You may think whole blood is a dinosaur, a relic of long-forgotten blood banks past. Mark Yazer is on a mission to change your mind about this “old school” solution!

Dr. Mark Yazer

Dr. Mark Yazer

In the remote history of transfusion medicine, life was simple. We had exactly one product. Someone could call and say, “hey, my patient needs red cells,” and our response: “Great, we’ve got some nice whole blood for ya!” Or, “this guy could really use some plasma.” Blood bankers: “We’ve got just the thing: Whole blood!”

However, around 50 years ago, we started separating whole blood into red cells, plasma, and platelets, and the age of “component therapy” was born. Hardly anyone used whole blood (except the military, where such use continued throughout numerous US combat campaigns).

Back to the Future

In 2017, as we learn more and more about what works and what doesn’t in trauma resuscitation, some are looking again at whole blood. Dr. Mark Yazer is helping to lead the charge toward the use of this product, specifically low-titer group O cold-stored whole blood, which he calls “the ideal pre- and early in-hospital resuscitation fluid!” In this episode, Mark returns to outline his case for that outrageous statement, making the following points (with time-stamps for where you can hear the points in the discussion):

  • There is a long history of transfusing whole blood [17:48]
  • It simplifies the logistics of resuscitation [25:10]
  • It is more concentrated than components [29:03]
  • Cold-stored platelets might be great! [33:37]
  • Nobody hemolyzes! [39:48]
  • Outcomes are not worse compared to component therapy [47:53]

About My Guest:

Dr. Mark Yazer graduated from medical school at the University of Ottawa and completed his residency in hematological pathology at the University of Alberta. He is currently a Professor of Pathology at the University of Pittsburgh, and the medical director of the RBC serology laboratory at the centralized transfusion service in Pittsburgh, one of the largest transfusion services in North America. Mark is also an adjunct professor of clinical immunology at the University of Southern Denmark. He has published over 150 peer reviewed papers, and is an associate editor of the journal Transfusion Medicine and the journal Hematology. Mark is on the editorial board of 4 other journals, and is on the scientific advisory/speakers board of 7 corporations. He is the chairman of the AABB’s molecular testing standards unit, and the co-chairman of the AABB/THOR working group. Dr. Yazer has given over 200 lectures on his research worldwide. His interests include patient blood management, blood utilization in trauma, and electronic enhancements for patient safety (and don’t forget ice hockey!).

Free CE

This podcast episode offers a FREE continuing education activity where you can earn the following types of credit: 1 AMA PRA Category 1 CreditTM, 1 ASCLS P.A.C.E.® Contact Hour (including Florida Clinical Laboratory Credit), and American Board of Pathology Self-Assessment Modules (SAMs) for Continuing Certification (CC, formerly MOC).

To receive credit and review the accreditation information and related disclosures, please visit Transfusion News Continuing Education on Wiley Health Learning.

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DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Mark discloses honoraria from Terumo, while I have no relevant financial disclosures.

The images below are generously provided by Dr. Yazer.

Slide 1 - Description of Pittsburgh program for whole blood in adult trauma
Slide 2 - Details on units of whole blood used in adult trauma in Pittsburgh program
Slide 3 - No hemolysis evident when comparing group O recipients of group O whole blood vs non-group O recipients
Slide 4 - More markers with no difference between O and non-O recipients of O whole blood
Slide 5 - Outcomes? Here are a few, with no difference between recipients of whole blood vs components
Slide 6 - Small numbers, but no difference in outcomes for pediatric O whole blood recipients

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