Improving the Safety and Availability of Blood Transfusions

National Heart Lung and Blood Institute (NHLBI)
A nurse tends a woman donating blood
In the United States, someone needs blood every two seconds. The safety and availability of blood for transfusions depend on careful screening and selection of donors. Understanding which donor characteristics lead to the best outcomes for blood transfusion recipients is key to improving health care for millions of patients.

As the data coordinating center for the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III), RTI is working to close gaps in previous research, which have not comprehensively linked characteristics of donated blood to patient outcome. By identifying factors that lead to positive transfusion outcomes, results from REDS-III will allow practitioners to better utilize donated blood.

Basic, Translational, and Clinical Research in Four Countries

REDS-III is a seven-year transfusion safety research initiative launched by NHLBI that aims to improve transfusion practice, as well as blood donor safety and availability in both domestic and international settings.

The third in a series of NHLBI epidemiologic programs, REDS-III is the first to evaluate recipient outcomes as part of its portfolio of U.S. studies.

As the data coordinating center, RTI processes all data from the domestic studies—which gather information from four blood centers, 12 hospitals, and a central lab unit.

We also serve as the coordinating center for the international programs, which focus on donor and lab research regarding HIV transmission in Brazil, China, and South Africa, and on improving blood donor screening and management in these settings. We are also supporting efforts at these international sites to develop the capacity to rapidly investigate new or emerging transfusion-transmitted infections.

Better Data Supports Improvements in Blood Safety and Transfusion Medicine Practices

As a result of REDS-III, for the first time investigators have research data that enable linkage between blood donors and their donations to recipient clinical data. This allows researchers to investigate transfusion triggers, possible transfusion-transmitted infections and factors that contribute to transmission, and the effects of various transfusion medicine practices.

In addition to the donor and recipient data routinely captured by REDS-III, the program has 25 focused research protocols on topics such as genetic factors that may affect blood storage, establishment of a Brazilian sickle cell disease cohort, and molecular determinants of response to transfusion.

Other international studies investigate blood-borne infections such as chikungunya and dengue.

“The risks presented by the migration of tropical mosquito-borne diseases and emerging viruses challenge our ability to respond rapidly to identify and mitigate the potential for transmission of new and emerging diseases by blood transfusion,” noted Donald Brambilla, senior research statistician and co-principal investigator for REDS-III. “This aspect of the program will inform improvements in global surveillance of blood supplies, directly improving the safety of blood transfusions worldwide.”