Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects

Abshire

Brief Table of Contents

Copyright Page

About the Editors

Contributors

Preface

Acknowledgments

I. Blood Banking and Transfusion Medicine

Chapter 1. Blood Banking and Transfusion Medicine – the Field, the Discipline and the Industry

Chapter 2. Brief History of Blood Transfusion

Chapter 3. Introduction to Quality Systems and Quality Management

Chapter 4. The Role of the Physician in the Blood Center

Chapter 5. The Blood Donor, Donation Process and Technical Aspects of Blood Collection

Chapter 6. Apheresis Blood Component Collections

Chapter 7. Recipient-specific Blood Donations

Chapter 8. Adverse Donor Reactions

Chapter 9. Component Preparation and Manufacturing

Chapter 10. Serologic Testing of Donor Products

Chapter 11. Overview of Infectious Disease Testing

Chapter 12. HIV Screening of Donor Products

Chapter 13. Hepatitis B Screening of Donor Products

Chapter 14. Hepatitis C Screening of Donor Products

Chapter 15. West Nile Virus Screening of Donor Products

Chapter 16. Syphilis, HTLV and Chagas Testing of Donor Products

Chapter 17. Bacterial Detection Methods

Chapter 18. The Role of the Transfusion Service Physician

Chapter 19. Pretransfusion Testing

Chapter 20. Antibody Identification

Chapter 21. Direct Antiglobulin Test

Chapter 22. ABO and H Blood Group Systems

Chapter 23. Rh Blood Group System

Chapter 24. Kell and Kidd Blood Group Systems

Chapter 25. MNS and Duffy Blood Group Systems

Chapter 26. Lewis, I and P Blood Group Systems

Chapter 27. Other Blood Group Systems, Collections and Antigens

Chapter 28. Red Blood Cells and Related Products

Chapter 29. Plasma Products

Chapter 30. Platelet Products

Chapter 31. Cryoprecipitate

Chapter 32. Granulocyte products

Chapter 33. Albumin and Related Products

Chapter 34. Human Immunoglobulin Preparations

Chapter 35. Rh Immune Globulin

Chapter 36. Irradiation of Blood Products

Chapter 37. Leukoreduction of Blood Products

Chapter 38. CMV-safe Blood Products

Chapter 39. Frozen Blood Products

Chapter 40. Washed Blood Products

Chapter 41. Volume-reduced Products

Chapter 42. Neonatal and Pediatric Transfusion Medicine

Chapter 43. Perinatal Transfusion Medicine

Chapter 44. Autoimmune Hemolytic Anemias

Chapter 45. Transfusion Management in Patients with Hemoglobinopathies

Chapter 46. Transfusion of Patients Undergoing HPC and Solid-organ Transplantation

Chapter 47. Transfusion of HIV-positive Patients

Chapter 48. Management of Patients Who Refuse Blood Transfusion

Chapter 49. Platelet Transfusion Refractory Patients

Chapter 50. Massive Transfusion

Chapter 51. Perioperative Blood Management

Chapter 52. Adverse Events and Outcomes Following Transfusion

Chapter 53. Febrile Non-hemolytic Transfusion Reactions

Chapter 54. Allergic, Anaphylactoid and Anaphylactic Reactions

Chapter 55. Acute Hemolytic Transfusion Reactions

Chapter 56. Delayed Hemolytic Transfusion Reactions

Chapter 57. Transfusion Associated Circulatory Overload

Chapter 58. Transfusion Related Acute Lung Injury

Chapter 59. Septic Transfusion Reactions

Chapter 60. Metabolic, Hypotensive and Other Acute Reactions and Complications

Chapter 61. Posttransfusion Purpura

Chapter 62. Transfusion Associated Graft Versus Host Disease

Chapter 63. Microchimerism

Chapter 64. Transfusion Related Immunomodulation

Chapter 65. Iron Overload

Chapter 66. Transfusion Transmitted Diseases

Chapter 67. Overview of Therapeutic Apheresis

Chapter 68. Therapeutic Plasma Exchange

Chapter 69. Therapeutic Erythrocytapheresis

Chapter 70. Therapeutic Thrombocytapheresis

Chapter 71. Therapeutic Leukapheresis

Chapter 72. Extracorporeal Photopheresis

Chapter 73. LDL Pheresis

Chapter 74. Immunoadsorption

Chapter 75. Therapeutic Phlebotomy

Chapter 76. HPC Products

Chapter 77. Tissue Banking in the Hospital Setting

II. Coagulation

Chapter 78. Overview of the Coagulation System

Chapter 79. Approach to the Bleeding Patient

Chapter 80. Congenital Thrombocytopenia

Chapter 81. Neonatal Alloimmune Thrombocytopenia

Chapter 82. Acquired Neonatal Thrombocytopenia

Chapter 83. Bernard-Soulier Syndrome and Other GPIb-IX-V Related Receptor Defects

Chapter 84. Glanzmann Thrombasthenia

Chapter 85. Platelet Storage-granule Defects

Chapter 86. Failure to Release and Aspirin-like Defects

Chapter 87. Acute (Childhood) Immune Thrombocytopenic Purpura

Chapter 88. Chronic Immune Thrombocytopenic Purpura

Chapter 89. Drug-induced Thrombocytopenia

Chapter 90. Heparin-induced Thrombocytopenia

Chapter 91. Autoimmune Lymphoproliferative Syndrome

Chapter 92. Hemolytic Uremic Syndrome

Chapter 93. Thrombotic Thrombocytopenic Purpura

Chapter 94. Antiphospholipid Antibody Syndrome

Chapter 95. von Willebrand Disease

Chapter 96. Hemophilia A

Chapter 97. Hemophilia B

Chapter 98. Congenital Disorders of Fibrinogen

Chapter 99. Factor XIII, α2-Antiplasmin and Plasminogen Activator Inhibitor-1 Deficiencies

Chapter 100. Factor XI Deficiency

Chapter 101. Factor VII Deficiency

Chapter 102. Factor II, Factor V and Factor X Deficiencies

Chapter 103. Bleeding Disorders in Pregnancy

Chapter 104. Vascular Bleeding Disorders

Chapter 105. Bleeding Risks with Liver Disease

Chapter 106. Bleeding Risks with Vitamin K Deficiency

Chapter 107. Bleeding Risks with Cardiac Disease

Chapter 108. Bleeding Risks with Renal Disease

Chapter 109. Bleeding Risks in Cancer

Chapter 110. Disseminated Intravascular Coagulopathy

Chapter 111. Acquired Coagulation Factor Inhibitors

Chapter 112. Introduction to Coagulation Testing

Chapter 113. Prothrombin Time and Activated Partial Thromboplastin Time

Chapter 114. Platelet Count

Chapter 115. Global Tests of Primary Hemostasis

Chapter 116. Platelet Aggregation Studies

Chapter 117. Laboratory Diagnosis of Genetic Platelet Function Defects

Chapter 118. Laboratory Diagnosis of Acquired Platelet Function Defects

Chapter 119. Laboratory Diagnosis of Immune Thrombocytopenic Purpura

Chapter 120. ADAMTS13 Testing

Chapter 121. Laboratory Diagnosis of Heparin-induced Thrombocytopenia

Chapter 122. Molecular Biology of von Willebrand Disease

Chapter 123. Laboratory Diagnosis of Inherited von Willebrand Disease

Chapter 124. Laboratory Diagnosis of Acquired von Willebrand Syndrome

Chapter 125. Laboratory Assessment of Treatment of von Willebrand Disease

Chapter 126. Coagulation Factor Testing

Chapter 127. Mixing Studies

Chapter 128. Specific Factor Inhibitor Testing

Chapter 129. Laboratory Diagnosis of Dysfibrinogenemia and Afibrinogenemia

Chapter 130. Laboratory Assessment of Fibrinolysis

Chapter 131. General Overview of the Hypercoaguable State

Chapter 132. Antithrombin Testing

Chapter 133. Proteins C, S and Z Testing

Chapter 134. Activated Protein C Resistance and Factor V Leiden Testing

Chapter 135. Prothrombin Gene Mutation Testing

Chapter 136. Laboratory Diagnosis of Hyperhomocysteinemia

Chapter 137. Laboratory Diagnosis of Lupus Anticoagulant and Antiphospholipid Antibodies

Chapter 138. Lipoprotein (a) Testing

Chapter 139. Laboratory Diagnosis of Factor Level Abnormalities Associated with Thrombosis

Chapter 140. Laboratory Management of DIC

Chapter 141. Laboratory Support for Heparin Monitoring

Chapter 142. Laboratory Support for Warfarin Monitoring

Chapter 143. Prothrombin Complex Concentrates

Chapter 144. von Willebrand Factor Concentrates

Chapter 145. Factor VIII Concentrates

Chapter 146. Factor IX Concentrates

Chapter 147. Factor VII Concentrates

Chapter 148. Antithrombin Concentrates

Chapter 149. Protein C Concentrates

Table of Contents

Copyright Page

About the Editors

Contributors

Preface

Acknowledgments

I. Blood Banking and Transfusion Medicine

Chapter 1. Blood Banking and Transfusion Medicine – the Field, the Discipline and the Industry

Blood Banking and Transfusion Medicine as a Discipline:

Blood Banking Defined:

Transfusion Medicine Defined:

The Blood Pipeline:

Additional Services:

Structure of Blood Banks and Transfusion Services:

Structure of Blood Banks and Transfusion Services within the US:

The Blood Industry:

Blood Banking and Transfusion Medicine as a Medical Specialty:

Subspecialties within Blood Banking and Transfusion Medicine:

The Role of the Physician in Blood Centers and Hospital Transfusion Services:

Oversight and Regulation of the Blood Industry:

The Federal Food and Drug Administration (FDA):

Other Applicable Regulatory Agencies:

Current Good Manufacturing Practices:

Oversight by Non-governmental Organizations:

AABB:

The Joint Commission:

College of American Pathologists:

Recommended Reading

Chapter 2. Brief History of Blood Transfusion

Early Transfusion:

Blood Groups:

Blood Storage:

Blood Derivatives:

Blood Component and Derivative Therapy:

Apheresis:

Adverse Effects of Transfusion:

Current Transfusion Medicine and Blood Banking:

Recommended Reading

Chapter 3. Introduction to Quality Systems and Quality Management

Compliance versus Quality:

Background:

Quality System Essentials:

Other Systems:

NCCLS GP26-A:

World Health Organization:

Quality as a Philosophy and Culture:

Additional and Related Terms:

Facility Inspections:

Recommended Reading

Chapter 4. The Role of the Physician in the Blood Center

Blood Center Table of Organization:

Specific Roles in Blood Center Core Operations:

Collections: Donor Selection and Complications:

Manufacturing and Processing:

Quality Systems and Laboratories:

Clinical Services:

Therapeutic Apheresis:

Immunohematology Reference, HLA and HPC Laboratories:

Financial Issues and Conflict of Interest:

Research and Advancement of the Field:

Recommended Reading

Chapter 5. The Blood Donor, Donation Process and Technical Aspects of Blood Collection

Blood Donor:

Blood Donation Process:

Recruitment Materials:

Educational Materials:

Registration:

Donor History Questionnaire:

Drug Therapy:

Medical History:

Donor Informed Consent:

Technical Aspects of Blood Donation:

Identification:

Preparation of the Venipuncture Site:

Phlebotomy:

Post-donation Care:

Donor Adverse Reactions:

Recommended Reading

Chapter 6. Apheresis Blood Component Collections

Apheresis RBC Collections:

Platelet Apheresis (Plateletpheresis) Collections:

Plasmapheresis Collections:

Recommended Reading

Chapter 7. Recipient-specific Blood Donations

Exceptional Medical Need:

Directed Donation:

Autologous Donation:

Chapter 8. Adverse Donor Reactions

Complications of Whole Blood Donation:

Minor Local Tissue Injury:

Nerve Injury:

Vasovagal Reactions:

Prolonged Recovery:

Arterial Puncture:

Complications of Apheresis Donations:

Apheresis-specific Reactions:

Hypocalcemia:

Machine Malfunction:

Allergic Reactions:

Platepheresis/Granulocytapheresis:

Approach to the Donor and Donation Process:

Recommended Reading

Chapter 9. Component Preparation and Manufacturing

Whole Blood:

Component Manufacturing:

Anticoagulant-preservative Solutions:

RBC Components:

Additive Solutions:

RBC Modification:

Plasma Components:

Cryoprecipitate:

Cryoprecipitate-reduced Plasma:

Plasma Derivatives:

Platelet Components:

Buffy Coat Platelets:

Platelet Modification:

Granulocytes:

Component Labeling:

Recommended Reading

Chapter 10. Serologic Testing of Donor Products

ABO Group Typing:

D-antigen Phenotype:

Antibody Screening for the Presence of Unexpected RBC Antibodies:

Phenotyping RBC Products:

Antibody Titer Anti-A, Anti-B:

International:

Recommended Reading

Chapter 11. Overview of Infectious Disease Testing

Background:

Approach to Testing:

Determination of Need and Requirement for Testing:

Selection of a Testing Methodology:

The Biology of an Infection, the Window Period and Testing Strategies:

Recommended Reading

Chapter 12. HIV Screening of Donor Products

Description:

Infection:

HIV Types:

Methods and Interventions to Ensure the Safety of the Blood Supply:

Donor Deferral:

Early HIV Testing – Anti-HBc and Anti-HIV:

HIV p24 Antigen:

Nucleic Acid Testing:

Automation:

Determination of Need and Requirement for Testing:

Approach to Testing:

Current US Methods and Approach:

International Considerations:

Recommended Reading

Chapter 13. Hepatitis B Screening of Donor Products

Determination of Need and Requirement for Testing:

Approach to Donor Testing:

HBsAg:

Anti-HBc:

HBV NAT:

International Considerations:

Recommended Reading

Chapter 14. Hepatitis C Screening of Donor Products

Determination of Need and Requirement for Testing:

Approach to Testing:

Anti-HCV:

HCV NAT:

International Standards:

Recommended Reading

Chapter 15. West Nile Virus Screening of Donor Products

Determination of Need and Requirement for Testing:

Approach to Testing:

Confirmatory Test:

Donor Deferral:

International Considerations:

Recommended Reading

Chapter 16. Syphilis, HTLV and Chagas Testing of Donor Products

Syphilis:

Background:

Determination of Need and Requirement for Testing:

Approach to Testing:

Donor Deferral:

International Considerations:

Human T-cell Lymphotropic Virus:

Background:

Determination of Need and Requirement for Testing:

Approach to Testing:

International Considerations:

Chagas Disease:

Description:

Determination of Need and Requirement for Testing:

Approach to Testing:

Confirmatory Tests:

Recommended Reading

Chapter 17. Bacterial Detection Methods

Methods to Avoid Bacterial Contamination:

Donor Screening:

Skin Preparation:

Methods to Reduce Bacterial Contamination:

Diversion Pouch:

Leukoreduction:

Methods to Inhibit or Inactivate Bacteria:

Cold Storage:

Storage Solutions:

Pathogen Inactivation:

Methods to Detect Contaminated Products:

Culture-based Methods:

Methods Performed Just Prior to Product Release:

Future Considerations:

Recommended Reading

Chapter 18. The Role of the Transfusion Service Physician

Organization chart:

Specific TM physician roles:

Transfusion Service:

Transfusion Service Management:

Quality Management:

Patient Care:

Transfusion Committee:

Audit:

Transfusion Practice Guidelines:

Maximum Surgical Blood Order:

Informed Consent:

Inventory Management:

Education:

Research:

TS Medical Direction Within Small- to Medium-sized Community Hospitals:

TM as a Career:

Recommended Reading

Chapter 19. Pretransfusion Testing

Patient Identification:

Specimen Requirements:

Method:

Immediate Spin Phase:

Anti-human Globulin Phase:

AHG Reagents:

Detection Techniques:

Tube Test:

Gel Test:

Solid Phase Test:

Automation:

ABO Blood Type:

D Type:

D Type of a Blood Product:

Antibody Screen:

Blood Component Selection:

ABO Compatibility:

D Compatibility:

Crossmatch:

Immediate Spin Crossmatch:

Electronic Crossmatch:

AHG Crossmatch:

Neonates:

Labeling and Release of Blood Components:

Causes of Unexpected Test Results:

Quality Assurance:

Recommended Reading

Chapter 20. Antibody Identification

Antibody Identification Panel:

Determination of Clinical Significance:

History of Antibody:

Indication:

Specimen Requirements:

Method:

Panel of RBCs of Known Antigenic Composition:

RBC Phenotype:

Prewarm Technique:

Cold Antibody Screen:

Enzyme-treated RBCs:

Neutralization:

Adsorption:

Autologous Adsorption:

Allogeneic Adsorption:

Blood Component Selection:

Warm Autoimmune Hemolytic Anemia:

Paroxysmal Nocturnal Hemoglobinuria (PNH):

Crossmatch:

Warm Autoantibodies:

Neonates:

Quality Assurance:

Recommended Reading

Chapter 21. Direct Antiglobulin Test

Indication:

Specimen Requirements:

Method:

Evaluation of a Positive DAT:

Eluate:

Panagglutinin:

Non-reactive Eluate:

Enhancement of Reactivity:

False-negative DAT:

False-positive DAT:

Clinical Significance of a Positive DAT:

Recommended Reading

Chapter 22. ABO and H Blood Group Systems

Antigens:

ABO variants:

Expression:

Antibodies:

Antibody Titers:

Plasma-rich Blood Components:

Solid Organ Transplantation:

Incompatible HPC Transplantation:

Typing Discrepancies:

Resolving Discrepancies Due to Absence of Expected Antigens:

Resolving Discrepancies Due to Unexpected Reactions with Anti-A/Anti-B:

Resolving Discrepancies Due to Unexpected Serum Reactions:

Genotyping:

Recommended Reading

Chapter 23. Rh Blood Group System

Antigens:

D Antigen:

Weak D:

Partial D:

C/c and E/e Antigens:

G Antigen:

V and VS Antigens:

Variation in e Antigens:

Rh-null:

D Typing Discrepancies:

RH Genotyping:

Expression:

Antibodies:

Autoantibodies:

Recommended Reading

Chapter 24. Kell and Kidd Blood Group Systems

Kell Blood Group System:

Antigens:

McLeod Phenotype:

Expression:

Antibodies:

Kidd Blood Group System:

Antigens:

Expression:

Antibodies:

Recommended Reading

Chapter 25. MNS and Duffy Blood Group Systems

MNS Blood Group System:

Antigens:

Expression:

Antibodies:

Duffy Blood Group System:

Antigens:

Expression:

Antibodies:

Recommended Reading

Chapter 26. Lewis, I and P Blood Group Systems

Lewis Blood Group System:

Antigens:

Expression:

Antibodies:

Ii Antigens:

Antigens:

Expression:

Antibodies:

P and GLOB Blood Group Systems:

Antigens:

Expression:

Antibodies:

Autoanti-P:

Recommended Reading

Chapter 27. Other Blood Group Systems, Collections and Antigens

Blood Group Systems:

Chido/Rogers Blood Group System:

Colton Blood Group System:

Cromer Blood Group System:

Diego Blood Group System:

Dombrock Blood Group System:

Gerbich Blood Group System:

Indian Blood Group System:

John Milton Hagen Blood Group System:

Knops Blood Group System:

Lutheran Blood Group System:

LW Blood Group System:

Ok Blood Group System:

Raph Blood Group System:

Scianna Blood Group System:

Yt Blood Group System:

Xg Blood Group System:

Blood Group Collections:

Cost Blood Group Collection:

Er Blood Group Collection:

High-incidence RBC Antigens:

Vel Antigen:

Lan Antigen:

Jra Antigen:

AnWj Antigen:

Sda Antigen:

Low-incidence RBC Antigens:

Chapter 28. Red Blood Cells and Related Products

Product Names:

Description:

RBC Storage Lesion:

Indications:

Signs and Symptoms of Anemia:

RBC Exchange:

As an Adjunct to Radiation Therapy:

Laboratory Values as Transfusion Triggers and Guidelines for RBC Administration:

Special RBC Products and Circumstances:

Contraindications:

Processing and Storage:

Preparation and Administration:

ABO/D Compatibility:

Quality Assurance:

Dose:

Adverse Events:

Alternatives and Future Considerations:

International Considerations:

Recommended Reading

Chapter 29. Plasma Products

Product Names:

Description:

Fresh Frozen Plasma:

Plasma Frozen within 24 hours After Phlebotomy:

Thawed Plasma:

Recovered Plasma (Plasma for Manufacture):

Source Plasma:

Cryoprecipitate-reduced Plasma:

Solvent-detergent Plasma (SD Plasma):

Indications:

Liver Disease and Transplantation:

Massive Transfusion:

Rapid Reversal of Warfarin:

Disseminated Intravascular Coagulopathy:

Plasma as a Replacement Fluid for Plasma Exchange:

Thrombotic Thrombocytopenic Purpura:

Congenital Coagulation Factor Deficiencies:

Other Multiple Coagulation Defects:

Dosage:

Compatibility:

Adverse Events:

Alternatives to Plasma Products:

International Considerations:

Recommended Reading

Chapter 30. Platelet Products

Product Names:

Description:

Indications:

Prophylactic Platelet Transfusion:

Therapeutic Platelet Transfusion:

Transfusion for Platelet Dysfunction:

Platelet Transfusion for Neonates:

Relative Contraindicated for Platelet Transfusions:

Preparation and Administration:

Whole Blood Derived:

Apheresis:

Storage:

Storage Containers:

Bacterial Testing:

TRALI Reduction Strategies:

Leukoreduction:

Irradiation:

Washing or Volume Reduction:

Aliquots:

Quality Assurance:

Dose:

Prophylactic Transfusion:

Therapeutic Transfusion:

Product Selection:

ABO Compatibility:

D Compatibility:

Adverse Events:

Alternatives and Future Considerations:

International Standards:

Buffy Coat Prepared:

Platelet Solutions:

Pathogen-reduction/-inactivation Technologies:

Quality Assurance:

Recommended Reading

Chapter 31. Cryoprecipitate

Product Names:

Description:

Indications:

Fibrinogen Replacement:

Massive Transfusion:

Fibrin Glue or Fibrin Sealant:

Factor XIII Deficiency:

Bleeding Complications After Thrombolytic Therapy:

Uremic Bleeding:

Processing and Storage:

Preparation and Administration:

ABO/D Compatibility:

Thawing and Pooling:

Expiration:

Quality Assurance:

Dose:

Fibrinogen Deficiency States:

Factor XIII Deficiency States:

Adverse Events:

International Standards:

Recommended Reading

Chapter 32. Granulocyte products

Description:

Indications:

Neonatal Sepsis:

Neutrophil Function Defects:

Neutropenic Patients:

Processing and Storage:

Collection:

Storage:

Patient Selection, Dose Preparation, Administration and Toxicities:

Patient Selection:

Dose:

Preparation:

Administration:

Toxicities:

Quality Assurance:

International Issues:

Recommended Reading

Chapter 33. Albumin and Related Products

Indications:

Therapeutic Plasma Exchange:

Ovarian Hyperstimulation Syndrome:

Cirrhosis with Spontaneous Bacterial Peritonitis:

Large-volume Therapeutic Paracentesis:

Nephrotic Syndrome:

Hypoalbuminemia:

Contraindications:

Adverse Effects:

Cost and Usage:

Manufacturing:

Storage:

Preparation and Administration:

Albumin Dosing:

Adult Dosing:

Pediatric Dosing:

Other Colloid Solutions:

Plasma Protein Fraction:

Dextrans:

Gelatins:

Hydroxyethylene Starch:

Recommended Reading

Chapter 34. Human Immunoglobulin Preparations

Intravenous Immune Globulin (IVIG):

Description:

Mechanism of Action:

Indications and Dose:

Organ Transplantation:

Preparation and Administration:

Adverse events:

Hyperimmune Globulin Products:

Pathophysiology:

Preparation and Administration:

Adverse Events:

Recommended Reading

Chapter 35. Rh Immune Globulin

Indications in the Prevention of Anti-D Formation:

Perinatal Administration:

D-positive Blood Product Transfusion into a D Negative Recipient:

Indications in Idiopathic Thrombocytopenia Purpura:

Preparation and Administration:

Adverse Events:

International Standards:

Recommended Reading

Chapter 36. Irradiation of Blood Products

Risk of TA-GVHD:

Indications for Irradiated Products:

Guidelines and Standards for Irradiation and Mitigation of TA-GVHD:

Universal Irradiation:

Blood Products Requiring Irradiation:

Processing and Storage:

Sources of Irradiation:

Dose:

Storage and Expiration:

Quality Assurance:

Adverse Events:

International Considerations:

Recommended Reading

Chapter 37. Leukoreduction of Blood Products

Indications for Leukoreduction:

Decreasing Incidence of Febrile Non-Hemolytic Transfusion Reactions (FNHTR):

Decreasing Incidence of HLA Alloimmunization:

Decreasing Cytomegalovirus (CMV) Transmission:

Potential Indications:

Decreasing other Human Herpesvirus Transfusion Transmitted Infections:

Prion Disease:

Controversial Indications:

Transfusion Related Immunomodulation (TRIM):

Contraindications:

Methods of Leukoreduction:

Filtration Leukoreduction:

Process Leukoreduction:

Quality Assurance:

Pre-storage versus Bedside Leukoreduction:

Universal versus Diagnosis-specific Leukoreduction:

International Differences:

Recommended Reading

Chapter 38. CMV-safe Blood Products

Description:

Indications:

Processing and Storage:

CMV Seronegative Products:

CMV Seronegative versus CMV-safe by Leukoreduction:

Quality Assurance:

Antibody Tests:

Adverse Events:

International Differences:

Recommended Reading

Chapter 39. Frozen Blood Products

Cryopreservation of RBC Products:

Cryopreservation with Glycerol:

Rejuvenation:

Thawing of Frozen RBC Product:

Refreezing of Thawed RBC Products:

Indications:

Cryopreservation of HPC Products:

Cryopreservation with DMSO:

Thawing of HPC Product:

Recommended Reading

Chapter 40. Washed Blood Products

Washing of RBC Products:

Washing of Platelet Products:

Indications:

Prevention of Recurrent Severe Allergic/Anaphylactic Transfusion Reactions:

Neonatal Alloimmune Thrombocytopenia:

Large-volume or Rapid Transfusion into Neonates and Small Children:

Irradiated RBC Products:

Patients with T-Activation:

Paroxysmal Nocturnal Hemoglobinuria:

Recommended Reading

Chapter 41. Volume-reduced Products

Red Blood Cell Products:

Methods:

Indications:

Adverse Effects:

Platelet Products:

Methods:

Indications:

Adverse Effects:

Hematopoietic Progenitor Cell Products:

Recommended Reading

Chapter 42. Neonatal and Pediatric Transfusion Medicine

Red Blood Cell Transfusions:

RBC Transfusion Considerations in Neonates:

RBC Product Selection for Neonates:

Neonatal RBC Compatibility Testing:

Neonatal RBC Exchange Transfusion Considerations:

RBC Transfusions in Children and Adolescents:

RBC Product Selection in Children and Adolescents:

Platelet Transfusions:

Platelet Transfusions in Neonates:

Platelet Transfusions in Children:

Platelet Product Selection:

Plasma Transfusions:

Plasma Product Selection:

Cryoprecipitate Transfusions:

Cryoprecipitate Product Selection:

Granulocyte Transfusions:

Granulocyte Product Selection:

Recommended Reading

Chapter 43. Perinatal Transfusion Medicine

Hemolytic Disease of the Fetus and Newborn:

Prenatal Testing:

D Positive, No Alloantibodies:

D Negative, Unsensitized to the D Antigen:

Alloantibodies Currently or Previously Detected:

Intrauterine Transfusions:

RBC Transfusions:

Platelet Transfusions:

Neonatal Testing:

Treatment of the Neonate with HDFN:

RBC Exchange Transfusion:

Recommended Reading

Chapter 44. Autoimmune Hemolytic Anemias

Clinical Manifestations:

Warm Autoimmune/Hemolytic Anemia:

Pathogenesis:

Treatment:

Blood Bank and Transfusion Management:

AIHA Associated with a Negative DAT:

Cold Agglutinin Disease:

Pathogenesis:

Treatment:

Blood Bank and Transfusion Management:

Combined Cold and Warm AIHA:

Paroxysmal Cold Hemoglobinuria:

Drug-induced Hemolytic Anemia:

Drug Adsorption (Hapten) Hypothesis:

Immune Complex Hypothesis:

Autoantibody Induction by Drugs:

Non-immunologic Protein Adsorption (Membrane Modification):

Recommended Reading

Chapter 45. Transfusion Management in Patients with Hemoglobinopathies

Sickle Cell Disease:

Pathophysiology:

Methods

Calculations:

Indications for Acute Transfusions:

Indications for Chronic Transfusions:

Controversial Indications for Transfusion:

Not Indicated for Transfusion:

RBC Product Selection:

Adverse Effects:

β-Thalassemia:

Pathophysiology:

Indications:

Management:

Adverse Effects:

Recommended Reading

Chapter 46. Transfusion of Patients Undergoing HPC and Solid-organ Transplantation

Transfusion of Patients Undergoing HPC Transplantation:

Description:

Red Blood Cell Transfusion and Product Selection:

Platelet Transfusion:

Plasma Transfusion:

Granulocyte Transfusion:

Transfusion of Patients Undergoing Solid-organ Transplantation:

Description:

ABO-incompatible Transplantation:

RBC Product Selection:

Platelet Product Selection:

Plasma Product Selection:

Recommended Reading

Chapter 47. Transfusion of HIV-positive Patients

Pathophysiology:

Anemia in HIV-positive Patients:

Thrombocytopenia in the HIV-positive Patient:

RBC Transfusion:

Indication:

RBC Product Selection:

Leukoreduction:

Irradiation:

Platelet Transfusion:

Indication:

Platelet Product Selection:

Leukoreduction and Irradiation:

Adverse Effects:

Transfusion-transmitted Diseases:

Recommended Reading

Chapter 48. Management of Patients Who Refuse Blood Transfusion

Specific Circumstances:

Trauma:

Pregnant Women and Children:

Blood Management:

Documentation of Consent or Non-consent:

Recommended Reading

Chapter 49. Platelet Transfusion Refractory Patients

Non-immune Refractoriness:

Immune Refractoriness:

Calculation of Refractoriness:

Testing:

HLA Antibody Detection:

HPA Antibody Detection:

Treatment of the Alloimmunized Patient:

HLA Antigen Based Selection:

Platelet Crossmatching:

Sibling Donors:

Bleeding, Platelet-refractory Patient:

Prevention:

Recommended Reading

Chapter 50. Massive Transfusion

Clinical Significance:

Resuscitation Approaches:

Crystalloid versus Colloid Replacement:

RBC Transfusion:

Component Therapy Based Approaches:

Massive Transfusion Protocols:

Multidisciplinary Communication:

Complications of Massive RBC Transfusion:

Recommended Reading

Chapter 51. Perioperative Blood Management

Factors Influencing the Risk of Transfusion:

Preoperative Factors:

Intraoperative Factors:

Postoperative Factors:

Blood Utilization Guidelines:

Pharmaceutical Preparations:

Desmopressin:

Antifibrinolytics:

Recombinant Factor VIIa:

Fibrin Sealant:

Autologous Blood:

Advantages:

Disadvantages:

Costs:

Preoperative Autologous Donation:

Autologous Platelet-rich Plasma:

Acute Normovolemic Hemodilution:

Intraoperative Autologous Transfusion:

Postoperative Autologous Transfusion:

Controlled Hypotension:

Recommended Reading

Chapter 52. Adverse Events and Outcomes Following Transfusion

Transfusion Reactions:

Posttransfusion Complications:

Serious Hazards of Transfusion:

Efforts to Mitigate the Leading Causes of Transfusion-associated Death: