Recently, a thought-provoking commentary on the “Evolution of the nation’s blood supply system” appeared inTransfusiononline, ahead of print. The authors predict our current network of independent and American Red Cross blood centers will evolve to either a “consolidated” system of four to six independent suppliers or a single national system. Disturbingly, the authors predict a period of “temporary localized disruption of services” as we move to the new format, with shortages of certain products and a lack of full support for patients needing specialized products.
If such shortages are occurring now, they are not well-documented. Naturally, it’s not in the best interests of the hospital nor the supplier to publicize any supply issues. However, in every recent disaster or emergency, the needs of patients have been met through the AABB Interorganizational Disaster Task Force or more informal networks. The recent thousands of blood units provisioned to Puerto Rico to cover during the Zika crisis is an excellent case in point.
Another disturbing note in this piece regards innovation by the blood community. “There has been wonderful innovation in transfusion medicine supported by blood centers, federal funding, industry, and universities…Industry is no longer willing to develop new products as there is little likelihood that the innovations will be implemented.” The recent response to the threat from Zika virus, however, belies this statement, as one of the major NAT manufacturers already has a test under IND, and the other is expected to launch one shortly. Interestingly, exactly 20 years ago, one of the authors published a similarly-titled piece in AJCP. McCullough wrote, “Research in transfusion medicine and related fields is bringing potential new transfusion therapies and blood components closer to reality. The blood system and the organizations and people who compose it must continue to evolve in ways to implement these new therapies.” Sadly, some of the promising products of that time, notably red cell substitutes, have not worked out. Pathogen reduction, however, is now a licensed product and available as another tool in the battle with Zika and other pathogens. We do move ahead, even as the rate of change sometimes seems glacial in the scientific and regulatory world but rapid in the organizational world.
Susan Rossmann, MD, PhD; Board President; firstname.lastname@example.org