Faculty Bibliography

In 2007, the American Society for Apheresis (ASFA) published guidance for physician documentation related to oversight of therapeutic apheresis (TA). Due to 21st century changes in healthcare delivery, the ASFA Board of Directors (BOD) charged its Public Affairs and Advocacy Committee (PAAC) to coordinate a review and update of the guidance. PAAC members reviewed minutes from various ASFA committees' earlier deliberations and sought additional information from the medical and general literature and regulatory/professional organizations involved with medical records documentation as well as from ASFA membership. A draft document was developed, reviewed, and approved by pertinent parties with changes incorporated into the guidance revision. Major change agents impacting TA documentation were identified including the importance of multidisciplinary care teams, the adoption of telemedicine in TA delivery, and the challenges highlighted by the SARS-CoV-2 pandemic. Formats involving TA documentation scenarios related to initial TA consultations and subsequent care activities by TA staff were developed. The introduction of new technologies, the advancing and mandating of electronic medical records (EMRs) adoption and a renewed emphasis on the team-based nature of healthcare delivery have all impacted TA services. Revised documentation formatting practices related to these changes, not only for physicians' involvement but recognition and inclusion of other members of multidisciplinary teams participating in TA, should be incorporated into TA operations. Such revisions can potentially enhance patient care and provide a foundation for TA-related biovigilance activities.

Blood transfusion rates in obstetrics reflect critical care needs but pose risks and resource challenges. A multimodal, multidisciplinary strategy was implemented at NYU Langone Brooklyn's Labor and Delivery unit to reduce red blood cell transfusion rates through standardized care, risk assessment, and rapid escalation protocols. A retrospective study evaluated transfusion practices from 2022 to 2024. Double-unit RBC transfusion orders decreased from 32% in 2022 to 19% in 2024, while overall transfusion rates fell from 20.7 to 14.5 units per 1,000 patient days. The findings demonstrate that a multidisciplinary approach can reduce transfusion rates while optimizing resource utilization.

The American Society for Apheresis (ASFA) Attending Physician Subcommittee of the Physicians' Committee performed an annual review of articles published in 2024 related to apheresis medicine. The 10 seminal apheresis articles selected by the subcommittee members are summarized in this review. PubMed was used to identify manuscripts published in 2024 in four areas of interest: donor apheresis, therapeutic apheresis, apheresis education, and apheresis for cellular therapy. Only full length, peer-reviewed manuscripts in English with data from human subjects were included. Case reports, review articles, and meta-analyses were excluded. Articles were considered seminal if they met at least one of the following previously established criteria: novel finding(s), practice-altering outcomes, international in scope, randomized-controlled trial, relevant to current clinical practice, and/or provide evidence for category III or IV indications based on the ASFA 9th special issue of the Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach.

Platelet transfusions are a cornerstone of hemorrhage management in patients with thrombocytopenia or platelet dysfunction, yet their indications and dosing are largely based on expert opinion and low-quality evidence. This review offers a timely and comprehensive analysis of platelet transfusion practices in the United States (U.S.), uniquely integrating clinical evidence, such as the pivotal PLADO trial, with emerging technological advancements. Using a holistic approach, this manuscript addresses not only conventional practices (such as dosing standards and storage methods), but also cutting-edge alternatives like cold-stored and freeze-dried platelets, pathogen reduction technologies, and synthetic platelet substitutes. By juxtaposing U.S. practices with international standards, it highlights inefficiencies in dosing and supply management, proposing actionable solutions like lower-dose transfusions and diversified platelet inventories. Furthermore, the manuscript's exploration of whole blood-derived platelets and the ethical debate surrounding paid donors adds a forward-looking perspective. By examining these innovations alongside strategies to optimize supply, this work aims to provide a comprehensive overview of how transfusion medicine is adapting to meet clinical and logistical demands.

In this first annual review article, the American Society for Apheresis (ASFA) Attending Physician Subcommittee (APSc) of the Physicians' Committee (PC) curated key apheresis literature in 2023 and presented their choices for the 10 most seminal apheresis articles. PubMed and OVID search engines were used to identify manuscripts from four topic areas: donor apheresis, therapeutic apheresis, education, and cellular therapy. To further identify seminal criteria, they had to present at least one of the following: novel findings, practice-altering outcomes, international scope, randomized controlled trial, relevant to current clinical practice, and/or provide evidence for category III or IV indications based on the ASFA ninth special issue of the Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach. Inclusion criteria included: full-length, peer-reviewed, English language, and human subjects. Case reports, review articles, and meta-analyses were excluded.