BLOOD NET - Update

Montreal, 2011

BLOOD NET

• Name change from TRICKS • Pediatric Blood Research Network– BLOOD NET

• Formed 2-3 years ago as subgroup of PALISI– Meet 4 X yr– 47 members

• Unfunded – Self Funded Network

BLOOD NET – Research Focus

• How blood becomes dysfunctional with critical illness– RBC vasoregulation– Hemostasis

• How transfusion may affect outcomes– Storage Lesion– Immunology/infection risk

BLOOD NET Goals• Support/Perform Multidisciplinary Blood Related

Research in Critically Ill Children– Development

• Encourage/Motivate/stimulate ideas • Study Design/Methods• Identify Funding Sources

– Completion• Site recruitment

– Analysis• Data Analysis and Manuscript preparation

BLOOD NET-Leadership

• Steering Committee– Phil Spinella (Chair), Marisa Tucci (Vice-Chair),

Jacques Lacroix, Marie Steiner, Allan Doctor, Cassandra Josephson

• Scientific Review Committee– Steering Committee– Christopher Silliman, Neil Blumberg, Philip Norris,

Mark Hall

BLOOD NET Sub-Groups

• Transfusion Outcomes– Tucci and Spinella

• Transfusion Immunology– Mark Hall

• Thrombosis and Coagulation Monitoring– Sheila Hanson– Marie Steiner– Vince Faustino

BLOOD NET Productivity

• 7 Manuscripts • 9 Studies in development/ongoing• 10 million – extramural funding

Manuscripts Published• Cholette JM , et al. Washing blood cells transfused in open heart surgery reduces post-

operative inflammation and transfusion requirements: Results of a prospective, randomized controlled trial. In Press

• Cholette JM, et al. Children with single-ventricle physiology do not benefit from higher hemoglobin levels post cavopulmonary connection: results of a prospective, randomized, controlled trial of a restrictive versus liberal red-cell transfusion strategy. Pediatr Crit Care Med. 2011 Jan;12(1):39-45

• Spinella PC, Dressler A, Tucci M, Carroll CL, Sanchez R, Hume H, Sloan S, Lacroix J. Survey of Transfusion Policies at US and Canadian Children’s Hospitals in 2008 and 2009. Transfusion. E pub 2010 May 28.

• France Gauvin, Philip C. Spinella, Jacques Lacroix, Ghassan Choker, Thierry Ducruet, Oliver Karam, Paul C. Hébert, James S. Hutchison, Heather A. Hume, Marisa Tucci. Association between length of storage of transfused red blood cells and multiple organ dysfunction syndrome in pediatric intensive care patients. Transfusion. E pub 2010 Apr 30.

• Karam O, Tucci M, Bateman ST, Ducruet T, Spinella PC, Randolph AG, Lacroix J. Association between length of storage of red blood cell units and outcome of critically ill children. Crit Care. 2010 Apr 8;14(2):R57.

Transfusion Outcomes Group

• ARMS and MARS– Mechanistic & Repository Studies to Age of Blood RCTs (ABLE and RESTORE)– 1 RO1, 2 DOD grants, supplemental $ via TMH network ($10M in funding)

• Blood Conservation Implementation– York/Doctor/Spinella

• Survey of Plasma Transfusion Practice Patterns– Oliver Karam

Transfusion Outcomes Group• Transfusion epidemiology and impact of interaction

between blood products– Jacques Lacriox, Marisa Tucci & Helen Trottier

• Transfusion Outcomes Data Platform – Hanson and Spinella

• ABC study (Tucci/Spinella/Lacroix) – CIHR proposal submitted Sept 2011– IND FDA approved Oct 2011– RO1 to NHLBI Feb 2012

Transfusion Outcomes Group• Efficacy of Blood Conservation Program in Spinal

Surgery– Nabil Hassan

• Role of vWF and ADAMTS13 in surgical blood loss.– Surrender Rajasekaran

Transfusion Immunology• Transfusion and storage duration effect on monocyte

and T-cell function – Hall and Muszinsky

• EBV Transmission via Transfusion to HSCT patients– Helen Trottier

• Transfusion Associated Microchimerism - R21– Spinella

Thrombosis and Coagulation Monitoring

• Incidence and outcomes for catheter related DVT– Faustino (Completed)

• Post thrombotic syndrome in children with CHD post cath– Faustino (Partial funding by AHA)

• Thromboprophylactic Prevalence (PROTRACT) – Faustino – Prospective Observational Practice Study– 70 International Centers

Thrombosis and Coagulation Monitoring

• Incidence of ASA resistance in cardiac surgery pts– Truong/Spinella

• COAgulation in Sepsis and Trauma (COAST) Study– Incidence of hypercoagulation in Sepsis and Trauma patients– Hanson/Steiner/Spinella

• Anticoagulation effectiveness according to clot strength (TEG)– Spinella

BLOOD NET Extramural Activities• NIH/NHLBI Transfusion Brach– Comparative effectiveness symposium– RBC age mechanism and clinical trials symposium

• Best Pharmaceutical for Children’s Act (BCPA)• Society for Advancement of Blood Management• Norwegian Navy Blood Research Program• US Army Blood Research Program• Industry Sponsored Trials

– Alternative Plasma Products, WBC/pathogen inactivation

spinella_p@kids.wustl.edu

marisa.tucci@recherche-ste-justine.qc.ca

BLOOD NET– It’s an Offer You Can’t Refuse