A dialogue with AABB President, Dr. Michael Murphy

Feb. 3, 2019
Dr. Michael Murphy, President, AABB

Congratulations on your new position! How did you first hear about AABB and when did you become a member? Thank you. It is a great honor for me to be the next President of AABB and to continue advancing the association’s vision of making transfusion medicine and cellular therapies safe, available, and effective worldwide. I first heard about AABB when I was training as a hematologist in the mid-1980s. I became aware of the AABB scientific journal, TRANSFUSION, and the AABB Annual Meetings. I attended my first meeting in Los Angeles in 1990 to present some research work from our group and became an AABB member the same year.

Why did you choose hematology? I trained as a general physician in London and decided to do specialist training in hematology—I was attracted by the possibility of combining clinical and laboratory work with research. I then became interested in transfusion medicine when managing the transfusion problems of patients with hematological malignancies.

Which areas of transfusion medicine interest you the most? I continue to work as a hospital hematologist, therefore, the issues of hospital transfusion practice remain my focus. I am interested in the use of information technology to improve the safety and appropriateness of transfusion practice by ensuring that patients receive the correct blood, and support clinicians to make good decisions about the use of blood. I am also involved in clinical research to provide the evidence for improving transfusion practice and the use of alternatives to transfusion.

What is the public’s biggest misconception about blood banking? I think the public needs to be better informed to better understand the risks and benefits of transfusion and the importance of blood donation. Blood has a limited shelf life and regular blood donations are fundamental to ensure that the blood supply remains adequate. In case of disaster—natural or manmade—it is the blood that is already on the shelves that saves lives.

Blood can only be stored safely for up to 42 days and platelets last only five days. What efforts are being made to extend the shelf life of blood products? There is no doubt that a limited shelf life for cellular blood components like red blood cells and platelet units is a significant challenge for blood suppliers and hospitals in terms of supply and minimizing wastage. There has been recent debate about the potential risks associated with stored red blood cell transfusions, but a number of high-quality clinical trials have not confirmed this effect. There is ongoing research into methods to allow safe extension of the shelf life of red blood cell units using new storage solutions and conditions. The concern about extended storage of platelet units is bacterial contamination as these products are stored at 22 oC, and there is research into new storage solutions to allow extension of the shelf life beyond five days. There is also considerable interest in storing platelets at 4 oC, the same temperature as for storing red blood cell units, because of some evidence of their superior immediate hemostatic effect.

What is trending in the field of umbilical cord blood banking? Cord blood has unique attributes that make it the stem cell source of choice for many pediatric patients, and those who cannot find a well-matched adult donor. However, the need for double unit transplants to achieve a sufficient cell dose has significant cost implications, and haplomismatched donations from family members are being used increasingly instead of cord blood. To overcome the limiting number of stem cells in cord units, several ex vivo expansion protocols have been developed and are now in clinical trials. Moving beyond cord blood itself, umbilical cord and placental tissues have proven to be advantageous sources of mesenchymal stromal cells whose immunoregulatory and regenerative properties are being tested in a wide range of clinical applications.

Extreme blood loss is the most common cause of death on the battlefield, accounting for 90 percent of fatalities. What relationship does AABB have with the military? AABB has close ties with the Armed Services Blood Program (ASBP), which provides blood products for service members and their families, both in the U.S. and internationally. ASBP blood collection centers are AABB-accredited and follow AABB standards that promote donor and patient safety. We also hold an annual workshop with the THOR (Translational Hematology and Oncology Research) network that helps to translate lessons from the battlefield to civilian care.

What is a typical day in the office like for you? Being a morning person, I like to make an early start and that is a challenge for me toward the end of the U.K. working day, since it is still early afternoon or even morning in the U.S.  Some early mornings involve teaching of residents followed by daily transfusion rounds in the blood bank with our transfusion team to review any transfusion problems. We also review the transfusions from the previous day, which have triggered an alert on our electronic decision support process and which need to be followed up with the doctor who made the order. The rest of the day will be taken up with meetings with our transfusion team and clinical fellows to review progress with quality improvement initiatives and research projects. Toward the end of the day comes AABB business and conference calls, and if there is time I will relax with a session in the gym or a gentle run before heading home.

What type of career path would you recommend for students wanting to pursue a career in transfusion medicine? The traditional route for medical staff into transfusion medicine is through pathology, but alternative career paths are now possible including anesthesiology, emergency medicine, or critical care medicine. The field of transfusion medicine is being strengthened by specialists from varied medical backgrounds.