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Transfusion 2024: What did we learn and where will we be?

Dr Nicholas Watkins
Assistant Director - Research & Development, NHSBT

Over the past 20 years the fundamentals of transfusion medicine have not significantly changed – volunteer donors continue to provide donations which save patient lives.  However, since 2000, the use of blood has fallen by 30% due to changes in clinical practice.  This reduction in use has been delivered by a concerted effort by transfusion experts and blood use is forecast to continue to fall.

So what will Transfusion Medicine look like in 2024?  One thing that was made abundantly clear at the Transfusion 2024 conference, held by NHS Blood and Transplant and NHS England, was the challenges hospitals face in attracting, training and retaining transfusion laboratory staff.  

Many Transfusion Laboratory Managers are seeing their most experienced colleagues retiring and with these retirements’ specialist know-how is being lost.  Steps are being taken to replace this expertise by NHS England through the training of the next generation of Consultant Clinical and BioMedical Scientists.  However, replacing decades of experience will take time.

Can Innovation and Technology relieve some of these pressures?  Undoubtedly the answer is yes.

Led by Genomics England, the application of genomics is transforming healthcare.  Improvements in the supply of blood and providing a better match to patients will be achieved by more extensive use of DNA-based donor and patient testing.  Technologies being used in research laboratories today to determine a donors’ complete blood group will transition into clinical use in blood services.  These could pave the way for electronic cross-matches, reducing the need for pre-transfusion testing.

When a patient requires a platelet transfusion, because of the different blood groups and processing methods, there are a staggering 128 different types to choose from.  NHSBT has to be able to maintain a supply of each one of these 128 different types.  In many cases the choice of which one to transfuse is based on clinical requirements (e.g. blood group), however, there are opportunities to reduce the complexity.  For example, moving to either 0% or 100% irradiated platelets would half the different types of platelets.  This move towards less complex and more “universal” blood components will make transfusion medicine more efficient and reduce overall cost to the NHS. 

We now live in a data-rich world where data relating to transfusion medicine requires a fundamentally different analytical approach.  Electronic donor and patient records are key to improving transfusion medicine through a big data approach.  Insights into how best to deliver transfusion medicine will be made by combining large, complex and unstructured datasets and analysing them with artificial intelligence and machine learning.

Delivery of Transfusion Medicine in 2024 will be different to how it is performed today and the conference helped set the ground work for the next 5-year strategy.  As Bill Gates once said: “We always over-estimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let yourself be lulled into inaction.” 

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21 Feb 2020
3:52 am