The Jon J van Rood Center for Clinical Transfusion Research (CCTR) includes a laboratory for near patient, and point of care-like assays as well as cryopreservation and biobanking facilities. The laboratory is crucial for several of the current CCTR projects:
The Inflame study
‘The Inflame study’ investigates risk factors for transfusion induced lung injury in patients which undergo cardiopulmonary bypass supported surgery. For this the CCTR laboratory measures markers of both inflammation in plasma and on cells (e.g. by flow cytometry), activation of the hemostatic system and vascular damage at five time points: before, during and after surgery and transfusions. Biomarkers that clearly precede and are correlated with, especially the pulmonary complications in these patients will show us which causal mechanisms are in play but might eventually also help us to design preventive measures. Moreover, the found risk factors are hypothesized to also apply to TRALI, one of the most feared acute side effects of transfusion.
The Prepares study
‘The Prepares study’ investigates the clinical effectiveness of standard versus pathogen-reduced buffy coat-derived platelet concentrates in patients with acute myeloid leukemia (AML) which standardly receive prophylactic platelet transfusions to prevent bleeding. In the CCTR laboratory pre and post transfusion platelet function is monitored, moreover, both humoral as well as T-cell alloimmunization by the different platelet products is measured and compared. Such immunization namely will lead to low or absent transfusion induced platelet increments.
The R-FACT study (Risk Factors for Alloimmunization after red blood Cell Transfusion) investigates donor and patient related factors (e.g. clinical, genetic and environmental factors) influencing the risk of transfusion induced red cell alloimmunization. Golden aim of the study involves identification of patients at high risk of alloimmunization who ultimately will profit most from extended matched red cell transfusions.
As such, some future plans include analysis of genetic and biochemical factors associated with alloimmunization risks (e.g. HLA phenotypes, genes encoding cytokines and chemokines essential in innate and adaptive immune responses). In addition, we would like to assess a potential existing association between titers of naturally occurring anti-A and anti-B and red cell alloimmunization. When proven to be predictive, these titers could be easily implemented in an ‘alloimmunization prediction score’.