Concluding commentary on current trends to enhance the clinical safety of pediatric transfusion, focusing on prevention of untoward complications of HSC transplantation & newer strategies for improving the standards of safety/quality of stem cells expansi

Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure. Some other safety related issues issues in clinical management of neonates/young infants with urgent medical conditions, requiring immediate transfusion or apheresis treatment, especially, those resulting from hematopoietic stem cell transplantation (HSCT), have been addressed. Pediatric HSCT has evolved along with its growth and progress in adult population. New sources of stem cells, and greater donor options including apheresis donation by identical or haploidentical young children, new immunosuppressive drug and cell therapy regimens for prevention and treatment of transplantation related graft versus host disease (GVHD), recent developments in gene and immune cell as well as regenerative therapies, requiring implementation of advanced laboratory methods designed for efficient and safe HSC cell engineering are also discussed. Finally, the use of novel blood components, obtained from allogeneic cord bloods or platelet concentrates in successful treatment of ulcerative lesions in inherited or acquired conditions and in expansion of stem cells, as the growth media clinical grade supplement will be presented. Management of these new and challenging clinical situations in pediatric patients requires an integrated approach involving many specialties with overall goal of improving treatment outcome and quality of life. This only could be accomplished by adhering to existing practice standards in current practices and timely developing guidelines for new clinical applications. It is hoped that this commentary on the pediatric theme, by bridging the gap from bench to bedside and bringing the input from the prospective clinical trials back to laboratories provides a step forward to help in educational aspects of better understanding the specifics of pediatric patient care more fitting for the future interventional treatments.