Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150958
Hitoshi Ohto , Kenneth E. Nollet , Jill R. Storry
Maternal alloantibody-induced hemolytic disease of the fetus and newborn (HDFN) remains a significant concern worldwide. Alloimmune HDFN can be pathogenetically named by the specific alloantibodies involved. Moreover, four mechanistic pathway types are generally recognized in clinical practice: classical or extravascular hemolysis; immune-pressure-escaped, also known as antibody-mediated antigen-modulation; apoptotic or dysplastic; and failed transaction. Another proposed pathway is worthy of discussion: lactation-mediated. Management strategies for alloimmune HDFN should take account of these underlying mechanisms.
{"title":"Five Pathogenetic Classifications for Alloimmune Hemolytic Disease of the Fetus And Newborn","authors":"Hitoshi Ohto , Kenneth E. Nollet , Jill R. Storry","doi":"10.1016/j.tmrv.2025.150958","DOIUrl":"10.1016/j.tmrv.2025.150958","url":null,"abstract":"<div><div>Maternal alloantibody-induced hemolytic disease of the fetus and newborn (HDFN) remains a significant concern worldwide. Alloimmune HDFN can be pathogenetically named by the specific alloantibodies involved. Moreover, four mechanistic pathway types are generally recognized in clinical practice: classical or extravascular hemolysis; immune-pressure-escaped, also known as antibody-mediated antigen-modulation; apoptotic or dysplastic; and failed transaction. Another proposed pathway is worthy of discussion: lactation-mediated. Management strategies for alloimmune HDFN should take account of these underlying mechanisms.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150958"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150951
Femmeke Prinsze , Hans Vrielink , Yared Paalvast , Ryanne Lieshout-Krikke , Katja van den Hurk
Demands for plasma continue to rise, but the effects of frequent donations on donor-health remain unclear. The aim of this observational study was to assess associations of plasma donation frequencies with biomarker (protein, ferritin, and hemoglobin) levels, and to evaluate the contribution of high or very high-frequency donors to the collected plasma. We included all plasma donors (N = 42,390) of 2019 who donated only plasma in 2 preceding years. Total protein and hemoglobin were measured in all donors, ferritin only in a subpopulation (N = 953). Associations between the number of donations and biomarker levels were analyzed using linear regression, adjusted for age and days since previous donation, and stratified by sex and menopausal status. We grouped the donors based on their yearly donation frequency: low frequency (LF) 1 to 6, medium frequency (MF) 7 to 12, high frequency (HF) 13 to 18 and Very High Frequency (VHF) >18. Linear regression analyses showed significant negative associations between numbers of donations and protein (odds ratios: males −0.04 (−0.05 to −0.03), premenopausal females −0.09 (−0.11 to −0.03), postmenopausal females −0.05 (−0.07 to −0.04)) and ferritin levels (odds ratios: males −1.98 (−2.47 to −1.48), premenopausal females −1.81 (2.23 to −0.75), postmenopausal females −1.24 (−2.10 to −0.38)). HF- and VHF-donors (6% of donors) are predominantly male with high donation volumes, contributing approximately 17% to the amount of collected plasma. High-frequency plasma donations are associated with significantly lower protein and ferritin, but not Hb levels. Despite the low number of HF- and VHF-donors, their contribution to the plasma supply is high.
{"title":"Donation-Induced Protein and Iron Depletion in High-Frequency Plasma Donors","authors":"Femmeke Prinsze , Hans Vrielink , Yared Paalvast , Ryanne Lieshout-Krikke , Katja van den Hurk","doi":"10.1016/j.tmrv.2025.150951","DOIUrl":"10.1016/j.tmrv.2025.150951","url":null,"abstract":"<div><div>Demands for plasma continue to rise, but the effects of frequent donations on donor-health remain unclear. The aim of this observational study was to assess associations of plasma donation frequencies with biomarker (protein, ferritin, and hemoglobin) levels, and to evaluate the contribution of high or very high-frequency donors to the collected plasma. We included all plasma donors (<em>N</em> = 42,390) of 2019 who donated only plasma in 2 preceding years. Total protein and hemoglobin were measured in all donors, ferritin only in a subpopulation (<em>N</em> = 953). Associations between the number of donations and biomarker levels were analyzed using linear regression, adjusted for age and days since previous donation, and stratified by sex and menopausal status. We grouped the donors based on their yearly donation frequency: low frequency (LF) 1 to 6, medium frequency (MF) 7 to 12, high frequency (HF) 13 to 18 and Very High Frequency (VHF) >18. Linear regression analyses showed significant negative associations between numbers of donations and protein (odds ratios: males −0.04 (−0.05 to −0.03), premenopausal females −0.09 (−0.11 to −0.03), postmenopausal females −0.05 (−0.07 to −0.04)) and ferritin levels (odds ratios: males −1.98 (−2.47 to −1.48), premenopausal females −1.81 (2.23 to −0.75), postmenopausal females −1.24 (−2.10 to −0.38)). HF- and VHF-donors (6% of donors) are predominantly male with high donation volumes, contributing approximately 17% to the amount of collected plasma. High-frequency plasma donations are associated with significantly lower protein and ferritin, but not Hb levels. Despite the low number of HF- and VHF-donors, their contribution to the plasma supply is high.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150951"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150954
Na Li
{"title":"Reply to “Strengthening Translational Pathways: The Need for Readiness and Fairness Assessment in Transfusion AI Models”","authors":"Na Li","doi":"10.1016/j.tmrv.2025.150954","DOIUrl":"10.1016/j.tmrv.2025.150954","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150954"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150959
Amber Meulenbeld , Lucile Malard , Elodie Pouchol , Mart Janssen , Syria Laperche , Jean-Baptiste Thibert , Katja van den Hurk
Many blood establishments have hemoglobin (Hb) measurement policies to prevent anemia in blood donors. However, despite evidence of iron deficiency (ID) in donors with normal Hb levels, only few blood establishments have implemented iron management strategies. Recently, the Dutch and French national blood services implemented ferritin-guided donation interval policies, albeit in different ways. While in the Netherlands ferritin is measured every 5 donations, in France ferritin measurements are performed in predefined risk groups. We compared rates of ID (ferritin <15 ng/mL), low ferritin (15-30 ng/mL), and low Hb between the Netherlands and France before and after policy implementation. We also compared donor return rates and ferritin levels after ferritin-based deferrals. We found that before the policy change there were differences in rates of ID and low ferritin, but Hb deferral rates were very similar. After the policy change, more ferritin measurements were performed in the Netherlands, but both countries had similar ID rates (∼4.5% and ∼1% of measured females and males, respectively). Return rates within one year after the end of deferral for ID were similar in both countries (∼60% for females and ∼80% for males), but French donors had higher ferritin upon return despite the shorter deferral period. Because this is an observational study using retrospective data, and due to a lack of the standardization of ferritin measurements, comparisons need to be interpreted with caution. Nonetheless, the results offer valuable insights concerning the impact of ferritin-guided donation intervals for blood establishments that consider the implementation of similar policies.
{"title":"Impact of Ferritin-Guided Donation Interval Policies in the Netherlands and France","authors":"Amber Meulenbeld , Lucile Malard , Elodie Pouchol , Mart Janssen , Syria Laperche , Jean-Baptiste Thibert , Katja van den Hurk","doi":"10.1016/j.tmrv.2025.150959","DOIUrl":"10.1016/j.tmrv.2025.150959","url":null,"abstract":"<div><div>Many blood establishments have hemoglobin (Hb) measurement policies to prevent anemia in blood donors. However, despite evidence of iron deficiency (ID) in donors with normal Hb levels, only few blood establishments have implemented iron management strategies. Recently, the Dutch and French national blood services implemented ferritin-guided donation interval policies, albeit in different ways. While in the Netherlands ferritin is measured every 5 donations, in France ferritin measurements are performed in predefined risk groups. We compared rates of ID (ferritin <15 ng/mL), low ferritin (15-30 ng/mL), and low Hb between the Netherlands and France before and after policy implementation. We also compared donor return rates and ferritin levels after ferritin-based deferrals. We found that before the policy change there were differences in rates of ID and low ferritin, but Hb deferral rates were very similar. After the policy change, more ferritin measurements were performed in the Netherlands, but both countries had similar ID rates (∼4.5% and ∼1% of measured females and males, respectively). Return rates within one year after the end of deferral for ID were similar in both countries (∼60% for females and ∼80% for males), but French donors had higher ferritin upon return despite the shorter deferral period. Because this is an observational study using retrospective data, and due to a lack of the standardization of ferritin measurements, comparisons need to be interpreted with caution. Nonetheless, the results offer valuable insights concerning the impact of ferritin-guided donation intervals for blood establishments that consider the implementation of similar policies.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150959"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150956
Sunny Dzik , Jeannie Callum , Zoe McQuilten
{"title":"Transfusion Medicine Reviews in 2026","authors":"Sunny Dzik , Jeannie Callum , Zoe McQuilten","doi":"10.1016/j.tmrv.2025.150956","DOIUrl":"10.1016/j.tmrv.2025.150956","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150956"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150950
Fleur Krommendijk , Amber Meulenbeld , Jan Karregat , Bryan R. Spencer , Fredrik Toss , Noriko Namba , Nelson Tsuno , Klara Greffin , Konstanze Aurich , Eva-Maria Merz , Mindy Goldman , Eamonn Ferguson , Trynke Hoekstra , Mikko Arvas , Katja van den Hurk , BEST Collaborative
Frequent blood donation can deplete iron stores, increasing the risk of iron deficiency anemia. Postdonation iron supplements may help preserve donor health, but willingness to take supplements likely depends on donor knowledge and confidence. We conducted a cross-sectional survey among 5691 whole blood donors from 6 countries (Netherlands, USA, Japan, Finland, Sweden, Germany). Knowledge was assessed using 16 true-or-false statements on 4 blood donation-related topics; confidence by asking if donors were "certain" or "guessing." Willingness to take supplements was assessed using 3 scenarios: to continue donating, when advised by a donor physician, and general iron supplementation rejection. Using logistic regressions, we assessed associations between knowledge, confidence, and willingness to take iron supplements for each scenario, adjusted for sex, age, country, prior supplement use, and trust in the blood service. Most donors exhibited medium to high knowledge and under confidence in that knowledge. Willingness to take supplements was high (80.6%-84.2% across scenarios). Knowledge and confidence were not consistently associated with willingness to take supplements. In contrast, trust in the blood service (odds ratio [OR] = 1.64, P < .001) and prior supplement use (OR = 1.87, P < .001) were strongly associated with willingness when supplements were required to continue donating, with similar effects across other scenarios. Willingness varied across countries, with higher willingness in Nordic countries. These findings suggest that trust-building approaches may be more promising than education-focused strategies, though causal relationships require further research. High acceptance rates suggest that postdonation iron supplementation may be a feasible strategy for donor iron management.
频繁献血会消耗铁储备，增加缺铁性贫血的风险。捐献后补充铁元素可能有助于保持捐赠者的健康，但是否愿意补充铁元素可能取决于捐赠者的知识和信心。我们对来自6个国家（荷兰、美国、日本、芬兰、瑞典和德国）的5691名全血献血者进行了横断面调查。对4项献血相关主题的16项真假陈述进行知识评估；通过询问捐赠者是“确定”还是“猜测”来提高信心。服用铁补充剂的意愿通过三种情况进行评估：在供体医生的建议下继续捐献，以及普遍的铁补充排斥。使用逻辑回归，我们评估了知识、信心和意愿在每种情况下服用铁补充剂之间的关系，并根据性别、年龄、国家、既往使用补充剂和对血液服务的信任进行了调整。大多数捐助者表现出中等到较高的知识，但对这些知识缺乏信心。服用补充剂的意愿很高（80.6%-84.2%）。知识和信心并不总是与服用补充剂的意愿相关。相比之下，对血液服务的信任（优势比[OR] = 1.64, P < .001）和之前使用过补品（OR = 1.87, P < .001）与需要补品时继续献血的意愿密切相关，在其他情况下也有类似的效果。各国的意愿各不相同，北欧国家的意愿更高。这些发现表明，建立信任的方法可能比以教育为重点的策略更有希望，尽管因果关系需要进一步研究。高接受率提示捐献后补铁可能是一种可行的捐献铁管理策略。
{"title":"Knowledge Related to Blood Donation and Iron, and Willingness to Take Iron Supplements Among Blood Donors in Multiple Countries","authors":"Fleur Krommendijk , Amber Meulenbeld , Jan Karregat , Bryan R. Spencer , Fredrik Toss , Noriko Namba , Nelson Tsuno , Klara Greffin , Konstanze Aurich , Eva-Maria Merz , Mindy Goldman , Eamonn Ferguson , Trynke Hoekstra , Mikko Arvas , Katja van den Hurk , BEST Collaborative","doi":"10.1016/j.tmrv.2025.150950","DOIUrl":"10.1016/j.tmrv.2025.150950","url":null,"abstract":"<div><div>Frequent blood donation can deplete iron stores, increasing the risk of iron deficiency anemia. Postdonation iron supplements may help preserve donor health, but willingness to take supplements likely depends on donor knowledge and confidence. We conducted a cross-sectional survey among 5691 whole blood donors from 6 countries (Netherlands, USA, Japan, Finland, Sweden, Germany). Knowledge was assessed using 16 true-or-false statements on 4 blood donation-related topics; confidence by asking if donors were \"certain\" or \"guessing.\" Willingness to take supplements was assessed using 3 scenarios: to continue donating, when advised by a donor physician, and general iron supplementation rejection. Using logistic regressions, we assessed associations between knowledge, confidence, and willingness to take iron supplements for each scenario, adjusted for sex, age, country, prior supplement use, and trust in the blood service. Most donors exhibited medium to high knowledge and under confidence in that knowledge. Willingness to take supplements was high (80.6%-84.2% across scenarios). Knowledge and confidence were not consistently associated with willingness to take supplements. In contrast, trust in the blood service (odds ratio [OR] = 1.64, <em>P</em> < .001) and prior supplement use (OR = 1.87, <em>P</em> < .001) were strongly associated with willingness when supplements were required to continue donating, with similar effects across other scenarios. Willingness varied across countries, with higher willingness in Nordic countries. These findings suggest that trust-building approaches may be more promising than education-focused strategies, though causal relationships require further research. High acceptance rates suggest that postdonation iron supplementation may be a feasible strategy for donor iron management.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150950"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmrv.2025.150957
Sunny Dzik , Zoe McQuilten , Jeannie Callum
{"title":"Recommended Papers of 2025 From the TMR Editorial Board","authors":"Sunny Dzik , Zoe McQuilten , Jeannie Callum","doi":"10.1016/j.tmrv.2025.150957","DOIUrl":"10.1016/j.tmrv.2025.150957","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150957"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.1016/j.tmrv.2025.150955
Riza Amalia, Ronal Surya Aditya, Muhammad Sandy Al Fath
{"title":"Strengthening Translational Pathways: The Need for Readiness and Fairness Assessment in Transfusion AI Models.","authors":"Riza Amalia, Ronal Surya Aditya, Muhammad Sandy Al Fath","doi":"10.1016/j.tmrv.2025.150955","DOIUrl":"https://doi.org/10.1016/j.tmrv.2025.150955","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":" ","pages":"150955"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-25DOI: 10.1016/j.tmrv.2025.150936
Antoine Lewin , Samuel Rochette , Andrew W. Shih , Alan Tinmouth , Michaël Chassé , Sheila F O'Brien , Michael P. Busch , Nareg H. Roubinian , Christian Erikstrup , Mélanie Dieudé , François Martin Carrier , Jeannie Callum , Donald M. Arnold , Canadian Transfusion Trials Group
The increasing availability of digital health data heralds a new era in transfusion research. These data can be assembled into large databases integrating donor, component, and recipient information, enabling studies across the transfusion continuum (“vein-to-vein”). However, establishing and maintaining such databases requires significant resources, and few investigators currently have access to them. To guide future efforts, we reviewed published vein-to-vein databases, focusing on their research use, data scope, limitations, and technical design considerations. Several studies have used vein-to-vein databases to examine determinants of transfusion effectiveness and safety. These studies would benefit from more international collaboration to explore variation and validate findings. Such collaborations could be facilitated through public protocol and data sharing, adherence to recognized standards, or the development of new, widely accepted ones. Investigators who develop vein-to-vein databases must consider the need for data quality and validation checks. Where feasible, investigators should also consider linking vein-to-vein data with prospective cohort studies that include donation and recipient biospecimens to evaluate novel or emerging exposures and explore epidemiological and mechanistic associations. They should also recognize the limitations of vein-to-vein database studies, including residual confounding, data quality issues, and missing data due to outpatient transfusions, home transfusions, or patients without health insurance. Despite these limitations, vein-to-vein databases should be developed, enhanced, and leveraged to provide insights into transfusion efficacy and support pragmatic or emulated randomized controlled trials (RCTs), especially where traditional RCTs are not feasible (eg, platelet thresholds to prevent bleeding complications after lumbar puncture).
{"title":"Vein-To-Vein Databases: Uses and Considerations in Transfusion Research","authors":"Antoine Lewin , Samuel Rochette , Andrew W. Shih , Alan Tinmouth , Michaël Chassé , Sheila F O'Brien , Michael P. Busch , Nareg H. Roubinian , Christian Erikstrup , Mélanie Dieudé , François Martin Carrier , Jeannie Callum , Donald M. Arnold , Canadian Transfusion Trials Group","doi":"10.1016/j.tmrv.2025.150936","DOIUrl":"10.1016/j.tmrv.2025.150936","url":null,"abstract":"<div><div>The increasing availability of digital health data heralds a new era in transfusion research. These data can be assembled into large databases integrating donor, component, and recipient information, enabling studies across the transfusion continuum (“vein-to-vein”). However, establishing and maintaining such databases requires significant resources, and few investigators currently have access to them. To guide future efforts, we reviewed published vein-to-vein databases, focusing on their research use, data scope, limitations, and technical design considerations. Several studies have used vein-to-vein databases to examine determinants of transfusion effectiveness and safety. These studies would benefit from more international collaboration to explore variation and validate findings. Such collaborations could be facilitated through public protocol and data sharing, adherence to recognized standards, or the development of new, widely accepted ones. Investigators who develop vein-to-vein databases must consider the need for data quality and validation checks. Where feasible, investigators should also consider linking vein-to-vein data with prospective cohort studies that include donation and recipient biospecimens to evaluate novel or emerging exposures and explore epidemiological and mechanistic associations. They should also recognize the limitations of vein-to-vein database studies, including residual confounding, data quality issues, and missing data due to outpatient transfusions, home transfusions, or patients without health insurance. Despite these limitations, vein-to-vein databases should be developed, enhanced, and leveraged to provide insights into transfusion efficacy and support pragmatic or emulated randomized controlled trials (RCTs), especially where traditional RCTs are not feasible (eg, platelet thresholds to prevent bleeding complications after lumbar puncture).</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150936"},"PeriodicalIF":2.5,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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