Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01170.X
F. Gomollón, J. Gisbert
SUMMARY From a global perspective, poor nutrition is the most important cause of iron deficiency and iron deficiency anemia. However, in developed countries gastrointestinal diseases are the most probable causes that should be taken into account in the differential diagnosis. Blood losses through mucosal ulceration, malabsorption, chronic inflammation, neoplasia, difficulties in intake of food, or a combination of these mechanisms can be found in various gastrointestinal diseases. Several iron compounds suitable for oral use are available, the most simple and most commonly used being iron salts such as iron sulfate or iron fumarate. However, oral iron is not always the best option. Intravenous (IV) iron has been shown to be effective in several observational and controlled studies. In cancer patients, oral iron has been shown to be effective in some studies, but IV iron has several advantages in this particular scenario: it is well tolerated, even in frail patients, and is quick to obtain a response, something rather convenient if prompt surgery is needed. IV iron is also widely used in chronic gastrointestinal blood loss caused by vascular malformations, a rather common scenario in patients on anticoagulant treatment. It is also relatively common in clinical gastroenterological practice to find anemia and iron deficiency in patients treated with nonsteroidal anti-inflammatory agents and/or antiplatelet drugs. IV iron is a useful and effective tool to treat iron deficiency in digestive diseases. Although we need more and larger trials to further define indications, protocols and follow-up rules in different pathologies, the available guidelines for the management of iron deficiency and anemia inflammatory bowel disease patients are good practical guides.
{"title":"Intravenous iron in digestive diseases: INTRAVENOUS IRON IN DIGESTIVE DISEASES","authors":"F. Gomollón, J. Gisbert","doi":"10.1111/J.1778-428X.2012.01170.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01170.X","url":null,"abstract":"SUMMARY \u0000 \u0000From a global perspective, poor nutrition is the most important cause of iron deficiency and iron deficiency anemia. However, in developed countries gastrointestinal diseases are the most probable causes that should be taken into account in the differential diagnosis. Blood losses through mucosal ulceration, malabsorption, chronic inflammation, neoplasia, difficulties in intake of food, or a combination of these mechanisms can be found in various gastrointestinal diseases. Several iron compounds suitable for oral use are available, the most simple and most commonly used being iron salts such as iron sulfate or iron fumarate. However, oral iron is not always the best option. Intravenous (IV) iron has been shown to be effective in several observational and controlled studies. In cancer patients, oral iron has been shown to be effective in some studies, but IV iron has several advantages in this particular scenario: it is well tolerated, even in frail patients, and is quick to obtain a response, something rather convenient if prompt surgery is needed. IV iron is also widely used in chronic gastrointestinal blood loss caused by vascular malformations, a rather common scenario in patients on anticoagulant treatment. It is also relatively common in clinical gastroenterological practice to find anemia and iron deficiency in patients treated with nonsteroidal anti-inflammatory agents and/or antiplatelet drugs. IV iron is a useful and effective tool to treat iron deficiency in digestive diseases. Although we need more and larger trials to further define indications, protocols and follow-up rules in different pathologies, the available guidelines for the management of iron deficiency and anemia inflammatory bowel disease patients are good practical guides.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01170.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01173.X
E. Bisbe
SUMMARY Preoperative anemia is an independent risk factor for allogeneic blood transfusion in surgical procedures associated with moderate-to-high perioperative blood loss. Allogeneic blood transfusion and preoperative anemia have been independently associated with worse postoperative outcomes in patients undergoing major surgery. In addition, hematinic deficiency may blunt the recovery from postoperative anemia. Therefore, patients scheduled for major surgery can benefit from preoperative correction of absolute or functional iron deficiency. In both cases, intravenous (IV) iron is safe and effective for treating preoperative anemia, leading to a median hemoglobin increase of 1–3 g/dL in one month, depending of the type of surgery. The availability of new IV iron formulations allowing rapid administration of high single doses may reduce the number of treatment sessions, thus contributing to a wider use of IV iron as a blood-saving strategy in surgical patients.
{"title":"Role of iron replacement in the management of preoperative anemia: PREOPERATIVE IRON REPLACEMENT","authors":"E. Bisbe","doi":"10.1111/J.1778-428X.2012.01173.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01173.X","url":null,"abstract":"SUMMARY \u0000 \u0000Preoperative anemia is an independent risk factor for allogeneic blood transfusion in surgical procedures associated with moderate-to-high perioperative blood loss. Allogeneic blood transfusion and preoperative anemia have been independently associated with worse postoperative outcomes in patients undergoing major surgery. In addition, hematinic deficiency may blunt the recovery from postoperative anemia. Therefore, patients scheduled for major surgery can benefit from preoperative correction of absolute or functional iron deficiency. In both cases, intravenous (IV) iron is safe and effective for treating preoperative anemia, leading to a median hemoglobin increase of 1–3 g/dL in one month, depending of the type of surgery. The availability of new IV iron formulations allowing rapid administration of high single doses may reduce the number of treatment sessions, thus contributing to a wider use of IV iron as a blood-saving strategy in surgical patients.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01173.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01167.X
H. Roberts, C. Carroll
{"title":"Use of intraoperative cell salvage in neurosurgery","authors":"H. Roberts, C. Carroll","doi":"10.1111/J.1778-428X.2012.01167.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01167.X","url":null,"abstract":"","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01167.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01168.X
C. Cromey, Dafydd Thomas
SUMMARY To help minimize the risks of blood component transfusion various techniques have been developed. These novel therapies have focused on the use of autologous transfusion techniques and the use of pharmacologic agents to reduce bleeding and therefore reduce transfusion requirements. These have the potential to drastically reduce transfusion requirements and benefit patients enormously. However, it is important that these therapies are not considered risk-free and auditing their safety and monitoring their use is essential. There is a need to develop a hemovigilance reporting system to identify and quantify adverse effects associated with the use of these transfusion alternatives.
{"title":"Vigilance of alternatives to blood components","authors":"C. Cromey, Dafydd Thomas","doi":"10.1111/J.1778-428X.2012.01168.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01168.X","url":null,"abstract":"SUMMARY \u0000 \u0000To help minimize the risks of blood component transfusion various techniques have been developed. These novel therapies have focused on the use of autologous transfusion techniques and the use of pharmacologic agents to reduce bleeding and therefore reduce transfusion requirements. These have the potential to drastically reduce transfusion requirements and benefit patients enormously. However, it is important that these therapies are not considered risk-free and auditing their safety and monitoring their use is essential. There is a need to develop a hemovigilance reporting system to identify and quantify adverse effects associated with the use of these transfusion alternatives.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01168.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01171.X
P. Gascón
SUMMARY Erythropoiesis-stimulating agents (ESAs) are widely used in oncology to correct the anemia associated with chemotherapy, although only 50–70% of patients show an optimal response, mostly because of functional iron deficiency (FID). As intravenous (IV) iron can overcome this FID, it has become an important adjunct to obtaining and maintaining adequate hemoglobin levels in patients with cancer receiving chemotherapy. In fact, six out of seven published randomized, controlled trials performed in cancer patients have demonstrated that IV iron given concomitantly to ESAs induces a faster and much more robust response than with ESAs alone. The possibility that giving only IV iron can also produce adequate hemoglobin responses requires further studies. However, there still exists some reluctance among many oncologists to use IV iron because of the poor safety profile observed in the past with the old iron preparations, in particular high-molecular-weight iron dextran. As the efficacy and safety of the new iron preparations have been proven, the use of IV iron should be considered in the management of anemia secondary to chemotherapy treatments.
{"title":"Iron therapy in cancer-induced anemia: IRON THERAPY IN CANCER-INDUCED ANEMIA","authors":"P. Gascón","doi":"10.1111/J.1778-428X.2012.01171.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01171.X","url":null,"abstract":"SUMMARY \u0000 \u0000Erythropoiesis-stimulating agents (ESAs) are widely used in oncology to correct the anemia associated with chemotherapy, although only 50–70% of patients show an optimal response, mostly because of functional iron deficiency (FID). As intravenous (IV) iron can overcome this FID, it has become an important adjunct to obtaining and maintaining adequate hemoglobin levels in patients with cancer receiving chemotherapy. In fact, six out of seven published randomized, controlled trials performed in cancer patients have demonstrated that IV iron given concomitantly to ESAs induces a faster and much more robust response than with ESAs alone. The possibility that giving only IV iron can also produce adequate hemoglobin responses requires further studies. However, there still exists some reluctance among many oncologists to use IV iron because of the poor safety profile observed in the past with the old iron preparations, in particular high-molecular-weight iron dextran. As the efficacy and safety of the new iron preparations have been proven, the use of IV iron should be considered in the management of anemia secondary to chemotherapy treatments.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01171.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01160.X
L. Peacock, V. Clark, S. Catling
SUMMARY The acceptance of cell salvage in obstetrics has been hampered by concerns about amniotic fluid embolism and maternal alloimmunization. The removal of amniotic fluid debris by cell salvage has been proven, but controversy remains as to whether using one or two separate suction devices for removal of amniotic fluid and blood is necessary. There have been recent reports of hypotensive episodes occurring during re-infusion of the salvaged blood with leukodepletion filters. Bradykinin release may be the responsible agent. Maternal alloimmunization can potentially occur as the cell saver cannot differentiate between maternal and fetal red cells. However, the fetal cell transference rate in salvaged blood is of the same magnitude as during a feto-maternal hemorrhage and can be treated by appropriate administration of anti-D. Salvaged blood does not contain any coagulation factors and in massive hemorrhage these factors must be replaced in addition to the red cells. Coagulopathy in bleeding patients that have cell salvage should not be viewed as an adverse event associated with this technique, but rather as inadequate replacement of coagulation products. There is currently no evidence base that cell salvage in obstetrics reduces allogeneic transfusion or is cost-effective. A randomized controlled trial is urgently needed.
{"title":"Recent developments in the obstetric use of cell salvage: CELL SALVAGE IN OBSTETRICS","authors":"L. Peacock, V. Clark, S. Catling","doi":"10.1111/J.1778-428X.2012.01160.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01160.X","url":null,"abstract":"SUMMARY \u0000 \u0000The acceptance of cell salvage in obstetrics has been hampered by concerns about amniotic fluid embolism and maternal alloimmunization. The removal of amniotic fluid debris by cell salvage has been proven, but controversy remains as to whether using one or two separate suction devices for removal of amniotic fluid and blood is necessary. There have been recent reports of hypotensive episodes occurring during re-infusion of the salvaged blood with leukodepletion filters. Bradykinin release may be the responsible agent. Maternal alloimmunization can potentially occur as the cell saver cannot differentiate between maternal and fetal red cells. However, the fetal cell transference rate in salvaged blood is of the same magnitude as during a feto-maternal hemorrhage and can be treated by appropriate administration of anti-D. Salvaged blood does not contain any coagulation factors and in massive hemorrhage these factors must be replaced in addition to the red cells. Coagulopathy in bleeding patients that have cell salvage should not be viewed as an adverse event associated with this technique, but rather as inadequate replacement of coagulation products. There is currently no evidence base that cell salvage in obstetrics reduces allogeneic transfusion or is cost-effective. A randomized controlled trial is urgently needed.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01160.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/j.1778-428X.2012.01155.x
Gerhardt Konig, Jonathan H Waters
{"title":"Washing and filtering of cell-salvaged blood - does it make autotransfusion safer?","authors":"Gerhardt Konig, Jonathan H Waters","doi":"10.1111/j.1778-428X.2012.01155.x","DOIUrl":"10.1111/j.1778-428X.2012.01155.x","url":null,"abstract":"","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064293/pdf/nihms-583556.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32445557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01179.X
M. Muñoz
{"title":"Editorial: iron therapy in clinical practice: an overview","authors":"M. Muñoz","doi":"10.1111/J.1778-428X.2012.01179.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01179.X","url":null,"abstract":"","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01179.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63390060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01176.X
K. Messmer
Transfusion Alternatives in Transfusion Medicine (TATM) was launched in 1999 shortly after the Network for the Advancement of Transfusion Alternatives (NATA) was created by Professor Jean-Francois Baron (Paris, France), who served both as NATA chair and as TATM editor-inchief. At that time, clinicians and scientists had realized that the risks associated with the administration of blood components and blood-derived products were too high to be accepted by doctors and patients. Efforts were made to avoid allogeneic blood transfusions by establishing alternative methods such as preoperative autologous blood donation, normovolemic hemodilution and cell salvage autotransfusion. The annual symposia organized by NATA were a unique platform to present and discuss the various forms of alternatives to allogeneic blood transfusions in order to evaluate their potential benefits and risks. At each meeting, the actual state of artificial blood, more precisely fluorocarbons and hemoglobinbased solutions, was presented to a multidisciplinary audience. TATM was then published by LM Sante (now Med Ed Global Solutions), the agency also in charge of organizing NATA symposia. In 2002, when Professor Baron retired from his positions of NATA chair and TATM editor-in-chief, I was assigned by the NATA board of directors to take over both positions. At the end of my 3-year term, Professor Maniatis was elected as NATA chair and I was invited to continue as TATM editor-in-chief. At that time, the NATA board decided to look for a professional publisher for the journal and entrusted Wiley-Blackwell (Oxford, UK) with the publication of the journal. The publisher put high energy and efforts in relaunching TATM; however, the potential authors of articles dealing with transfusion medicine and alternatives remained reluctant to send their original papers to TATM as it was not indexed in the main medical databases, which in turn made it difficult to maintain a regular publication schedule, one of the key requirements for indexing. Although TATM was able to publish excellent review articles by leading experts on specific topics, as well as several outstanding themed issues coordinated by renowned guest editors, the board of directors finally came to the conclusion that the efforts required to maintain the journal may be more fruitfully dedicated to developing the NATA website (http://www.nataonline. com) and a continuing medical education e-learning program, while developing partnerships with indexed journals in the field of transfusion medicine. As editor-in-chief, I would like to express my sincere gratitude to the NATA board of directors for entrusting me the official journal of NATA for the last decade. Today I would like to thank all the colleagues who submitted manuscripts to TATM, the associate editors, editorial board members, reviewers and guest editors who helped the journal stick to high quality standards, and the team at Wiley-Blackwell, particularly Sam Gough and Valer
输血医学中的输血替代方案(TATM)是在输血替代方案促进网络(NATA)由Jean-Francois Baron教授(法国巴黎)创建后不久于1999年启动的，他曾担任NATA主席和TATM主编。当时，临床医生和科学家已经意识到，与血液成分和血液制品管理相关的风险太高，无法被医生和患者接受。通过建立术前自体献血、等容血液稀释和细胞挽救性自体输血等替代方法，努力避免异体输血。NATA组织的年度专题讨论会是一个独特的平台，介绍和讨论各种形式的同种异体输血替代方案，以评估其潜在的益处和风险。在每次会议上，向多学科听众介绍了人造血液的实际状况，更确切地说，是基于氟碳化合物和血红蛋白的解决方案。TATM随后由LM Sante(现在的Med Ed Global Solutions)出版，该机构还负责组织NATA专题讨论会。2002年，当Baron教授从NATA主席和TATM总编辑的职位上退休时，我被NATA董事会指派接替这两个职位。在我3年的任期结束时，Maniatis教授被选为NATA主席，我被邀请继续担任TATM总编辑。当时，NATA董事会决定为该期刊寻找专业出版商，并委托Wiley-Blackwell (Oxford, UK)出版该期刊。出版商为重新发行《TATM》付出了巨大的精力和努力;然而，涉及输血医学和替代方法的文章的潜在作者仍然不愿意将其原始论文发送给TATM，因为它没有在主要医学数据库中编入索引，这反过来又使其难以维持定期出版时间表，而这是索引的关键要求之一。尽管《TATM》能够发表由知名专家就特定主题撰写的优秀评论文章，以及由知名客座编辑协调的若干杰出主题问题，但董事会最终得出的结论是，维持期刊所需的努力可能更有效地用于开发NATA网站(http://www.nataonline)。Com)和继续医学教育电子学习计划，同时与输血医学领域的索引期刊发展伙伴关系。作为总编辑，我衷心感谢NATA董事会在过去十年中委托我担任NATA官方期刊。今天，我要感谢所有向《TATM》投稿的同事，感谢帮助《TATM》坚持高质量标准的副编辑、编委会成员、审稿人和客座编辑，感谢Wiley-Blackwell的团队，特别是Sam Gough和Valerie Oliveiro，他们近年来为我们提供了高度专业的支持。然而，这些年来最大的支持来自弗朗索瓦·克里斯托里，他自2001年以来一直担任《TATM》的总编辑。如果没有他的帮助和对NATA和TATM目标的热情，即减少或避免与异体血液和血液制品管理相关的风险，TATM不可能成功地为医学界服务这么多年。输血医学中的输血选择
{"title":"Editorial: Transfusion Alternatives in Transfusion Medicine 1999–2012","authors":"K. Messmer","doi":"10.1111/J.1778-428X.2012.01176.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2012.01176.X","url":null,"abstract":"Transfusion Alternatives in Transfusion Medicine (TATM) was launched in 1999 shortly after the Network for the Advancement of Transfusion Alternatives (NATA) was created by Professor Jean-Francois Baron (Paris, France), who served both as NATA chair and as TATM editor-inchief. At that time, clinicians and scientists had realized that the risks associated with the administration of blood components and blood-derived products were too high to be accepted by doctors and patients. Efforts were made to avoid allogeneic blood transfusions by establishing alternative methods such as preoperative autologous blood donation, normovolemic hemodilution and cell salvage autotransfusion. The annual symposia organized by NATA were a unique platform to present and discuss the various forms of alternatives to allogeneic blood transfusions in order to evaluate their potential benefits and risks. At each meeting, the actual state of artificial blood, more precisely fluorocarbons and hemoglobinbased solutions, was presented to a multidisciplinary audience. TATM was then published by LM Sante (now Med Ed Global Solutions), the agency also in charge of organizing NATA symposia. In 2002, when Professor Baron retired from his positions of NATA chair and TATM editor-in-chief, I was assigned by the NATA board of directors to take over both positions. At the end of my 3-year term, Professor Maniatis was elected as NATA chair and I was invited to continue as TATM editor-in-chief. At that time, the NATA board decided to look for a professional publisher for the journal and entrusted Wiley-Blackwell (Oxford, UK) with the publication of the journal. The publisher put high energy and efforts in relaunching TATM; however, the potential authors of articles dealing with transfusion medicine and alternatives remained reluctant to send their original papers to TATM as it was not indexed in the main medical databases, which in turn made it difficult to maintain a regular publication schedule, one of the key requirements for indexing. Although TATM was able to publish excellent review articles by leading experts on specific topics, as well as several outstanding themed issues coordinated by renowned guest editors, the board of directors finally came to the conclusion that the efforts required to maintain the journal may be more fruitfully dedicated to developing the NATA website (http://www.nataonline. com) and a continuing medical education e-learning program, while developing partnerships with indexed journals in the field of transfusion medicine. As editor-in-chief, I would like to express my sincere gratitude to the NATA board of directors for entrusting me the official journal of NATA for the last decade. Today I would like to thank all the colleagues who submitted manuscripts to TATM, the associate editors, editorial board members, reviewers and guest editors who helped the journal stick to high quality standards, and the team at Wiley-Blackwell, particularly Sam Gough and Valer","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2012.01176.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1111/J.1778-428X.2012.01172.X
C. Breymann, A. Krafft
SUMMARY Iron deficiency (ID), iron deficiency anemia (IDA) and the resulting reduction in blood reserves are one the most common problems in pregnancy. Both oral iron – the traditional treatment – and blood transfusion involve significant drawbacks. High doses of oral iron frequently cause side effects, and noncompliance is common. Therefore, intravenous iron, alone or in association with recombinant human erythropoietin (rHuEPO), has been evaluated as an alternative in the management of ID in this setting. There is increasing evidence that iron sucrose is effective for treating IDA and safe for the mother and the fetus, using the recommended dosages and treatment regimens. In the postpartum period, both iron sucrose and ferric carboxymaltose have been shown to be efficacious, alone or in combination with rHuEPO. In pregnancy and in the postpartum period, the expected hemoglobin increase and treatment times are predictable according to the present data; therefore, in the presence of moderate-to-severe anemia, it can be questioned whether it is reasonable to wait for a response to oral iron. Indications for the use of iron sucrose and ferric carboxymaltose are preexisting moderate-to-severe anemia, no effect of oral iron, side effects of oral iron, refusal of blood transfusion, limited time until delivery, coexisting risk factors (e.g. inflammatory bowel disease, renal disease), the preoperative and postoperative periods and postpartum anemia. Future fields of research include the impact of intravenous iron therapy on patient satisfaction and quality of life, costs, hospital length of stay, blood transfusion rate, mortality rate, and other outcomes such as breastfeeding behavior and neonatal outcomes (e.g. birth weight, prematurity and neonatal iron stores).
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