Regional
Advancing multidisciplinary patient blood management: insights from University Malaya Medical Centre
Muhammad Amir Rasyid Ahmad Makmom
University Malaya Medical Centre, Malaysia
Kumaran Krishnan
University Malaya Medical Centre, Malaysia
Mohd Fitry Bin Zainal Abidin
Faculty of Medicine, University Malaya, Malaysia
Shasha binti Khairullah
University Malaya Medical Centre, Malaysia
Christina Lee Lai Ling
University Malaya Medical Centre, Malaysia
On 13 August 2026, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, brought together almost 130 healthcare professionals for a multidisciplinary Patient Blood Management (PBM) Course. Participants represented a broad range of clinical disciplines, including transfusion medicine, anaesthesiology, surgery, clinical haematology, pathology, surgery, emergency medicine and nursing.
From UMMC and healthcare institutions across Malaysia. The programme reflected a central principle of PBM: improving transfusion practice requires collaboration across specialties and throughout the patient journey.
Opening the course, Mohammad Salleh Yahya, Deputy Director of Clinical Services (Medical), UMMC, highlighted blood conservation as an integral component of quality patient care. Keynote speaker Jameela Sathar, Consultant Clinical Haematologist and founding member of Malaysia Society of Patient Blood Management (MyPBM), reinforced this message in her presentation, “Why PBM Matters: Impact on Outcomes, Safety and Cost”. She emphasised the need to move beyond transfusion decisions based primarily on isolated laboratory parameters towards a patient-centred approach incorporating anaemia management, minimisation of blood loss, optimisation of haemostasis and appropriate transfusion strategies.
Participants of the UMMC Patient Blood Management (PBM) course received a copy of the Consensus Statement on Patient Blood Management, published by the Ministry of Health Malaysia.
From evidence to local practice Providing a regional perspective, Christopher King, Senior Consultant Anaesthesiologist at the National University Hospital, Singapore, discussed their local bleeding management algorithm, including calibration of qLabs FIB device, contemporary use of plasma-derived products and coagulation factor concentrates, including targeted administration of fibrinogen, coagulation factors, immunoglobulins and albumin in appropriate clinical settings.
At the institutional level, Christina Lee Lai Ling, Transfusion Medicine Consultant and Chairperson of PBM UMMC, presented findings from UMMC red cell transfusion audits. The audits identified areas where clinical transfusion practice could be further aligned with evidence-based recommendations and established baseline measures for future quality improvement initiatives.
The programme subsequently addressed practical strategies across the core principles of PBM. Prof Ina Ismiarti Shariffuddin, Senior Consultant Anaesthesiologist, discussed preoperative anaemia screening and iron optimisation. Kumaran Krishnan, Transfusion Medicine Specialist and Secretary of PBM UMMC, together with Shasha Khairullah, Consultant Clinical Haematologist and Co-Chairperson of PBM UMMC, examined evidence-based red cell transfusion thresholds, emphasising clinical assessment and individual physiological tolerance rather than reliance on a single haemoglobin value.
A multidisciplinary panel discusses clinical case scenarios, highlighting collaborative approaches to patient blood management.
Minimising blood loss and optimising haemostasis
Blood conservation and haemostatic management were explored from complementary clinical perspectives. Sivakumar Krishnasamy, Senior Consultant Cardiothoracic Surgeon, presented surgical blood-sparing strategies in cardiovascular procedures. Ng Yi De, Consultant Radiologist, discussed interventional radiology approaches for endovascular control of acute haemorrhage, while Wong Gin Leong, Consultant Anaesthesiologist, reviewed intraoperative cell salvage and acute normovolaemic haemodilution.
Nor'azim bin Mohd Yunos, joins the cake-cutting ceremony at the closing of the UMMC PBM course, demonstrating his support for the hospital’s PBM initiatives.
Assoc Mohd Fitry Zainal Abidin, discussed point-of-care viscoelastic testing, including TEG and ROTEM, for goal-directed haemostatic management. Complementing this clinical approach, Hana Shafinaz Jamaluddin, outlined a systematic approach to the assessment and management of patients presenting with bleeding.
Azim, Deputy Director (Surgical), graces the closing ceremony alongside the organising team, reaffirming support for advancing patient blood management at UMMC.
PBM across clinical specialties
A case-based multidisciplinary panel demonstrated how PBM principles can be adapted to diverse clinical scenarios.
In orthopaedic and spine surgery, Mohd Shahnaz Hasan discussed strategies for managing substantial intraoperative blood loss during major spinal procedures. In obstetrics, Vallikkannu Narayanan and Nur Azreen Hussain reviewed multidisciplinary management of postpartum haemorrhage, including haemostatic assessment and timely clinical intervention. Gan Gin Gin and Yap Mei Hoon addressed transfusion decision making in haematooncology and intensive care service, where anaemia, thrombocytopenia and repeated transfusion requirements present distinct challenges. From the emergency medicine perspective, Ganti Sameera discussed damage control resuscitation and rapid transfusion decision making in severe trauma.
Together, these sessions illustrated that PBM cannot be delivered by a single discipline. Effective implementation requires coordinated involvement of clinicians, transfusion services, laboratories, nursing teams and hospital leadership.
Participants attend a lecture on tranexamic acid and perioperative bleeding as part of the UMMC PBM course.
From education to implementation
Participant feedback provided encouraging evidence of the educational value of the programme. From the respondents, the mean evaluation score was 3.76 out of 4 across learning and facilitator domains. Participants particularly valued the multidisciplinary case discussions, practical clinical scenarios, evidence-based updates and opportunities to exchange experiences across specialties.
Respondents reported improved understanding of PBM principles and greater confidence in incorporating PBM practices into daily clinical care. Suggestions for future programmes included allocating additional time for case discussions, providing more practical training in viscoelastic testing interpretation, sharing educational materials and extending the programme to areas such as paediatrics, nephrology and blood supply management.
Closing the course, Nor'azim Mohd Yunos, Deputy Director of Clinical Services (Surgical), UMMC, highlighted the importance of translating education into sustainable clinical practice. For UMMC, the course represents part of a broader effort to embed PBM within routine patient care.
The next phase will require continued multidisciplinary engagement, audit and feedback, locally appropriate clinical pathways and measurable quality indicators. The experience from Kuala Lumpur reinforces a simple but important message: PBM is most effective when it moves beyond individual transfusion decisions and becomes a shared institutional responsibility centred on the patient.
Christopher King from the National University of Singapore delivers a lunchtime talk on platelet function and viscoelastic testing.
References
1. World Health Organization. The urgent need to implement patient blood management: policy brief. Geneva, World Health Organization, 2021.
2. Mueller MM, Van Remoortel H, Meybohm P, Aranko K, Aubron C, Burger R, et al. Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference. JAMA 2019; 321: 983–997.
3. Ministry of Health Malaysia. Consensus statement on patient blood management. Putrajaya, Ministry of Health Malaysia, 2024. Ministry of Health Malaysia
4. Ministry of Health Malaysia. National policy for transfusion medicine services in Malaysia. 2nd ed. Putrajaya, Ministry of Health Malaysia, 2025.
