New horizons in blood transfusion medicine: present status and future trends.

In the past two decades, we have witnessed enormous advances in all areas of transfusion medicine, from simple and practical aspects of blood component collection and processing to the development of "designer products" and the use of recombinant products or other alternatives. Considerable efforts were directed, in particular, towards transfusion support for specific categories of patients, such as neonates and those undergoing transplant procedures, where patients' clinical states ultimately influence the choice of product(s) and where emphasis should be placed on both the optimisation of clinical effectiveness and safety, as well as minimising the adverse/untoward effects of transfusion. The objective of this Forum Discussion is to provide an overview of what is currently on the horizon and then describe the potential changes that are expected on the new horizon, within the next decade. In this BBTS-Component Special Interest Group, therefore, we have attempted to build a bridge between the new expanding areas of related specialties at both cellular and molecular levels and the equally important practical and clinical aspects. Thus, alongside the presentation on the overall safety/efficacy of standard products, the potential use of some alternatives and recombinant products were discussed. Emphasis is also placed on the new generation test for function testing and the potential application of DNA-based technologies in blood transfusion, which will continue to be more innovative in respect to the avoidance of transfusion associated infections and its immunological risks, and will bring about continual improvement of the clinical effectiveness of products derived from human blood.