The Comprehensive Thalassemia Program of the Children's Memorial Hospital (CMH) is committed to providing state-of the-art medical service services using a multidisciplinary approach, including ongoing hemo-vigilance activities. Patients with thalassemia are a vulnerable population who comprise the single largest group of red cell transfusion users at Children's Memorial Hospital and other major U.S. thalassemia treatment centers. As such, they remain at high risk from both known and potential blood-borne pathogens and other complications related to transfusion therapy. This application will delineate expected contributions of CMH to ongoing initiatives by the CDC on blood safety in thalassemia and will describe current and proposed activities to enhance medical services and facilitate research in the prevention and improved management of disease- and/or transfusion-related complications. As the largest thalassemia treatment center in the Midwestern United States, the Comprehensive Thalassemia Program of the Children's Memorial Hospital is uniquely positioned to provide expertise over a wide geographic area to an increasingly diverse ethnic and cultural population affected by this condition. Relevance: Red cell transfusions are a cornerstone for the management of thalassemia, a serious inherited blood disorder. Activities directed at improvements in blood safety monitoring have broad implication on the health of the general public. Projects proposed in this application are aimed at improvements in surveillance for blood borne infections, iron overload and other transfusion-related complications. ? ? ? ?