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Description:
Over the past decade there has been intense debate regarding potential adverse effects of stored RBC transfusions on clinical outcomes. Some studies, primarily observational, found associations between transfusions of RBCs stored for longer durations and increased morbidity and mortality. However, recent randomized controlled trials do not demonstrate differences in outcomes following transfusions of RBCs stored for short (<7-10 days) vs standard (oldest available compatible blood) periods in several at-risk patient populations. Recent research has also led to new insights into mechanisms underlying deleterious effects of storage hemolysis and other storage-induced RBC damage, including genetic polymorphisms which result in abnormal expression or varying function of RBC proteins. Recent studies also identified roles for RBCs in clot contraction, which imply a new role for RBCs in hemostasis, and suggest that they could be a marker for thromboembolic disease.
Dr. Glynn has focused the NHLBI agenda for transfusion medicine on better understanding the RBC storage lesion and the clinical effect of transfused RBC stored for different periods. She will review recent developments in the field with attention to the results of recently-published randomized clinical trials.
Dr. Spitalnik has a long-standing interest in the pathophysiological consequences of acute RBC clearance, whether the RBCs are antibody coated, malaria infected, or damaged by refrigerated storage. He will describe the real and potential effects of genetically-encoded RBC polymorphisms on the RBC storage lesion and on the consequences of transfusing these storage-damaged cells.
Dr. Weisel will discuss compression of RBCs during clot contraction to comprise a tightly packed array of polyhedra with platelets and fibrin on the outside, forming a tight seal to stem bleeding that may be especially important in venous hemostasis. He will also present findings on prevalence of these polyhedrocytes in thrombi and pulmonary emboli, suggesting that they may also be a marker for thrombosis.