Principles of Rational Haemotherapy Interdisciplinary Consensus Statement

Czech version

Authors: M. Bohoněk, (STL) ^1,2; J. Bláha, (ČSARIM, ČSIM, ČSTH) ³; A. Buliková, (ČHS) ^4,5; R. Češka, (ČIS) ⁶; J. Gumulec, (ČSTH) ⁷; Z. Kala, (ČCHS) ⁸; T. Kuhn, (ČPS*) ⁹; Luboš Kotík, (ČIS) ¹⁰; J. Masopust, (STL) ¹¹; J. Malý, (ČNeoS) ¹²; P. Mazánek, (ČPS*) ¹³; R. Procházková, (STL) ^14,15; Martin Repko, (ČSOT) ¹⁶; A. Truhlář, (SUMMK) ^17,18; M. Tuček, (ČSOT) ¹⁹; K. Zdráhalová, (ČHS) ²⁰; P. Žák, (ČHS) ²¹
Authors‘ workplace: Ústav laboratorní medicíny, hematologie a transfuziologie FBMI ČVUT a ÚVN, Oddělení hematologie a krevní transfuze, ÚVN – VFN Praha ¹; Fakulta biomedicínského inženýrství, ČVUT Praha ²; Klinika anesteziologie, resuscitace a intenzivni mediciny, 1. LF UK a VFN v Praze ³; Oddělení klinické hematologie, FN Brno ⁴; Interní hematologická a onkologická klinika LF MU, Brno ⁵; III. interní klinika-klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze ⁶; Klinika hematologie LF OU a FN Ostrava ⁷; Chirurgická klinika LF MU a FN Brno ⁸; Klinika dětského lékařství FN Ostrava ⁹; Interní klinika FTN Praha ¹⁰; Transfuzní oddělení, KZ, a. s., Masarykova nemocnice v Ústí nad Labem, o. z. ¹¹; Dětská klinika LF UK a FN Hradec Králové ¹²; Oddělení dětské hematologie a biochemie, FN Brno ¹³; Transfuzní oddělení, Krajská nemocnice Liberec, a. s. ¹⁴; Fakulta zdravotnických studií, Technická univerzita v Liberci ¹⁵; Ortopedická klinika LF MU a FN Brno ¹⁶; Zdravotnická záchranná služba Královéhradeckého kraje, Hradec Králové ¹⁷; Klinika anesteziologie, resuscitace a intenzívní medicíny LF UK a FN Hradec Králové ¹⁸; Klinika ortopedie 1. LF UK a ÚVN – VFN Praha ¹⁹; Klinika dětské hematologie a onkologie 2. LF UK a FNMH – Motol ²⁰; IV. interní hematologická klinika LF UK a FN Hradec Králové ²¹
Published in: Transfuze Hematol. dnes,32, 2026, No. 1, p. 54-64.
Category: Best Practices
doi: https://doi.org/10.48095/cctahd202608

Overview

The administration of blood and blood products requires careful indication and procedures with regard to maximizing the effectiveness of transfusion therapy while minimizing known risks. We present consensus-based interdisciplinary recommendations on the principles of rational hemotherapy as best practices for the indication and administration of blood products.

Keywords:

Patient Blood Management – rational haemotherapy – blood products

Sources

1. Mueller MM, Van Remoortel H, Meybohm P, et al. Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference. JAMA. 2019; 321 (10): 983–997.

2. https: //www.bloodcomponents.org.uk.

3. Treleaven J, Gennery A, Marsh J, et al. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. Br J Haematol. 2011; 152 : 35–51.

4. Squizzato A, Hunt BJ, Kinasewitz BT, et al. Supportive management strategies for disseminated intravascular coagulation, An international consensus. Throm Haemost. 2016; 115 (5): 896–904.

5. Liu P, Hum J, Jou J, Scanlan RM, Shatzel J. Transfusion strategies in patients with cirrhosis. Eur J Haematol. 2020; 104 : 15–25.

6. Kirpalani H, Bell EF, Hintz SR, et al. Eunice Kennedy Shriver NICHD Neonatal Research Network. Higher or lower hemoglobin transfusion thresholds for preterm infants. N Engl J Med. 2020; 383 (27): 2639–2651. doi: 10.1056/NEJMoa2020248.

7. Franz AR, Engel C, Bassler D, et al. Effects of liberal vs restrictive transfusion thresholds on survival and neurocognitive outcomes in extremely low-birth-weight infants: The ETTNO randomized clinical trial. JAMA. 2020; 324 (6): 560–570. doi: 10.1001/jama.2020.10690. Erratum in: JAMA. 2022; 328 (2): 217.

8. Howarth C, Banerjee J, Aladangady N. Red blood cell transfusion in preterm infants: current evidence and controversies. Neonatology. 2018; 114 (1): 7–16. doi: 10.1159/000 486584.

9. Villeneuve A, Arsenault V, Lacroix J, Tucci M. Neonatal red blood cell transfusion. Vox Sang. 2021; 116 (4): 366–378. doi: 10.1111/vox. 13036.

10. Ohls R. Red blood cells transfusions in the newborn. Dostupné na https: //www.uptodate.com/contents/red-blood-cell-rbc-transfusions-in-the-neonate

11. New HV, Berryman J, Bolton-Maggs PH, et al. British Committee for Standards in Haematology. Guidelines on transfusion for fetuses, neonates and older children. Br J Haematol. 2016; 175 (5): 784–828. doi: 10.1111/bjh.14233.

12. New HV, Grant-Casey J, Lowe D, et al. Red blood cell transfusion practice in children: current status and areas for improvement? A study of the use of red blood cell transfusions in children and infants. Transfusion. 2014; 54 (1): 119–127. doi: 10. 1111/trf. 12313.

13. O‘Brien SH, Badawy SM, Rotz SJ, et al. The ASH-ASPHO choosing wisely campaign: 5 hematologic tests and treatments to question. Blood Adv. 2022; 6 (2): 679–685. doi: 10.1182/bloodadvances.2020003635.

14. Foukaneli T, Kerr P, Bolton-Maggs PHB, et al. BCSH Committee. Guidelines on the use of irradiated blood components. Br J Haematol. 2020; 191 (5): 704–724. doi: 10.1111/bjh. 17015.

15. King KE, Ness PM. How do we prevent transfusion-associated graft-versus-host disease in children? Transfusion. 2011; 51 (5): 916–920. doi: 10.1111/j.1537-2995.2010.03011.x.

16. Nellis ME, Goel R, Karam O. Transfusion management in pediatric oncology patients. Hematol Oncol Clin North Am. 2019; 33 (5): 903–913. doi: 10.1016/j.hoc.2019.05.011.

17. Granulocyte Working Group. Clinical guidelines for the use of granulocyte transfusion, Blood and Transplant, Revised by S. Morton & S. Stanworth, 2021.

18. Ohsaka A, Kikuta A, Ohto H, et al. Guidelines for safety management of granulocytes transfusion in Japan. Int J Hematol. 2010; 91 : 201–208.

19. New HV, Berryman J, Bolton-Maggs PH, et al. British Committee for Standards in Haematology. Guidelines on transfusion for fetuses, neonates and older children. Br J Haematol. 2016; 175 (5): 784–828. doi: 10.1111/bjh.14233.

20. Wlodarski MW, Vlachos A, Farrar JE, et al. Diagnosis, treatment, and surveillance of Diamond-Blackfan anaemia syndrome: international consensus statement. Lancet Haematol. 2024; 11 (5): e368–e382.

21. Curley A, Stanworth SJ, Willoughby K, et al. Randomized trial of platelet-transfusion thresholds in neonates. N Engl J Med. 2019; 380 (3): 242–251. doi: 10.1056/NEJMoa1807320.

22. Fustolo-Gunnink SF, Fijnvandraat K, van Klaveren D, et al. Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death. Blood. 2019; 134 (26): 2354–2360. doi: 10.1182/blood.2019000899. Erratum in: Blood. 2020; 135 (24): 2199. doi: 10.1182/blood.2020 006498.

23. Hasan R, Saifee NH. Benefits of lower neonatal platelet transfusion thresholds. Transfusion. 2021; 61 (6): 1672–1675. doi: 10.1111/trf. 16386.

24. New HV, Berryman J, Bolton-Maggs PH, et al. British Committee for Standards in Haematology. Guidelines on transfusion for fetuses, neonates and older children. Br J Haematol. 2016; 175 (5): 784–828. doi: 10.1111/bjh. 14233.

25. Houben NAM, Lopriore E, Fijnvandraat K, et al. Platelet transfusion in neonatal intensive care units of 22 European countries: a prospective observational study. Lancet Regional Health –⁠ Europe. 2024; 47 : 101086. DOI: 10.1016/j.lanepe.2024.101086.

26. Zerra PE, Josephson C. Transfusion in the neonatal patient: review of evidence based guidelines. Clin Lab Med. 2021; 41 (1): 15–34.

27. Christensen RD, Bahr TM, Davenport P, et al. Implementing evidence-based restrictive neonatal intensive care unit platelet transfusion guidelines. J Perinatol. 2024; 44 : 1394–1401.

28. Orkin SH, Nathan DG, Ginsburg D, Look AT, Fischer DE, Lux SE eds. Nathan and Oski‘s Hematology and Oncology of Infancy and Childhood. Elsevier Health Sciences, 2014.

Do redakce doručeno dne: 7. 11. 2025.

Přijato dne: 11. 11. 2025.

MUDr. Miloš Bohoněk, Ph.D.

Ústav laboratorní medicíny, hematologie a transfuziologie FBMI ČVUT

Oddělení hematologie a krevní transfuze

ÚVN –⁠ VFN Praha

U Vojenské nemocnice 1200

169 02 Praha 6

e-mail: milos.bohonek@uvn.cz