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Background and Objectives: Debate exists surrounding the optimal duration of red blood cell (RBC) storage. A hypothesis emerging from previous research suggests that exposure to fresh blood may be harmful to patients undergoing cardiac surgery. This study uses a large transfusion medicine database to explore the association between in‐hospital mortality and red cell storage duration. Materials and Methods: This is an exploratory retrospective cohort study of all adult patients at Hamilton, Canada, over a 14‐year period that received at least one allogeneic red cell transfusion during their hospitalization for cardiac surgery requiring bypass. The primary outcome for the study was in‐hospital death. Analysis was performed using multivariate Cox regression modelling with time‐dependent and time‐independent covariates and stratification variables. Five models with varying definitions for short, intermediate and prolonged duration of RBC storage were tested. Results: From March 2004 to December 2017, 11,205 patients met the inclusion criteria and were included in the regression analyses. No significant effect of short‐duration red storage on patient mortality was observed in all statistical models, with the red cells stored for the longest duration as the reference group. When patients who received exclusively fresh (hazard ratio [HR] 1.040, 95% confidence interval [CI] 0.588–1.841, p‐value = 0.893) and older aged (HR 1.038, 95% CI 0.769–1.1.402, p‐value = 0.0801) RBCs were compared with those who received exclusively mid‐age red cells as the reference, statistical significance was similarly not reached. Conclusion: Red cells stored for the shortest duration are not associated with increased risk of mortality among cardiac surgery patients. [ABSTRACT FROM AUTHOR]

Background Methods and Discussion Conclusion Health data comprise data from different aspects of healthcare including administrative, digital health, and research‐oriented data. Together, health data contribute to and inform healthcare operations, patient care, and research. Integrating artificial intelligence (AI) into healthcare requires understanding these data infrastructures and addressing challenges such as data availability, privacy, and governance. Federated learning (FL), a decentralized AI training approach, addresses these challenges by allowing models to learn from diverse datasets without data leaving its source, thus ensuring privacy and security are maintained. This report introduces FL and discusses its potential in transfusion medicine and blood supply chain management.FL can offer significant benefits in transfusion medicine by enhancing predictive analytics, personalized medicine, and operational efficiency. Predictive models trained on diverse datasets by FL can improve accuracy in forecasting blood transfusion demands. Personalized treatment plans can be refined by aggregating patient data from multiple institutions using FL, reducing adverse reactions and improving outcomes. Operational efficiency can also be achieved through precise demand forecasting and optimized logistics. Despite its advantages, FL faces challenges such as data standardization, governance, and bias. Harmonizing diverse data sources and ensuring fair, unbiased models require advanced analytical solutions. Robust IT infrastructure and specialized expertise are needed for successful FL implementation.FL represents a transformative approach to AI development in healthcare, particularly in transfusion medicine. By leveraging diverse datasets while maintaining data privacy, FL has the potential to enhance predictions, support personalized treatments, and optimize resource management, ultimately improving patient care and healthcare efficiency. [ABSTRACT FROM AUTHOR]

The transfusion chain is susceptible to error at every step. Accurate patient registration is a key first step that links a patient with their historical medical profile, yet patient registration is marked by its own challenges. Registration errors are deviations from standard operating procedures that occur during the process of patient registration. A frequent consequence of registration errors is the obfuscation of historical information and patient misidentification. Through duplicate registrations, patient information can be spread across multiple records and through hybrid registrations information from multiple patients can be combined into a single record. Patients with the same core identifiers, and the misuse of health insurance information also pose a threat to accurate registration. In the context of transfusion, this can lead to ABO discrepancies, failing to match for previously identified alloantibodies, and redundant serological investigations. Other consequences include missed billing opportunities and the inadvertent sharing of medical information. Reducing the occurrence of registration errors can be achieved through a multifaceted approach combining targeted educational efforts with technological improvements to the registration system. A recent development being the use of biometric identifiers. Despite their frequency, published reports on the occurrence and underlying cause of registration errors are rare. Most reports are found within articles on general medical errors or misidentification events and consequently, the true rate of registration errors among health information systems is not known. Here we summarize literature pertaining to how and why registration errors occur and their implications in the context of blood transfusion. • There are three types of registration errors: Duplicate, hybrid and Doppelgängers. • Impacts of transfusion safety: ABO errors and failure to match for other antibodies. • Strategies to improve accuracy of registration have been implemented effectively. [ABSTRACT FROM AUTHOR]

The impact of donor characteristics, red cell age, and red cell processing methods on recipient outcomes is an emerging area of research. Knowledge generated from exploring this transfusion continuum has the potential to change the way donors are selected and how donations are processed and stored with important clinical and operational impact. Recently, donor characteristics including age, gender, donation frequency, genetics, and ethnicity have been shown to affect product quality and possibly recipient outcomes. The structural, biochemical and immunological changes that occur with red cell storage appear to not cause harm to blood recipients after 14 randomized clinical trials. However, both in vitro and clinical data are now beginning to question the safety of blood stored for a shorter duration. Whole blood filtration, a method of blood processing, has been linked to inferior recipient outcomes when compared to red cell filtration. Collectively, this emerging body of literature suggests that pre-transfusion parameters impact product quality and recipient outcomes and that no 2 units of red cells are quite the same. This review will summarize both the pre-clinical and clinical studies evaluating these associations. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented concerning the implementation of an electronic reporting system for transfusion reactions that led to a sustained and significant increase in reporting at a tertiary care hospital with high transfusion activity.

Canadian Blood Services (CBS), Canada’s national blood transfusion service, has for many years sponsored an annual conference, for the education and awareness of interested participants, showcasing the latest evidence-based understanding of both basic science and clinical issues in transfusion medicine and science. The 15th iteration of this symposium took place September 9, 2017 and focused on some of the vital aspects of red blood cells (RBC), in line with the” 3Rs” concept, namely the provision of the Right red blood cell (RBC) product to the Right patient at the Right time. Presentations touched upon: the evolution of blood banking in North America; the monocyte monolayer assay as a predictor of post-transfusion hemolysis; hemoglobin-based oxygen carriers; RBC alloimmunization; serological approaches to complex RBC antibody problems; randomized clinical trials related to the age of stored RBC; RBC genotyping; pathophysiology, prevention and treatment of hemolytic disease of the fetus and newborn (HDFN); and testing and timing in perinatal serology. This commentary provides summaries of all speakers’ presentations annotated with relevant references. Special thanks are due to all contributors for their praiseworthy approaches in sharing their experiences and knowledge on this interesting scientific/clinical and management theme. [ABSTRACT FROM AUTHOR]