Inherited Bleeding Disorders in the Obstetric Patient
AbstractInherited bleeding disorders increase the risk of bleeding in the obstetric patient. Randomized controlled trials to compare prophylactic or therapeutic interventions are rare, and guidance documents rely heavily on expert opinion. Here we report the results of a systematic review of the literature for the treatment and prevention of peripartum bleeding in women with an inherited bleeding disorder. The highest quality evidence is for the use of tranexamic acid (TXA) in postpartum hemorrhage (PPH), which has been shown to decrease bleeding-related mortality in women without bleeding disorders. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - July 12, 2018 Category: Hematology Authors: Bethany Samuelson Bannow, Barbara A. Konkle Source Type: research
Patient-centered outcomes in the management of anemia: A scoping review
Anemia is a frequently diagnosed condition that may be a symptom of or complication of many illnesses affecting patients of all demographics. Anemia can lead to both worsened clinical outcomes and reduced quality of life. Patient-reported outcome measures (PROMs) are methodological tools used to capture the impact of disease on patient wellbeing. Use of PROMs in medical research is becoming more common as it is increasingly recognized that disease outcomes of interest to researchers and clinicians are not always consistent with patients' greatest concerns related to their diseases. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - July 12, 2018 Category: Hematology Authors: Phillip Staibano, Iris Perelman, Julia Lombardi, Alexandra Davis, Alan Tinmouth, Marc Carrier, Ciara Stevenson, Elianna Saidenberg Source Type: research
Re-thinking the Value of Transfusion Guidelines
A 72 year-old lady is soon to be discharged from a standard hospital ward after recovering from recent pneumonia. Her hemoglobin is 8.1 g/dL. She is afebrile and her BP is 170/80. She has known longstanding hypertension under treatment with a diuretic and has left ventricular hypertrophy on electrocardiogram. Her pulse is 82 beats per minute. She admits to feeling weak and out-of-breath when she takes “laps” around the nursing station. When questioned about her breathing, she replies: “I am 72 years old, you know”. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - July 1, 2018 Category: Hematology Authors: Sunny Dzik Tags: Editorial Source Type: research
Editorial Board
(Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - July 1, 2018 Category: Hematology Source Type: research
Transfusion Medicine in a Multidisciplinary Approach to Morbidly Adherent Placenta: Preparing for and Preventing the Worst
The increasing incidence of placenta accreta has paralleled the rise in its greatest risk factor: cesarean delivery. In placenta accreta, the abnormal invasion of the chorionic villi into the myometrium prevents separation of the placenta at delivery, and the myometrium is unable to contract to prevent hemorrhage. Spontaneous uterine rupture and hemoperitoneum may also occur in the setting of placenta percreta. The average blood loss during a delivery complicated by placenta accreta is 2 to 5L, compared to less than 0.5L for a normal spontaneous vaginal delivery and less than 1L for a cesarean delivery. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - June 27, 2018 Category: Hematology Authors: Robert A. DeSimone, Wendy K. Leung, Joseph Schwartz Source Type: research
Biomolecular Consequences of Platelet Pathogen Inactivation Methods
Pathogen inactivation (PI) for platelet concentrates (PC) is a fairly recent development in transfusion medicine that is intended to decrease infectious disease transmission from the donor to the receiving patient. Effective inactivation of viruses, bacteria and eukaryotic parasites adds a layer of safety, protecting the blood supply against customary and emerging pathogens. Three PI methods have been described for platelets. These are based on photochemical damage of nucleic acids which prevents replication of most infectious pathogens and contaminating donor leukocytes. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - June 27, 2018 Category: Hematology Authors: Hendrik B. Feys, Britt Van Aelst, Veerle Compernolle Source Type: research
Current Evidence for the Use of Prophylactic Transfusion to Treat Sickle Cell Disease During Pregnancy
The role of prophylactic transfusion therapy for the treatment of sickle cell disease during pregnancy is unclear. An analysis of the existing literature shows a limited number of publications that address this issue and specifically compare clinical outcomes in this population based on a treatment strategy of prophylactic transfusion versus transfusion only for clinical indications (on demand transfusion). The existing studies show a wide variation in study design and outcomes measured. The results of this analysis suggest that there are insufficient data to support a clinically significant difference in morbidity and mor...
Source: Transfusion Medicine Reviews - June 17, 2018 Category: Hematology Authors: Bryon Jackson, Ross Fasano, John Roback Source Type: research
Quality of Evidence-Based Guidelines for Transfusion of Red Blood Cells and Plasma: A Systematic Review
Many transfusion guidelines are available, but little appraisal of their quality has been undertaken. The quality of guidelines may potentially influence adoption. Our aim was to determine the quality of evidence-based transfusion guidelines (EBG) for red cells and plasma, using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and assess duplication and consistency of recommendations. MEDLINE and EMBASE were systematically searched for EBG from 2005 to June 3, 2016. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - June 1, 2018 Category: Hematology Authors: Katerina Pavenski, S. Stanworth, M. Fung, E.M. Wood, J. Pink, M.F. Murphy, H. Hume, S. Nahirniak, K.E. Webert, S. Tanael, D. Landry, N. Shehata, for the International Collaboration for Transfusion Medicine Guidelines (ICTMG) Source Type: research
Adverse Events Associated with Infusion of Hematopoietic Stem Cell Products: A Prospective and Multicenter Surveillance Study
Adverse events (AEs) associated with blood transfusions, including component-specific red cell, platelet, and plasma products, have been extensively surveyed. In contrast, surveillance of AEs associated with hematopoietic stem cell (HSC) products in HSC transplantation (HSCT) has been less rigorous, even though HSC products include a diversity of immature and mature hematopoietic cells, substantial plasma, and dimethyl sulfoxide (DMSO) in the case of cryopreserved HSC products. HSC infusion-related AEs have been attributed to DMSO toxicity, but AEs associated with the infusion of non-cryopreserved HSC products are not unco...
Source: Transfusion Medicine Reviews - June 1, 2018 Category: Hematology Authors: Kazuhiko Ikeda, Hitoshi Ohto, Yoshiki Okuyama, Minami Yamada-Fujiwara, Heiwa Kanamori, Shin-ichiro Fujiwara, Kazuo Muroi, Takehiko Mori, Kinuyo Kasama, Tohru Iseki, Tokiko Nagamura-Inoue, Nobuharu Fujii, Takashi Ashida, Kazuaki Kameda, Junya Kanda, Asao H Source Type: research
Transfusion Management of Obstetric Hemorrhage
Obstetric hemorrhage is one of the leading, as well as one of the most treatable, causes of maternal morbidity and mortality worldwide. As obstetric hemorrhage often occurs in patients without risk factors, there is virtually unanimous agreement from obstetric professional societies to establish obstetric hemorrhage protocols in anticipation of these emergencies. These protocols involve multidisciplinary teams in which the transfusion service plays an essential and vital role. This manuscript will examine the epidemiology of obstetric hemorrhage, risk factors that may be present, and recommendations for these protocols, wi...
Source: Transfusion Medicine Reviews - May 31, 2018 Category: Hematology Authors: Kerry L. O'Brien, Scott A. Shainker, Evelyn L. Lockhart Source Type: research
Journal Club
Changes in hemoglobin profile reflect autologous blood transfusion misuse in sports. Lamberti N, Finotti A, Gasparello J, et al. Intern Emerg Med. 2018; [Epub ahead of print]. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - May 29, 2018 Category: Hematology Authors: Richard Haspel, Johnathan Mack, Simon Stanworth Source Type: research
Acquired Antibodies to αIIbβ3 in Glanzmann Thrombasthenia: From Transfusion and Pregnancy to Bone Marrow Transplants and beyond
Patients with the inherited bleeding disorder Glanzmann thrombasthenia (GT) possess platelets that lack αIIbβ3 integrin, fail to aggregate, and have moderate to severe mucocutaneous bleeding. Many become refractory to platelet transfusions due to the formation of iso-antibodies to αIIbβ3 with the rapid elimination of donor platelets and/or a block of function. Epitope characterization has shown is o-antibodies to be polyclonal and to recognize different epitopes on the integrin with β3 a major site and αvβ3 on endothelial and vascular cells a newly recognized target. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - May 22, 2018 Category: Hematology Authors: Alan T Nurden Source Type: research
Platelet Storage Lesions: What More Do We Know Now?
Platelet concentrate (PC) transfusions are a lifesaving adjunct to control and prevent bleeding in cancer, hematologic, surgical, and trauma patients. Platelet concentrate availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. Platelet storage lesions are a series of biochemical, structural, and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - April 16, 2018 Category: Hematology Authors: Monica Suet Ying Ng, John-Paul Tung, John Francis Fraser Source Type: research
Platelet storage lesions: What more do we know now?
Platelet concentrate (PC) transfusions are a life-saving adjunct to control and prevent bleeding in cancer, haematological, surgical and trauma patients. PC availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. PSLs are a series of biochemical, structural and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage. (Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - April 16, 2018 Category: Hematology Authors: Monica Suet Ying Ng, John-Paul Tung, John Francis Fraser Source Type: research
Editorial Board
(Source: Transfusion Medicine Reviews)
Source: Transfusion Medicine Reviews - April 1, 2018 Category: Hematology Source Type: research
