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Chapter 111  Principles of Red Blood Cell Transfusion  1713


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            a system of production in batches. Neildez-Nguyen et al first reported   Goodnough LT, Rudnick S, Price TH, et al: Increased preoperative collec-
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            apheresis collection) for the sole purpose of RBC production. Stem   Hod  EA,  Zhang  N,  Sokol  SA,  et al:  Transfusion  of  red  blood  cells  after
            cells cultured from umbilical cords would necessitate the use of cord   prolonged storage produces harmful effects that are mediated by iron and
            blood banks and would still be dependent on human donation. Alter-  inflammation. Blood 115(21):4284–4292, 2010.
            natively,  embryonic  stem  cells  and  induced  pluripotent  stem  cells   Holcomb JB, Tilley BC, Baraniuk S, et al: Transfusion of plasma, platelets,
            (iPSCs) can be obtained, generated, then maintained indefinitely in   and red blood cells in a 1 : 1 : 1 vs a 1 : 1 : 2 ratio and mortality in patients
            culture, thus providing an unlimited source of cells. Like embryonic   with  severe  trauma:  the  PROPPR  randomized  clinical  trial.  JAMA
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            and can be selected based on known phenotypes. Researchers have   Kirpalasni H, Whyte RK, Andersen C, et al: The premature infants in need
            been able to demonstrate that iPSCs can differentiate into terminally   of tranfusion (PINT) study: a randomized, controlled trial of a restrictive
            mature and fully functional red cells.                  (low) versus liberal (high) transfusion threshold for extremely low birth
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            enucleate and can be safely irradiated) while still ensuring the func-  Lee  AC,  Reduque  LL,  Luban  NLC,  et al: Transfusion-associated  hyperka-
            tionality of the end product. Finally, the use of GMP conditions for   lemic cardiac arrest in pediatric patients receiving massive transfusions.
            mass production within a reasonable amount of time and at a reason-  Transfusion 54(1):244–254, 2014.
            able cost seems to be the greatest hurdle to date. The current chal-  Mazurier  C,  Douay  L,  Lapillonne  H:  Red  blood  cells  from  induced
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