CURRENT CLINICAL INTERESTS
Platelet transfusion and platelet immunology; autoimmune platelet disorders; bleeding in cardiovascular surgery; hemostasis and transfusion in the hematopoietic stem cell transplant patient
CURRENT RESEARCH INTERESTS
Platelet transfusion and bleeding in the hematopoietic stem cell transplant patient.
Hgb threshold for transfusion of the patient with acute coronary syndrome
Best practice for transfusion management of the patient refractory to platelet txn.
Investigation of new treatment approaches to management of ITP.
Currently I am the principal investigator of the American Trial Using Tranexamic Acid in Thrombocytopenia (A-TREAT) a multicenter ,prospective, randomized, placebo controlled trial using antifibrinolytic therapy to prevent bleeding in the severely thrombocytopenic patient with hematologic malignancy undergoing chemotherapy, immunotherapy and/or stem cell transplantation:
As Medical Director of Transfusion at the SCCA, we have the opportunity to use large databases of information regarding bleeding and transfusion in leukemia and stem cell transplant patients, as well as a large patient population. Our group is also conducting trials with pathogen reduced platelets and cryopreserved platelets in platelet transfusion dependent patients with hematologic malignancy and using our databases to determine best platelet support approaches to our patients and to design the needed clinical trials to answer these questions.
We are currently enrolling patients in a pilot trial to determine whether mild to moderately coagulopathic patients should receive plasma prior to invasive procedures.
As part of the ITP international consortium we are developing new combinations of therapy for chronic ITP patients and investigating the use of new immunomodulators.
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Gernsheimer T. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. As a member of “The Trial to Reduce Alloimmunization to Platelets (TRAP) Study Group.” N Engl J Med. 1997 Dec 25;337(26):1861-9.
Gernsheimer TB. The pathophysiology of ITP revisited: ineffective thrombopoiesis and the emerging role of thrombopoietin receptor agonists in the management of chronic immune thrombocytopenic purpura. Hematology Am Soc Hematol Educ Program. 2008:219-26. PubMed
Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, Chong BH, Cines DB, Gernsheimer TB, Godeau B, Grainger J, Greer I, Hunt BJ, Imbach PA, Lyons G, McMillan R, Rodeghiero F, Sanz MA, Tarantino M, Watson S, Young J, Kuter DJ. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010 Jan 14;115(2):168-86. Epub 2009 Oct 21. Review.
Slichter SJ, Kaufman RM, Assmann SF, McCullough J, Triulzi DJ, Strauss RG, Gernsheimer TB, Ness PM, Brecher ME, Josephson CD, Konkle BA, Woodson RD, Ortel TL, Hillyer CD, Skerrett DL, McCrae KR, Sloan SR, Uhl L, George JN, Aquino VM, Manno CS, McFarland JG, Hess JR, Leissinger C, Granger S. Dose of prophylactic platelet transfusions and prevention of hemorrhage. N Engl J Med. 2010 Feb 18;362(7):600-13.