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Pearl Toy, MD

TitleProfessor Emeritus
InstitutionUniversity of California San Francisco
DepartmentLaboratory Medicine
Address521 Parnassus Avenue
San Francisco CA 94117
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    Collapse Biography 
    Collapse Education and Training
    Smith College, Northampton, MAB.A., Phi Beta Kappa1969Biochemistry
    Stanford Medical School, Stanford, CAM.D., Alpha Omega Alpha1973Medicine
    Collapse Awards and Honors
    California Blood Bank Society2017Herbert Perkins & George Garratty Memorial Lectureship Award
    International Soc Blood Transfusion, Am Assoc Blood Banks, and British Blood Transfusion Society2007International Woman in Transfusion Medicine Award
    Harvard Hospitals Transfusion Medicine Joint Program2007Inaugural Transfusion Medicine Margot S. Kruskall Lectureship
    UCSF2005Nominee, Chancellor's Award for Public Service
    NIH2000  - 2004Member, NHLBI Advisory Council
    TCU/Cliburn Institute, Fort Worth, Texas1999Winner, Amateur Piano Concerto Competition
    Various orchestras1997  - 2002Soloist, the 5 Beethoven piano concertos
    NHLBI, NIH1996  - 2011PI, Transfusion Medicine Specialized Center of Research SCOR grants (3 consecutive 5-yr awards)
    Smith College, Northampton, MA1991Smith College Medal
    UCSF Academic Senate1985Distinguished Teaching Award
    NHLBI, NIH1983  - 1988Transfusion Medicine Academic Award
    UCSF Department of Laboratory Medicine1983Faculty Teaching Award
    Stanford University School of Medicine1973Alpha Omega Alpha
    Smith College, Northampton, MA1968Phi Beta Kappa (Jr year), Sigma Xi

    Collapse Overview 
    Collapse Overview
    Primary Board Certification: Internal Medicine
    Subspecialties: Hematology, Transfusion Medicine

    1980-2010: Chief, Blood Bank, UCSF (1980-1992 SF General, 1991-2010 Moffitt-Long Hospital)

    1998-present: Founder and Director of the noontime Chancellor's Concert Series that brings free, high-quality, live classical music to the all-science UCSF campus.



    1980-present: Prevention of diseases transmitted by blood and blood transfusion:

    1. Prevention of hepatitis B transmission from mother-to-infant, by perinatal administration of hepatitis B immunoglobulin and hepatitis B vaccine to infants of carrier mothers. After this work was published and provided evidence that vaccination of infants was safe and effective, the US Advisory Committee on Immunization Practices recommended routine hepatitis B vaccination for infants in 1991.

    REF: Stevens CE, Toy PT, Tong MJ, Taylor PE, Vyas GN, Nair PV, Gudavalli M, Krugman S. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. JAMA. 1985 Mar 22-29; 253(12):1740-5.

    2. Prevention of transfusion-associated diseases associated with transfusion by the use of autologous blood.

    REF: Toy PT, Strauss RG, Stehling LC, Sears R, Price TH, Rossi EC, Collins ML, Crowley JP, Eisenstaedt RS, Goodnough LT, et al. Predeposited autologous blood for elective surgery. A national multicenter study. N Engl J Med. 1987 Feb 26; 316(9):517-20.

    3. Prevention of unnecessary plasma transfusion, by determining that there is no increased risk of bleeding in patients with mild coagulopathy who underwent percutaneous needle procedures.

    REF: McVay PA, Toy PT. Lack of increased bleeding after liver biopsy in patients with mild hemostatic abnormalities. Am J Clin Pathol. 1990 Dec; 94(6):747-53.

    REF: McVay PA, Toy PT. Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities. Transfusion. 1991 Feb; 31(2):164-71.

    4. Prevention of bleeding from dilutional coagulopathy in trauma patients massively transfused with packed red blood cells, by earlier transfusion of plasma and/or whole blood.

    REF: Leslie SD, Toy PT. Laboratory hemostatic abnormalities in massively transfused patients given red blood cells and crystalloid. Am J Clin Pathol. 1991 Dec; 96(6):770-3.

    REF: San Francisco General Hospital Blood Bank procedures


    5. Prevention of unnecessary transfusions by physician education and prospective review of blood orders.

    REF: Toy PT. Audit and education in transfusion medicine. Vox Sang. 1996; 70(1):1-5.

    REF: UCSF Blood Bank procedures

    6. Prevention of unnecessary red blood cell transfusion, by examining the red blood cell transfusion trigger level. We determined that only hemoglobin levels below 7 g/dL are associated with organ impairment (cognitive dysfunction) during acute normovolemic anemia in normal humans.

    REF: Weiskopf RB, Feiner J, Hopf HW, Viele MK, Watson JJ, Kramer JH, Ho R, Toy P. Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia. Anesthesiology. 2002 Apr; 96(4):871-7.


    7. Prevention of hyperkalemia (high potassium levels) and associated cardiac abnormalities in pediatric cardiac surgery patients, by washing stored red blood cells prior to transfusion on the morning of surgery.

    REF: Weiskopf RB, Schnapp S, Rouine-Rapp K, Bostrom A, Toy P. Extracellular potassium concentrations in red blood cell suspensions after irradiation and washing. Transfusion. 2005 Aug; 45(8):1295-301.

    REF: UCSF Blood Bank procedures

    8. Prevention of exsanguination in acutely bleeding hospitalized patients, by establishing an Emergency Release procedure so that blood and blood components are rapidly available.

    REF: Weiskopf RB, Webb M, Stangle D, Klinbergs G, Toy P. A procedure for rapid issue of red cells for emergency use. Arch Pathol Lab Med. 2005 Apr; 129(4):492-6.

    REF: UCSF Blood Bank procedures

    9. Prevention of most hemolytic transfusion reactions associated with transfusion of Group O plasma, by not transfusing group O plasma to group A and AB patients (most ABO hemolytic reactions associated with transfusion of group O plasma are in group A patients, and rarely in group B patients).

    REF: UCSF Blood Bank Procedures

    10. Prevention of transfusion-related acute lung injury (TRALI) by establishing a clinical definition, determining the transfusion and patient risk factors, and observing the efficacy of transfusing plasma from predominantly male donors in reducing TRALI incidence.

    REF: Toy P, Popovsky MA, Abraham E, Ambruso DR, Holness LG, Kopko PM, McFarland JG, Nathens AB, Silliman CC, Stroncek D. Transfusion-related acute lung injury: definition and review. Crit Care Med. 2005 Apr; 33(4):721-6.

    REF: Toy P, Gajic O, Bacchetti P, Looney MR, Gropper MA, Hubmayr R, Lowell CA, Norris PJ, Murphy EL, Weiskopf RB, Wilson G, Koenigsberg M, Lee D, Schuller R, Wu P, Grimes B, Gandhi MJ, Winters JL, Mair D, Hirschler N, Sanchez Rosen R, Matthay MA. Transfusion-related acute lung injury: incidence and risk factors. Blood. 2012 Feb 16; 119(7):1757-67.

    11. Prevention of TRALI in pediatric patients undergoing spine surgery, by identifying transfusion of maternal blood as an important risk factor.

    REF: Dunbar N, Cooke M, Diab M, Toy P. Transfusion-related acute lung injury after transfusion of maternal blood: a case-control study. Spine (Phila Pa 1976). 2010 Nov 1; 35(23):E1322-7.

    REF: UCSF Blood Donor Center procedures

    12. Prevention of septic platelet transfusion reactions being mistaken for TRALI.

    REF: Rollins MD, Molofsky AB, Nambiar A, Pandey S, Weiskopf RB, Toy P. Two septic transfusion reactions presenting as transfusion-related acute lung injury from a split plateletpheresis unit. Crit Care Med. 2012 Aug; 40(8):2488-91.


    Collapse Research 
    Collapse Research Activities and Funding
    Transfusion and Lung Injury
    NIH/NHLBI P50HL081027Sep 30, 2005 - Aug 31, 2011
    Role: Principal Investigator
    TRANSFUSION BIOLOGY AND MEDICINE
    NIH/NHLBI P50HL054476Feb 1, 1996 - Dec 31, 2006
    Role: Principal Investigator
    TRANSFUSION REQUIREMENTS FOR ELECTIVE SURGERY PROCEDURES
    NIH/NHLBI R03HL050280Apr 1, 1994 - Mar 31, 1998
    Role: Principal Investigator
    MODEL AUTOLOGOUS PREDEPOSIT BLOOD DONATION PROGRAM
    NIH/NHLBI R01HL036715Apr 1, 1987 - Mar 31, 1993
    Role: Principal Investigator
    SCIENTIFIC REVIEW AND EVALUATION AWARD
    NIH/NHLBI U09HL007541Jul 1, 1985 - Jun 30, 1996
    Role: Co-Principal Investigator
    TRANSFUSION MEDICINE
    NIH/NHLBI K07HL001270Sep 30, 1983 - Sep 29, 1988
    Role: Principal Investigator
    General Clinical Research Center
    NIH/NCRR M01RR000079Dec 1, 1974 - Mar 31, 2009
    Role: Co-Investigator

    Collapse Bibliographic 
    Collapse Publications
    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
    List All   |   Timeline
    1. Stevens CE, Toy P, Kamili S, Taylor PE, Tong MJ, Xia GL, Vyas GN. Eradicating hepatitis B virus: The critical role of preventing perinatal transmission. Biologicals. 2017 Nov; 50:3-19. PMID: 28870397.
      View in: PubMed
    2. 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. Differentiating pulmonary transfusion reactions using recipient and transfusion factors. Transfusion. 2017 07; 57(7):1684-1690. PMID: 28470756.
      View in: PubMed
    3. Toy P, Kleinman SH, Looney MR. Proposed revised nomenclature for transfusion-related acute lung injury. Transfusion. 2017 03; 57(3):709-713. PMID: 28019007.
      View in: PubMed
    4. Toy P, Kleinman SH, Looney MR. Reply to concerns regarding dropping the term "possible TRALI". Transfusion. 2016 09; 56(9):2394-5. PMID: 27624212.
      View in: PubMed
    5. Feiner JR, Gropper MA, Toy P, Lieberman J, Twiford J, Weiskopf RB. A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery. Anesthesiology. 2015 Jul; 123(1):126-35. PMID: 25946480; PMCID: PMC4626309.
    6. Roubinian NH, Looney MR, Kor DJ, Lowell CA, Gajic O, Hubmayr RD, Gropper MA, Koenigsberg M, Wilson GA, Matthay MA, Toy P, Murphy EL. Cytokines and clinical predictors in distinguishing pulmonary transfusion reactions. Transfusion. 2015 Aug; 55(8):1838-46. PMID: 25702590; PMCID: PMC4536135.
    7. Schmickl CN, Mastrobuoni S, Filippidis FT, Shah S, Radic J, Murad MH, Toy P, Gajic O. Male-predominant plasma transfusion strategy for preventing transfusion-related acute lung injury: a systematic review. Crit Care Med. 2015 Jan; 43(1):205-25. PMID: 25514705.
      View in: PubMed
    8. Toy P, Bacchetti P, Grimes B, Gajic O, Murphy EL, Winters JL, Gropper MA, Hubmayr RD, Matthay MA, Wilson G, Koenigsberg M, Lee DC, Hirschler NV, Lowell CA, Schuller RM, Gandhi MJ, Norris PJ, Mair DC, Sanchez Rosen R, Looney MR. Recipient clinical risk factors predominate in possible transfusion-related acute lung injury. Transfusion. 2015 May; 55(5):947-52. PMID: 25488517.
      View in: PubMed
    9. 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, Hirschler NV, Rosen RS, Matthay MA, Toy P. Prospective study on the clinical course and outcomes in transfusion-related acute lung injury*. Crit Care Med. 2014 Jul; 42(7):1676-87. PMID: 24776608; PMCID: PMC4284060.
    10. Murphy EL, Kwaan N, Looney MR, Gajic O, Hubmayr RD, Gropper MA, Koenigsberg M, Wilson G, Matthay M, Bacchetti P, Toy P. Risk factors and outcomes in transfusion-associated circulatory overload. Am J Med. 2013 Apr; 126(4):357.e29-38. PMID: 23357450; PMCID: PMC3652681.
    11. Gandhi MJ, Carrick DM, Jenkins S, De Goey S, Ploeger NA, Wilson GA, Lee JH, Winters JL, Stubbs JR, Toy P, Norris PJ. Lot-to-lot variability in HLA antibody screening using a multiplexed bead-based assay. Transfusion. 2013 Sep; 53(9):1940-7. PMID: 23305156; PMCID: PMC3626740.
    12. Clifford L, Singh A, Wilson GA, Toy P, Gajic O, Malinchoc M, Herasevich V, Pathak J, Kor DJ. Electronic health record surveillance algorithms facilitate the detection of transfusion-related pulmonary complications. Transfusion. 2013 Jun; 53(6):1205-16. PMID: 22934792; PMCID: PMC4839484.
    13. Rollins MD, Molofsky AB, Nambiar A, Pandey S, Weiskopf RB, Toy P. Two septic transfusion reactions presenting as transfusion-related acute lung injury from a split plateletpheresis unit. Crit Care Med. 2012 Aug; 40(8):2488-91. PMID: 22809916; PMCID: PMC3733455.
    14. Sayah DM, Looney MR, Toy P. Transfusion reactions: newer concepts on the pathophysiology, incidence, treatment, and prevention of transfusion-related acute lung injury. Crit Care Clin. 2012 Jul; 28(3):363-72, v. PMID: 22713611; PMCID: PMC3380279.
    15. Caudrillier A, Kessenbrock K, Gilliss BM, Nguyen JX, Marques MB, Monestier M, Toy P, Werb Z, Looney MR. Platelets induce neutrophil extracellular traps in transfusion-related acute lung injury. J Clin Invest. 2012 Jul; 122(7):2661-71. PMID: 22684106; PMCID: PMC3386815.
    16. Weiskopf RB, Feiner J, Toy P, Twiford J, Shimabukuro D, Lieberman J, Looney MR, Lowell CA, Gropper MA. Fresh and stored red blood cell transfusion equivalently induce subclinical pulmonary gas exchange deficit in normal humans. Anesth Analg. 2012 Mar; 114(3):511-9. PMID: 22262647; PMCID: PMC3927839.
    17. Toy P, Gajic O, Bacchetti P, Looney MR, Gropper MA, Hubmayr R, Lowell CA, Norris PJ, Murphy EL, Weiskopf RB, Wilson G, Koenigsberg M, Lee D, Schuller R, Wu P, Grimes B, Gandhi MJ, Winters JL, Mair D, Hirschler N, Sanchez Rosen R, Matthay MA. Transfusion-related acute lung injury: incidence and risk factors. Blood. 2012 Feb 16; 119(7):1757-67. PMID: 22117051; PMCID: PMC3286351.
    18. Feiner JR, Finlay-Morreale HE, Toy P, Lieberman JA, Viele MK, Hopf HW, Weiskopf RB. High oxygen partial pressure decreases anemia-induced heart rate increase equivalent to transfusion. Anesthesiology. 2011 Sep; 115(3):492-8. PMID: 21768873; PMCID: PMC3166888.
    19. Dunbar N, Cooke M, Diab M, Toy P. Transfusion-related acute lung injury after transfusion of maternal blood: a case-control study. Spine (Phila Pa 1976). 2010 Nov 01; 35(23):E1322-7. PMID: 20938390; PMCID: PMC2964398.
    20. Weiskopf RB, Yau R, Sanchez R, Lowell C, Toy P. Microarray kit analysis of cytokines in blood product units and segments. Transfusion. 2009 Nov; 49(11):2269-75. PMID: 19548981; PMCID: PMC2783862.
    21. Green WS, Toy P, Bozic KJ. Cost minimization analysis of preoperative erythropoietin vs autologous and allogeneic blood donation in total joint arthroplasty. J Arthroplasty. 2010 Jan; 25(1):93-6. PMID: 19056224.
      View in: PubMed
    22. Weiskopf RB, Feiner J, Toy P. Red blood cell age and function. Transfusion. 2008 Sep; 48(9):2026. PMID: 18811899.
      View in: PubMed
    23. Finlay-Morreale HE, Louie C, Toy P. Computer-generated automatic alerts of respiratory distress after blood transfusion. J Am Med Inform Assoc. 2008 May-Jun; 15(3):383-5. PMID: 18308991; PMCID: PMC2410003.
    24. Sanchez R, Bacchetti P, Toy P. Transfusion-related acute lung injury: a case-control pilot study of risk factors. Am J Clin Pathol. 2007 Jul; 128(1):128-34. PMID: 17580280.
      View in: PubMed
    25. Toy P, Lowell C. TRALI--definition, mechanisms, incidence and clinical relevance. Best Pract Res Clin Anaesthesiol. 2007 Jun; 21(2):183-93. PMID: 17650771; PMCID: PMC2767181.
    26. Fiebig EW, Wu AH, Krombach J, Tang J, Nguyen KA, Toy P. Transfusion-related acute lung injury and transfusion-associated circulatory overload: mutually exclusive or coexisting entities? Transfusion. 2007 Jan; 47(1):171-2. PMID: 17207246.
      View in: PubMed
    27. Gajic O, Dzik WH, Toy P. Fresh frozen plasma and platelet transfusion for nonbleeding patients in the intensive care unit: benefit or harm? Crit Care Med. 2006 May; 34(5 Suppl):S170-3. PMID: 16617262.
      View in: PubMed
    28. Weiskopf RB, Feiner J, Hopf H, Lieberman J, Finlay HE, Quah C, Kramer JH, Bostrom A, Toy P. Fresh blood and aged stored blood are equally efficacious in immediately reversing anemia-induced brain oxygenation deficits in humans. Anesthesiology. 2006 May; 104(5):911-20. PMID: 16645441.
      View in: PubMed
    29. Finlay HE, Cassorla L, Feiner J, Toy P. Designing and testing a computer-based screening system for transfusion-related acute lung injury. Am J Clin Pathol. 2005 Oct; 124(4):601-9. PMID: 16146824.
      View in: PubMed
    30. Sanchez R, Toy P. Transfusion related acute lung injury: a pediatric perspective. Pediatr Blood Cancer. 2005 Sep; 45(3):248-55. PMID: 15852432.
      View in: PubMed
    31. Weiskopf RB, Schnapp S, Rouine-Rapp K, Bostrom A, Toy P. Extracellular potassium concentrations in red blood cell suspensions after irradiation and washing. Transfusion. 2005 Aug; 45(8):1295-301. PMID: 16078915.
      View in: PubMed
    32. Weiskopf RB, Webb M, Stangle D, Klinbergs G, Toy P. A procedure for rapid issue of red cells for emergency use. Arch Pathol Lab Med. 2005 Apr; 129(4):492-6. PMID: 15794672.
      View in: PubMed
    33. Toy P, Popovsky MA, Abraham E, Ambruso DR, Holness LG, Kopko PM, McFarland JG, Nathens AB, Silliman CC, Stroncek D. Transfusion-related acute lung injury: definition and review. Crit Care Med. 2005 Apr; 33(4):721-6. PMID: 15818095.
      View in: PubMed
    34. Weiskopf RB, Toy P, Hopf HW, Feiner J, Finlay HE, Takahashi M, Bostrom A, Songster C, Aminoff MJ. Acute isovolemic anemia impairs central processing as determined by P300 latency. Clin Neurophysiol. 2005 May; 116(5):1028-32. PMID: 15826842.
      View in: PubMed
    35. Toy P, Gajic O. Transfusion-related acute lung injury. Anesth Analg. 2004 Dec; 99(6):1623-4, table of contents. PMID: 15562043.
      View in: PubMed
    36. Toy P, Hollis-Perry KM, Jun J, Nakagawa M. Recipients of blood from a donor with multiple HLA antibodies: a lookback study of transfusion-related acute lung injury. Transfusion. 2004 Dec; 44(12):1683-8. PMID: 15584980.
      View in: PubMed
    37. Nakagawa M, Toy P. Acute and transient decrease in neutrophil count in transfusion-related acute lung injury: cases at one hospital. Transfusion. 2004 Dec; 44(12):1689-94. PMID: 15584981.
      View in: PubMed
    38. Nakagawa M, Dempsey DA, Haller C, Toy P. Safe lead levels: blood transfusion of extremely low birth weight infants. Clin Pediatr (Phila). 2004 Sep; 43(7):681. PMID: 15378161.
      View in: PubMed
    39. Weiskopf RB, Aminoff MJ, Hopf HW, Feiner J, Viele MK, Watson JJ, Ho R, Songster C, Toy P. Acute isovolemic anemia does not impair peripheral or central nerve conduction. Anesthesiology. 2003 Sep; 99(3):546-51. PMID: 12960537.
      View in: PubMed
    40. Weiskopf RB, Feiner J, Hopf H, Viele MK, Watson JJ, Lieberman J, Kelley S, Toy P. Heart rate increases linearly in response to acute isovolemic anemia. Transfusion. 2003 Feb; 43(2):235-40. PMID: 12559019.
      View in: PubMed
    41. Weiskopf RB, Feiner J, Hopf HW, Viele MK, Watson JJ, Kramer JH, Ho R, Toy P. Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia. Anesthesiology. 2002 Apr; 96(4):871-7. PMID: 11964594.
      View in: PubMed
    42. Stevens CE, Taylor PE, Tong MJ, Toy PT, Vyas GN, Nair PV, Weissman JY, Krugman S. Yeast-recombinant hepatitis B vaccine. Efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission. JAMA. 1987 May 15; 257(19):2612-6. PMID: 2952812.
      View in: PubMed
    43. Stevens CE, Toy PT, Tong MJ, Taylor PE, Vyas GN, Nair PV, Gudavalli M, Krugman S. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. JAMA. 1985 Mar 22-29; 253(12):1740-5. PMID: 3974052.
      View in: PubMed