{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:19:29Z","timestamp":1780373969220,"version":"3.54.1"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cardiac surgery is associated with numerous peri\u2010 and post\u2010operative haemostatic complications and blood transfusion requirements. Complex procedures such as redo\u2010sternotomy heart transplantation or type A aortic dissection repairs are at high\u2010risk for severe coagulopathy and significant transfusion requirements. However, current practice guidelines do not specifically address high\u2010risk surgeries, resulting in variable practice. To optimise outcomes, a multidisciplinary approach to blood transfusion and haemostasis is critical. How individual institutions construct these multidisciplinary teams, delegate responsibilities, and build procedures may differ depending on the institution and availability of resources. In this article, we compare how the transfusion medicine services support their cardiac surgery and transplant programs at three large medical centres\u2014Vanderbilt University Medical Center (the largest heart transplant centre in the world by volume in 2021), Toronto General Hospital\u2010University Health Network (a quaternary\u2010care centre in Canada's most populous city, performing more &gt;20 heart transplants annually), and Vancouver General Hospital (a quaternary\u2010care centre that performs numerous high\u2010risk cardiac surgeries). This article discusses management from multiple perspectives, including the blood bank and perioperative environments, and highlights how institutions have evolved their programs in accordance with nation\u2010specific policies and provisions.<\/jats:p>","DOI":"10.1111\/tme.12972","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T07:40:52Z","timestamp":1683877252000},"page":"337-348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A multidisciplinary comparison of transfusion and perioperative support for high\u2010risk cardiac surgery at three large academic centres in North America"],"prefix":"10.1111","volume":"33","author":[{"given":"Jeremy W.","family":"Jacobs","sequence":"first","affiliation":[{"name":"Department of Pathology, Microbiology &amp; Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Laboratory Medicine Yale School 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