Academy
Advances in Transfusion Medicine 2024
Josephine McCullagh
Barts Health NHS Trust and NHS Blood and Transplant, United Kingdom
Elizabeth Hutchinson
NHSBT, United Kingdom
Alison Muir
Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom
The Royal College of Pathologists (RCPath) and Serious Hazards of Transfusion (SHOT) hosted the virtual Advances in Transfusion Medicine Symposium on November 20–21, 2024 with co-badging by the International Society of Blood Transfusion (ISBT). Around 400 attendees on each day from more than 30 countries joined this two-day event, which addressed contemporary challenges and innovations in transfusion medicine through a dynamic and interdisciplinary program.
Clinical challenges and evidence-based practice in transfusion Medicine were the themes of the symposiums first day. NHSBT Medical Director for Transfusion Lise Estcourt opened the symposium with an exploration of shifting transfusion patterns and the challenges posed by increasing demand for blood from an aging population. She detailed advancements in patient blood management (PBM), including early anaemia detection, restrictive transfusion thresholds, and enhanced donor recruitment strategies.
Screenshot from the Pathology Portal
Katie Hands, associate medical director of the Scottish blood transfusion service addressed the large volumes of red blood cells and platelets being transfused to patients with haematological conditions. She reviewed recent trials like RED and RBC Enhance and emphasised the importance of further research required to evaluate the optimum strategies for managing patients with myelodysplastic syndrome (MDS), ensuring quality of life in this patient group. Consultant anaesthetist Samantha Warnakulasuriya highlighted inefficiencies in preoperative care, including untreated anaemia leading to surgery cancellations. Strategies such as tranexamic acid (TXA) and preoperative iron therapy were discussed as solutions to bridge gaps between national guidelines and local practices. Sue Robinson, consultant haematologist concluded the talks on clinical challenges by recounting the significant impact of a June cyberattack on transfusion operations, emphasising the importance of robust contingency planning and interdisciplinary collaboration during crises.
In the evidence-based transfusion section, Sue Pavord, haematology consultant at Oxford University Hospitals discussed PBM in obstetric patients. She highlighted the importance of correcting iron deficiency in pregnancy and shared helpful hints for getting the most efficacy with oral iron supplementation and in management of major obstetric haemorrhage as well as highlighting the utility of an obstetric transfusion committee. Professor Laura Green, consultant haematologist at Barts Health Trust, London spoke about transfusion in Trauma. She advised on; mechanisms of trauma induced coagulopathy, trials which have guided practice and how these have been applied and the need for better tools to assess coagulopathy in trauma patients. Anne Kelly, consultant haematologist at Great Ormond Steet Hospital, London outlined the nuances in paediatric transfusion, in grouping, prescribing and administering. She discussed the difficulties in formulating consensus guidelines given initial evidence was sparse or extrapolated from adult studies and the resources used to try and answer outstanding questions.
Within educational resources, Jill Caulfield, NHSBT Educational development lead for Transfusion 2024, has developed the transfusion hub, aimed at supporting transfusion laboratory staff in response to demand for this, having now received over 20,000 website views. Haematology Registrar Sarah Wheeldon presented the Pathology Portal, developed after a need for more training in transfusion in medics and clinical scientists was recognised and continues to build on progress. Stephen Hibbs, Haematology Registrar informed us about sustainability development in transfusion and on the carbon footprint of a blood transfusion (7.45kg Co2 Or equivalent to 100 covid tests!) from collection to administration.
Day 2 kicked off with discussions about transfusion safety. Vivienne Parry OBE, Science writer, broadcaster and facilitator, brought perspective from her experience personally and professionally and suggested improvement by mobilising the patients may be the way forward. Su Brailsford Consultant in Epidemiology and Health Protection, NHSBT delivered some important learning points from the infected blood inquiry, focusing in on a few of the reports 12 recommendations; education, preventing future harm, safety in transfusion, finding the undiagnosed and giving patients a voice. She also discussed implementation and organisations involved in actioning the report’s recommendations.
The Medical Director of SHOT, Shruthi Narayan took us on a journey through hemovigilance, an area previously focused on recipients but now exploring donor aspects too. She discussed her ‘moonshots’ or aspirations for hemovigilance moving forward, previous successes and learning points for the future, including collaborative leadership and personalised healthcare.
Professor Mike Makris presented on innovative treatments for haemophilia management, discussing new therapies for bleeding prevention and risk reduction. The RCPath Cameron Lecture (RCPath Cameron Lecture 2024) was given by Farrukh Shah MBE who provided an update on advances in haemoglobinopathy treatments including the curative options of haplo-identical transplantation and gene therapies as well as new therapeutic agents such as Mitapivat. She concluded with a summary of the challenges facing patients on disease modifying therapies.
‘Looking forward’ was the theme of the afternoon session. NBTC Chair Professor Toh gave a summary of the Transfusion 2024 strategy with recent recommendations from the Infected Blood Inquiry, outlining key priorities needed for long-term transfusion transformation. Creating a sustainable transfusion workforce was the topic for both Jennifer Rock and Joanna Andrews. As Transfusion 2024 Education Lead, Jennifer discussed the development of the national Transfusion Practitioner Framework and how this will provide essential support to the TP profession while IBMS President, Joanna Andrews highlighted the work needed to address current laboratory workforce challenges as outlined in the IBMS Long Term BMS Workforce plan. The final 2 talks of the day were focused on data driven transfusion practice. Gustaf Edgren from the Karolinska Institute highlighted the work of the SCANDAT database and using data to improve donor and recipient safety while Professor Simon Stanworth discussed the need for better linkage between data repositories and more robust data collection for meaningful transfusion research.
The Advances in Transfusion Medicine Symposium 2024 showcased the dynamic and multifaceted landscape of transfusion medicine. Over two days, experts shared critical insights into clinical challenges, evidence-based practices, and innovative strategies. From addressing the complexities of blood shortages and advancing patient blood management to exploring groundbreaking therapies in haemophilia and haemoglobinopathies, the symposium highlighted the importance of collaboration and continuous innovation.
