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 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 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 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

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