Recipient Epidemiology and Donor Evaluation Study (REDS) Program

Project began

What is the goal of the REDS program?

The REDS program works to proactively address potential emerging threats to the Nation’s blood supply, evaluate how to enhance the effectiveness and safety of transfusions, and serve as a resource for ongoing work in transfusion research. This highly successful program assesses blood banking (blood collection, screening, and processing strategies) and transfusion medicine practices. Now in its third phase, the REDS-III research program aims primarily to improve the benefits of transfusion while reducing its risks. Over the past 20 years, REDS has proven to be the premier research program in blood collection and transfusion safety in the United States.

The second phase of the program, REDS-II, expanded the original program’s focus by including countries seriously affected by the HIV/AIDS epidemic. Many of those countries face critical blood safety and supply challenges. Underscoring the importance of global blood safety, Brazil, China, and South Africa now have joined other countries that have sites participating in REDS-III.

The domestic component of REDS-III has undergone a major shift in emphasis since the start of the REDS and REDS-II programs. While REDS-III continues to address donor health and blood donation safety and availability issues, it now integrates adult transfusion recipient epidemiology and laboratory studies. In addition, NHLBI has committed to the development of comprehensive databases which link demographic, clinical, and laboratory data on blood donors and their recipients. These data allow investigators to rapidly address key research questions in blood banking and transfusion medicine and inform blood policy decisions.

Internationally, the goal of the REDS program has been to reduce and prevent the transmission of HIV and other infectious agents, such as Dengue and Zika viruses, through blood transfusions. The program also seeks to evaluate transfusion practices and associated clinical outcomes in specific situations, such as with peripartum hemorrhage in HIV patients in South Africa and sickle cell disease in patients in Brazil.

  • The program protects the Nation’s blood supply by conducting research to improve blood component safety and availability.
  • NHLBI launched the REDS program in 1989 and has had two follow-up studies, REDS-II and REDS-III.
  • Internationally, REDS seeks to reduce and prevent the transmission of HIV and infectious agents, such as Dengue and Zika viruses, through blood transfusions.

How does the REDS program contribute to scientific discoveries?

So far the program has established scientific approaches to assessing the risks of contracting transfusion-transmitted infectious agents; established databases to evaluate specific transfused patient populations; and added shareable biorepository resources for the scientific community.

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- Recipient Epidemiology and Donor Evaluation Study (REDS) Program

Under the original REDS program, created in response to the emerging HIV/AIDS epidemic, researchers studied human retroviruses (such as human T-lymphotropic virus and HIV) and their impact on the blood supply. Implementation of findings from these studies has dramatically improved blood safety.

REDS-II approached both infectious and non-infectious problems, such as transfusion-related acute lung injury, that could affect the U.S. and international blood supply. Through these research efforts, scientists identified the factors which affected the risks of a viral infection, such as HIV being transmitted through blood transfusions.

The REDS program has also made key scientific contributions by developing studies on iron metabolism, reducing the risk of HIV transfusion-transmission, evaluating transfusion strategies in specific patient populations with HIV, and evaluating severe cardiopulmonary adverse events in transfused patients. Research by the program also has had an impact on donor screenings by helping to inform public health policies and the development of methods to reduce the risk of transfusion-transmitted infection.

How is the current REDS-III program conducted?

The U.S. part of the REDS-III program has four research hubs, and each hub has a blood center and transfusion services to support healthcare and community hospitals. The international part of the REDS-III program involves collaborations between investigators in the United States and scientists at blood centers in Brazil, China, and South Africa. The research activities of all REDS-III centers are supported by a data coordinating center (RTI International) and a central laboratory (Blood Systems Research Institute, San Francisco).

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- Recipient Epidemiology and Donor Evaluation Study (REDS) Program

Another piece of the collaborative research effort in REDS-III is the opportunity to train junior investigators in blood banking and/or transfusion medicine research, which allows NHLBI to build research capacity in an area of tremendous global public health importance.