Editor's Note: Transfusion medicine is an essential foundation for the diagnosis and treatment of hematologic diseases, and its underlying philosophy is undergoing a profound transformation from a “blood-centered” to a “patient-centered” approach. As the field advances standardized blood utilization and transfusion safety, how to establish a scientific blood management system and implement precision transfusion strategies remains a key clinical challenge. During the 2026 Cross-Strait Hematology Academic Conference, Oncology Frontier – Hematology Frontier invited Dr. Sheng‑Hsuan Chien of Taipei Veterans General Hospital to systematically review the evolution of transfusion medicine and practical experience from Taiwan, provide an in-depth interpretation of the core principles and precision transfusion pathways of patient blood management (PBM), and explore future directions for collaboration between the two sides of the Taiwan Strait in transfusion quality control, standardized blood utilization, and PBM system development. His insights provide valuable guidance for optimizing clinical blood management.Oncology Frontier – Hematology Frontier: Your presentation provided a systematic review of the development of transfusion medicine, connecting historical experience with modern clinical practice. Looking back at the evolution of transfusion medicine, what important lessons can current hematology practice draw when promoting standardized blood utilization, ensuring transfusion safety, and optimizing clinical blood management systems?
Dr. Sheng‑Hsuan Chien: One of Taiwan’s most valuable experiences in blood management is the establishment of a single blood donation center responsible for unified blood supply across the entire region. As a non-governmental, nonprofit public-interest organization, the center operates with a high degree of transparency, institutionalization, and standardization.
In terms of its operational mechanisms, the center has rigorous workflows: from stringent donor screening and high-standard blood testing to the scientific allocation and distribution of blood products, all processes are managed in a standardized manner. Its blood distribution network has extensive coverage and uses scientific probability models to deliver blood products accurately and appropriately to medical institutions at all levels, from major medical centers to community and rural hospitals.
This professional and transparent operating model has established a strong foundation of trust between healthcare providers and patients. On the one hand, it ensures that every unit of donated blood is used fully and effectively, so that donors’ goodwill is not wasted. On the other hand, stringent quality control and transparent testing mechanisms ensure blood quality, allowing recipients to undergo transfusion treatment with confidence.
The combination of donor confidence and recipient reassurance creates a virtuous cycle, which is also a key reason why Taiwan has maintained a relatively high blood donation rate. Adequate blood reserves provide a solid resource foundation for the clinical management of critically ill and complex patients, effectively addressing patients’ needs related to anemia and blood loss.
Oncology Frontier – Hematology Frontier: You have long been engaged in patient blood management, with a focus on precision and appropriate blood utilization and reducing unnecessary transfusions. Compared with the traditional transfusion model, what are the key innovations introduced by the current PBM concept? Furthermore, throughout the diagnosis and treatment of patients with hematologic malignancies, what tangible clinical benefits can be achieved through refined blood utilization management?
Dr. Sheng‑Hsuan Chien: Transfusion is essentially a medical intervention, and every medical intervention carries potential risks. Therefore, transfusion should never be regarded as a routine measure to be administered simply because a patient is ill, nor as something that can strengthen a healthy person. Instead, it must strictly follow the principle of “precision transfusion.” For patients without clear indications, unnecessary transfusion merely exposes them to additional transfusion-related risks without providing corresponding clinical benefits.
In precision transfusion, the first priority is to establish clear and standardized indications for transfusion. Transfusion is justified only when the expected clinical benefit outweighs the associated risks. Determining this threshold requires guidance from extensive evidence-based medical evidence and previous clinical studies, which is also a core component of patient blood management (PBM).
Second, the use of blood component therapy is an important practical application of precision transfusion. The fundamental principle is “replace what is missing with what is needed.” For patients with anemia or blood loss, red blood cells should be transfused; for patients with thrombocytopenia, platelets should be transfused; and for patients with coagulation factor deficiencies, plasma should be administered.
In addition, with the development of precision medicine, transfusion therapy is becoming increasingly individualized. For patients with irregular antibodies or alloantibodies against specific antigens, antigen/antibody screening can be used to accurately identify compatible blood products for transfusion. This not only further improves transfusion safety but also enables precision transfusion in the true sense of the term.
Oncology Frontier – Hematology Frontier: The Cross-Strait Hematology Academic Conference has established a strong platform for academic exchange over many years, while transfusion medicine provides an essential foundation for the diagnosis and treatment of hematologic diseases. Based on your experience at this conference and your professional field, how do you assess the value and significance of this year’s meeting for the development of transfusion medicine and patient blood management (PBM) on both sides of the Taiwan Strait? Looking ahead, in which areas of transfusion quality control, standardized blood utilization, and PBM system development would deeper collaboration between the two sides be valuable?
Dr. Sheng‑Hsuan Chien: First, I am very honored to participate in this Cross-Strait hematology exchange. In transfusion medicine, patient blood management has recently become a major topic of discussion. In Taiwan, we regularly organize PBM seminars to facilitate experience sharing among different medical institutions.
Different hospitals place emphasis on different aspects of PBM implementation. For example, some hospitals focus on optimizing information systems and integrating knowledge bases. By incorporating appropriate transfusion restrictions and decision support into electronic medical order systems, they aim to standardize physicians’ blood utilization practices. Other hospitals focus more on in-hospital education, providing continuous training to disseminate the latest evidence-based advances in PBM among healthcare professionals.
Considering that mainland China has made an early start in PBM management and has developed rapidly in this area, accumulating extensive practical experience, we very much look forward to engaging in deeper exchanges and learning from our colleagues in mainland China.
In addition, both sides of the Taiwan Strait share a common Chinese heritage and have highly similar frequency distributions of red blood cell antigens. Therefore, we share a common clinical foundation and have considerable opportunities for collaboration in areas such as alloantibody screening and the implementation of precision transfusion. Looking ahead, we hope to engage in deeper exchanges and collaboration with colleagues in mainland China in these two major areas.
