238 Chapter 7 alludes to the fact that there may be upcoming phases of great speed in a product’s life cycle. Lastly, the use of Artificial Intelligence (AI) has increased in healthcare,7 affecting clinical medicine, including blood loss in surgery,8–10 PBM,11 and various Transfusion Medicine tasks.12 For BEs, AI research is being done related to blood donors and donations,13–15 patients,16,17 and the supply chain of products, both in times of crisis18 and non-crisis.19 Hence, the use of AI will likely be integrated in healthcare and BE practices, concurrent to grappling with and answering the various legal, ethical, and environmental issues surrounding it.7 Another way of differentiating between the transformational factors listed in Chapters 2 and 4 is to assess their slow versus rapid natures of development. For example, an important (and slow) transformational factor is demographics, particularly an increasing aging population concurrent to a shrinking younger population. This is a well-known global health phenomenon documented in high-income countries. There is literature that predict a much larger volume of blood donations and products needed to meet future demand.20,21 However, the effects of increased blood demand by the elderly will likely be counterbalanced by the effects of medical or surgical advances that decrease or eliminate blood loss, as previously described and historically shown in literature.22–25 Another demographic-related factor is the migrant population, particularly those who have blood-related diseases and require rare blood. As European populations are affected by the waves of migrant and refugee movement, there is growing interest in monitoring these populations and increasing the migrant donor population, which needs to continue to better serve these minority groups. However, factors can be both slow and rapid, for example, in how disruptive events (an umbrella term used to denote significant societal, economical, ecological, political, and operational events) can have a slow, relatively unknown build-up which then explodes and remains in the forefront for a while, as illustrated in recent world events. As the SARS-CoV-2 virus has shown what a global multi-year pandemic can look like, it seems plausible that such scenarios can occur again. Blood demand would be cataclysmically impacted if future viruses would be transmissible by transfusion (i.e., cause a Transfusion-Transmitted Infectious Disease, TTID). Thus, it is important for BE management to have an adaptive (emergency) plan in place, such as dynamic adaptive planning (DAP) or dynamic adaptive policy pathways (DAPP).26 Transformational factors that would affect future immunoglobulin demand Ig is embedded in a complex system of supply and demand, financial, regulatory, social, and regulatory issues, which we attempted to portray in Chapter 3, Figures 3.2-3.4. Since demand of Ig is skyrocketing, and global supply originates predomi-
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