Markus M. Mueller

DRK Blutspendedienst Frankfurt/Main · Blood Donation

Disseminated intravascular coagulation (DIC) and liver diseases are complex clinical conditions. Both disorders frequently disturb the finely tuned coagulation and fibrinolysis equilibrium. In DIC, a wide range of underlying disorders can induce a systemic activation of the coagulation system with generation of soluble fibrin, possible deposition o...

Demographic changes in developed countries as their populations age lead to a steady increase in the consumption of standard blood components. Complex therapeutic procedures like haematopoietic stem cell transplantation, cardiovascular surgery and solid organ transplantation are options for an increasing proportion of older patients nowadays. This...

Background and objectives: G-CSF-mobilized peripheral blood stem cells have long replaced marrow as the major source for allogeneic transplants. Conclusive evidence questioning the long-term safety of G-CSF for donors has not been provided, but the cumulative number of followed donors remains insufficient to rule out rare adverse events. A long-te...

About four million units of packed red cells are transfused in Germany every year. The safety of blood transfusions is further improved by modern production methods and molecular diagnostic techniques. This review is based on selected publications,including the German guidelines and regulations and the German Transfusion Act. Packed red blood cells...

Importance Blood transfusion is one of the most frequently used therapies worldwide and is associated with benefits, risks, and costs. Objective To develop a set of evidence-based recommendations for patient blood management (PBM) and for research. Evidence Review The scientific committee developed 17 Population/Intervention/Comparison/Outcome (P...

Background Bone marrow (BM) transplantation is a life-saving therapy for hematological diseases, and the BM harbors also highly useful (progenitor) cell types for novel cell therapies manufacture. Yet, the BM collection technique is not standardized. Methods Benchmarking our collection efficiency to BM collections worldwide (N = 1248), we noted a...

Background: Patient Blood Management (PBM) is a patient-centred, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient's own blood whilst promoting patient safety and empowerment. The effectiveness and safety of PBM over a longer period have not yet been investigated. Methods: We performed a prospec...

The ABO blood group (BG) system is of great importance for blood transfusion and organ transplantation. Since the same transcription factors (TFs) and microRNAs (miRNAs) govern the expression of ABO BG antigens and regulate erythropoiesis, we hypothesized functional connections between both processes. We found significantly higher hemoglobin and he...

Background Blood transfusions are common medical procedures and every age group requires detailed insights and treatment bundles. The aim of this study was to examine the association of anaemia, co-morbidities, complications, in-hospital mortality, and transfusion according to age groups to identify patient groups who are particularly at risk when...

The biomedical consequences of allogeneic blood transfusions and the possible pathomechanisms of transfusion-related morbidity and mortality are still not entirely understood. In retrospective studies, allogeneic transfusion was associated with increased rates of cancer recurrence, metastasis and death in patients with colorectal cancer. However, c...

Purpose Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort obse...

Purpose Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort obse...

Aims An International Consensus Conference (ICC) on PBM was held in 2018 to develop evidence‐based clinical and research recommendations for preoperative anaemia, red blood cell (RBC) transfusion thresholds for adults and implementation of PBM programmes. Methods An international scientific committee (SC) defined 17 Population‐Intervention‐Compari...

Background Conditions during blood product storage and transportation should maintain quality. The aim of this in vitro study was to investigate the effect of interruption of agitation, temporary cooling (TC), and pneumatic tube system transportation (PTST) on the aggregation ability (AA) and mitochondrial function (MF) of platelet concentrates (PC...

Zusammenfassung Hintergrund: Entsprechend der Richtlinie Hämotherapie müssen bei Patienten mit planbaren Eingriffen, bei denen periope-rativ eine Transfusion von Erythrozyten-konzentraten (EK) ernsthaft in Betracht kommt, ein gültiger Befund der Blutgrup-penbestimmung und ein Ergebnis des Antikörpersuchtests vorliegen. Die lo-kale eingriffsspezifis...

Background and Objectives Red blood cell (RBC) transfusions are needed by almost every acute myeloid leukaemia (AML) patient undergoing induction chemotherapy and constitute a cornerstone in supportive measures for cancer patients in general. Randomized controlled trials have shown non‐inferiority or even superiority of restrictive transfusion guid...

Background and objectives: Preoperative anaemia is an independent risk factor for a higher morbidity and mortality, a longer hospitalization and increased perioperative transfusion rates. Managing preoperative anaemia is the first of three pillars of Patient Blood Management (PBM), a multidisciplinary concept to improve patient safety. While vario...

Background: Approximately 4550 persons were under treatment for hemophilia in Germany in 2017. The condition is currently treated with intravenous supplementa- tion of the missing clotting factor, either prophylactically or as needed. Newer treat- ment options rely on novel mechanisms of action. Methods: This review is based on pertinent publica...

Introduction: The analysis of published clinical trial results is essential for the evidence base of patient blood management (PBM). In addition, an evidence-based way of developing guidelines and recommendation is indispensable for high quality patient-centred hemotherapy. The international Consensus Conference (ICC) was set up in order to develop...

Background and objectives: Patient Blood Management (PBM) aims to optimize the care of patients who might need a blood transfusion. The International Consensus Conference on PBM (ICC-PBM) aimed to develop evidence-based recommendations on three topics: preoperative anaemia, red blood cell transfusion thresholds and implementation of PBM programmes...

Nowadays, management of hemotherapy is regulated in Germany by the transfusion act and several guidelines while the transfusing physician is responsible for correct implementation at the bedside. Indications for blood products have to be carefully adapted to the patient's current clinical situation and pre-existing diseases have to be considered as...

Background Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and age-related decline of functional reserves. The purpose of the st...

Background: Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and aging-related decline of functional reserves. The purpose of the...

Background: Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and aging-related decline of functional reserves. The purpose of the...

Background: Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and aging-related decline of functional reserves. The purpose of the...

BACKGROUND RNA viruses are associated with a high frequency of mutations because of the missing proofreading function of polymerases, such as reverse transcriptase. Between 2007 and 2010, six blood donations with false‐negative nucleic acid technology (NAT) results were reported in Germany. Therefore, NAT screening in two viral genome regions was i...

Background: A multicomponent evidence-based and interdisciplinary Patient Blood Management programme was introduced at the University Hospital Frankfurt in July 2013. A broad spectrum of measures also included training programmes on evidence-based haemotherapy and the introduction of a digital checklist to document transfusion triggers. This study...

Background: The therapeutic goal of red blood cell transfusion is to improve the oxygen-carrying capacity in order to avoid hypoxia. However, many open questions regarding the adequate transfusion thresholds for intensive care patients still remain unanswered. This study assesses the changes in indicators of hypoxia and transfusion triggers in the...

Background: Nucleic acid-targeted pathogen inactivation technology using amustaline (S-303) and glutathione (GSH) was developed to reduce the risk of transfusion-transmitted infectious disease and transfusion-associated graft-versus-host disease with red blood cell (RBC) transfusion. Study design and methods: A randomized, double-blind, controll...

Background: The pathomechanisms of morbidity due to blood transfusions are not yet entirely understood. Elevated levels of red blood cell-derived microparticles (RMPs) are found in coagulation-related pathologies and also in stored blood. Previous research has shown that RMPs mediate transfusion-related complications by the intrinsic pathway. We h...

Zusammenfassung Patient Blood Management (PBM) fokussiert auf ein umfassendes Anämiemanagement, die Minimierung (unnötiger) iatrogener Blutverluste und die Ausschöpfung der natürlichen Anämietoleranz mit rationalem Einsatz von Erythrozytenkonzentrat-Transfusionen. Im Mittelpunkt des aktuellen Beitrags stehen die in der präoperativen Phase entscheid...

Transfusion of blood components is an irreplaceable form of treatment for many patients1. However, besides providing sufficient amounts of blood components of excellent quality, blood transfusion services should protect the safety of blood donors. Numerous studies have proven that iron deficiency is common in frequent blood donors, particularly wom...

Background: Patient blood management (PBM) is a multidisciplinary approach focusing on the diagnosis and treatment of preoperative anaemia, the minimisation of blood loss, and the optimisation of the patient-specific anaemia reserve to improve clinical outcomes. Economic aspects of PBM have not yet been sufficiently analysed. Objectives: The aim...

Objective: To determine whether the implementation of patient blood management (PBM) is effective to decrease the use of red blood cell without impairment of patient's safety. Background: The World Health Organization encouraged all member states to implement PBM programs employing multiple combined strategies to increase and preserve autologous...

Background: The S-303 Treatment System was developed to inactivate contaminating bacteria, viruses, leukocytes and parasites in RBCs prior to transfusion and reduce the risk of transfusion-transmitted infection. RBCs carry numerous cell surface structures that can be recognized as antigens resulting in alloimmunization. Patients requiring chronic t...

Background: The INTERCEPTTM Blood System for Red Blood Cells (RBC) has been developed to prevent replication of contaminating pathogens and leukocytes in RBC components for transfusion. S-303 is used in the system to crosslink nucleic acids and glutathione to quench nonspecific reactions of S-303. The INTERCEPT Blood System for RBCs inactivates a v...

Background: The risks of red blood cell (RBC) transfusion have been greatly reduced in the past decades thanks to improvements in donor screening, good manufacturing practices, and viral marker testing. Nevertheless, threats to the blood supply remain either from known pathogens which are not tested routinely and/or from emerging pathogens. The sec...

Background: The second generation S-303 pathogen and leukocyte inactivation system for red blood cells (RBC) is intended to improve blood transfusion safety by reducing the risk of transfusion transmitted infections and transfusion-associated graft vs host disease. Aims: The clinical safety and efficacy in adult cardiovascular surgery patients requ...

Background Patient blood management (PBM) concepts aim to identify patients with anemia and optimize their treatment including use of preoperative iron substitution, blood-sparing techniques and adequate transfusion practice. PBM concepts thus have great potential to increase patient safety and clinical outcome. Nevertheless, up to now, structured...

Introduction: A multicomponent, evidence-based and interdisciplinary Patient Blood Management (PBM) program was introduced at the University Hospital Frankfurt in July 2013. The implementation strategy included practical and tactical components aimed to increase knowledge on the risks of preoperative anemia, to standardize hemotherapy, and to faci...

Preoperative and hospital-acquired anaemia is common among surgical patients. It is associated with an increased risk of morbidity and mortality and a strong risk factor for allogeneic blood transfusions with their own inherent risks. Patient Blood Management (PBM) concepts aim to increase and preserve autologous erythrocyte volume and to optimise...

Background: The S-303 Treatment System was developed to inactivate contaminating bacteria, viruses, leukocytes and parasites in RBCs prior to transfusion and reduce the risk of transfusion-transmitted infection. Previous experience with the first Generation process showed a small proportion of patients (1 to 2%) had pre-existing antibodies against...

Background: The INTERCEPT System for Red Blood Cells (RBC) was developed to inactivate pathogens and leukocytes in RBC components for transfusion. The Second Generation System uses S‑303 to crosslink nucleic acids, preventing replication of contaminating pathogens and residual leukocytes. Glutathione (GSH) is included to quench non-specific reactio...

Acute normovolemic hemodilution (ANH) is performed with the intention to reduce the requirement for allogeneic blood transfusions. After preoperative withdrawal of whole blood, corresponding amounts of crystalloids and/or colloids are infused to maintain normovolemia. The main benefit of ANH is the availability of whole blood containing red blood c...

Preoperative anaemia is an independent risk factor for an increase in perioperative morbidity and mortality. Patient Blood Management (PBM) aims for an early detection of anaemia in elective surgery patients. Reasons for anaemia should be detected and causally treated if possible. A multidisciplinary team of specialists aims for diagnosis and causa...

Patient blood management (PBM), as a multidisciplinary, evidence-based treatment concept for reducing anemia and blood losses, should be realized in individual hospitals after local adaptation according to the available facilities.The implementation of a PBM program in clinical institutions will be a challenging but in every case worthwhile task. T...

The multimodal concept of Patient Blood Management touches many aspects of in-hospital treatment. The goals are to preserve and strengthen the patients' own resources in order to avoid transfusion-associated adverse events. This can be achieved by meticulous minimization of perioperative blood loss and the enhancement and full utilization of indivi...

In patients suffering from massive bleeding, transfusion of allogenic blood products (red blood cells, fresh frozen plasma and platelets) and the application of other hemostatic therapy in form of coagulation factor concentrates represent therapeutic approaches to optimize hemostasis and to restore and assure tissue oxygenation. In accordance to th...

Background The cobas® TaqScreen MPX Test, version 2.0, a multiplex, multi-dye nucleic acid amplification technology (NAT) test from Roche was evaluated by two European Blood Banks, the German Red Cross Blood Donor Service, Frankfurt, Germany and Centro de Hemoterapia y Hemodonación de Castilla y León, Valladolid, Spain. In addition, the cobas® TaqS...

IntroductionProducts and processes: Standards, specifications, and documentationDocumentation of jobs: Tasks and responsibilities, training and assessmentMonitoring and assessmentImplementation and evaluation of measures for improvementConclusion References

Haemotherapy is an integral part of modern high-tech medicine. Without supportive care including red blood cell (RBC), platelet concentrate (PC) and fresh frozen plasma (FFP) transfusion, invasive therapies such as high-dose chemotherapy regimens for haematological and solid malignancies, haematopoietic stem cell (HSC) and solid organ transplantati...

Although the transfusion of red blood cells (RBCs) is safer than ever regarding infections, it is still associated with several adverse reactions and therefore should only be used on the basis of evidence-based triggers. However, prevention of RBC transfusion and subsequent substitution of blood losses with acellular solutions will inevitably resul...

The residual risk for bacterial contamination in blood components especially in platelets is one to two orders of magnitude higher than for transfusion relevant viral infections. The majority of all bacterial transmitted fatalities occurred at the end of platelet shelf life. Therefore, the maximum shelf life of platelet concentrates (PC) was reduce...

Donor history questionnaires for the determination of blood donor eligibility are a critical layer of blood safety. Early in the course of the AIDS epidemic in North America homosexual men with multiple partners were identified as one of the segments of the population with the highest risk of infection. Voluntary deferral of this group from blood d...

Individualized, (stem) cell-based therapies of congenital and acquired illnesses are among the most exciting medical challenges of the twenty-first century. Before the full potential of such therapies can be achieved, many basic scientific and biotechnological questions remain to be answered. What is the ideal source for the generation of such cell...

Individualized, (stem) cell-based therapies of congenital and acquired illnesses are among the most exciting medical challenges of the twenty-first century. Before the full potential of such therapies can be achieved, many basic scientific and biotechnological questions remain to be answered. What is the ideal source for the generation of such cell...

Over the past decades, the fields of activity and knowledge in transfusion medicine have evolved into an array of diverse areas and sub-specialities including immunohaematology, blood component production, haemapheresis, pathogen detection, methods of cell and tissue collection and manipulation, cell conservation and banking, transplant immunology...

Background The aim of the present study was to assess ex-vivo function of pathogen-inactivated versus conventional platelet concentrates (PC) in the perioperative setting. Material and methods A total of 30 patients who underwent cardiac surgery and who postoperatively depended on the transfusion of two platelet concentrates were enrolled into this...

Die häufigsten angeborenen hämorrhagischen Diathesen sind Störungen der plasmatischen Gerinnung. Ursachen sind die quantitative Verminderung eines oder mehrerer Gerinnungsfaktoren, verminderte oder fehlende Aktivierbarkeit eines oder mehrerer Gerinnungsfaktoren aufgrund eines qualitativen Defekts, die Präsenz eines Inhibitors, der ihre Aktivierung...

The aim of the present study was to assess ex-vivo function of pathogen-inactivated versus conventional platelet concentrates (PC) in the perioperative setting. A total of 30 patients who underwent cardiac surgery and who postoperatively depended on the transfusion of two platelet concentrates were enrolled into this study. Of the patients 15 recei...

In the past three decades, the production of standard blood components from whole blood donations and from apheresis collections has reached a widely accepted high technical standard, paralleled by semi-automated methodology to safeguard the stability of the production process and an internationally harmonized pharmaceutical quality. More recent me...