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Toward a patient-based paradigm for blood transfusion

Authors Farrugia A, Vamvakas E

Received 11 October 2013

Accepted for publication 23 December 2013

Published 31 January 2014 Volume 2014:5 Pages 5—13

DOI https://doi.org/10.2147/JBM.S55769

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4


Video abstract presented by Albert Farrugia.

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Albert Farrugia,1,2 Eleftherios Vamvakas3

1College of Medicine, Biology and Environment, Australian National University, Acton, ACT, Australia; 2Centre for Orthopaedic Research, Department of Surgery, Faculty of Medicine and Surgery, University of Western Australia, Perth, WA, Australia; 3Cedars-Sinai Medical Center, Los Angeles, CA, USA

Abstract: The current "manufacturing paradigm" of transfusion practice has detached transfusion from the clinical environment. As an example, fresh whole blood in large-volume hemorrhage may be superior to whole blood reconstituted from multiple components. Multicomponent apheresis can overcome logistical difficulties in matching patient needs with fresh component availability and can deliver the benefits of fresh whole blood. Because of the different transfusion needs of patients in emerging economies and the vulnerability of these blood systems to emerging infections, fresh whole blood and multicomponent apheresis can better meet patient needs when compared with transplants of the "manufacturing paradigm". We propose that patient blood management, along with panels of repeat, paid, accredited apheresis and fresh whole-blood donors can be used in emerging economies to support decentralized blood services. This alternative transfusion–medicine paradigm could eventually also be adopted by established economies to focus transfusion medicine on local patient needs and to alleviate the problem of the aging volunteer donor base.

Keywords: indications, emerging countries, patient blood management

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