Pearl Toy, MD
Professor Emeritus
Laboratory Medicine
School of Medicine

Early on in 1981, she was director of the San Francisco Center, one of three centers of a study led by Cladd Stevens MD to determine the efficacy and safety of the hepatitis B virus (HBV) vaccine; the successful results led to FDA approval of the vaccines that safely prevented transmission of HBV from infected mother to child. In the AIDS era, she was Director of the American Red Cross in San Jose, CA (1983-84) where she installed some preventive measures to somewhat protect the safety of the blood supply prior to the availability of HIV testing. She also promoted the practice of patients donating their own blood for elective surgery. In 2003-5, she was Chair of the NIH committee on Transfusion-Related Acute Lung Injury (TRALI), the #1 cause of death from transfusion at that time. To investigate the causes and a prevention method, she was Principal Investigator of the NIH supported two-center TRALI study at UCSF and Mayo Clinic.

She graduated with honors from Smith College (Phi Beta Kappa) and the Stanford School of Medicine (Alpha Omega Alpha). Other honors include the Smith College Medal, UCSF Distinguished Teaching Award, the California Blood Bank Systems Award and the International Woman in Transfusion Medicine Award. She was invited to speak at the inaugural Margot Kruskall Lecture series at Harvard Medical School.

• Complement activation on endothelium initiates antibody-mediated acute lung injury.
  The Journal of clinical investigation 2020 Cleary SJ, Kwaan N, Tian JJ, Calabrese DR, Mallavia B, Magnen M, Greenland JR, Urisman A, Singer JP, Hays SR, Kukreja J, Hay AM, Howie HL, Toy P, Lowell CA, Morrell CN, Zimring JC, Looney MR
• Update on transfusion-related acute lung injury.
  Clinical advances in hematology & oncology : H&O 2019 Toy P
• An update of the transfusion-related acute lung injury (TRALI) definition.
  Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine 2019 Vlaar APJ, Toy P, Fung M, Looney MR, Juffermans NP, Bux J, Bolton-Maggs P, Peters AL, Silliman CC, Kor DJ, Kleinman S
• Eradicating hepatitis B virus: The critical role of preventing perinatal transmission.
  Biologicals : journal of the International Association of Biological Standardization 2017 Stevens CE, Toy P, Kamili S, Taylor PE, Tong MJ, Xia GL, Vyas GN
• Differentiating pulmonary transfusion reactions using recipient and transfusion factors.
  Transfusion 2017 Roubinian NH, Looney MR, Keating S, Kor DJ, Lowell CA, Gajic O, Hubmayr R, Gropper M, Koenigsberg M, Wilson GA, A Matthay M, Toy P, Murphy EL, TRALI Study Group
• Reply to concerns regarding dropping the term "possible TRALI".
  Transfusion 2016 Toy P, Kleinman SH, Looney MR
• A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery.
  Anesthesiology 2015 Feiner JR, Gropper MA, Toy P, Lieberman J, Twiford J, Weiskopf RB
• Cytokines and clinical predictors in distinguishing pulmonary transfusion reactions.
  Transfusion 2015 Roubinian NH, Looney MR, Kor DJ, Lowell CA, Gajic O, Hubmayr RD, Gropper MA, Koenigsberg M, Wilson GA, Matthay MA, Toy P, Murphy EL, TRALI Study Group
• Male-predominant plasma transfusion strategy for preventing transfusion-related acute lung injury: a systematic review.
  Critical care medicine 2015 Schmickl CN, Mastrobuoni S, Filippidis FT, Shah S, Radic J, Murad MH, Toy P, Gajic O
• Prospective study on the clinical course and outcomes in transfusion-related acute lung injury*.
  Critical care medicine 2014 Looney MR, Roubinian N, Gajic O, Gropper MA, Hubmayr RD, Lowell CA, Bacchetti P, Wilson G, Koenigsberg M, Lee DC, Wu P, Grimes B, Norris PJ, Murphy EL, Gandhi MJ, Winters JL, Mair DC, Schuller RM, …
• Lot-to-lot variability in HLA antibody screening using a multiplexed bead-based assay.
  Transfusion 2013 Gandhi MJ, Carrick DM, Jenkins S, De Goey S, Ploeger NA, Wilson GA, Lee JH, Winters JL, Stubbs JR, Toy P, Norris PJ, National Heart, Lung, and Blood Institute Specialized Center of Clinically Oriented…
• Transfusion reactions: newer concepts on the pathophysiology, incidence, treatment, and prevention of transfusion-related acute lung injury.
  Critical care clinics 2012 Sayah DM, Looney MR, Toy P
• Platelets induce neutrophil extracellular traps in transfusion-related acute lung injury.
  The Journal of clinical investigation 2012 Caudrillier A, Kessenbrock K, Gilliss BM, Nguyen JX, Marques MB, Monestier M, Toy P, Werb Z, Looney MR
• Fresh and stored red blood cell transfusion equivalently induce subclinical pulmonary gas exchange deficit in normal humans.
  Anesthesia and analgesia 2012 Weiskopf RB, Feiner J, Toy P, Twiford J, Shimabukuro D, Lieberman J, Looney MR, Lowell CA, Gropper MA
• Current problems and future directions of transfusion-induced alloimmunization: summary of an NHLBI working group.
  Transfusion 2011 Zimring JC, Welniak L, Semple JW, Ness PM, Slichter SJ, Spitalnik SL, NHLBI Alloimmunization Working Group
• A multidisciplinary "think tank": the top 10 clinical trial opportunities in transfusion medicine from the National Heart, Lung, and Blood Institute-sponsored 2009 state-of-the-science symposium.
  Transfusion 2010 Josephson CD, Glynn SA, Kleinman SH, Blajchman MA, State-of-the Science Symposium Transfusion Medicine Committee
• Clinical trial opportunities in Transfusion Medicine: proceedings of a National Heart, Lung, and Blood Institute State-of-the-Science Symposium.
  Transfusion medicine reviews 2010 Blajchman MA, Glynn SA, Josephson CD, Kleinman SH, State-of-the Science Symposium Transfusion Medicine Committee
• Microarray kit analysis of cytokines in blood product units and segments.
  Transfusion 2009 Weiskopf RB, Yau R, Sanchez R, Lowell C, Toy P
• Research opportunities for pathogen reduction/inactivation of blood components: summary of an NHLBI workshop.
  Transfusion 2009 Klein HG, Glynn SA, Ness PM, Blajchman MA, NHLBI Working Group on Research Opportunities for the Pathogen Reduction/Inactivation of Blood Compo
• Cost minimization analysis of preoperative erythropoietin vs autologous and allogeneic blood donation in total joint arthroplasty.
  The Journal of arthroplasty 2008 Green WS, Toy P, Bozic KJ
• Red blood cell age and function.
  Transfusion 2008 Weiskopf RB, Feiner J, Toy P
• Transfusion-related acute lung injury: a case-control pilot study of risk factors.
  American journal of clinical pathology 2007 Sanchez R, Bacchetti P, Toy P
• TRALI--definition, mechanisms, incidence and clinical relevance.
  Best practice & research. Clinical anaesthesiology 2007 Toy P, Lowell C
• Transfusion-related acute lung injury and transfusion-associated circulatory overload: mutually exclusive or coexisting entities?
  Transfusion 2007 Fiebig EW, Wu AH, Krombach J, Tang J, Nguyen KA, Toy P
• Fresh frozen plasma and platelet transfusion for nonbleeding patients in the intensive care unit: benefit or harm?
  Critical care medicine 2006 Gajic O, Dzik WH, Toy P
• Designing and testing a computer-based screening system for transfusion-related acute lung injury.
  American journal of clinical pathology 2005 Finlay HE, Cassorla L, Feiner J, Toy P
• Transfusion related acute lung injury: a pediatric perspective.
  Pediatric blood & cancer 2005 Sanchez R, Toy P
• Acute and transient decrease in neutrophil count in transfusion-related acute lung injury: cases at one hospital.
  Transfusion 2004 Nakagawa M, Toy P
• Transfusion-related acute lung injury.
  Anesthesia and analgesia 2004 Toy P, Gajic O
• Safe lead levels: blood transfusion of extremely low birth weight infants.
  Clinical pediatrics 2004 Nakagawa M, Dempsey DA, Haller C, Toy P
• Research opportunities in transfusion medicine.
  JAMA 2001 Silberstein LE, Toy P
• Subcutaneous perfusion and oxygen during acute severe isovolemic hemodilution in healthy volunteers.
  Archives of surgery (Chicago, Ill. : 1960) 2000 Hopf HW, Viele M, Watson JJ, Feiner J, Weiskopf R, Hunt TK, Noorani M, Yeap H, Ho R, Toy P
• Universal WBC reduction.
  Transfusion 2000 Thurer RL, Luban NL, AuBuchon JP, Silver H, McCarthy LJ, Dzik S, Stowell CP, Moore SB, Vamvakas EC, Armstrong W, Kanter MH, Jeter E, Becker J, Higgins M, Galel S, Kleinman S, Marshall CS, Newman R, …
• Very severe outcomes associated with autologous blood donation.
  Transfusion 1996 McVay PA, Toy PT
• Preoperative autologous blood donation.
  AACN clinical issues 1996 Toy PT, Kerr K
• Physician recommendation as the key factor in patients' decisions to participate in preoperative autologous blood donation programs: Preoperative Autologous Blood Donation Study Group.
  American journal of surgery 1994 Ferguson KJ, Strauss RG, Toy PT
• Effectiveness of transfusion audits and practice guidelines.
  Archives of pathology & laboratory medicine 1994 Toy PT
• Efficacy of preoperative donation of blood for autologous use in radical prostatectomy.
  Transfusion 1993 Toy PT, Menozzi D, Strauss RG, Stehling LC, Kruskall M, Ahn DK
• Improvement in appropriate autologous donations with local education: 1987 to 1989.
  Transfusion 1992 Toy PT, McVay PA, Strauss RG, Stehling LC, Ahn DK
• Prospects for control of hepatitis B virus infection: implications of childhood vaccination and long-term protection.
  Pediatrics 1992 Stevens CE, Toy PT, Taylor PE, Lee T, Yip HY
• Continuous quality improvement. Autologous blood donations.
  Archives of pathology & laboratory medicine 1992 Toy PT
• Factors associated with successful autologous blood donation for elective surgery.
  American journal of clinical pathology 1992 McVay PA, Hoag MS, Lee SJ, Toy PT
• Blood loss and replacement in total hip arthroplasty: a multicenter study. The Preoperative Autologous Blood Donation Study Group.
  Transfusion 1992 Toy PT, Kaplan EB, McVay PA, Lee SJ, Strauss RG, Stehling LC
• Probable reasons that autologous blood was not donated by patients having surgery for which crossmatched blood was ordered.
  Transfusion 1991 McVay PA, Strauss RG, Stehling LC, Toy PT
• Donor room personnel attitudes toward autologous donors.
  Transfusion 1991 Skettino S, Ferguson K, Andrews A, Stehling LC, Strauss RG, Toy PT
• Hypotension during transfusion of autologous blood.
  Anesthesiology 1991 Miller AC, Scherba-Krugliak L, Toy PT, Drasner K
• Return of autologous blood donors as homologous blood donors.
  Transfusion 1991 McVay PA, Fung HC, Toy PT
• The variability of transfusion practice in coronary artery bypass surgery. Transfusion Medicine Academic Award Group.
  JAMA 1991 Goodnough LT, Johnston MF, Toy PT
• Surgeons' knowledge, attitude, and use of preoperative autologous blood donation.
  Transfusion 1990 Strauss RG, Ferguson KJ, Stone GG, McVay PA, Black D, Stehling L, Toy PT, Daniels M, Randels J, Sears R
• Donation reactions among autologous donors.
  Transfusion 1990 McVay PA, Andrews A, Kaplan EB, Black DB, Stehling LC, Strauss RG, Toy PT
• Red cell transfusion therapy for anemia in patients with AIDS and ARC: incidence, associated factors, and outcome.
  Transfusion 1990 Jacobson MA, Peiperl L, Volberding PA, Porteous D, Toy PT, Feigal D
• Agglutination of red blood cells from patients with diabetes mellitus by a polyclonal human antibody specific for D-glucose.
  Vox sanguinis 1990 Ellisor SS, Toy PT, Reid ME, Avoy DR
• Moderate and severe reactions during autologous blood donations are no more frequent than during homologous blood donations.
  Vox sanguinis 1990 McVay PA, Andrews A, Hoag MS, Polan D, Skettino S, Stehling LC, Strauss RG, Toy PT
• Safety and use of autologous blood donation during the third trimester of pregnancy.
  American journal of obstetrics and gynecology 1989 McVay PA, Hoag RW, Hoag MS, Toy PT
• Exposure of cryptantigens on red blood cell membranes in patients with acquired immune deficiency syndrome or AIDS-related complex.
  Journal of acquired immune deficiency syndromes 1989 Adams M, Toy PT, Reid ME
• Oxygen-induced marrow red cell hypoplasia leading to transfusion in sickle painful crisis.
  American journal of hematology 1988 Lane PK, Embury SH, Toy PT
• Prevalence of ABO maternal-infant incompatibility in Asians, Blacks, Hispanics and Caucasians.
  Vox sanguinis 1988 Toy PT, Reid ME, Papenfus L, Yeap HH, Black D
• Underutilization of autologous blood donation among eligible elective surgical patients.
  American journal of surgery 1986 Toy PT, Stehling LC, Strauss RG, Esposito B, Huling D, Poole L, Sears R
• Yeast recombinant hepatitis B vaccine in perinatal hepatitis B virus transmission: a preliminary report.
  The Journal of infection 1986 Stevens CE, Taylor PE, Tong MJ, Toy PT, Vyas GN
• Positive direct antiglobulin test associated with hyperglobulinemia in acquired immunodeficiency syndrome (AIDS).
  American journal of hematology 1985 Toy PT, Reid ME, Burns M
• Agglutination of an EDTA blood sample caused by an EDTA-dependent panagglutinin.
  American journal of clinical pathology 1985 Reid ME, Bottenfield LK, Toy PT, Ellisor SS, Hart CA
• Effect of fibronectin on adherence of Staphylococcus aureus to fibrin thrombi in vitro.
  Infection and immunity 1985 Toy PT, Lai LW, Drake TA, Sande MA
• Factors associated with positive direct antiglobulin tests in pretransfusion patients: a case-control study.
  Vox sanguinis 1985 Toy PT, Chin CA, Reid ME, Burns MA
• Elimination of 37 degrees C reading: reduction of workload in a transfusion service.
  Transfusion 1984 Purcelli J, Reid ME, Burns MA, Toy PT
• Sample collection for determination of plasma fibronectin concentration.
  Journal of clinical pathology 1984 Toy PT, Reid ME
• Use of preserved autologous red blood cells to absorb warm autoantibodies from the serum of patients receiving blood transfusion therapy.
  Vox sanguinis 1984 Reid ME, Toy PT
• Intravenous dimethylsulfoxide therapy causes severe hemolysis mimicking a hemolytic transfusion reaction.
  Transfusion 1983 Samoszuk M, Reid ME, Toy PT
• Simplified method for recovery of autologous red blood cells from transfused patients.
  American journal of clinical pathology 1983 Reid ME, Toy PT
• Severity of ABO-hemolytic disease of the newborn.
  Acta paediatrica Scandinavica 1982 Toy PT, Reid M
• Transient anti-Gya in an untransfused man. Serologic characteristics and cell survival study.
  Transfusion 1982 Ellisor SS, Reid ME, Avoy DR, Toy PT, Mecoli J
• Amniotic fluid assessement of Jra-sensitized pregnant patients.
  American journal of obstetrics and gynecology 1981 Toy PT, Reid M, Lewis T, Ellisor S, Avoy DR
• Occlusive impedance plethysmography. A noninvasive method of diagnosis of proximal deep vein thrombosis.
  The Western journal of medicine 1978 Toy PT, Schrier SL