25 June 2026 (Thursday) - Transfusion Evidence Library

The nice people at the Transfusion Evidence Library sent their update today. A couple of articles caught my eye…

The use of blood transfusions in trauma cases before hospital admission didn’t seem to have much of an effect on final outcome… I suppose that if someone is in such desperate need of a transfusion that we can skip all of the safety protocols they aren’t going to be likely to survive the trauma.

But what really made me think was the article about the transportation and large-scale long-distance airdrops of blood. These days we document every single thing that every happens to a unit of blood. Back in the day things weren’t quite so tight… it would seem that things weren’t as bad then as we’ve now been led to believe…

ARTICLE OF THE MONTH

Prehospital resuscitation with type O whole blood for trauma and hemorrhage.
Sperry, J.L., et al. (2026). The New England Journal of Medicine.
PICO SUMMARY

 

 

TOP ARTICLES

Early erythropoiesis-stimulating agents in preterm or low-birthweight infants.
Anarna, K., et al. (2026). The Cochrane Database of Systematic Reviews.

Clinical outcomes of intravenous albumin administration after acute variceal hemorrhage in patients with cirrhosis: an open-label, randomized controlled trial.
Biswas, S., et al. (2026). Digestive Diseases and Sciences.

Platelet transfusion thresholds for thrombocytopenic infants.
Chotas, W., et al. (2026). The Cochrane Database of Systematic Reviews.

A prospective, randomized, multicenter trial comparing lactated Ringer's alone or with 5% albumin for resuscitation of large burns The Acute Burn ResUscitation Multicenter Prospective Trial 2 (ABRUPT2).
Greenhalgh, D.G., et al. (2026). Annals of Surgery. [Record in progress].

The clinical use of cryoprecipitate and fibrinogen concentrate: a scoping review.
Hess, A.S., et al. (2026). Transfusion. [Record in progress].

Convalescent plasma for people with COVID-19.
Iannizzi, C., et al. (2026). The Cochrane Database of Systematic Reviews.

Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding.
Kvisselgaard, A.D., et al. (2026). The Cochrane Database of Systematic Reviews.

A study on the impact of blood large-scale long-distance airdrop on storage quality of suspended red blood cells.
Liu, L., et al. (2026). Transfusion. [Record in progress].

Efficacy and safety of albumin combined with endovascular therapy in the treatment of patients with acute ischemic stroke: a randomized clinical trial.
Liu, Y., et al. (2026). Nature Communications.

Approaches to guide red blood cell transfusion in patients with subarachnoid hemorrhage: a systematic review and meta-analysis.
Pinedo-Avila, J.B., et al. (2026). Journal of Intensive Care Medicine. [Record in progress].

Impact of Rh five-antigen-matched transfusion on alloimmunization and clinical outcomes in patients requiring repeated red blood cell transfusions: a prospective randomized controlled study.
Xie, X., et al. (2026). Frontiers in Medicine.

Prophylactic tranexamic acid for the prevention of postpartum haemorrhage in women with placenta praevia: multicentre, double blind, randomised, placebo controlled, phase 3 trial.
Zhang, L., et al. (2026). BMJ.

24 June 2026 (Wednesday) - Some Training

I had some formal training today. Like buses, nothing for ages and then two loads come at once.

This morning with an IT specialist learning about the new blood transfusion system which is coming. It looks to be rather good compared with that which I’ve used before.

And this afternoon with a product specialist learning about apixaban and rivaroxaban and anti-Xa assays.

 

I learned a lot, but I will make the observation that back in the day these reps used to come with loads of goodies, a free lunch and cake…

 

21 June 2026 (Sunday) - Still Waiting

Here’s food for thought – During my first week in this job I spend a day in each of the various laboratories. One of my most vivid memories was from Friday 18 September 1981 when the chief in the microbiology laboratory went off on a major rant about how the science of blood transfusion was dead. Apparently there were dogs in Japan being kept alive on cell-free haemoglobin-based oxygen carriers, and this chap was adamant that they would be used in humans in only a few short months, and the traditional hospital blood bank would be gone.

There was a *lot* of inter-departmental animosity (outright hatred) at the now-demolished Royal East Sussex Hospital, and the subject of artificial blood was never far from anyone’s lips back then.

Forty-five years later and the stuff still hasn’t delivered…

 

20 June 2026 (Saturday) - End of an Era?

I’ve not written anything here for two weeks – I’ve been on holiday. And whilst I wasn’t looking one of my major sources of CPD has gone belly-up.

Every so often there would be a work-related post appearing on the Lablogatory blog which I could sometimes use here on my personal continuing professional development. Naively I always thought the site was created by volunteers. It turns out that those producing material for the site were being paid to do so, and the money has dried up. My CPD blog is open to all, and a surprising amount of people seem to refer to it. Am I wrong in providing this for free? Personally I don’t think so.

2 June 2026 (Tuesday) - Fritsma Factor Newsletter

 The nice people at the Fritsma Factor sent their update today. This time there’s quite a bit of stuff which went over my head. Perhaps it shouldn’t… which is why I do CPD…

2 June 2026 (Tuesday) - BTLP-TACT Exercise

I’m always getting prompts to do more BTLP-TACT exercises, I’ve walked the dogs, and it is raining outside anyway…
 
I was given two cases:
 

33586 – a thirty-year-old woman with appendicitis needing group and save.

She grouped as O Rh(D) Positive with a negative antibody screen.

 

15253 – an eight-one-year-old woman needing four units of blood for a pancreatectomy.

She grouped as B Rh(D) Positive with an antibody screen positive in cells 2 & 3.

I performed antibody panels.

The enzyme and IAT panels were positive in cells 1, 3, 4, 6 & 7 corresponding with anti Jk(a) but not excluding anti-Cw.

I scared up four units of various compatible ABO and RH groups that were Jk(a) Negative

 
I got it wrong…
Anti-Cw *could* have been excluded from the screening panel. Dur !!! 
But if that was the only hiccup I’m content. Better to err on the side of caution, eh?

1 June 2026 (Monday) - VEXAS Syndrome

I saw a diagnosis today: VEXAS syndrome. A new one on me – it is an adult-onset, severe autoinflammatory and blood disorder caused by a random, acquired mutation in the UBA1 gene. It primarily affects men over fifty. The name is an acronym outlining its core characteristics:

 

·  Vacuoles in bone marrow cells

·  E1 enzyme malfunction

·  X-linked genetic origin

·  Autoinflammation (immune system attacking healthy tissue)

·  Somatic mutation (not inherited)

 

Here’s a link about it.