Blood Transfusions and Patient Outcomes – a New National Dataset

Blood is a precious resource. Every day, Australians receive transfusions for critical bleeding, whether from trauma, surgery, ulcers, obstetric bleeding or transplants, and for other medical conditions such as cancer, iron deficiency and bleeding disorders. Australia spends over $1.2 billion each year on blood products, and even more on the systems to administer them. Transfusions are done in ambulances, hospitals, community facilities and even in people’s homes. 

Now, for the first time, data on how, where and when the various blood products are used has been aggregated nationally and linked to the outcomes for patients receiving blood transfusions.    

The new National Transfusion Dataset builds on the existing Massive Transfusion Registry for Australia and New Zealand and is integrated with clinical registries for blood disorders and cancers.

Developed with ARDC co-investment, the National Transfusion Dataset is an invaluable resource for understanding:

• how and why the various blood products are used
• the characteristics of patients receiving transfusions
• clinical outcomes, such as mortality rates, for patients following transfusion.

The dataset is available for use by researchers, clinicians, governments, industry and others to inform patient care, develop clinical guidelines, and generate hypothesis-driven research in the area. 

Professor Erica Wood AO, Head of the Transfusion Research Unit at Monash University, leads the program to develop the National Transfusion Dataset.

“We’ve been very pleased to work with the ARDC on this important research. Blood products can save lives, but they carry risks and costs. They are donated by volunteers, so it’s essential that we use them wisely.” 

Pilot Shows the Benefits of Linking Transfusion Data With Patient Outcomes

Professor Wood and colleagues ran a pilot to make the first linkages of transfusion data with national clinical registry data. The initial data came from Ambulance Victoria and pilot hospitals The Alfred and the Flinders Medical Centre.

“While transfusions are currently captured in some registries, data are often incomplete as the registries rely on on-site staff to enter clinical and laboratory data for participating patients,” said Professor Wood. 

“The linkages enabled the team to examine blood use and clinical outcomes in patients with blood disorders such as aplastic anaemia (who often require high-volume, medium to long-term support with red cells and platelets), and blood cancers such as myeloma (who may require immunoglobulin replacement prepared from donated plasma to prevent or treat infections).”

“The National Transfusion Dataset was able to supplement transfusion data in these registries to provide a clearer picture at our pilot sites of how blood products were being used in these patient populations.”

Dataset Expanding Thanks to Medical Research Future Fund

The scope of the National Transfusion Dataset is now being expanded as part of the National Transfusion Research Data Infrastructure Initiative, which is receiving $2.9 million from the Australian Government’s Medical Research Future Fund (MRFF). 

“The success of the National Transfusion Dataset pilot laid the groundwork for the successful MRFF application,” said Professor Wood. 

New linkages are being made to more “pre-hospital” datasets (from ambulance and retrieval services), more clinical registries (such as critical care), and data from Lifeblood, Australia’s national blood service. 

“We need better national data to improve our practice and outcomes, and securing this additional MRFF funding and bringing new partners on board will really help develop the project further.” 

The MRFF-funded project, led by the Transfusion Research Unit at Monash University, also includes a cutting-edge project using AI algorithms to analyse unstructured data in the form of hospital electronic medical records.

The expansion will facilitate research into national priority areas, including:

• areas of high use of blood products, such as the support of critically ill patients and those with major haemorrhage or bone marrow failure
• the development of haemovigilance datasets to monitor blood product safety
• economic analyses of blood product use for health
• Australia’s first registry-based transfusion clinical trial.

The new National Transfusion Research Data Infrastructure Initiative is a partnership between:

• Monash University’s NHMRC-funded Blood Synergy research program and NHMRC Centre for Research Excellence in Critical Care
• Alfred Health
• Ambulance Victoria
• Australasian Leukaemia & Lymphoma Group
• Australian and New Zealand Intensive Care Research Centre
• Australian and New Zealand Society of Blood Transfusion
• ARDC
• CSL Behring
• Flinders Medical Centre
• Australian Red Cross Lifeblood
• National Blood Authority, Australia.

The ARDC is continuing to address the health and medical data challenges associated with data integration through the People Research Data Commons.

Learn more and access the dataset via the National Transfusion Dataset.

Participate in a National Survey

Have you ever donated blood? Do you work with patients or blood products? Ever received a blood transfusion or immunoglobulin infusion? If any of these apply to you, the Blood Synergy would love to hear your thoughts on how we use donated blood, how we deliver care to people receiving blood products, or where future research should be focused.

The survey is anonymous, takes 5 to 10 minutes to complete, and will help to identify the research questions of most interest and importance to the Australian community.

Find out more at Blood Synergy website or access the survey.

The National Transfusion Dataset received co-investment (doi.org/10.47486/DP708) from the ARDC. It is led by Monash University in partnership with the ARDC, Ambulance Victoria, Blood Synergy, Myeloma and Related Diseases Registry, Lymphoma and Related Diseases Registry, Australian and New Zealand Intensive Care Society, Pre-hospital Emergency Care Australia and New Zealand, and Aplastic Anaemia and Other Bone Marrow Failure Syndromes Registry.

Written by Jo Savill, ARDC. Reviewed by Catherine Brady, Dr Adrian Burton, ARDC, and Prof Erica Wood, Monash University.