Today is #WorldHaemophiliaDay ( #WHD2026), this year's theme being 'Diagnosis: First step to care'. A webinar discussing previous top 10 Transfusion Evidence Round-Up papers on bleeding disorders, in recognition of this day, is available on the ISBT website. Link in replies.

🔗 #TransfusionEvidence Library link to:
Global burden of asymptomatic malaria among blood donors: systematic review and meta-analysis
by Malede et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Global burden of asymptomatic malaria among blood donors: systematic review and meta-analysis by Malede et al. featured in the Transfusion Evidence Alert - March 2026

From the #Transfusion Evidence Alert:

Global burden of asymptomatic malaria among #blooddonors: #systematicreview and #meta-analysis
by Malede et al.
🔗 Link in the comments
#MedSky

#TransfusionEvidence Library link to:
Comparison of safety and efficacy of liberal versus restrictive red blood cell transfusion thresholds on the quality of life in patients with myelodysplastic syndromes (...)
by Mandal et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Comparison of safety and efficacy of liberal versus restrictive red blood cell transfusion thresholds on the quality of life in patients with myelodysplastic syndromes: a systematic review and meta-analysis by Mandal et al. featured in the Transfusion Evidence Alert - March 2026

New from the #Transfusion Evidence Alert:

Comparison of safety and efficacy of liberal versus restrictive red blood cell transfusion thresholds on the quality of life in patients with myelodysplastic syndromes: a #systematicreview and #meta-analysis
by Mandal et al.
🔗 Link in the comments
#MedSky

Randomized, sham-controlled trial of intraoperative ticagrelor removal to reduce perioperative bleeding OBJECTIVE: Patients on ticagrelor who are undergoing cardiac surgery before completing guideline-recommended washout are at high risk for severe bleeding. This study evaluated whether a novel drug removal device reduces bleeding in patients operated within 2 days from ticagrelor discontinuation. METHODS: Eligible patients were randomized 1:1 to intraoperative DrugSorb-ATR or sham control. Primary safety end point was adverse events at 30 days. Efficacy was assessed by composite end points comprising bleeding events using Universal Definition of Perioperative Bleeding (UDPB) and 24-hour chest tube drainage (CTD) in the overall and isolated coronary artery bypass grafting (CABG) populations with a hierarchical win ratio (WR) method. RESULTS: In total, 140 patients were randomized; 132 had surgery and received a study device; and 92% were isolated CABG. Mean age was 65 ± 5 years, and 15% were female. The primary safety end point was met, with similar adverse events reported between groups. The primary efficacy end point was not met in the overall or CABG populations (Win ratio [WR], 1.07; 95% CI, 0.72-1.58; P = .748 and WR, 1.33; 95% CI, 0.86-2.04; P = .202 respectively). The supplementary efficacy end point was met in the CABG population (WR, 1.59; 95% CI, 1.02-2.46, P = .041) with significant reductions also shown in large CTD bleeding events (P = .016) and major bleeding, a composite of severe bleeding events or 24-hour CTD ≥1 L (P = .041). The number needed to treat to prevent a major bleed was 6. CONCLUSIONS: Intraoperative use of DrugSorb-ATR is safe in patients operated within 2 days of ticagrelor discontinuation. Although the primary end point was not met in the overall population, there were significant reductions in severe bleeding events in the prespecified CABG population.

🔗 #TransfusionEvidence Library link to:
Randomized, sham-controlled trial of intraoperative ticagrelor removal to reduce perioperative bleeding
by Mack et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Randomized, sham-controlled trial of intraoperative ticagrelor removal to reduce perioperative bleeding by Mack et al. featured in the Transfusion Evidence Alert - March 2026

From the #Transfusion Evidence Alert:

Randomized, sham-controlled trial of intraoperative ticagrelor removal to reduce perioperative bleeding
by Mack et al.
🔗 Link in the comments
#MedSky

Comparative efficacy of prehospital resuscitation strategies on mortality for patients with major trauma: a network meta-analysis BACKGROUND AND IMPORTANCE: Patients with major trauma face high rates of coagulopathy, hemorrhage, and organ failure, with prehospital resuscitation strategies critical for stabilization. Comparative evidence on prehospital blood [red blood cells (RBCs) and plasma] and non-blood [intravenous crystalloids and dextran, intravenous crystalloids only, and tranexamic acid (TXA)] resuscitation strategies remains limited and inconclusive. OBJECTIVES: To evaluate and compare the efficacy of prehospital blood and non-blood resuscitation strategies in patients with major trauma using network meta-analysis. DESIGN, SETTINGS, AND PARTICIPANTS: Network meta-analysis of randomized controlled trials (RCTs). Databases: PubMed, CINAHL, Cochrane Library, and Web of Science and reference lists of relevant previous studies. Participants: patients with major trauma. INTERVENTION OR EXPOSURE: Prehospital blood (RBC + plasma, RBC, and plasma) and non-blood (intravenous crystalloids + dextran, intravenous crystalloids only, and TXA) resuscitation strategies. OUTCOME MEASURE AND ANALYSIS: Study outcomes were 24-h and 28-day mortality. Data analysis was performed using Frequentist and Bayesian frameworks on MetaInsight, an R-Language web-based analytical platform, presenting odds ratio (OR) and corresponding 95% confidence interval (95% CI). Ranking of prehospital resuscitation strategies was confirmed by the surface under cumulative ranking. MAIN RESULTS: A total of 15 RCTs involving 7504 participants were included. Compared with intravenous crystalloids only, RBC + plasma (OR: 0.68, 95% CI: 0.38-1.22), plasma (OR: 0.72, 95% CI: 0.46-1.16), TXA (OR: 0.73, 95% CI: 0.52-1.04), RBC (OR: 0.81, 95% CI: 0.22-3.08), and intravenous crystalloids + dextran (OR: 0.91, 95% CI: 0.65-1.28) demonstrated no significant difference in reducing 24-h mortality. Similarly, TXA (OR: 0.83, 95% CI: 0.35-1.92), intravenous crystalloids + dextran (OR: 0.84, 95% CI: 0.46-1.52), RBC + plasma (OR: 0.88, 95% CI: 0.21-3.73), RBC (OR: 0.94, 95% CI: 0.10-8.64), and plasma (OR: 0.97, 95% CI: 0.38-2.46) revealed no significant difference in reducing 28-day mortality compared with intravenous crystalloids only. Based on ranking probabilities, RBC + plasma (65.8%) for 24-h mortality and TXA (74.6%) for 28-day mortality were ranked highest. CONCLUSION: Prehospital blood (RBC + plasma, RBC, and plasma) and non-blood (intravenous crystalloids + dextran and TXA) resuscitation strategies were associated with comparable nonsignificant effects on early and late mortality. Current evidence is insufficient to support the superiority of a single prehospital intervention with future large-scale RCTs needed to clarify role of prehospital blood and non-blood resuscitation strategies.

#TransfusionEvidence Library link to:
Comparative efficacy of prehospital resuscitation strategies on mortality for patients with major trauma: a network #meta-analysis
by Hsu et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Comparative efficacy of prehospital resuscitation strategies on mortality for patients with major trauma: a network meta-analysis by Hsu et al. featured in the Transfusion Evidence Alert - March 2026

From the #Transfusion Evidence Alert:

Comparative efficacy of prehospital resuscitation strategies on mortality for patients with major trauma: a network #meta-analysis
by Hsu et al.
🔗 Link in the comments
#MedSky

Today is #WorldHealthDay, commemorating the establishment of @who.int. In honour of this year’s theme, “Together for Health. #StandWithScience”, the SRI team has published a blog exploring its collaborative #SystematicReview work, with groups such as @isbt.bsky.social. Link in replies.

Use of albumin in patients with hepatic encephalopathy: A systematic review and meta-analysis of randomized controlled studies with trial sequential analysis BACKGROUND AND AIM: Hepatic encephalopathy (HE) is a complication of cirrhosis and one of the most important manifestations of this disease. Intravenous albumin may have the potential to mitigate oxidative stress injury inherent to the pathogenesis of HE. Our study aims to evaluate the efficacy and safety of albumin for the treatment of HE. MATERIALS AND METHODS: We performed a systematic review and meta-analysis using the PubMed, Embase, and Cochrane databases. We searched for randomized controlled trials (RCTs) comparing albumin to placebo in patients with HE and decompensated cirrhosis. The outcomes were mortality and clinical improvement of HE. The odds ratio (OR) was used for binary outcomes and the mean difference (MD) for continuous outcomes with their respective 95% confidence interval (CI). Heterogeneity was assessed using the Cochran Q test and I2 statistics. Trial sequential analysis (TSA) was performed for all outcomes. RESULTS: This study included four RCTs, amounting to 306 patients. There was a significant difference favoring albumin use for mortality (OR 0.44; 95% CI 0.24 to 0.79; p=0.007; I2=0%) and for HE improvement (OR 2.41; 95% CI 1.22 to 4.75, p=0.011; I2=34.9%) compared to placebo. There was no significant difference in ammonia levels (p=0.580), liver transplantation (p=0.732), and significant adverse events (AE) rate (p=0.586). TSA revealed that the pooled effect is statistically significant for mortality reduction with albumin use; however, regarding sample size, the result is not definitive. CONCLUSION: In patients with HE, intravenous albumin leads to HE improvement and reduced mortality, without an increase in AE rates. However, the TSA indicated that further studies are required to draw precise evidence regarding the use of albumin to reduce mortality in this population.

🔗 #TransfusionEvidence Library link to:
Use of #albumin in patients with hepatic encephalopathy: A #systematicreview and #metaanalysis of randomized controlled studies with trial sequential analysis
by Coan et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Use of #albumin in patients with hepatic encephalopathy: A #systematicreview and #metaanalysis of randomized controlled studies with trial sequential analysis by Coan et al. featured in the Transfusion Evidence Alert - March 2026

New from the #Transfusion Evidence Alert:

Use of #albumin in patients with hepatic encephalopathy: A #systematicreview and #metaanalysis of randomized controlled studies with trial sequential analysis
by Coan et al.
Link in the comments
#MedSky

WHO calls for action: “Together for health. Stand with science.” to mark World Health Day The World Health Organization (WHO) today calls on people everywhere to renew their commitment to working together and supporting science as the twin engines driving better health, under the World Hea...

Science is one of humanity's most powerful tools for protecting and improving health. Ahead of #WorldHealthDay, WHO calls on everyone to work together and champion science for a healthier world. Together for health. #StandWithScience. Learn more about the year-long campaign: bit.ly/4mdztxL

Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders RATIONALE: People with haematological disorders are frequently at risk of severe or life-threatening bleeding as a result of thrombocytopenia (reduced platelet count). This is despite the routine use of prophylactic platelet transfusions to prevent bleeding once the platelet count falls below a certain threshold. Platelet transfusions are not without risk and adverse events may be life-threatening. A possible adjunct to prophylactic platelet transfusions is the use of antifibrinolytics, specifically the lysine analogues tranexamic acid (TXA) and epsilon aminocaproic acid (EACA). This is an update of a Cochrane review last published in 2016 (with database searches conducted on 7 March 2016). OBJECTIVES: To determine the benefits and harms of antifibrinolytics (lysine analogues) in preventing bleeding in people with haematological disorders. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Transfusion Evidence Library, and ongoing trial databases on 21 January 2025. We handsearched the reference lists of all identified randomised controlled trials (RCTs). We contacted the authors of relevant studies, study groups, and experts worldwide known to be active in the field to request information about unpublished material or further information on ongoing studies. ELIGIBILITY CRITERIA: We included RCTs in people with haematological disorders who required prophylactic platelet transfusions to prevent bleeding. We only included RCTs in which the interventions were the lysine analogues TXA or EACA. OUTCOMES: We assessed bleeding severity using the World Health Organization (WHO) bleeding scale (ordinal grades 0 to 4, with higher grades indicating more severe bleeding), which has been widely applied in thrombocytopenia studies. The outcomes prioritised for the summary of findings tables were: number of participants with grade 2 bleeding or higher; number of participants with grade 3 bleeding or higher; number of participants with any thromboembolism; all-cause mortality; and adverse events attributable to antifibrinolytic drugs. We provide results only for these outcomes below. RISK OF BIAS: We used Cochrane's risk of bias 2 (RoB 2) tool. We used this tool to re-assess the previously included trials. SYNTHESIS METHODS: For this update, two review authors independently selected trials for inclusion, assessed methodological quality and risk of bias, and extracted data. We used fixed-effect models for the meta-analysis. We analysed dichotomous outcomes using risk ratios (RRs) with 95% confidence intervals (CIs), and the Peto odds ratio (Peto OR) for outcomes with very low event rates (< 3% in both arms). We assessed the certainty of the evidence using the GRADE approach. INCLUDED STUDIES: We included eight RCTs (four newly included studies plus four from the previous versions) with a total of 1041 participants in this review update. Six trials compared TXA to placebo, one trial compared EACA to no EACA, and one trial compared EACA to standard platelet transfusion. We found no trials comparing TXA to EACA. Seven trials recruited adults, while one enroled children. SYNTHESIS OF RESULTS: Tranexamic acid (TXA) versus placebo There may be no difference between TXA and placebo in the risk of experiencing grade 2 bleeding or higher, grade 3 bleeding or higher, thromboembolism, death, and drug-related adverse events, although the certainty of the evidence varied from very low to moderate for these outcomes: grade 2 bleeding or higher: RR 0.89, 95% CI 0.75 to 1.05; I² = 7%; 3 studies, 894 participants; moderate-certainty evidence; grade 3 bleeding or higher: RR 1.07, 95% CI 0.51 to 2.22; I² = 6%; 3 studies, 894 participants; low-certainty evidence; any thromboembolism: Peto OR 0.85, 95% CI 0.39 to 1.86; I² = 0%; 5 studies, 984 participants; low-certainty evidence; all-cause mortality: Peto OR 1.50, 95% CI 0.62 to 3.63; I² = 37%; 3 studies, 930 participants; very low-certainty evidence; and number of adverse events attributable to antifibrinolytic drugs: Peto OR 2.24, 95% CI 0.64 to 7.78; I² = 0%; 3 studies, 949 participants; very low-certainty evidence. Epsilon aminocaproic acid (EACA) versus no EACA The single study addressing this comparison did not report bleeding severity in a form suitable for analysis, and did not report on the number of participants with any thromboembolism or all-cause mortality. The study reported that no patient died of thrombosis. There was insufficient evidence to analyse adverse events attributable to antifibrinolytic drugs. AUTHORS' CONCLUSIONS: For people with thrombocytopenia and haematological malignancies, TXA probably makes little to no difference to clinically significant bleeding (i.e. grade 2 or higher), and may make little to no difference to severe or life-threatening bleeding (i.e. grade 3 or higher) or any thromboembolism. The evidence is of very low certainty for all-cause mortality and serious adverse events attributable to antifibrinolytic drugs. For EACA compared to no EACA, there are insufficient data to assess clinically significant bleeding, life-threatening bleeding, any thromboembolism, all-cause mortality, and serious adverse events. Those making decisions about administration of prophylactic TXA to people with thrombocytopenia and haematological malignancies should consider that current evidence does not show a benefit or harm for TXA for preventing clinically significant or life-threatening bleeding. FUNDING: This Cochrane review had no dedicated funding. REGISTRATION: Protocol (2012): DOI: 10.1002/14651858.CD009733. Original review (2013): DOI: 10.1002/14651858.CD009733.pub2. Review update (2016): DOI: 10.1002/14651858.CD009733.pub3.kljkj.

🔗 #TransfusionEvidence Library link to:
Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders
by Champaneria et al.
@liseestcourt.bsky.social
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: #Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders by Champaneria et al. featured in the Transfusion Evidence Alert - March 2026

From the #Transfusion Evidence Alert:

#Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders
by Champaneria et al.
🔗 Link in the comments
@liseestcourt.bsky.social
#MedSky

Image showing a PICO summary for: Who is the best allogeneic hematopoietic stem cell transplant donor for severe aplastic anemia? Data from the Chinese Bone Marrow Transplantation Registry Group (CBMTRG) by Xu et al. featured in the Stem Cell Evidence Alert - March 2026

New from the #StemCellEvidence Alert:

Who is the best allogeneic hematopoietic stem cell transplant donor for severe aplastic anemia? Data from the Chinese Bone Marrow Transplantation Registry Group (CBMTRG)
by Xu et al.
🔗 Link in the comments
#MedSky

Recombinant factor VIIa versus placebo for spontaneous intracerebral haemorrhage within 2 h of symptom onset (FASTEST): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial BACKGROUND: Recombinant factor VIIa has been shown to slow bleeding in patients with intracerebral haemorrhage (ICH), but no haemostatic agent has been shown to improve clinical outcomes. We aimed to evaluate the safety, clinical efficacy, and effect on growth of ICH and intraventricular haemorrhage (IVH) of recombinant factor VIIa in patients with acute spontaneous ICH who were most likely to benefit from treatment with this agent. METHODS: We conducted a multicentre, prospective, double-blind, randomised, placebo-controlled, adaptive, phase 3 trial (FASTEST) at 93 sites across the USA, Japan, Canada, Spain, Germany, and the UK. Adults aged 18-80 years with a spontaneous ICH of 2-60 mL, IVH in less than two-thirds of one lateral ventricle or in less than a third of both lateral ventricles, a Glasgow Coma Scale score of at least 8, no evidence of recent ischaemic stroke or myocardial infarction, no recent use of anticoagulation medication or other structural cause of ICH, and who had been treated with study medication within 2 h of stroke onset or last known well were eligible for inclusion. Patients were randomly assigned (1:1) by a simple randomisation scheme to either 80 μg/kg recombinant factor VIIa (intervention group) or an identical placebo (placebo group), administered intravenously over 2 min. All investigators and participants were masked to allocated group assignment. The primary outcome was functional outcome at 180 days, measured by modified Rankin Scale (mRS; score 0-2, 3, and 4-6) and analysed by intention to treat in all randomly assigned patients. The primary safety outcome was life-threatening thromboembolic events during the first 4 days, assessed in all randomly assigned participants. The secondary aim was change in ICH volume and ICH plus IVH volume between baseline and 24 h of treatment administration. We performed an ordinal logistic regression, adjusted for age, baseline ICH volume, baseline IVH volume, and pre-stroke mRS. Preplanned interim analyses, including adaptive sample size re-estimation and enrichment to a younger subgroup (aged ≤70 years), were also conducted. This trial is registered with ClinicalTrials.gov (NCT03496883) and is closed to new participants. FINDINGS: Between Dec 3, 2021, and Oct 1, 2025, we screened 3288 patients, of whom 626 participants were randomly assigned and included in the intention-to-treat analyses: 298 (48%) in the placebo group and 328 (52%) in the intervention group. 216 (35%) participants were female and 410 (65%) were male, with a mean age of 61 years (SD 12). Mean time from stroke onset to administration of study drug was 100 min (SD 22). The trial met the prespecified stopping criteria for futility at the second interim analysis. There was no differential effect in the primary clinical outcome measure of mRS at 180 days between the intervention group and placebo group (adjusted common odds ratio 1·09 [95% CI 0·79-1·51]; p=0·61). Life-threatening thromboembolic complications within 4 days occurred in 15 (<5%) participants in the intervention group and in four (1%) in the placebo group (relative risk 3·41 [95% CI 1·14-10·15]; p=0·020). Compared with placebo, recombinant factor VIIa was associated with decreased growth of ICH (-3·7 mL [95% CI -5·4 to -1·9]) and of ICH plus IVH growth (-5·2 mL [-7·6 to -2·8]) between baseline and CT scan at 24 h. INTERPRETATION: Recombinant factor VIIa administered within 2 h of ICH onset slowed haematoma growth, but did not improve functional outcomes and showed a small increased risk of life-threatening thromboembolic complications. Further testing of recombinant factor VIIa in patients with the greatest risk of continued bleeding is ongoing. FUNDING: National Institute of Neurological Diseases and Stroke, Japan Agency for Medical Research and Development, and Novo Nordisk.

#TransfusionEvidence Library link to:
Recombinant factor VIIa versus placebo for spontaneous intracerebral haemorrhage within 2 h of symptom onset (FASTEST) (...)
by Broderick et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Recombinant factor VIIa versus placebo for spontaneous intracerebral haemorrhage within 2 h of symptom onset (FASTEST): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial by Broderick et al. featured in the Transfusion Evidence Alert - March 2026

New from #Transfusion Evidence Library:

Recombinant factor VIIa versus placebo for spontaneous intracerebral haemorrhage within 2 h of symptom onset (FASTEST): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial
by Broderick et al.
🔗 Link in the comments

Interventions to Prevent Intraventricular Haemorrhage in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-Analyses INTRODUCTION: Intraventricular haemorrhage (IVH) leads to significant morbidity among preterm infants. We conducted an overview of systematic reviews of RCTs assessing the effects of perinatal/neonatal interventions in reducing IVH among preterm infants. METHODS: PubMed, Embase, Cochrane database for systematic reviews, and systematic review repositories were searched for meta-analyses of RCTs involving preterm infants or women at high risk of preterm birth and reporting on IVH. Metaumbrella package of R software was used to pool outcome data for each intervention. Quality of the systematic reviews was assessed using AMSTAR 2 tool. Certainty of evidence (COE) was reported using GRADE recommendations. RESULTS: A total of 148 systematic reviews (110 Cochrane vs. 38 non-Cochrane) were included. Postnatal interventions were reported in 118 reviews. Severe IVH was reported in 100/148 reviews that included 39,483 infants and 20,400 antenatal women. In total, 78% (n = 116) of the reviews were rated high or moderate quality on AMSTAR-2 assessment. Antenatal corticosteroids and magnesium sulphate for imminent preterm birth, volume-targeted ventilation, early rescue surfactant administration through thin catheter, prophylactic indomethacin significantly reduced the rates of severe IVH (moderate COE). Use of respiratory function monitors and heated humidified respiratory gases in the delivery room and early prophylactic erythropoietin supplementation for preterm infants may reduce the rates of severe IVH (very low COE). DISCUSSION: Antenatal steroids and magnesium sulphate administration and early neonatal lung protective strategies reduce the rates of IVH in preterm neonates. Adequately powered RCTs evaluating IVH care bundles with long-term follow-up are required.

🔗 #TransfusionEvidence Library link to:
Interventions to Prevent Intraventricular Haemorrhage in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-Analyses
by Bhanushali et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Interventions to Prevent Intraventricular Haemorrhage in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-Analyses by Bhanushali et al. featured in the Transfusion Evidence Alert - March 2026

New from the #Transfusion Evidence Alert:

Interventions to Prevent Intraventricular Haemorrhage in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-Analyses
by Bhanushali et al.
🔗 Link in the comments
#MedSky #systematicreview #metaanalysis

Image showing a PICO summary for: Longitudinal Study of Late Acute and Chronic Graft-Versus-Host Disease after Allogeneic Hematopoietic Cell Transplantation: A Long-Term Follow-up Study from the Chronic Graft-Versus-Host Disease Consortium by Pidala et al. featured in the Stem Cell Evidence Alert - March 2026

From the #StemCellEvidence Alert:

Longitudinal Study of Late Acute and Chronic Graft-Versus-Host Disease after Allogeneic Hematopoietic Cell Transplantation: A Long-Term Follow-up Study from the Chronic Graft-Versus-Host Disease Consortium
by Pidala et al.
Link in the comments
#MedSky

N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial Linezolid-associated thrombocytopenia (LAT) limits its use in critically ill patients. This double-blind, randomized, placebo-controlled trial evaluated intravenous N-acetylcysteine (IV NAC) for LAT prevention in 250 critically ill adults receiving linezolid for ≥ 48 h. Patients received IV NAC (600 mg every 12 h) or placebo. The primary endpoint was LAT incidence (platelet count <150 × 10 ³/mm³ or >50 % reduction from baseline). NAC significantly reduced LAT incidence (16.8 % vs. 41.6 %; p < 0.001), platelet transfusions (1.6 % vs. 11.2 %; p = 0.003), and linezolid discontinuations (6.4 % vs. 32.0 %; p < 0.001). NAC delayed LAT onset (adjusted hazard ratio 0.24; p < 0.001) and accelerated platelet recovery (adjusted hazard ratio 3.88; p = 0.011), with greatest benefit in moderate-severity cases. These findings suggest IV NAC may offer a preventive benefit against LAT in critically ill patients, though multicenter validation is needed to confirm generalizability across diverse clinical settings. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT05944458. Registered on July 6, 2023.

🔗 #TransfusionEvidence Library link to:
N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial
by Abdeltawab et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial by Abdeltawab et al. featured in the Transfusion Evidence Alert - March 2026

From the #Transfusion Evidence Alert:

N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial
by Abdeltawab et al.

🔗link in the comments
#MedSky

Image showing a PICO summary for: The role of HLA transcription in unrelated hematopoietic cell transplantation by Morishima et al. featured in the Stem Cell Evidence Alert - March 2026

New from the #StemCellEvidence Alert:

The role of HLA transcription in unrelated hematopoietic cell transplantation
by Morishima et al.
🔗Link in the comments
#MedSky

Preventive interventions for vasovagal reactions in whole blood donors: a cluster-randomised, stepped-wedge, crossover trial of 73 sites involving 1·4 million donors in England BACKGROUND: Vasovagal reactions are the most common acute systemic complications of whole blood donations and are associated with significant morbidity and medicolegal costs. Blood services worldwide have implemented various strategies to prevent vasovagal reactions, often without robust evidence. We compared standard practice in England with four vasovagal reaction prevention interventions used in other services or previously tested in small-scale studies. METHODS: This cluster-randomised, stepped-wedge, crossover trial involved 73 blood donation sites (clusters) across England, UK. Each site was randomly allocated to one of 64 possible sequences for implementing one or more of four interventions over four 9-month periods, yielding a total of 292 site-periods for a 36-month overall trial duration. Participants within each period were not unique, as repeat donations were included. Cluster randomisation was chosen for operational feasibility. Potential carry-over effects were minimised by use of stepped-wedge, crossover, and factorial design elements. The interventions assessed were: 500 mL pre-donation isotonic drink (vs standard 500 mL plain water), extended 3-minute post-donation rest on the donation chair (vs standard 2-minute rest), modified applied muscle tension (AMT) exercise (vs current AMT practice); and psychosocial intervention using preparatory materials (vs no materials). The primary outcome was in-session vasovagal reaction with loss of consciousness. Analysis was by intention-to-treat, including data from all donors attending the donation sites during the trial, unless the donor opted-out. This trial registered with isrctn.com (ISRCTN 10412338) and is complete. FINDINGS: Between Nov 4, 2019, and Nov 3, 2022, we recruited 1 379 095 blood donors who made 4 134 712 blood donations. The median age of donors at time of baseline trial visit was 41 years (IQR 30-54), 785 271 (56·9%) of 1 379 095 donors were female and 593 824 (43·1%) were male. 461 954 (33·5%) were first-time donors. We recorded 4388 vasovagal reactions with loss of consciousness and 60 517 total in-session vasovagal reactions (ie, with and without loss of consciousness). Compared with standard practices, none of the interventions clearly reduced the primary outcome (joint p=0·21) with an odds ratio of 0·98 (95% CI 0·92-1·04) for isotonic drink, 0·99 (0·92-1·06) for extended chair rest, 1·12 (1·00-1·26) for modified AMT, and 1·03 (0·93-1·14) for psychosocial intervention. Absolute event rates per 10 000 donations were 10·7 without intervention and 10·5 with intervention. Findings were similar for total in-session vasovagal reactions with higher absolute event rates. INTERPRETATION: Four interventions used to prevent donation-related vasovagal reactions showed no clear benefits compared with standard practices in England, suggesting potential policy implications for blood services worldwide to streamline donation practices and save resources. FUNDING: NHS Blood and Transplant and the NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (formerly Donor Health and Genomics).

#TransfusionEvidence Library link to:

Preventive interventions for vasovagal reactions in whole blood donors: a cluster-randomised, stepped-wedge, crossover trial of 73 sites involving 1·4 million donors in England
by Kaptoge et al.
www.transfusionevidencelibrary.com/alerts/artic...
#MedSky

Image showing a PICO summary for: Preventive interventions for vasovagal reactions in whole blood donors: a cluster-randomised, stepped-wedge, crossover trial of 73 sites involving 1·4 million donors in England by Kaptoge et al. featured in the Transfusion Evidence Alert - March 2026

New from the #Transfusion Evidence Alert:

Preventive interventions for vasovagal reactions in whole blood donors: a cluster-randomised, stepped-wedge, crossover trial of 73 sites involving 1·4 million donors in England
by Kaptoge et al.

🔗Link in the comments
#MedSky

Image showing a PICO summary for: The BIOPREVENT machine-learning algorithm predicts chronic graft-versus-host disease and mortality risk using posttransplant biomarkers by Martens et al. featured in the Stem Cell Evidence Alert - March 2026

From the #StemCellEvidence Alert:

The BIOPREVENT machine-learning algorithm predicts chronic graft-versus-host disease and mortality risk using posttransplant biomarkers
by Martens et al.

🔗Link in the comments

Transfusion Evidence Library The Transfusion Evidence Library is a database of systematic reviews (since 1980) and randomised controlled trials (since 1950) relevant to transfusion medicine. It is fully searchable, updated monthly and aims to be a key resource for medical practitioners, policy makers and researchers both in the UK and around the world. The Library is produced by the Systematic Review Initiative, supported by the UK Blood Services.

🔗Sign up to get the #Transfusion Evidence Alert in your inbox: www.transfusionevidencelibrary.com/alerts/latest

Image showing an extract of the Transfusion Evidence Alert - March 2026

The #Transfusion Evidence Alert is out!

Each month our clinical team picks the ten top references in the #transfusionmedicine field, each with a quick-format PICO summary, so you can rapidly identify what you need to read.
🔗Link in the comments
#MedSky

Image showing a PICO summary for: Baseline IPSS-M vs Pretransplant Risk Downstaging as Prognostic Determinants in MDS Undergoing Allogeneic Transplantation by Aguirre et al. featured in the Stem Cell Evidence Alert - March 2026

From the #StemCellEvidence Alert:

Baseline IPSS-M vs Pretransplant Risk Downstaging as Prognostic Determinants in MDS Undergoing Allogeneic Transplantation
by Aguirre et al.
🔗Link in the comments.