A multidisciplinary "think tank": the top 10 clinical trial opportunities in transfusion medicine from the National Heart, Lung, and Blood Institute-sponsored 2009 state-of-the-science symposium.
A multidisciplinary "think tank": the top 10 clinical trial opportunities in transfusion medicine from the National Heart, Lung, and Blood Institute-sponsored 2009 state-of-the-science symposium.
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DOI：
10.1111/j.1537-2995.2010.02898.x
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发表时间：
2011-04
期刊：
影响因子：
2.9
通讯作者：
State-of-the Science Symposium Transfusion Medicine Committee
中科院分区：
文献类型：
--
作者：
Josephson CD;Glynn SA;Kleinman SH;Blajchman MA;State-of-the Science Symposium Transfusion Medicine Committee
In September 2009, the National, Heart, Lung, and Blood Institute (NHLBI) convened a State of the Science Symposium in Transfusion Medicine to identify phase II/III clinical trials that would provide important information to advance transfusion medicine. Seven multidisciplinary Subcommittees developed proposals in the following areas: a) platelet product use, b) neonatal/pediatric transfusion practice, c) surgical transfusion practice, d) intensive care unit (ICU) and/or in trauma transfusion practice, e) plasma/cryoprecipitate product use, and therapeutic apheresis practice, f) red blood cell (RBC) product use/blood conservation management, and g) medical transfusion practice or blood donor studies. The committees consisted of transfusion medicine specialists, hematologists, cardiovascular surgeons, anesthesiologists, neonatologists, critical care physicians, and clinical trial methodologists. Proposals were presented and an External Panel evaluated and prioritized each concept for scientific merit, clinical importance, and feasibility. 24 concepts were presented by the Subcommittees. Ten concepts addressed four areas deemed most important: 1) platelet transfusion strategies to prevent/mitigate bleeding in neonates and patients with hematologic malignancies, 2) RBC transfusion trigger strategies to improve overall outcomes in different patient populations, 3) evaluation of optimal plasma:platelet:RBC ratios in trauma resuscitation , and 4) pathogen inactivation of platelets to improve platelet transfusion safety. Conclusions: The proposal themes not only represent inquiries about the indications for transfusion, but also epitomize the lack of consensus when clinical practice lacks a strong evidence base. Ultimately, the purpose of this publication is to provide a “blueprint” of ideas for further development rather than endorse any one specific clinical trial design.
