Enhancing Patient Safety Internationally

AABB has selected Willy A. Flegel, MD, chief, laboratory services section, department of transfusion medicine, and senior research physician at the National Institutes of Health, as the recipient of the 2026 Dale A. Smith Memorial Award in recognition of his original scientific and clinical contributions within the field of molecular immunohematology.

The Dale A. Smith Memorial Award was created in 2022 to honor Dale A. Smith, a long-time Baxter Healthcare executive who was responsible for establishing the Fenwal Division of Baxter. This award is given to an individual(s) or institution to recognize groundbreaking work performed in the application of technology to the practice of transfusion medicine or biotherapies.¹

“I am very honored by this prestigious award from AABB,” said Flegel, who will receive the award in person at the 2026 AABB Annual Meeting, to be held Oct 17-19 in Atlanta.

Patient Care

Flegel first became interested in hematology early in his medical career and completed a transfusion medicine residency in Germany.

“In this field, one can give critical support for therapies in numerous fields of medicine and provide support for a variety of patients. This broad impact on patient care is relatively unique to transfusion medicine,” Flegel said. “Then, of course, there is the link between what we do on the patient care side and on the lab side by developing and applying cutting edge technology, which makes transfusion medicine so special.”

On the patient care side of things, Flegel developed the largest external quality assessment for proficiency testing in molecular immunohematology that helped to improve patient safety. These types of assessments can be instrumental for the introduction of new technology in a laboratory and are typically required in many health care systems for clinical application and to maintain accreditation.²

“Quality assessments were developed for programs that want to do molecular testing for blood groups and assure that quality standards are met,” Flegel said.

During this assessment, a lab has to apply routine methods to a series of unknown samples to see whether they can come up with the correct answer.

“We started this program more than 20 years ago, and it continues to run to this day,” Flegel said. “It is the oldest and probably the largest proficiency testing program for molecular immunohematology worldwide.”

Lab Discoveries

On the laboratory side, scientists and clinicians worldwide have been able to benefit from Flegel’s discovery of the molecular structure of the RH gene locus and most of the clinically relevant molecular variants in the RHD and RHCE genes.

Additionally, the RhesusBase was created by Flegel’s initiative, the first online database for blood group alleles. Specifically, RhesusBase is an online compilation of published information on the molecular variability observed at the Rhesus (RHD) locus.³

“This was created in the 1990s – the early years of the internet – and it was the first freely available, complete and curated database for blood group variants on the internet,” Flegel said. “It was a totally new approach at the time. When people found a new gene variant, they could look it up in the database, easily determining if it was a known variant or something novel. If it was novel, it would be integrated into the database.”

The database is still online today; although, Flegel noted, it has been transferred in several iterations into larger databases.

“This whole novel approach started when I found 17 RHD gene variants in my lab, which at the time doubled the number of all known RHD variants,” Flegel said. “Now there are between 500 and 600 alleles in the database.”

 

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More Work to Be Done

Looking to the future, Flegel has other important areas of interest that he is hoping to devote his time and efforts to, one of which is the erythrocyte membrane — or the red cell membrane — a structure containing both lipids and proteins that are essential to red cell function.⁴

“The red cell membrane is a super important structure, and we do not yet completely understand how it functions,” Flegel said. “This is a topic that should be investigated much more thoroughly.” 

Studying blood group systems is one way of gaining a better understanding of the red cell membrane, he said, because the blood group system is defined by proteins and sugars that are integrated into the red cell membrane.

Overall, Flegel said that he hopes that awards like the Dale A. Smith Memorial Award bring more attention to this and similar topics in this important field of scientific research.

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References

1. AABB. Dale A. Smith Memorial Award. https://www.aabb.org/membership/get-involved/awards/aabb-memorial-awards/dale-a-smith-memorial-award. Accessed June 29, 2026.
2. Flegel WA, Chiosea I, Sachs UJ, Bein G. External quality assessment (EQA) in molecular immunohematology: the INSTAND proficiency test program. Transfusion. 2013;53(11 0 2):10.1111/trf.12414. doi: 10.1111/trf.12414.
3. RhesusBase. About the RhesusBase. https://www.rhesusbase.info/AboutRB.htm. Accessed June 29, 2026.
4. Lux IV SE. Anatomy of the red cell membrane skeleton: unanswered questions. Blood. 2016;127(2):187–199.