October 2020 DOI: 10.21276/APALM.2822
• Dwivedi P, Basavarajegowda A *, Sastry AS. Surrogate markers and their correlation to bacterial contamination and other quality parameters in random-donor platelets by a platelet-rich plasma method. Glob J Transfus Med 2019;4:33-8. DOI: 10.4103/GJTM.GJTM_5_19
• Loganathan R, Kulkarni RG, Kar R, Abhishekh B , Basu D. Assessment and association of coagulation factors (FVIII and fibrinogen) with the mode of collection and storage of fresh frozen plasma. Glob J Transfus Med 2019;4:204-7 DOI: 10.4103/GJTM.GJTM_41_19
• Joy A, Sahoo D, Abhishekh B and Kulkarni R. Incidence of Adverse Transfusion Reaction and Practices for its Prevention. Haematol Int J 2021, 5(1): 00183 https://doi.org/10.23880/hij-16000183
• Anuragaa S, Sahoo D, Abhishekh B . Resolving crossmatch incompatibility due to daratumumab in multiple myeloma. Glob J Transfus Med 2020;5:225-7. DOI: 10.4103/GJTM.GJTM_78_20
• Cherukat J, Basavarajegowda A *. Green plasma day … Was sterilization agent the culprit? Glob J Transfus Med 2020;5:234-5 DOI: 10.4103/GJTM.GJTM_69_20
• S Das, V Kumar, E Jafa, A Basavarajegowda , S Kayal. Complete disappearance of ABO antigen—a cause of ABO discrepancy. Transfusion 58 (1), 5-6
• A Mukherjee, A Basavarajegowda , KT Harichandrakumar. Olfactory function and its association with ABO blood group in adults: A cross-sectional study. Global Journal of Transfusion Medicine 2 (2), 143-8
• LB Elakkumanan, J Cherukat, JN Tolson, S Sistla, A Basavarajegowda . Out of the blue: Blue blood!. Asian journal of transfusion science 11 (2), 212
• Anuragaa S, Sahoo D, Abhishekh B, Nair R. A rare case of antibody against enhancement media interfering with crossmatching: A case report and review of literature. Asian J Transfus Sci 2021;15:100-3
• Prakash S, Sahoo D, Mishra D, Routray S, Ray GK, Das PK, et al. Association of transfusion transmitted infections with ABO and Rh D blood group system in healthy blood donors: a retrospective analysis. Int J Community Med Public Health 2020;7:4444-8.
• Ray GK, Mukherjee S, Sahoo D, Mishra D, Routray SS, Prakash S. Resolution of the complexity of transfusion support by alloadsorption in a patient of thalassaemia intermedia with multiple alloantibodies. J Appl Hematol 2020;11:195-8
• Mishra D, Prakash S, Sahoo D, Ray GK, Routray SS, Das PK, Mukherjee S. Prevalence of A2and A2B subgroups along with anti-A1antibody in patients and donor population and its clinical significance. J Appl Hematol 2020;11:112-5
• Mishra D, Sahoo D, Mahapatra S, Panigrahi A. Best‑match blood transfusion in pediatric patients with mixed autoantibodies. Cancer Transl Med 2020;6(1):21-3.
• Jena PS, Sahoo D, Acharya DP, Pati B, Kanungo GN and BeheraR. Analysis of Platelet Refractoriness in a Tertiary Care Hospital. Haematol Int J 2020, 4(2): 000158

Important Links

Public / other.

• Public Grievances
• JIPMER In News
• Recruitment Rules
• Public Relations Office
• Important links
• Periodicals
• WHO Checklist
• Logo,Invocation Song & National Anthem
• TOLIC Puducherry
• Online Patient Portal
• Blood Donation
• eOffice : User Manual
• Administration
• JIPMER Email for (@jipmer.edu.in)
• JIPMER Internal Access
• JIPMER SCIENTIFIC SOCIETY
• JIPMER ALUMNI ASSOCIATION
• JIPMER Email for (@jipmer.ac.in)
• Observership

On Medicine

Topics in blood transfusion

Today marks World Blood Donor Day and so we asked Deputy Editor for Journal of Intensive Care , Hiroshi Morisaki, to explain more about the importance of blood transfusion, and how research in this area is progressing.

Hiroshi Morisaki 14 Jun 2016

To date, humans have uncovered a number of natural principles and issues such as the origin and mysteries of the universe, the earth and even life. We have simultaneously developed innumerable non-natural products for human use.

However, we have not yet succeeded in creating a man-made, cost-effective alternative to red blood cells (RBCs) despite the performance of extensive research and numerous clinical trials.

A life-saving intervention

The cellular health of the host requires an oxygen (O 2 ) supply that matches the O 2 requirements of its tissue. An insufficient O 2 supply results in ischemia, subsequently inducing tissue and/or organ injury, frequently observed in critically ill patients.

RBC transfusion, first performed over 300 years ago, remains a fundamental life-saving intervention in medicine.

Hemoglobin, which is enclosed in RBCs as an O 2 carrier, plays the most important role in supplying O 2 to the tissues. Accordingly, RBC transfusion, first performed over 300 years ago, remains a fundamental life-saving intervention in medicine.

Until the early 1980s, RBC transfusion was considered to be practically risk-free and a truly effective intervention in patients with active bleeding or anemia due to a variety of reasons in the intensive care field.

However, the threat of potentially-fatal transfusion-related infections, i.e., human immunodeficiency virus, has led physicians throughout the world to obviate this conventional intervention to the extent that is possible.

Research in the literature

In 1999, Canadian investigators examined the effects of a restrictive RBC transfusion strategy in comparison to a liberal strategy in critically ill patients. They indicated that a restrictive strategy was at least as effective as and possibly superior to a liberal transfusion strategy in critically ill patients with some exceptions.

Although several debates are currently ongoing, most physicians now agree that a restrictive strategy to limit RBC transfusion is a valuable approach in the treatment of stable patients with anemia.

However, we need to be cautious when interpreting the results of the Canadian study as it indicated some exceptions.

Even though we have seen extraordinary advances in medical science and related technology over the last several decades, clinical practices have been determined based on the balance between the benefits and related risks of intervention.

They found that a restrictive transfusion strategy was significantly associated with reduced mortality in younger patients and in those with less severe conditions. In other words, a liberal RBC transfusion strategy might be more effective for older patients and patients with more severe conditions.

RBC transfusion by itself is not an exception. The level of hemoglobin that works in some patients may not work in others. Indeed, a previous cohort study of intensive care unit patients suggests that restrictive RBC transfusion policies may not be uniformly applicable in the clinical setting.

World Blood Donor Day

In 2012, the World Health Organization (WHO) released a document entitled, “ Blood donor selection – Guideline on assessing donor suitability for blood donation ”. In this guideline, the authors noted that a careful process to assess the suitability of donors is essential for protecting the safety and sufficiency of the blood supply, and safeguarding the health of both ‘recipients’ and ‘donors’. We should therefore understand that blood transfusion not only improves the recipients’ conditions but also affects the donors’ health.

Away from the discussion of whether restrictive or liberal RBC transfusion strategies should be applied, natural human blood is needed to save the lives in emergency and long-term treatment settings, even in the 21 st century.

If you believe yourself to be in good health, you should donate your blood to prove it and to save lives at the same time.

View the latest posts on the On Medicine homepage

• Latest Posts

Hiroshi Morisaki

Latest posts by hiroshi morisaki ( see all ).

• Topics in blood transfusion - 14th June 2016

Recommended posts

Popular on medicine tags.

• BMC Medicine
• clinical trials
• medical evidence
• Genome Medicine
• ISRCTN Registry
• Alzheimer's
• Alzheimer's Research & Therapy
• breast cancer

Popular posts

• Most shared

Sorry. No data so far.

Most Shared Posts

• Teaching recovery techniques plus parenting: a cluster randomized controlled trial in Ukrainian schools in Ternopil (TRUST)
• Winners of the 2022 Cardio-Oncology Journal Prize
• A unique approach. A unique population. Investing in nurses’ mental health
• Does the midwife-led continuity of carer model improve birth outcomes and maternal mental health in vulnerable women?
• A proactive diabetes review model: from concept to nurse-led research
• March 2024  (1)
• February 2024  (2)
• January 2024  (1)
• November 2023  (1)
• October 2023  (1)
• September 2023  (7)
• July 2023  (1)
• June 2023  (1)
• May 2023  (4)
• April 2023  (1)
• March 2023  (2)
• February 2023  (7)

Subscribe To Get 1 Week’s access to Premium Thesis Topics. This will not only give you access to premium thesis topics but also you will get guidance for selection of thesis topics as well as guidance for synopsis writing.

  I’ve a vast experience of guiding PG students for thesis writing as well as getting their papers  published in reputed medical journals.

Even if you don’t subscribe, please do not forget to drop me a WhatsApp message and i will definitely guide you even if you don’t subscribe.

The Subscription Will Give You access to 1. 2500 + Premium MedicineThesis Topics. 2. 500+ Thesis Topics on Diabetes Mellitus. 3. 200+ thesis topics on Hypertension. 4. 500+ Thesis topics on Hematology. 5. 500+ Thesis topics on Nephrology. 6. 500+ Thesis Topics on Neurology. 7. 1000+ Thesis Topics on Cardiology. 8. 500+ thesis topics on HepatoBiliary System. 9. 500+ thesis topics on Infectious Diseases. 10. 100+ thesis topics on Geriatric Medicine. 11. 100+ thesis topics on Transfusion Medicine. 12. 500+ thesis topics on Endocrinology. 13. 500+ thesis topics on Pulmonology. 14. 500+ thesis topics on Neurodegenerative diseases 15. 500+ thesis topics on GIT. 16. 500+ thesis topics on Autoimmune Diseases. 17. 2000+ thesis topics on emergency medicine 18. 2200 thesis topics on chest and TB Approximately 14,400 Premium Medicine Thesis topics In addition to that 1. Online Help in selecting thesis topics. 2. Free Help in Synopsis Writing.

For any query or any technical problem you may contact us.

The Content You are trying to Access is Premium

Subscribe to get 1 weeks access to premium thesis topics. this will not only give you access to premium thesis topics but also you will get guidance for selection of thesis topics as well as guidance for synopsis writing. i’ve a vast experience of guiding pg students for thesis writing as well as getting their papers published in reputed medical journals. even if you don’t subscribe please do not forget to drop me a whatsapp message and i will definitely guide you even if you dont subscribe., disclaimer.

There are many methods of sample size determination. It is one of the first hurdle when someone starts writing a thesis. I have tried to give simplest way of determination of sample size. You need to show the method to your PG teacher before you include this method in your thesis. First confirm from your PG teacher and then only proceed.

Medical Research / Thesis / Dissertation

Medical research / thesis made easy...

Wednesday 29 July 2015

Md transfusion medicine - thesis topics tn.

After conducting research, a researcher collates all of his/her findings and presents them in the form of a manuscript. Manuscripts that are well-written and error-free have better chances of being accepted for publication than those that are poorly written. Click here

• Alzheimer's disease & dementia
• Arthritis & Rheumatism
• Attention deficit disorders
• Autism spectrum disorders
• Biomedical technology
• Diseases, Conditions, Syndromes
• Endocrinology & Metabolism
• Gastroenterology
• Gerontology & Geriatrics
• Health informatics
• Inflammatory disorders
• Medical economics
• Medical research
• Medications
• Neuroscience
• Obstetrics & gynaecology
• Oncology & Cancer
• Ophthalmology
• Overweight & Obesity
• Parkinson's & Movement disorders
• Psychology & Psychiatry
• Radiology & Imaging
• Sleep disorders
• Sports medicine & Kinesiology
• Vaccination
• Breast cancer
• Cardiovascular disease
• Chronic obstructive pulmonary disease
• Colon cancer
• Coronary artery disease
• Heart attack
• Heart disease
• High blood pressure
• Kidney disease
• Lung cancer
• Multiple sclerosis
• Myocardial infarction
• Ovarian cancer
• Post traumatic stress disorder
• Rheumatoid arthritis
• Schizophrenia
• Skin cancer
• Type 2 diabetes
• Full List »

share this!

June 3, 2024

This article has been reviewed according to Science X's editorial process and policies . Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

trusted source

Pain scale tool not effective in detecting pain in cancer patients, says researcher

by Claes Björnberg, Umea University

Every year, several thousand cancer patients in Sweden risk receiving too little pain relief in the end of life, as the health care system fails to detect that the patients are suffering from pain. When patients cannot verbalize their pain, the pain assessment instrument Abbey Pain Scale is sometimes used instead—but it does not work for patients with cancer, according to a thesis.

"Even though half of the patients self-reported moderate or severe pain , the instrument showed only mild pain according to our study. This can lead to undertreatment of the pain for many dying patients with cancer," says Sussi Tegenborg, doctoral student.

The Abbey Pain Scale is one of three recommended pain assessment instruments in Sweden for patients who, for various reasons, cannot self-report their pain. The problem is that available instruments are designed to find pain in patients with dementia and not in those suffering from cancer.

"There is no assessment instrument specifically developed for cancer patients . When we interviewed health care professionals about the instrument, they pointed out that some parts of the instrument are not adapted to how cancer patients physically express pain at the end of life ," says Tegenborg.

"If we succeed in developing a well-functioning instrument, it will not only be able to help patients here in Sweden, but potentially also cancer patients around the world."

On Wednesday 5 June, Tegenborg, Department of Diagnostics and Intervention at Umeå University, will defend her dissertation, titled "Pain or not pain? That is the question. An evaluation of the observational Abbey Pain Scale when used in patients with cancer."

Explore further

Feedback to editors

Facial thermal imaging and AI can accurately predict presence of coronary artery disease

2 hours ago

Study: High excess death rates in the West for 3 years running since start of pandemic despite containment and vaccines

Inflight alcohol plus cabin pressure can lower blood oxygen and raise heart rate, even in the young and healthy

Personalized oxygenation could improve outcomes for patients on ventilators

3 hours ago

Molecule produced in gut can have protective effect against flu, study shows

Genetic changes identified as key to childhood lupus

4 hours ago

New method offers faster, more accurate pathogen identification, even in complex DNA sequences

Oral nucleoside antiviral is progressing toward future pandemic preparedness

New machine learning method can better predict spine surgery outcomes

Airplane noise exposure may increase risk of chronic disease

5 hours ago

Related Stories

Virtual reality sessions lessen cancer pain in clinical trial

Apr 8, 2024

Exercise and pain education no boost for chronic pain after knee replacement

May 30, 2024

When to seek care for pelvic pain

May 23, 2024

Physical activity may lessen pain intensity for cancer survivors

Feb 12, 2024

Both acupuncture and massage can benefit those with cancer-related pain: Study

Nov 27, 2023

ASA: Deep learning model can improve pain assessment

Dec 29, 2023

Recommended for you

Two-pronged attack strategy boosts immunotherapy in preclinical studies

Scientists develop AI tool to predict how cancer patients will respond to immunotherapy

7 hours ago

New study shows vitamin C boosts DNA damage and cell death in melanoma cells

Researchers create 'chameleon' compound that targets drug-resistant brain cancers

10 hours ago

Chromatin openness sheds new light on prostate cancer plasticity

Neoadjuvant immunotherapy for early stage melanoma shows positive results

8 hours ago

Let us know if there is a problem with our content

Use this form if you have come across a typo, inaccuracy or would like to send an edit request for the content on this page. For general inquiries, please use our contact form . For general feedback, use the public comments section below (please adhere to guidelines ).

Please select the most appropriate category to facilitate processing of your request

Thank you for taking time to provide your feedback to the editors.

Your feedback is important to us. However, we do not guarantee individual replies due to the high volume of messages.

E-mail the story

Your email address is used only to let the recipient know who sent the email. Neither your address nor the recipient's address will be used for any other purpose. The information you enter will appear in your e-mail message and is not retained by Medical Xpress in any form.

Newsletter sign up

Get weekly and/or daily updates delivered to your inbox. You can unsubscribe at any time and we'll never share your details to third parties.

More information Privacy policy

Donate and enjoy an ad-free experience

We keep our content available to everyone. Consider supporting Science X's mission by getting a premium account.

E-mail newsletter