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The goal of the REDS program is to evaluate and improve the safety and availability of the blood supply and the safety and effectiveness of transfusion therapies. The program also works to proactively address potential emerging threats to the Nation's blood supply and serves as a resource for ongoing work in transfusion research. Now in its fourth phase, the Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P) program aims primarily at improving the benefits of transfusion while reducing its risks; the REDS program also has a new focus on previously understudied populations.
Over the past 30 years, REDS has been the premier research program in blood collection and transfusion safety in the United States. In its third phase — REDS-III — the program focused on conducting research on all elements of the transfusion chain, from the blood donor to the blood products made from their donation to the adult patients receiving the products through transfusion. The program compiled these linked demographic, clinical, and laboratory data on blood donors and recipients into comprehensive databases that are available through NHLBI's Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC).
REDS-IV-P builds on REDS-III with an additional focus on research with newborns, children, and pregnant women who need transfusions. The data compiled in REDS-IV-P will allow investigators to rapidly address key research questions in transfusion medicine and inform blood policy decisions, for adults as well as for children and other understudied patient populations.
REDS-IV-P also extends the Brazilian sickle cell disease cohort that was established in REDS-III to evaluate transfusion practices and associated clinical outcomes in sickle cell disease. The REDS-IV-P Brazilian transfusion program will also continue its monitoring and surveillance efforts for Zika, chikungunya, dengue, and other emerging viral threats to the blood supply.
The program has established scientific approaches to assessing the risks of contracting transfusion-transmitted infectious agents, established databases to evaluate the blood supply as well as specific populations of transfused patients, and added shareable biorepository resources for the scientific community.
Findings from the original REDS program, which was created in response to the emerging HIV/AIDS epidemic, dramatically improved blood safety. REDS-II approached both infectious and noninfectious problems, such as transfusion-related acute lung injury, that could affect the U.S. and international blood supply.
Key scientific contributions from REDS-III include:
The U.S. component of the REDS-IV-P program has four research hubs. Each hub has a blood center and offers transfusion services to support health care and community hospitals. The international component involves collaborations between U.S. and Brazilian researchers. The research activities of all REDS-IV-P hubs are supported by a data coordinating center (Westat, Maryland) and a center for transfusion laboratory studies (Vitalant Research Institute, California).
The REDS-IV-P program will serve as a resource to the scientific community by giving investigators outside the program opportunities that include:
Another important part of the collaborative research effort in REDS-IV-P is the training of junior investigators in blood banking and transfusion medicine research. This enables the NHLBI to build research capacity in an area of tremendous global public health importance.
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A study of more than 1 million transfusion recipients does not suggest a change in red blood cell donation practices
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