Transfusion medicine in the era of genomics and proteomics.
Viewing recent trends in transfusion medicine (TM), the authors make predictions about possible future developments within this specialty including greater cost-effectiveness and blood safety resulting from increased automation; techniques in genetics replacing serological typing in many standard assays; and TM service playing a major R&D role together with clinical services in the emerging cell-based therapeutics. To achieve this, the TM laboratory of the future will need to have available extensive skills in immunogenetics and database expertise; emerging techniques in genomics and proteomics will need to be integrated with classic immunohematology approaches; and collaborative networks of TM laboratories will need to raise their profiles as a competent partner in the ongoing clinical biotechnology revolution. Blood product safety is profiled to highlight some of these developments. Until recently, avoiding pathogen transmission has focused primarily on excluding at-risk donors and testing donor blood for pathogen markers. Newer trends in pathogen-inactivation procedures could alter the protein composition of the blood product, potentially causing unintended immune reactions that could outweigh their benefits in further reducing a very low current risk of pathogen transmission. By combining proteomics and immunohematology, those manufacturing processes least likely to generate posttranslational protein modifications will need to be identified.
Greinacher
Andreas
A
Department of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany. greinach@unireifswald.de
Warkentin
Theodore E
TE
D001331:Automation; D001788:Blood Grouping and Crossmatching / Q000379:methods / Q000639:trends; D001803:Blood Transfusion / Q000379:methods; D003257:Consumer Product Safety; D004203:Disinfection / Q000379:methods / Q000592:standards; D004340:Drug Contamination / Q000517:prevention & control; D023281:Genomics / Q000379:methods; D006801:Humans; D040901:Proteomics / Q000379:methods; D011786:Quality Control