The University of Maryland Medical Center Program in Trauma Research seeks to continue operating a Core Clinical Center in the NHLBI Transfusion Medicine and Hemostasis Clinical Research Network. We will work through the Network program to develop evidence through clinical trials concerning the safety and effectiveness of blood products, drugs, and devices for hemostasis and hemorrhage control. We have developed a highly qualified team to investigate these products. Trauma is the most frequent cause of death of Americans under the age of 35. Trauma is responsible for eight out of ten deaths in adolescents and young adults ages 15-24. Trauma from motor vehicle crashes, penetrating injuries, and falls are responsible for 93,000 deaths each year in the United States. Of the injured admitted to hospitals, 250,000 receive blood transfusions. Annually, trauma patients in the U.S. receive almost 2,000,000 units of red blood cells, which represent about 15% of the national total. Hemorrhage is the most frequent cause of preventable trauma death. The clinical trials we proposed in the initial period addressed the use of rVlla and the dry fibrin sealant dressing for controlling major hemorrhage. The rVlla trial we proposed was taken over by the manufacturer and conducted in eight other countries when the FDA placed the trial on hold in the US for more than 3 years. The dry fibrin sealant dressing development program collapsed when the American Red Cross got out of the plasma business. Nevertheless, ideas and evidence developed in attempting to establish these trials have proven lifesaving in both civilian and military casualty care. The social forces that make the University of Maryland Medical Center an outstanding site to conduct trauma studies work against its participation in some Network studies, as in the winter and spring of 2006 when 14 patients transferred to the Medical Center with acute leukemia and otherwise eligible for the Platelet Dose Study could not be approached because they did not speak English. Also, a change in Maryland state law has made it impossible to enroll children in some studies. We continue to develop ideas, such as the supplementation of massive transfusion with cryoprecipitate which can be developed as randomized controlled trials and to enroll patients in the ongoing trials. Reducing death from acute hemorrhage in trauma care will be a major step forward in reducing overall trauma mortality.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HL072359-08
Application #
8136617
Study Section
Special Emphasis Panel (ZHL1-CSR-J (M1))
Program Officer
Mondoro, Traci
Project Start
2002-09-30
Project End
2014-08-31
Budget Start
2012-09-01
Budget End
2014-08-31
Support Year
8
Fiscal Year
2012
Total Cost
$82,688
Indirect Cost
$17,063
Name
University of Maryland Baltimore
Department
Pathology
Type
Schools of Medicine
DUNS #
188435911
City
Baltimore
State
MD
Country
United States
Zip Code
21201
Uhl, Lynne; Assmann, Susan F; Hamza, Taye H et al. (2017) Laboratory predictors of bleeding and the effect of platelet and RBC transfusions on bleeding outcomes in the PLADO trial. Blood 130:1247-1258
Josephson, Cassandra D; Granger, Suzanne; Assmann, Susan F et al. (2012) Bleeding risks are higher in children versus adults given prophylactic platelet transfusions for treatment-induced hypoproliferative thrombocytopenia. Blood 120:748-60
Triulzi, Darrell J; Assmann, Susan F; Strauss, Ronald G et al. (2012) The impact of platelet transfusion characteristics on posttransfusion platelet increments and clinical bleeding in patients with hypoproliferative thrombocytopenia. Blood 119:5553-62
de Biasi, Andreas R; Stansbury, Lynn G; Dutton, Richard P et al. (2011) Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma (CME). Transfusion 51:1925-32
Slichter, Sherrill J; Kaufman, Richard M; Assmann, Susan F et al. (2010) Dose of prophylactic platelet transfusions and prevention of hemorrhage. N Engl J Med 362:600-13
Steiner, M E; Assmann, S F; Levy, J H et al. (2010) Addressing the question of the effect of RBC storage on clinical outcomes: the Red Cell Storage Duration Study (RECESS) (Section 7). Transfus Apher Sci 43:107-16
Hess, John R; Dutton, Richard B; Holcomb, John B et al. (2008) Giving plasma at a 1:1 ratio with red cells in resuscitation: who might benefit? Transfusion 48:1763-5
Zimrin, Ann B; Hess, John R (2006) Thrombotic thrombocytopenic purpura: Going with the evidence. Crit Care Med 34:2247-8
Slichter, Sherrill J (2006) Background, rationale, and design of a clinical trial to assess the effects of platelet dose on bleeding risk in thrombocytopenic patients. J Clin Apher 21:78-84
Malone, Debra L; Hess, John R; Fingerhut, Abe (2006) Massive transfusion practices around the globe and a suggestion for a common massive transfusion protocol. J Trauma 60:S91-6

Showing the most recent 10 out of 13 publications