Although a variety of strategies ranging from donor screening to compatibility testing and patient monitoring during hemotherapy (HT) exist to decrease transfusion complications, transfusion associated adverse events(TAAEs) can go undetected. Hemovigilance measures have been developed to capture many transfusion complications, however, even with these approaches, some adverse transfusion outcomes can occur days to weeks following HT, potentially compromising their detection. Two entities particularly challenging in this regard are delayed hemolytic transfusion reactions (DHTRs) and hyperhemolysis. Transfusion associated hyperkalemia (TAH), another potentially life-threatening rare complication of RBC transfusion may lead to severe cardiac comprise in patients and represents an TAAE that may have a particularly profound impact in pediatric patients. In this session we will explore common clinical presentations and pathophysiological mechanisms of DHTRs by examining the workup, diagnosis, transfusion support and management of DHTRs and hyperhemolysis. With respect to TAH we will explore its prevalence, characteristics of patients at particular risk, its morbidity and mortality, as well as the features of the blood units themselves and their associated infusion practices. Finally, we will highlight emerging opportunities to improve hemovigilance practices to capture these under-appreciated entities and potentially aid in their mitigation.

All relevant financial relationships have been mitigated.

The COVID-19 pandemic has created many challenges across the healthcare system. The greatest impact to transfusion medicine has been the ability to maintain a healthy blood supply across the nation and an imbalance between the supply of blood components and the demand to meet patient needs. The recent and ongoing severe blood shortage has led to the need make difficult decisions as to who should receive blood and who should wait. Beyond the potential for these difficult decisions within each hospital or region, the shortage has impacted the United States and the world unequally raising many ethical questions about how blood should be allocated fairly. An ethical framework is needed to guide these decisions. Speakers will share their perspectives on how should blood be allocated both within hospitals and across nations and how to prioritize patients most in need of blood components during critical blood shortages. Attendees will learn how to create ethical frameworks to guide decision making as well as generate proactive solutions including the development of futility protocols.

All relevant financial relationships have been mitigated.

Oral abstract session on Infectious Disease.

Twenty percent of what you do yields eighty percent of the results. How can we ensure quality while dealing with staffing shortages, increased workload per staff member, and other contributing factors? The key is to work smarter and NOT harder! In this presentation you will learn about the 80/20 rule and how it can transform how you spend your time and energy to yield maximum results in the least amount of time. We will discuss how the 80/20 rule can improve quality from both an operations and regulatory affairs perspective. This method has been used by one panel member to increase administrative productivity by an amazing 300%! If you are looking for a way to get more done in less time while ensuring quality and safety then this presentation is for you! While this presentation will mainly focus on the 80/20 rule and quality, the principles and methods are easily extrapolated to other functional and administrative areas.

All relevant financial relationships have been mitigated.

Agenda:
- Moderator Introductions (Dan Waxman) CCP & EUA for immunosuppressed population (Jonathon Senefeld)
- AABB Guidelines (Aaron Tobian)
- Research implications and considerations for the future (Eric Salazar)
- Lessons learned and blood centers preparation for future pandemics (Bill Block)
- Q&A/Panel Discussion

All relevant financial relationships have been mitigated.

This is an oral abstract session about Platelets and Novel Therapeutics.

Oral abstract session on Plenary Abstracts.

Novel biotherapies are often driven by industrial innovations but require clinical and academic medical collaborations. In the evolving fields of biotherapies and transfusion medicine, there is an ever-increasing demand for high quality products as raw materials for further manufacturing. An important challenge for apheresis centers is management of distinct industrial protocol details, including heterogenous operational parameters that may not always conform to routine clinical practices. Factors such adequate staffing, budget, equipment, space and shipping and delivering logistics pose formidable challenges to blood centers and hospitals and threaten the ability of these organizations to meet demand. This session will discuss real experiences from professionals in the field and will propose creative approaches in overcoming those challenges, including the business agreements as well as the regulatory framework involving these type of products. We will engage the audience to map out the goals of their own apheresis production pipelines by applying principles of process improvement that identify and then leverage their operational constraints, with concrete examples. The speakers will also share practical tips regarding the establishment of business agreements that include negotiations between the sponsor(s) and the institution.

All relevant financial relationships have been mitigated.

This session will focus on preparedness planning for a transfusion-transmissible pandemic. We are fortunate that SARS-CoV2 (Covid-19) was not transfusion-transmissible but this need not be true of the next pandemic. Pathogen reduction neither treats all components transfused, nor do they appear to be universally effective. The first presentation will address lessons learned from Covid-19, Zika and breakthrough cases of bacterial contamination in platelet units despite an approved pathogen reduction strategy. How will transfusion-transmissibility be assessed in a background of high community prevalence? What epidemiologic tools can address relative risk of transfusion-transmission relative to community acquisition? Given that Covid viremia can be detected molecularly but did not result in transmission, what are the requirements for transfusion-transmissibility? While we look forward to pathogen reduction for red cell components, what lessons are to be learned from the breakthrough bacterial transmission cases? What are the investigations to date, on how or why these breakthrough infections may occur and future strategies to prevent such cases. The second presentation will explore strategies for pathogen inactivation of a wide array of blood components. Development and incorporation of pathogen inactivation technologies to ensure a maximally safe, yet adequate blood supply raises questions: What does the ideal pathogen reduction system look like and what are our expectations of such a system? How does the use of pathogen inactivation technologies impact the need to use screening questions and tests? How do we balance the risks of TTDs with the risk of an inadequate blood supply? Advantages and disadvantages of current and alternative approaches will be discussed with a particular focus on safety and tolerability of the treated blood products.

All relevant financial relationships have been mitigated.

This is an oral abstract session about RBC Immunology- Mouse Models.