Regional
AABB’s Global Mission: Advancing Blood and Biotherapies
Kendra Y. Mims
AABB, Maryland, USA
Claudia S. Cohn
University of Minnesota, Minneapolis
Meghan Delaney
Children’s National Hospital, Washington, DC, USA.
The field of transfusion medicine is rapidly evolving, driven by emerging therapies and technological advancements that are transforming patient care and transfusion practices. To that end, the Association for the Advancement of Blood and Biotherapies (AABB) is committed to improving lives by making transfusion medicine and biotherapies safe, available and effective worldwide. To support this mission, AABB develops clinical guidelines and rigorous standards that advance transfusion medicine and biotherapies practices and help ensure a high-quality, reliable blood supply for all patients in need.
The following highlights the Association’s recent global contributions and ongoing efforts to promote blood safety throughout the world.
Advancing Transfusion Safety in Novel Settings
To meet the growing demand for blood transfusion administered in pre-hospital or out-of-hospital settings, AABB released the inaugural edition of Standards for Emergency Prehospital and Scheduled Out-of-Hospital Transfusions (EPSOHT Standards) in July 2025. This edition incorporates new prehospital concepts while updating the guidance previously outlined in the 2018 Standards for Out-of-Hospital Transfusion Administration Services.
Notable changes include the division of Chapter 5, “Process Control,” into two sections, one for prehospital activities, and one for out-of-hospital activities. Key new standards include: • Standard 5.8.2.1: Requires programs performing out-of-hospital activities to ensure that patients maintain their patient identification attached through the transfusion • Standard 5.4.4: Mandates that out-of-hospital programs have two determinations of the recipient’s ABO group. Audra L. Taylor, MS, SBB(ASCP), Chair of the AABB Prehospital and Out-of-Hospital Standards Committee, emphasized the importance of the work in the preface:
“AABB’s engagement with members over the past few years has under- scored an essential truth: collaboration and commitment can have a profound impact on patient care and outcomes. This edition symbolizes the development of standards designed to meet the unique challenges and demands of the prehospital and out-of-hospital settings.”1
Advancements for Optimal Transfusion Strategies
AABB, in collaboration with the International Collaboration for Transfusion Medicine Guidelines (ICTMG), recently developed new platelet transfusion guidelines to support the implementation of restrictive platelet transfusion strategies. Published in JAMA, these guidelines offer recommendations for transfusion based on specific patient criteria and reframe transfusion practices in adult and pediatric settings where platelet transfusions are commonly performed.
The guidelines were based on data from 21 randomized controlled trials and 13 observational studies, all comparing transfusion strategies using restrictive or liberal amounts of platelets.
The findings demonstrated that restrictive strategies reduce risk of transfusion-related adverse reactions, mitigate platelet shortages and lower costs without increasing risk of mortality or bleeding in most patient populations. The authors concluded, “it is good practice to consider overall clinical context and alternative therapies in the decision to perform platelet transfusion.”2
Mitigating Adverse Events
Each year, more than 3 million new cases of acute myocardial infarction (AMI) occur, with approximately 1 million deaths in the United States.3 In response to this significant burden, AABB convened an international panel of experts to provide evidence-based recommendations for red blood cell (RBC) transfusion in patients with AMI.
The expert panel’s recommendations were based on a review of four clinical trials involving 4,311 patients, a Cochrane meta-analysis and the use of GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to summarize evidence and formulate recommendations. Based on the data, the panel suggests a liberal red cell transfusion strategy for hospitalized patients with AMI when the hemoglobin concentration is less than 10 g/dL (conditional recommendation, low-certainty evidence).
The findings showed that 30-day mortality and the risk of recurrent myocardial infarction were both numerically lower with a liberal transfusion strategy (hemoglobin <10 g/dL) compared to those following a more stringent approach, but the results were not statistically significant (risk differences, 1.2% and 0.9%). However, patients receiving liberal transfusions experienced significantly higher risk of serious adverse events, including anaphylaxis, transfusion-related lung injury, and circulatory overload (risk difference, 1.4%).3
The authors emphasize that clinicians should implement mitigation strategies to reduce potential adverse events associated with a liberal transfusion approach. Moreover, all transfusion decisions should be based on the overall clinical context rather than relying solely on hemoglobin concentration.
Transforming Patient Care
The AABB biotherapies community plays a vital role in transforming patient care by establishing standards and accreditations for facilities that procure, process, store and/or distribute cellular therapy products. Building on this blueprint, AABB has launched the first edition of the Cell and Gene Therapy Standards for Pharmacy to establish quality systems for pharmacies who dispense approved cell and gene therapy (CGT) products. Developed through collaboration among academic and key biotherapies and pharmacy stakeholders and drawing on AABB’s extensive expertise in quality system development, AABB’s CGT Standards will provide guidance to pharmacies in the receipt, storage, handling and dispensing of these advanced therapies. The program aims to enhance patient safety by addressing a critical gap in accreditation, while also safeguarding product integrity and mitigating business risks. In conclusion, AABB’s priority is to develop evidence-based guidelines, standards and resources that advance donor safety and promote optimal patient care in transfusion medicine and biotherapies. As a global organization with members in more than 80 countries, AABB remains steadfast in its commitment to champion clinical practices that improve health outcomes worldwide. Looking ahead, AABB will continue to enhance quality and safety across the field and drive progress throughout the blood and biotherapies community.
References
1.Association for the Advancement of Blood & Biotherapies. Standards for Emergency Prehospital and Scheduled Out‑of‑Hospital Transfusions, 1st ed. Bethesda, MD: AABB; 2025
2. Metcalf RA, Nahirniak S, Guyatt G, et al. Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice Guidelines. JAMA. 2025;334(7):606–617. doi:10.1001/jama.2025.7529
3. Pagano MB, Stanworth SJ, Dennis J, et al. Red cell transfusion in acute myocardial infarction: AABB international clinical practice guidelines. Annals of Internal Medicine, 178(10), 1469–1477. 2025. https://doi.org/10.7326/ANNALS-25-00706
