UPMC Physician Resources
DOM Medical Grand Rounds: Red Cell Transfusion
Drs. Janet Lee and Darrell Triulzi each present from the 2016 UPMC Department of Medicine Grand Rounds. Dr. Lee provides a brief introduction on red cell “storage lesion” and surrounding controversy, discusses aged RBC transfusion and the disruption in iron handling and homeostasis, and the disruptions in nitric oxide availability. Dr. Triulzi discusses the red cell storage criteria and reviews some clinical data trials.
Upon completion of this activity, participants should be able to:
- Increase understanding of normal iron homeostasis in humans
- Improve diagnostic skills in identifying intra- and extravascular hemolysis
- Implement evidence-based RBC transfusion guidelines
- Carson, J. L., Guyatt, G., Heddle, N. M., Grossman, B. J., Cohn, C. S., Fung, M. K., Gernsheimer, T., Holcomb, J. B., Kaplan, L. J., Katz, L. M., Peterson, N., Ramsey, G., Rao, S. V., Roback, J. D., Shander, A. & Tobian, A. A. Clinical Practice Guidelines From the AABB: Red Blood Cell Transfusion Thresholds and Storage. JAMA 316, 2025-2035, doi:10.1001/jama.2016.9185 (2016).
- Andrews, N. C. Disorders of iron metabolism. N Engl J Med 341, 1986-1995, doi:10.1056/NEJM199912233412607 (1999).
- Hod, E. A., Brittenham, G. M., Billote, G. B., Francis, R. O., Ginzburg, Y. Z., Hendrickson, J. E., Jhang, J., Schwartz, J., Sharma, S., Sheth, S., Sireci, A. N., Stephens, H. L., Stotler, B. A., Wojczyk, B. S., Zimring, J. C. & Spitalnik, S. L. Transfusion of human volunteers with older, stored red blood cells produces extravascular hemolysis and circulating non-transferrin-bound iron. Blood 118, 6675-6682, doi:10.1182/blood-2011-08-371849 (2011).
- Risbano, M. G., Kanias, T., Triulzi, D., Donadee, C., Barge, S., Badlam, J., Jain, S., Belanger, A. M., Kim-Shapiro, D. B. & Gladwin, M. T. Effects of Aged Stored Autologous Red Blood Cells on Human Endothelial Function. Am J Respir Crit Care Med 192, 1223-1233, doi:10.1164/rccm.201501-0145OC (2015).
- Heddle NM etal. Effect of long term vs short term blood storage on mortality after transfusion. NEJM online Oct 24, 2016. 6.Carson et al . Red Blood Cell Transfusion:2016 Clinical Practice Guidelines from the AABB. JAMA online Oct 12, 2106
Dr. Lee has financial interests with the following proprietary entity or entities producing health care goods or services as indicated below:
- Grant/Research Support: NIH, University of Pittsburgh Vascular Institute
Dr. Triulzi has financial interests with the following proprietary entity or entities producing health care goods or services as indicated below:
- Grant/Reasearch Support: NIH
- Consultant: Fresenius-Kabi
The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1 contact hour.
For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.
ABIM MOC Part 2 Credit
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
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Release Date: 3/13/2017 | Last Modified On: 3/13/2017 | Expires: 3/13/2020