Clinical Transfusion Research
The current research focus of the Clinical Transfusion Research Group is on:
- iron (either iron depletion in donors as well as primary or secondary iron overload in patients).
- optimal red blood cell transfusion.
Iron is an essential nutrient for the human body. Lack of iron will cause anemia, which may result in red blood transfusion. Conversely, high amounts of iron (either primary of secondary due to blood transfusion) will cause harm as well. Nowadays iron depletion in donors has been recognized as a frequent side effect of whole blood donation. Research on this topic is mandatory for blood bank decision making both for safety of the donor and effectiveness of blood collection, since the most common reason for deferral is low hemoglobin.
In patients, iron overload may ultimately cause liver and heart failure besides other symptoms. Treatment and/or prevention of iron overload is essential for well-being of patients and to reduce or prevent its side effects. Primary iron overload will be mainly caused by hemochromatosis, a hereditary disease caused by a genetic defect in the hepcidin pathway. Apart from phlebotomies, these patients can also be effectively treated with erythrocytapheresis, as has been investigated in a randomized manner by Sanquin.
Frequent red blood transfusion will also lead to (secondary) iron overload. Although this serious side effect of blood transfusion is known by most clinicians, monitoring and treatment of secondary iron overload can be greatly improved, first by investigating whether a red blood cell transfusion is really needed (patient blood management) and secondly to improve guidelines of monitoring and treatment of iron overload. Next to effects of iron overload after frequent transfusions, iron may also has effect shortly after red blood cell transfusion (non-transferrin bound iron: NTBI) due to the so called “storage lesion” caused by a rapid and considerable loss of donor erythrocytes from the circulation. Whether NTBI has detrimental effects in this setting has still to be determined.
- PPOC (internal funding in competition), various projects