Preoperative anemia, red blood cell transfusion triggers and implementation of patient blood management (PBM) were on focus at the first International Consensus Conference on PBM, held in Frankfurt, Germany, on 24 and 25 April. The conference was initiated by the European Blood Alliance and co-organized by Professor Erhard Seifried of the Goethe University of Frankfurt and supported by a scientific committee of 17 international experts in the field of hemotherapy and Transfusion Medicine. Patient representatives and 200 recognized medical experts from the areas of transfusion medicine, surgery, anesthesia, hematology and other disciplines, representing 40 countries on 4 continents, worked intensively to make evidence-based consensus recommendations to care for patients who might need a blood transfusion.
In these three focus areas of patient blood management, 17 specific PICO (Patient, Intervention/Risk, Comparison, Outcome) questions were formulated by an international Scientific Committee. The Centre for Evidence-Based Practice (CEBaP) of the Red Cross Belgium then looked for scientific studies around these questions. Based on a rigorous process in close collaboration with the Scientific Committee and search strategies in 4 different biomedical databases (Pubmed, Embase, Cochrane Library and Transfusion Evidence Library), the CEBaP screened approximately 18000 publications to include 142 studies in the evidence summaries.
The consensus development format used engaged in the process the Scientific Committee, three multidisciplinary decision making panels and the expert participants of the conference. On the first day, the evidence summaries were presented and critically discussed in three parallel sessions. After these public sessions, the expert panels retreated and drafted their first recommendations, based on the available evidence and the discussions throughout the day. These draft recommendations were presented to the full audience on the second day of the conference and were then discussed and voted on to assess the support of all the participants. Experienced rapporteurs recoded the discussion and justifications of the recommendations to GRADEpro software securing a fully transparent process according to the evidence-to-decision framework.
This conference was unique in two aspects: first due to the rigorous way the GRADEpro was used throughout the consensus conference with a chair and a methodologically qualified co-chair in each of the panels and second to its international nature. The Consensus Conference was a collaborative scientific activity of the American Association of Blood Banks (AABB), the International Society of Blood Transfusion (ISBT), the German Transfusion Society (DGTI), the French Society of Blood Transfusion (SFTS), the Società Italiana di Medicina Transfusionale e Immunoematologia (SIMTI), the Centre for Evidence-Based Practice (CEBaP) and the European Blood Alliance (EBA) were all co-sponsors. Furthermore there were several other international partners* providing multidisciplinary expertise. Prof Erhard Seifried, President of the ICC-PBM 2018 and Executive Director of the Red Cross Baden Wurttemberg Hessen Blood Service was very pleased with the collaboration: “The global spread of the co-sponsors ensured broad support and made sure we were able to get a wide variety of experts and opinions before and at the conference” he noted.
The recommendations of the first International Consensus Conference on Patient Blood Management have been published in JAMA.
The Evidence Summaries, on which the consensus was build, can be read here.
The full program can be read in pdf