Child and Transfusion Network pools knowledge on transfusion medicine in children

Much knowledge about how blood transfusions work and are applied is based on research done on adults. But some biological processes work differently for children than for adults. Moreover, they have a body that is still growing. How does that impact the application of blood transfusions?

Elise Huisman works as a pediatric hematologist at the Erasmus University Medical Center Sophia Children's Hospital. Among other things, she treats children with congenital blood diseases or immune reactions against their own blood cells. She is also affiliated with Sanquin as a pediatric hematologist and transfusion specialist. From that position, she recently founded the Child and Transfusion Network

Connect physicians and researchers

"At one point I realized I was the only pediatrician in the Netherlands who specialized in transfusion medicine for children. While there are people making decisions about transfusion for children every day. Think pediatricians, emergency room physicians, surgeons, pediatric anesthesiologists. From my work as a transfusion specialist, I knew some other pediatricians and anesthesiologists who were researching a transfusion topic for children, but not all of them knew each other. That's why I created this network. The goal is to connect physicians and researchers in the field of pediatric transfusion medicine. In this way, knowledge can be shared more easily and the field can develop further. Two pediatric hematologists and a neonatologist are also currently being trained as transfusion specialists. Very nice to take up this project with new people and a fresh perspective in this way."

Although we have a very safe blood supply in the Netherlands, and care is arranged according to strict standards, there are questions surrounding transfusions in children. When is it too much, what can a child do for itself? 

"We as pediatricians naturally apply knowledge gained from scientific research in children, but still much of what we do now remains a copy of what is done in adults. There is still much to learn here. For example, why do we see a transfusion reaction more often in children? And is adult donor blood good enough for very small children who have a clotting system that is still developing? What does that mean for transfusion practice?"

Currently, scientific research is already being done on transfusion medicine in children. For example, in Rotterdam, Leiden and Amsterdam, pediatricians are investigating transfusion problems in neonates or children with sickle cell disease, but the questions are numerous and include much more than just these groups, Huisman said. For example, are the agreed-upon criteria for transfusion right for children? And what do innovations in blood processing mean for recipient children? 

Funding needed

"Gathering knowledge starts with designing and being able to elaborate studies. I hear back from other network participants that it is difficult to get funding for research that focuses on transfusion issues in children. One of the goals of the network is to get clearer about where the knowledge gaps are in this field and where physicians and researchers are already working on a topic. From there, clinical research questions can be embedded in fundamental research done at Sanquin. In that interaction, I believe very strongly."

Huisman hopes to connect not only pediatricians and pediatric hematologists in the network, but also other medical specialists. Basically all doctors who deal with children and transfusion: perinatologists, SEH doctors, pediatric anesthesiologists, and laboratory specialists. "The first ideas are already focusing on research into transfusion medicine questions in very premature children, children with cancer, and children with sickle cell disease. The first step to that is to get all the doctors and researchers involved, united in this network."

Awareness

The Child and Transfusion Network pools knowledge, protocols and key publications about the research field through a website. There is also a newsletter for physicians and symposia are organized. "The dot on the horizon is that several projects will start from this network, maybe one day it will have its own research budget that can be given to projects from the network. Who knows... But awareness is a first step. I am happy to be able to take that from Sanquin and the Sophia Children's Hospital."