Versiti investigators and physicians work together to use research discoveries to better diagnose and treat patients.
According to the Centers for Disease Control and Prevention, bleeding disorders like hemophilia and von Willebrand disease affect more than 3 million Americans. These individuals are prone to excessive bleeding and have higher risk factors for conditions like heart disease, and many rely on innovative research for the latest and greatest treatment options. Every day, Versiti Blood Research Institute (BRI) and Medical Sciences Institute (MSI) investigators and physicians work together to research better treatments—and even cures—for bleeding disorders, autoimmune diseases, cancers and more. This research spans the clinical continuum from bench to bedside, with laboratory researchers and physicians working together to analyze lab discoveries in a clinical setting.
Versiti Senior Medical Director of Transfusion Medicine Mehraboon Irani, MD, regularly treats patients receiving clinical apheresis procedures, which involve removing or exchanging blood products like red cells, platelets and plasma. Oftentimes, he collaborates with investigators at the BRI to connect what he sees in the clinic with current research projects.
“We take results from the lab and analyze the patient’s outcome based on what we found. We ask ourselves if what we found in the lab actually worked,” he said. “Versiti is unique in that we are a blood center that has close relationships with hospitals—we are integrated into the hospital staff. That’s unusual, because very few blood centers have physicians who are involved in academic and community hospitals.”
His clinical work also closely connects with Versiti’s Applied Research Lab and Clinical Trials Research Office, where external organizations lean on Versiti’s expertise to conduct translational research. “When a company comes out with a new product, they need an independent evaluator to submit it to the FDA. They use centers like ours; we prepare the product for them and transfuse it, and they gather the data from hospitals to see how patients are doing,” Dr. Irani said. “We have a long track record of doing this successfully.”
Chilled platelet study
Platelets help blood to clot and are often used to prevent bleeding and treat patients undergoing chemotherapy for cancer. Many years ago, BRI Senior Investigator Emeritus Richard Aster, MD, found that chilled platelets have better hemostatic function. However, other investigators at the time found that the post-transfusion survival rate of platelets is better when stored at room temperature. Back then, platelets were primarily used to treat oncology patients, who required long platelet survival times to maintain the health of their blood vessels and prevent bleeding. So, the standard practice became storing platelets at room temperature.
At room temperature, however, platelets have a very short shelf life: they can only be stored for five days after they’ve been donated, and some of that time is spent awaiting results of bacterial cultures to ensure their safety. After five days, the risk of bacterial contamination increases. Chilled platelets, however, can be stored longer and will still maintain their function, even though their post-transfusion survival rate may be lower.
However, as investigators have learned more about bleeding and clotting, they have also learned more about the benefits of chilled platelets. “Chilled platelets mainly benefit patients who are bleeding rapidly from platelet dysfunction, such as trauma patients, heart surgery patients—anyone going through a massive bleed,” Dr. Irani said. In these cases, platelet survival time is less important than their ability to rapidly localize and stop bleeding.
Dr. Irani, together with research collaborators from other medical centers, wants to see if giving chilled platelets to patients who have had heart surgery do as well, if not better, than patients who have received platelets that are stored at room temperature. Their hypothesis is that chilled platelets will be just as effective in terms of bleeding outcomes, which may inform a better—and longer—way of storing platelets. This knowledge will benefit a variety of patients who experience severe bleeding, including those recovering from surgery or undergoing emergency procedures following a trauma.
About the expert: Mehraboon Irani, MD, is the senior medical director of transfusion medicine at Versiti and an associate professor of pathology at the Medical College of Wisconsin.