59 Past, present, and future of red blood cells Historical RBC trends Trend/Theme Drivers/Factors Definition Example quote Future RBC demand will decrease Hb-oxygen carriers This sub-code describes how hemoglobinoxygen carriers, if successful, would contribute towards a reduction of RBC demand. We just had a patient...that we gave 2 units of Hemopure to. She had a Hb of 3; within 3 days, she had a Hb of 7. So there’s something magical about these products that could be very disruptive. Hemoglobinopathy innovations This sub-code encompasses innovations within hemoglobinopathies that could possibly reduce RBC transfusions within this sub-population. It includes new medications that help reduce the severity of sickle cell (SC) diseases, O2 binding of hemoglobin and thereby decreasing polymerization and reducing crises, knowledge of how alloimmunization works on the genetic level (including the identification of a single nuclear polymorphism), being able to shut down the alloimmune response so that unmatched blood could be given, and recognizing those who are responders vs non-responders within the patient population. Respondents said that the RBC reduction is not a certain consequence of these innovations, and if it were to lead to a reduction, it may only be a small amount. However, a pediatric hematologist mentioned that having SC patients undergo modulators at a younger age may lead to decreased complications for them as an adult, which would reduce the need for transfusions. And if you have less complications, because IF you are a grownup and have complications, you will end up with transfusions because that’s most of the time, the only thing you can do. If you have chronic liver disease, a complication of SC, then you cannot really modulate it and then the only thing you can do is try to lower your SC and prevent it from happening again. So a lot of complications ARE, in the grownups, being treated with transfusions. So if there are more modulators, starting at a young age, then maybe the use of transfusions in the adults will reduce finally.
RkJQdWJsaXNoZXIy MTk4NDMw