Osman Berk Usta, Ph.D., an investigator in the CEMS at Massachusetts General Hospital and an associate professor of Surgery at Harvard Medical School, is the senior author of a new study published in PNAS titled Assessment of Stored Red Blood Cells Through Lab-on-a-Chip Technologies for Precision Transfusion Medicine. Ziya Isiksacan, PhD, a research fellow in the Center for Engineering in Medicine and Surgery (CEMS), is the lead author. Ziya Isiks
The goal of the article, which was written in collaboration with a number of international institutes and fields, is to spark discussion and change in the direction of better assessing stored blood.
What question would you say you were researching?
This is a perspective article about problems with the quality of stored red blood cells (RBCs) and the lack of a good assessment before they are given to patients. In particular, we and others propose that stored RBCs are not always safe to transfuse under current procedures because of donor, processing, and time considerations. This is particularly dangerous for fundamentally sick patients, those on chronic transfusion regimens, and surgeries where enormous volumes of RBCs are transfused.
As a result, we have emphasized the importance of quantitatively assessing stored RBCs unit-by-unit prior to transfusion, a significant failure in the age of personalized medicine. In order to first identify a set of key quantitative quality metrics (i.e., a quality index) for stored RBCs, we anticipate that cutting-edge technologies such as -omics and machine learning can be combined over the course of the following ten years. These quality records can then direct lab-on-a-chip stages equipped with novel biosensors to screen put away RBC quality and afterward match the properties of the RBC unit to the necessities of the patient consistently.
What were your discoveries?
The wide range of authors who represent the various stakeholders that will ultimately contribute to the solutions proposed in the perspective article makes this article unique. In particular, we have enrolled specialists from hematology, transfusion medicine, blood storage and biopreservation, – omics, engineering and life sciences, global health, and ethics who represent both academic and industrial perspectives.
By enabling objective assessment of stored RBC units using quality metrics identified by -omics and machine learning, lab-on-a-chip technologies can ensure a more successful transfusion workflow and usher in a new era of precision transfusion medicine. Tending to the potential and difficulties of accuracy bonding medication will work with the proposed merged future by which each put away RBC unit is surveyed preceding transfusion by means of a quality index. This will necessitate the participation of all stakeholders—experts in blood banking, biopreservation, transfusion medicine, -omics, machine learning, bioengineering, ethics, regulation, and ultimately patients—instead of their current isolated efforts in multidisciplinary discussions and collaborations. A step toward this anticipated era of precision in transfusion medicine is this Perspective, in which we have a diverse team of such stakeholders.
What clinical implications are there?
From this point of view, we can see that the workflow we had in mind was designed to make transfusions safer and more effective. As previously mentioned, patients who are critically ill, those who are on long-term transfusion regimens, and surgeries in which large quantities of RBCs are transfused can be particularly affected by a lack of quality assessment of stored RBCs. Subsequently, in the event that the imagined work processes are understood, they would address a pivotal step in the right direction for patient wellbeing.
What next steps are there?
This point of view was written by a consortium of authors representing various stakeholders fully intent on imagining and making a better future for transfusion medication safety with the use of advanced technologies. As such, our next stages are to make interactive forums (conferences and workgroups) to connect with and prepare a bigger number of stakeholders to understand the imagined objectives framed in this point of view.