Transfusion Medicine

Cover
Title Page
Copyright Page
Contents
Contributors
Preface
Chapter 1 History
1.1 Ancient times
1.2 The period 1500–1700
1.3 The 1800s
1.4 First transfusions in the United States
1.5 The discovery of blood groups
1.6 Anticoagulation
1.7 Modern blood banking and blood banks
1.8 Cadaver blood
1.9 The Rh blood group system and prevention of Rh immunization
1.10 Coombs and antiglobulin serum
1.11 Plasma and the blood program during World War II
1.12 Plastic bags and blood components
1.13 Cryoprecipitate and factor VIII
1.14 Red cell preservation
1.15 Leukocyte antigens and antibodies
1.16 Platelet collection, storage, and transfusion
1.17 Apheresis
1.18 Granulocyte transfusions
1.19 Summary
References
Chapter 2 The Blood Supply
2.1 Worldwide blood supply
US blood supply
2.2 Amount of blood collected
Platelet production
Plasma production for transfusion
2.3 Management of the blood supply
2.4 Other activities of community blood centers
2.5 The plasma collection system
Plasma definitions
Federally licensed plasma collection and manufacturing organizations
Plasma collection activity
2.6 Nongovernmental blood bank organizations
AABB, formerly the American Association of Blood Bank
America’s Blood Centers
Plasma Protein Therapeutics Association
2.7 World Health Organization
2.8 Federation of Red Cross and Red Crescent Societies
2.9 International Society for Blood Transfusion
2.10 Regulation of the blood supply system
US Federal Regulation
Other required licensure
Voluntary accreditation of blood banks
College of American Pathologists Accreditation Program
References
Chapter 3 Recruitment of Blood Donors
3.1 Demographic characteristics of blood donors
Gender
Age
Race/Ethnicity
Education and socioeconomic characteristics
Employment
Other social characteristics
3.2 Motivation of whole blood donors
Psychosocial theories applicable to blood donation
Integrated model
Theory of planned behavior
Giving and not giving
3.3 The donation experience and factors that influence continued donation
Social influences on blood donation and social media
Family history of donation or blood use
The donation situation
Organizational influences
Role of incentives
3.4 Whole blood donor recruitment strategies
3.5 Apheresis donor recruitment
3.6 Bone marrow donors
References
Chapter 4 Blood Donor Medical Assessment, Collection, and Complications
4.1 Blood collection
4.2 Medical assessment of whole blood donors
Registration
Obtaining medical history
Patients with hemochromatosis as blood donors
Physical examination of the blood donor
Special blood donations
4.3 Collection of whole blood
Labeling
Blood bags
Anticoagulant preservative solutions
Selection of the vein and preparation of the venipuncture site
Venipuncture
Blood collection
4.4 Postdonation care and adverse reactions to blood donation
Postdonation care
Adverse reactions
Severe reactions to blood donation
Seizures
Nerve injuries
Hematoma, arterial puncture, and thrombosis
4.5 Therapeutic bleeding
4.6 Medical assessment of apheresis donors
General assessment
Plateletpheresis donors
Red cell loss
Blood volume shifts
Potential complications of serial donations
Platelet depletion
Leukapheresis donors
Plasmapheresis donors
Allogeneic donors for hematopoietic cell transplantation
Physical examination of apheresis donors
4.7 Adverse reactions in apheresis donors
General
Vasovagal reactions
Anticoagulation
Citrate toxicity
Circulatory effects
Air embolus
Hematoma
Mechanical hemolysis
Platelet depletion or damage
Lymphocyte depletion
Complications unique to granulocyte donation
Complications unique to plasmapheresis
Complications unique to mononuclear cell apheresis for collection of peripheral blood stem cells
References
Chapter 5 Preparation, Storage, and Characteristics of Whole Blood, Blood Components, and Plasma Derivatives
5.1 Whole blood preparation and storage
5.2 Preparation of blood components from whole blood
Anticoagulant–preservative solutions
Blood processing for the preparation of components
Red blood cells
Frozen or deglycerolized red blood cells
Leukocyte-reduced red blood cells
Fresh frozen plasma
Liquid plasma (never frozen)
5.3 Cryoprecipitate
Description of component
Thawing
5.4 Platelet concentrates—whole blood
Description of component
5.5 Granulocytes
5.6 Irradiation of blood components
5.7 Hematopoietic stem and progenitor cells
5.8 Plasma derivatives
General
Coagulation factor concentrates
Fibrinogen
Immune serum globulins
5.9 Pathogen-inactivated blood components
Solvent–detergent plasma (Octaplas)
Fresh frozen plasma
Platelets
Red cells
5.10 Universal red cells
Enzymatic cleavage of ABO and Rh antigen
Masking ABO antigens
5.11 Blood substitutes
Potential clinical uses and impact of hemoglobin substitutes
References
Chapter 6 Production of Components by Apheresis
6.1 Apheresis instruments
Fresenius Kabi Amicus Separator
Fresenius Kabi Alyx
Terumo Trima Accel
Haemonetics Instruments
6.2 Plateletpheresis
Single-donor platelet concentrates
Function and storage of platelets obtained by apheresis
6.3 Erythrocytapheresis
6.4 Leukapheresis for the collection of granulocytes
Hydroxyethyl starch in leukapheresis
Stimulation of donors with corticosteroid or G-CSF prior to leukapheresis
Filtration leukapheresis
Function of granulocytes obtained by leukapheresis
Storage of granulocytes for transfusion
Donor–recipient matching for granulocyte transfusion
6.5 Leukapheresis for the collection of mononuclear cells
6.6 Leukapheresis for the collection of peripheral blood stem cells
Collection procedures
Effects of peripheral blood stem cell collection on normal donors
Characteristics of the peripheral blood stem cell concentrates
Quality control of peripheral blood stem cell concentrates
Storage of peripheral blood stem cells
6.7 Donor selection and complications of cytapheresis in normal donors
6.8 Plasmapheresis and source plasma
References
Chapter 7 Laboratory Testing of Donated Blood
7.1 Background
7.2 Safety of the blood supply
7.3 Blood component testing
ABO typing
Rh typing
Red blood cell antibody detection
ABO antibody titers
Direct antiglobulin testing
7.4 Testing for transmissible diseases
General concepts of infectious disease testing
Testing in resource‐limited settings
Managing the results of infectious disease testing
HIV testing
Hepatitis B testing
Hepatitis C testing
Human T-cell lymphotropic virus testing
West Nile virus testing
Zika virus testing
Testing for babesiosis
Syphilis testing
Chagas’ disease testing
Cytomegalovirus testing
Bacterial testing of platelets
7.5 Other laboratory testing
HLA antibody testing
Extended blood group antigen typing
Role of platelet antigen typing
Role of platelet serology
Parvovirus and hepatitis A virus testing
Hemoglobin S testing
Screening donors for IgA deficiency
7.6 Summary
References
Chapter 8 Blood Groups
8.1 Red blood cell antigens and groups
8.2 ABO system
Genes and composition
A and B subgroups
Bombay type
Antigen distribution and subgroups
Antibodies of the ABH system
8.3 The Rh system
Discovery
Nomenclature and genetics
Structure and composition of the D antigen
Weak D, D variant, Du, and partial D
Rh null type
Rh antibodies
8.4 Other red cell blood groups
Kell system
Duffy system
Kidd system
Lutheran system
MNSs system
P system
Lewis system
LW system
Diego (Di)
Cartwright (Yt)
XG system
Dombrock (Do)
Scianna (Sc)
Colton (Co)
Rogers (Rg) and Chido (Ch)
Gerbich (Ge)
Cromer (Cr)
Knops (Kn)
Indian (In)
OK system
RAPH system
JMH system
GIL
Ii blood group antigens
Human leukocyte antigen
8.5 Antibodies to red cell antigens
8.6 Function of molecules containing red cell antigens
Red cell structure
Red cell function
Receptors and adhesion molecules
Transport protein
Complement regulatory molecules
Enzymatic activity
Microbial receptor
8.7 Platelets
8.8 Granulocytes
References
Chapter 9 Laboratory Detection of Blood Groups and Provision of Red Cells
9.1 Immunologic mechanisms of red cell destruction
9.2 Methods of detecting red cell antibody–antigen reactions
Factors that affect agglutination
Direct agglutination
Techniques to enhance red cell antibody detection
Techniques for detecting red cell antigen–antibody reactions
9.3 The antiglobulin test
Anti-human globulin serum
The indirect antiglobulin (indirect Coombs) test
The direct antiglobulin (Coombs) test
9.4 Red cell compatibility testing
Positive identification of recipient and blood sample
Review of transfusion service records for results of previous testing of samples from the recipient
Medication and Biologicals
ABO and Rh typing
Antibody detection (screening) test
Selection of blood components of appropriate ABO and Rh types
The crossmatch
Labeling and issue of the appropriate blood products
9.5 Red cell antibody identification
Chemical or enzymatic modification of test red cells
Elution
Adsorption
Neutralizing or inhibitor substances
Sulfhydryl reagents for distinguishing IgG from IgM antibodies
9.6 Strategies for making red cells available for transfusion
Blood availability
Standard or maximum surgical blood ordering
Type and screen
Emergency “crossmatch”
Uncrossmatched red cells
Factors that influence blood availability
9.7 Approach to the patient with an incompatible crossmatch
9.8 Hemolytic disease of the fetus and newborn
Laboratory investigation
Monitoring the at‐risk fetus
Prevention of HDFN–Rh immune globulin
Weak D phenotype
9.9 Platelet compatibility
Selection of ABO and Rh type for platelet transfusion
Platelet refractoriness
9.10 Granulocyte compatibility
Compatibility testing for granulocyte transfusion
References
Chapter 10 Clinical Uses of Blood Components
10.1 Blood component therapy
10.2 Transfusion of components that contain red blood cells
Physiology in red cell transfusion decisions
The red blood cell transfusion trigger (threshold)
Clinical uses of red cells
Bloodless medicine
Uses of specific red blood cell components
10.3 Transfusion of components and derivatives that contain coagulation factors
Fresh frozen plasma
24-Hour plasma
Plasma
Thawed plasma
Pathogen-reduced plasma
Lyophilized or freeze-dried plasma
Cryoprecipitate
Blood-derived local hemostatic agents (fibrin sealant or glue)
Deficiency of multiple coagulation factors
Deficiency of single coagulation factors
Blood group compatibility of components used to replace coagulation factors
10.4 Transfusion of platelets
Prevention of bleeding (prophylaxis)
Treatment of active bleeding
Prophylaxis for invasive procedures
Outcome of platelet transfusion
Strategies for managing patients refractory to platelet transfusion
10.5 Granulocyte transfusion
10.6 Cytomegalovirus-safe blood components
Neonates
Pregnant women
Hematopoietic progenitor cell transplantation
Kidney transplantation
Heart, heart–lung, liver, and pancreas transplantation
Acquired immune deficiency syndrome
Severe combined immune deficiency (congenital)
Patients receiving extensive chemotherapy
10.7 Graft-versus-host disease
Irradiation of blood components
Storage of irradiated components
Quality control of irradiation
Leukocyte depletion to prevent graft-versus-host disease
Pathogen inactivation and prevention of graft-versus-host disease
Indications for irradiated components
References
Chapter 11 Transfusion Therapy in Specific Clinical Situations
11.1 Acute blood loss and trauma
Physiology of blood loss
Blood bank/transfusion service procedures
Changing blood types
Massive transfusion
Coagulopathy in massive transfusion
Thromboelastography (TEG) and rotational thromboelastometry (ROTEM)
Trauma
Recombinant activated factor VII for acute blood loss
Hemoglobin function
Hypocalcemia
Hypothermia
Acid–base balance
Microaggregates
Plasticizers
Electrolytes
Blood samples for laboratory tests
11.2 Cardiovascular surgery
Stored red blood cells in cardiovascular surgery patients
Autologous blood in cardiac surgery
Extracorporeal membrane oxygenation
11.3 Hematopoietic cell transplantation
Before hematopoietic cell transplantation
After hematopoietic cell transplantation
Complications
ABO- and Rh-incompatible transplants
Immune cytopenias following marrow transplantation
Cytomegalovirus
11.4 Solid organ transplantation
Blood group antibodies following solid organ transplantation
11.5 Transfusion of patients with paroxysmal nocturnal hemoglobinuria
11.6 Neonates
Red blood cell transfusions
Pretransfusion testing
Cytomegalovirus-negative blood components
Irradiated, leukocyte-reduced, and cytomegalovirus-seronegative blood components
Transfusion of patients with T-activation
Platelet transfusions
Granulocyte transfusions
Exchange transfusion of the neonate
11.7 Pediatric patients
Techniques of transfusion
11.8 Transfusion therapy in hemoglobinopathies
Sickle cell disease
11.9 Hemophilia and von Willebrand disease
Hemophilia A and B
von Willebrand disease
11.10 Autoimmune hemolytic anemia
Decision to transfuse
11.11 Pregnant women
11.12 Acquired immune deficiency syndrome
Anemia
Thrombocytopenia
Leukopenia
Lupus anticoagulant
Disseminated intravascular coagulopathy
11.13 Transfusing patients with IgA deficiency
11.14 Autoimmune thrombocytopenia
11.15 Neonatal alloimmune thrombocytopenia
11.16 Neonatal alloimmune neutropenia
11.17 Autoimmune neutropenia
11.18 Rare blood types
References
Chapter 12 Patient Blood Management
12.1 Evidence-based guidelines for transfusion
12.2 Physician and health professional education program
12.3 Mechanism to monitor blood use and adherence to guidelines
Transfusion Safety Officer
12.4 Preoperative Anemia
12.5 Preoperative autologous blood donation
Medical requirements and evaluation for autologous blood donation
Collection processing and storage of autologous blood
Adverse reactions to autologous blood donation
Laboratory testing of autologous blood
Donation of autologous blood by patients known to be infectious
Use of erythropoietin to increase autologous blood donation
Indications for transfusion of preoperative autologous donated blood
Cost-effectiveness
Complications of transfusion of autologous blood
12.6 Acute normovolemic hemodilution
12.7 Intraoperative blood salvage
Development of blood salvage
Devices used for intraoperative blood salvage
12.8 Postoperative blood salvage
12.9 Use of hemostatic agents to minimize transfusion
12.10 Limiting blood loss for laboratory testing
12.11 Directed-donor blood
12.12 Patient-specific donation
12.13 Minimal donor exposure programs
References
Chapter 13 Pediatric Transfusion Medicine
13.1 Neonates
Neonates
Red blood cell transfusions
Pretransfusion testing
Red cell products used for neonatal transfusion
Transfusion of patients with T-activation
Platelet transfusions
Granulocyte transfusions
Exchange transfusion of the neonate
13.2 Pediatric patients
13.3 Modifications of blood products for neonates/children
Minimal donor exposure programs
Cytomegalovirus-safe blood components
Irradiated blood components
13.4 Transfusion techniques in children and neonates
Techniques of transfusion
13.5 Special scenarios in pediatric transfusion medicine
Hemolytic disease of the fetus and newborn
Prevention of hemolytic disease of the newborn–Rh immune globulin
Rh typing
Neonatal alloimmune thrombocytopenia
Neonatal alloimmune neutropenia
References
Chapter 14 Pathogen Reduced Blood Products
14.1 Pathogen Reduction Technologies
Methylene blue
Solvent–detergent
Amotosalen ultraviolet light
Riboflavin ultraviolet light
Ultraviolet C light
S-303
14.2 Toxicity of compounds used for pathogen inactivation
14.3 Immunologic effects
Prevention of graft-versus-host disease
Alloimmunization
14.4 Factors that influence transmission of infection
14.5 Microbial killing capacity of pathogen reduction therapy technologies
Amotosalen/Ultraviolet
Riboflavin for platelets and plasma
Riboflavin for whole blood
S-303
Ultraviolet C
14.6 Pathogen reduced blood products
Plasma
Ultraviolet C light
14.7 Pathogen reduced platelet products
Ultraviolet C–treated platelets
Amotosalen-treated platelets
Riboflavin-treated platelets
14.8 Red cells and whole blood
Riboflavin
S-303
14.9 Conclusions from in vitro and animal and observational human studies
14.10 Clinical trials of pathogen reduced components
Platelets
Plasma
Red cells
Summary of clinical trials
References
Chapter 15 Techniques of Blood Transfusion
15.1 Obtaining consent for transfusion
15.2 Venous access and the venipuncture
15.3 Transportation and storage of blood
15.4 Identification of the patient and blood component
15.5 Blood administration sets and filters
15.6 Infusion Devices
Infusion pumps
Pressure devices
Blood warmers
15.7 Infusion solutions
15.8 Starting the transfusion
15.9 Rate and duration of transfusion
15.10 Nursing care of patients receiving a transfusion
15.11 Transfusion techniques for neonates and infants
15.12 Transfusion of hematopoietic stem cell products
15.13 Transfusion in the nonhospital setting
References
Chapter 16 Complications of Transfusion
16.1 Immunologic complications of transfusion resulting in transfusion reactions
Hemolytic transfusion reactions
Delayed hemolytic transfusion reaction
Hemolysis due to passenger lymphocyte syndrome
16.2 Nonimmunologic hemolysis mimicking a transfusion reaction
16.3 Febrile nonhemolytic transfusion reactions
16.4 Allergic reactions
16.5 Pulmonary reactions, acute lung injury, and transfusion-related acute lung injury
16.6 Anaphylactic reactions
16.7 Hypotensive reactions
16.8 Reactions to platelet transfusions
16.9 Reactions to granulocyte transfusions
16.10 Reactions due to bacterial contamination of blood components
16.11 Signs, symptoms, and management of a transfusion reaction
Signs and symptoms of a transfusion reaction
Initial steps in the management of a transfusion reaction
Initial treatment of a transfusion reaction
16.12 Immunologic complications of transfusion
Immunization to blood group antigens
Alloimmunization to red cells
Alloimmunization affecting platelet transfusion
Alloimmunization following granulocyte transfusion
Transfusion-associated graft-versus-host disease
Transfusion-related immune modulation
Alteration of graft survival
Increased susceptibility to recurrence of malignancy
Increased susceptibility to infection
Long-term mortality
Microchimerism
16.13 Nonimmunologic complications of blood transfusion
Hypothermia
Citrate toxicity
Bleeding tendency
Clotting tendency
Electrolyte and acid–base imbalance
Circulatory overload
Iron overload
Embolism
16.14 Passive transfer of hypersensitivity
References
Chapter 17 Transfusion-Transmitted Diseases
17.1 Syphilis
17.2 Hepatitis
Hepatitis A
Hepatitis B
Non-A, non-B hepatitis and surrogate testing
Hepatitis C
Other hepatitis-related viruses
Hepatitis G
Hepatitis E virus
TT virus
SEN virus
17.3 HIV infection and AIDS
HIV laboratory screening tests
HIV-1 antibody tests
Risk of acquiring HIV by transfusion of anti-HIV-negative blood (window phase)
HIV antigen testing
Nucleic acid amplification testing
Risk of acquiring HIV infection from transfusion of anti-HIV-1-positive blood
Effect of transfusion on AIDS
17.4 Other transfusion-transmitted viruses
Cytomegalovirus
Human T-lymphotropic virus I and II
Parvovirus
Epstein–Barr virus
West Nile virus
Zika virus
Toscana virus
Human herpesvirus 6 and 8
Chikungunya virus
Simian foamy virus
Dengue virus
17.5 Transfusion-transmitted bacterial infections
17.6 Transfusion-transmitted parasitic and tick-borne diseases
Malaria
Chagas’ disease
Tick-borne diseases
Babesiosis
Granulocyte anaplasmosis
Lyme disease
Rocky mountain spotted fever
Leishmaniasis
17.7 Other issues with transfusion‐transmitted infections
Variant Creutzfeldt–Jakob disease and bovine spongiform encephalopathy
Xenotropic murine leukemia virus-related virus
Influenza
SARS-CoV-2
17.8 Other diseases of interest
17.9 Introduction of new tests
References
Chapter 18 The HLA System in Transfusion Medicine and Transplantation
18.1 The HLA system
Genomic organization of the human major histocompatibility complex
HLA haplotypes
Tissue expression of HLA
Structure and polymorphism of HLA molecules
Immunologic role of HLA molecules: peptide presentation
18.2 Clinical HLA testing for transplantation
Serologic typing of HLA antigens
Molecular typing of HLA alleles
HLA allele nomenclature
HLA antibody screening and lymphocyte crossmatch
18.3 The human minor histocompatibility antigens
18.4 The HLA system and transplantation
Solid organ transplantation
Allogeneic hematopoietic stem cell transplantation
Transfusion practice in stem cell transplantation
18.5 The HLA system in transfusion therapy
HLA alloimmunization
Refractoriness to platelet transfusion
Transfusion-associated graft-versus-host disease
Febrile nonhemolytic transfusion reaction
Granulocyte transfusion
Transfusion-related acute lung injury
Neonatal alloimmune thrombocytopenia
HLA–disease association
Parentage HLA testing
18.6 Conclusion and summary
References
Chapter 19 Cellular Engineering: Hematopoietic Transplant, Immune Cell Therapy, and Regenerative Medicine
19.1 Hematopoietic progenitor and stem cells
Increasing variety of sources of hematopoietic stem cells
Hematopoietic stem cells
Marrow
Peripheral blood stem cells
Umbilical cord blood
Hematopoietic stem cell preservation
19.2 General hematopoietic cellular engineering processes
Cell depletion
CD34+ cell enrichment
Expansion
19.3 Umbilical cord blood banking
19.4 Adoptive immunotherapy
Tumor-infiltrating lymphocytes
Chimeric antigen receptor T-cells
T-cell receptor–engineered T-cells
T-regulatory cells
Natural killer and activated natural killer cells
Peripheral blood mononuclear cells: donor leukocyte infusion
Dendritic cells
Virus-specific T-cells
19.5 Gene therapy for hereditary immune deficiencies and hemoglobin disorders
19.6 Immunotherapy for immune diseases
Autoimmune diseases
19.7 Mesenchymal stromal cells
19.8 Platelet-rich plasma
19.9 Regulation of cellular engineering
19.10 Quality assurance and good manufacturing practices for cellular engineering
References
Chapter 20 Therapeutic Apheresis
20.1 Clinical uses of plasma exchange
Neurologic diseases
Guillain–Barré syndrome
Chronic inflammatory demyelinating polyradiculoneuropathy
Monoclonal gammopathies
Amyotrophic lateral sclerosis
Multiple sclerosis and neuromyelitis optica
Myasthenia gravis
Lambert–Eaton myasthenic syndrome
Renal diseases
Hematologic diseases
Autoimmune hemolytic anemias
Alloimmune platelet refractoriness
Posttransfusion purpura
Red cell aplasia
Delayed hemolytic transfusion reaction
Coagulation factor inhibitors
Solid organ transplantation
Collagen vascular diseases
Other miscellaneous diseases
20.2 Plasma exchange
Vascular access for plasma exchange
Techniques of plasma exchange
Replacement solutions
Biochemical changes following plasma exchange
Complications of plasma exchange
Red cell depletion
20.3 Red cell exchange or erythrocytapheresis
20.4 Therapeutic cytapheresis
Myelogenous leukemias
Thrombocytosis
Collection of mononuclear cells for autologous and allogeneic treatments
Complications of cytapheresis
20.5 Photopheresis
20.6 Therapeutic apheresis using selective adsorption columns
Familial hypercholesterolemia
Lipoprotein(a) hyperlipoproteinemia
Autoimmune disease treated with dextran sulfate columns
Immune disease treated with staphylococcal protein A columns
Therapeutic apheresis in children
References
Chapter 21 Quality Programs in Blood Banking and Transfusion Medicine
21.1 Quality improvement systems and high reliability
21.2 Quality assurance in the blood supply system
Good Manufacturing Practices
International Organization for Standardization
American Association of Blood Banks quality program
Organization and leadership
Facilities work environment and safety
Human resources
Customer focus
Equipment
Supplies and material management
Documents and records
Labeling
Records management
Computers and information systems
Management of nonconforming events in blood product manufacture
Monitoring and assessment
Process improvement
21.3 Errors in transfusion medicine
21.4 Quality assurance in transfusion therapy
Blood supply
Hospital transfusion service operations
Transfusion procedures for blood and components
Quality assurance in patient therapy
21.5 Summary
References
Index
EULA