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Mark Elliot Brecher is a physician specializing in pathology, in particular blood transfusion.
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Mark Elliot Brecher is a physician specializing in pathology, in particular blood transfusion.
In 1982, Brecher earned a MD at the University of Chicago Pritzker School of Medicine; he also had his residency training in anatomic and clinical pathology there. He subsequently completed a blood banking and transfusion medicine fellowship at the Mayo Clinic.
He was a member of the faculty of the Mayo Clinic Department of Laboratory Medicine and Pathology from 1988 to 1992, and then moved to the University of North Carolina as a member of the faculty and vice-chair in the Department of Pathology and Laboratory Medicine from 1992 to 2009. [1]
In 2009 he became the Chief Medical Officer for the Laboratory Corporation of America, while retaining a position as adjunct professor of pathology and laboratory medicine at the University of North Carolina. [2] In 2018, he retired and became an Emeritus Professor at the University of North Carolina.
From 2001 to 2005 he chaired the United States Department of Health and Human Services (DHHS) Advisory Committee on Blood Safety and Availability. He served as the president of the American Society for Apheresis (2005 to 2006) and has received that society's ASFA Lecturer's award (2010), the Presidential award (2011) and the Morrison Memorial Lecture Award (2016). [3] In 2020, he received the Tibby Greenwalt Memorial award from the Association for the Advancement of Blood and Biotherapies (AABB). [4] His research and advocacy contributed to reducing the risk of bacterial contamination of blood products for transfusion. [5] [6]
His most cited, peer-reviewed publications are:
Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, platelets, and other clotting factors.
Transfusion medicine is the branch of medicine that encompasses all aspects of the transfusion of blood and blood components including aspects related to hemovigilance. It includes issues of blood donation, immunohematology and other laboratory testing for transfusion-transmitted diseases, management and monitoring of clinical transfusion practices, patient blood management, therapeutic apheresis, stem cell collections, cellular therapy, and coagulation. Laboratory management and understanding of state and federal regulations related to blood products are also a large part of the field.
Platelets or thrombocytes are a component of blood whose function is to react to bleeding from blood vessel injury by clumping, thereby initiating a blood clot. Platelets have no cell nucleus; they are fragments of cytoplasm derived from the megakaryocytes of the bone marrow or lung, which then enter the circulation. Platelets are found only in mammals, whereas in other vertebrates, thrombocytes circulate as intact mononuclear cells.
A blood-borne disease is a disease that can be spread through contamination by blood and other body fluids. Blood can contain pathogens of various types, chief among which are microorganisms, like bacteria and parasites, and non-living infectious agents such as viruses. Three blood-borne pathogens in particular, all viruses, are cited as of primary concern to health workers by the CDC-NIOSH: HIV, hepatitis B (HVB), & hepatitis C (HVC).
A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a department of a hospital usually within a Clinical Pathology laboratory where the storage of blood product occurs and where pre-transfusion and Blood compatibility testing is performed. However, it sometimes refers to a collection center, and some hospitals also perform collection. Blood banking includes tasks related to blood collection, processing, testing, separation, and storage.
A blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation. Donation may be of whole blood, or of specific components directly (apheresis). Blood banks often participate in the collection process as well as the procedures that follow it.
Thrombocytopenia is a condition characterized by abnormally low levels of platelets, also known as thrombocytes, in the blood. Low levels of platelets in turn may lead to prolonged or excessive bleeding. It is the most common coagulation disorder among intensive care patients and is seen in a fifth of medical patients and a third of surgical patients.
Apheresis is a medical technology in which the blood of a person is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation. It is thus an extracorporeal therapy.
Plateletpheresis is the process of collecting thrombocytes, more commonly called platelets, a component of blood involved in blood clotting. The term specifically refers to the method of collecting the platelets, which is performed by a device used in blood donation that separates the platelets and returns other portions of the blood to the donor. Platelet transfusion can be a life-saving procedure in preventing or treating serious complications from bleeding and hemorrhage in patients who have disorders manifesting as thrombocytopenia or platelet dysfunction. This process may also be used therapeutically to treat disorders resulting in extraordinarily high platelet counts such as essential thrombocytosis.
Platelet transfusion, also known as platelet concentrate, is used to prevent or treat bleeding in people with either a low platelet count or poor platelet function. Often this occurs in people receiving cancer chemotherapy. Preventive transfusion is often done in those with platelet levels of less than 10 x 109/L. In those who are bleeding transfusion is usually carried out at less than 50 x 109/L. Blood group matching (ABO, RhD) is typically recommended before platelets are given. Unmatched platelets, however, are often used due to the unavailability of matched platelets. They are given by injection into a vein.
Transfusion-related immunomodulation (TRIM) refers to the transient depression of the immune system following transfusion of blood products. This effect has been recognized in groups of individuals who have undergone kidney transplantation or have had multiple miscarriages. Some research studies have shown that, because of this immune depression, blood transfusions increase the risk of infections and cancer recurrence. However, other studies have not shown these differences and the degree of impact transfusion has on infection and tumor recurrence is not well understood. The Blood Products Advisory Committee of the Food and Drug Administration recommends that all transfused blood products undergo leukocyte reduction in order to offset the contribution of donor white blood cells to immune suppression.
Giulio Bizzozero was an Italian doctor and medical researcher. He was a pioneer of histology and is credited with the coining of the term platelets and identifying their function in coagulation.
The MNS antigen system is a human blood group system based upon two genes on chromosome 4. There are currently 50 antigens in the system, but the five most important are called M, N, S, s, and U.
P1PK is a human blood group system based upon the A4GALT gene on chromosome 22. The P antigen was first described by Karl Landsteiner and Philip Levine in 1927. The P1PK blood group system consists of three glycosphingolipid antigens: Pk, P1 and NOR. In addition to glycosphingolipids, terminal Galα1→4Galβ structures are present on complex-type N-glycans. The GLOB antigen is now the member of the separate GLOB blood group system.
Platelet transfusion refractoriness is the repeated failure to achieve the desired level of blood platelets in a patient following a platelet transfusion. The cause of refractoriness may be either immune or non-immune. Among immune-related refractoriness, antibodies against HLA antigens are the primary cause. Non-immune causes include splenomegaly, fever, and sepsis.
Patient Blood Management (PBM) is a set of medical practices designed to optimise the care of patients who might need a blood transfusion. Patient blood management programs use an organized framework to improve blood health, thus increasing patient safety and quality of life, reducing costs, and improving clinical outcomes. Some strategies to accomplish this include ensuring that anemia is treated prior to a surgical operation, using surgical techniques that limit blood loss, and returning blood lost during surgery to the patient via intraoperative blood salvage.
The American Society for Apheresis (ASFA) is an organization of physicians, scientists, nurses, and allied health professionals whose mission is to advance apheresis medicine for patients, donors and practitioners through education, evidence-based practice, research and advocacy. ASFA represents a broad range of health care professionals involved in apheresis medicine including those practicing pathology, transplantation, hematology, oncology, neurology, rheumatology, nephrology, hepatology, gastroenterology, cardiology, and ophthalmology. These health care providers are involved in the performance of therapeutic apheresis procedures including plasma exchange, red cell exchange, leukocytapheresis, plateletapheresis, photopheresis, LDL apheresis, and hematopoietic progenitor cell collection. ASFA also represents those physicians and allied health professionals involved in the collection of blood products from blood donors using apheresis instruments.
Frederic Duran i Jordà was a Spanish medical doctor, pioneer hematology and hemotherapy. He created the first transfusion service in the world in Barcelona in 1936 at the beginning of the Spanish Civil War. Previously there were blood banks, where donated blood to be transfused was stored. Dr. Duran i Jordà created a methodology that would serve to collect massive blood donations and be transfused distance, in this case the front lines of the Spanish Civil War. This method was subsequently applied in World War II.
George William Gregory Bird was a British medical doctor, academic, researcher and haematologist known for his expertise in the fields of blood transfusion and immunohaematology. He founded the Department of Transfusion Medicine at the Armed Forces Medical College, Pune and was inducted into their Hall of Fame in 2010. A winner of the Karl Landsteiner Memorial Prize and Morten Grove Rasmussen Memorial Award of the American Association of Blood Banks, Gregory Bird was honoured by the Government of India in 1963, with the award of Padma Shri, the fourth highest Indian civilian award for his services to the nation.
Dana Devine is a blood transfusion researcher and the president of AABB. She was the editor-in-chief of Vox Sanguinis from 2012 to 2020. Devine is also the Chief Scientist at Canadian Blood Services and the director of the Centre for Blood Research at the University of British Columbia. In 2015, she was elected as a fellow of the Canadian Academy of Health Sciences. In 2022, she was elected as the President of the Biomedical Excellence for Safer Transfusion Collaborative.