Postoperative anaemia has been identified as being strongly and independently associated with worse outcomes after major surgery. Until recently, available treatments were limited to allogeneic red blood cell transfusion and intravenous iron. However, recent work has revealed mechanistic targets which may improve restorative erythropoeisis in the setting of anaemia. However, it is not known whether some or all these mechanisms drive postoperative anaemia.
The MOSAICS study will follow adult patients for three months following elective cardiac surgery, during which time multiple blood samples will be collected that will form the basis of a mechanistic biobank. Firstly, samples will be analysed for haemoglobin concentration, reticulocyte count, reticulocyte haemoglobin concentration and hepcidin, with subsequent biomarkers to follow depending on these primary results. Our aim is to determine the mechanistic underpinnings of postoperative anaemia, and for how long these responses last for after major surgery.
Once the primary study and analysis of the biobank is complete, MOSAICS will provide important insights to the still unknown mechanisms that drive postoperative anaemia, and in turn direct which interventions might be tested in future clinical trials targeting specific steps in postoperative, restorative erythropoeisis.
Associate Professor Lachlan Miles, Austin Health, Melbourne
Dr Timothy Makar, Austin Health, Melbourne
Dr Anastazia Keegan, King Edward Memorial Hospital, Western Australia
The project was awarded $A69,970 funding through the ANZCA research grants program for 2023.