Transfusion Medicine and Cellular Therapies, Technical Manual - 18th Edition

  • ID: 3145302
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  • 840 pages
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The transfusion medicine and cellular therapies landscape is changing like never before, and it can be challenging to keep up to date with developments. The Technical Manual is a valuable resource that helps newcomers and seasoned professional alike find the information they need to stay ahead of the changes currently unfolding. Expert chapter authors give you the benefit of their knowledge and experience.

What’s new:

- Completely revised and expanded patient blood management content to reflect recent developments and initiatives.
- Enhanced suite of chapters on the most relevant topics of interest to cellular therapy professionals.
- Immunohematology chapters reflecting both serologic and molecular aspects.
- Methods provided in SOP format on accompanying USB flash card for easy adoption and customization by your facility.
- Helpful appendices that can be uploaded to your organization’s network.

Edited by: Mark K. Fung, MD, PhD; Brenda J. Grossman, MD, MPH; Christopher Hillyer, MD; Connie M. Westhoff, PhD, MT(ASCP)SBB
Note: Product cover images may vary from those shown
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Preface

QUALITY ISSUES

1. Quality Management Systems: Theory and Practice
Tania L. Motschman, MS, MT(ASCP)SBB, CQA(ASQ);
Betsy W. Jett, MT(ASCP), CQA(ASQ)CQM/OE; and
Susan L. Wilkinson, EdD, MS, MT(ASCP)SBB
Concepts in Quality
Practical Application of Quality Management Principles
Key Points
References
Appendix 1-1. Glossary of Commonly Used Quality Terms
Appendix 1-2. Code of Federal Regulations Quality-Related References
Appendix 1-3. Suggested Quality Control Performance Intervals for
Equipment and Reagents

2. Facilities, Work Environment, and Safety
Betsy W. Jett, MT(ASCP), CQA(ASQ)CQM/OE;
Susan L. Wilkinson, EdD, MS, MT(ASCP)SBB; and
Tania L. Motschman, MS, MT(ASCP)SBB, CQA(ASQ)
Facilities
Safety Program
Fire Prevention
Electrical Safety
Biosafety
Chemical Safety
Radiation Safety
Shipping Hazardous Materials
General Waste Management
Key Points
References
Appendix 2-1. Safety Regulations and Recommendations Applicable to
Health-Care Settings
Appendix 2-2. General Guidelines for Safe Work Practices, Personal
Protective Equipment, and Engineering Controls
Appendix 2-3. Biosafety Level 2 Precautions
Appendix 2-4. Sample List of Hazardous Chemicals that May Be
Encountered in a Blood Bank
Appendix 2-5. Chemical Categories and How to Work Safely with Them
Appendix 2-6. Incidental Spill Response
Appendix 2-7. Managing Hazardous Chemical Spills

3. Regulatory Issues in Blood Banking
Glenn Ramsey, MD
Biological Products
Licensure and Registration
FDA Inspections
Blood-Related Devices
Hematopoietic Progenitor Cells as Tissues
Managing Recalls and Withdrawals
Medical Laboratory Laws and Regulations
Hospital Regulations and Accreditation
Conclusion
Key Points
References

4. Disaster Management
Ruth D. Sylvester, MS, MT(ASCP)SBB; William FitzGerald, LTC USA (Ret);
Wendy Trivisonno; and Theresa Wiegmann, JD
Background
Business Operations Planning
Regulatory Considerations in Emergencies
Testing the Disaster Plan
Summary of Lessons Learned from Recent Disasters
Conclusion
Key Points
References

BLOOD DONATION AND COLLECTION

5 . Allogeneic and Autologous Blood Donor Selection
Anne F. Eder, MD, PhD, and Maria D.L.A. Muniz, MD
Overview of Blood Donor Screening
Selection of Allogeneic Blood Donors
Blood-Center-Defined Donor Eligibility Criteria
Abbreviated DHQ for Frequent Donors
Recipient-Specific “Designated” or “Directed” Blood Donation
Key Points
References

6. Whole-Blood Collection and Component Processing
Larry J. Dumont, MBA, PhD; Mona Papari, MD;
Colleen A. Aronson, MT(ASCP)SBB; and
Deborah F. Dumont, MT(ASCP)SBB
WB Collection
Blood Component Preparation and Processing
Descriptions of Major Blood Components
Blood Component Modification
Quarantine
Labeling
QC of Blood Components
Key Points
References

7. Blood Component Collection by Apheresis
James W. Smith, MD, PhD
Component Collection
Instruments and Systems for Donor Apheresis Collections
Key Points
References

8. Infectious Disease Screening
Susan A. Galel, MD
Historical Overview of Blood Donor Screening
Donor Screening Tests
Residual Infectious Risks of Transfusion
Screening for Specific Agents
Pathogen Reduction Technology
Summary
Key Points
References

9. Hospital Storage, Monitoring, Pretransfusion Processing, Distribution, and Inventory Management of Blood Components
Nancy M. Dunbar, MD
Blood and Blood Component Storage and Monitoring
Pretransfusion Processing
Distribution
Inventory Management
Key Points
References

BLOOD GROUPS

10. Molecular Biology and Immunology in Transfusion Medicine
James C. Zimring, MD, PhD, and Steven L. Spitalnik, MD
Nucleic Acid Analysis
Protein Analysis
Basic Immunology
Key Points
References

11. Blood Group Genetics
Christine Lomas-Francis, MSc, FIBMS
Basic Principles of Genetics
Inheritance of Genetic Traits
Population Genetics
Relationship Testing
Blood Group Gene Mapping
Chimerism
Blood Group Terminology
Blood Group Genomics
Key Points
References

12. ABO, H, and Lewis Blood Groups and Structurally
Related Antigens
Laura Cooling, MD, MS
ABO System
The H System
The Lewis System
I and i Antigens
P Blood Groups/GLOB Collection
Key Points
References

13. The Rh System
Gregory A. Denomme, PhD, FCSMLS(D), and
Connie M. Westhoff, PhD, SBB
Characterization of Rh
Terminology
Rh Genes and Rh Proteins
Antigens
Rh Genotyping
Rh Syndrome and RhAG Blood Group System
Rh Antibodies
Technical Considerations for Rh Typing
Key Points
References

14. Other Blood Group Systems and Antigens
Jill R. Storry, PhD, FIBMS
The MNS System
M (MNS1), N (MNS2), S (MNS3), and s (MNS4)
The Lutheran System
The Kell and Kx Systems
The Duffy System
The Kidd System
The Diego System
The Yt System
The Xg System
The Scianna System
The Dombrock System
The Colton System
The Landsteiner-Wiener System
The Chido/Rodgers System
The Gerbich System
The Cromer System
The Knops System
The Indian System
The Ok System
The Raph System
The John Milton Hagen System
The GILL System
The RHAG System
The FORS System
The Jr System
The Lan System
The Vel System
Antigens That Do Not Belong to a Blood Group System
Erythroid Phenotypes Caused by Mutations in Transcription
Factor Genes
Key Points
References

ANTIGEN AND ANTIBODY TESTING

15. Pretransfusion Testing
Katharine A. Downes, MD, and Ira A. Shulman, MD
Requests for Transfusion
Identification of Recipients and Labeling of Blood Specimens
Specimen Requirements
Serologic Testing Principles
Pretransfusion Tests
Tubeless Methods for Pretransfusion Testing
Comparison of Current Testing Results with Previous Records
Donor RBC Unit Testing
Donor RBC Unit Selection
Compatibility Testing or Crossmatch (Serologic or Computer/
Electronic)
Interpretation of Antibody Screening and Crossmatch Results
Pretransfusion Orders
Availability of Compatible Blood
Labeling of Blood and Blood Components with the Recipient’s
Information
Special Clinical Situations
Key Points
References

16. Identification of Antibodies to Red Cell Antigens
Phyllis S. Walker, MS, MT(ASCP)SBB, and
Janis R. Hamilton, MS, MT(ASCP)SBB
Significance of Alloantibodies
Preanalytical Considerations
Analytical Phase of Antibody Identification
Postanalytical Considerations: Selecting Blood for Transfusion
Key Points
References
Suggested Readings

17. The Positive Direct Antiglobulin Test and Immune Mediated Hemolysis
Regina M. Leger, MSQA, MT(ASCP)SBB, CMQ/OE(ASQ)
The DAT
Autoimmune Hemolytic Anemia
Drug-Induced Immune Hemolytic Anemia
Key Points
References
Appendix 17-1. Drugs Associated with Immune Hemolytic Anemia

18. Platelet and Granulocyte Antigens and Antibodies
Brian R. Curtis, PhD, D(ABMLI), MT(ASCP)SBB
Platelet Antigens and Antibodies
Granulocyte Antigens and Antibodies
Key Points
References

19. The HLA System
Robert A. Bray, PhD; Marilyn S. Pollack, PhD; and Howard M. Gebel, PhD
Genetics of the MHC
Biochemistry, Tissue Distribution, and Structure
Identification of HLA Antigens and Alleles
Crossmatching and Detection of HLA Antibodies
The HLA System and Transfusion
HLA Testing and Transplantation
Other Clinically Significant Aspects of HLA
Summary
Key Points
References

CLINICAL CONSIDERATIONS IN TRANSFUSION PRACTICE

20. Hemotherapy Decisions and Their Outcomes
Theresa Nester, MD; Shweta Jain, MD; and Jessica Poisson, MD
Red Cell Transfusion
Platelet Transfusion
Plasma Transfusion
Cryoprecipitate Transfusion
Granulocyte Transfusion
Plasma-Derivative Transfusion
Key Points
References

21. Administration of Blood Components
Kim Maynard, BSN, RN, OCN
Events and Considerations Before Dispensing Components
Blood Component Transportation and Dispensing
Events and Considerations Before Component Administration
Manual Administration
Unique Transfusion Settings
Conclusions
Key Points
References

22. Perinatal Issues in Transfusion Practice
Melanie S. Kennedy, MD; Meghan Delaney, DO, MPH; and Scott Scrape, MD
HDFN
RhIG
ABO Hemolytic Disease
Immune Thrombocytopenia
Key Points
References

23. Neonatal and Pediatric Transfusion Practice
Cassandra D. Josephson, MD, and Erin Meyer, DO, MPH
Transfusion in Infants Younger Than 4 Months
Transfusion in Infants Older Than 4 Months and Children
Prevention of Adverse Effects of Transfusion in Neonates,
Older Infants, and Children
Key Points
References

24. Patient Blood Management
Mary Ghiglione, RN, MSN, MHA, and
Kathleen E. Puca, MD, MT(ASCP)SBB
Definition and Scope of Patient Blood Management
The Rationale for Patient Blood Management
Basic Elements of a PBM Program
Postoperative Strategies
Blood Utilization Review and Changing Physician Behavior
Program Development
Key Points
References
Appendix 24-1. Pharmacologic Therapies for Supporting Patient
Blood Management
Appendix 24-2. Responsibilities for Activity Levels 1, 2, and 3 PBM
Programs

25. Transfusion Support for Hematopoietic Stem Cell Transplant Recipients
Christopher A. Tormey, MD, and Jeanne E. Hendrickson, MD
Implications of ABO- and Non-ABO-Antigen-Incompatible
Red Blood Cell Transplantation for Transfusion
Blood Component Considerations
Patients with Neutropenia and Infection that Is Unresponsive to
Antimicrobial Therapy
Special Processing of Blood Components for HSCT Recipients
Special Considerations for Transfusions in Pediatric HSCT Recipients
Information Portability for HSCT Recipients
Key Points
References

26. Therapeutic Apheresis
Robertson D. Davenport, MD
Principles and Modalities
Indications
Anticoagulation
Adverse Effects
Vascular Access
Patient Evaluation
Key Points
References

27. Noninfectious Complications of Blood Transfusion
Catherine A. Mazzei, MD; Mark A. Popovsky, MD; and Patricia M. Kopko, MD
Hemovigilance
Recognition and Evaluation of a Suspected Transfusion Reaction
Delayed Transfusion Reactions
Fatality Reporting Requirements
Key Points
References

28. Approaches to Blood Utilization Auditing
Alan Tinmouth, MD, FRCPC, MSc, and
Simon Stanworth, FRCP, FRCPath, DPhil
Rationale for Monitoring Blood Utilization
Types of Transfusion Audits
Interventions to Change Transfusion Practice
Effectiveness of Monitoring and Interventions to Change
Transfusion Practice
Selecting an Audit Process to Monitor Transfusions
Conclusions
Key Points
References
Appendix 28-1. Transfusion Order Form in Use at St. Vincent
Indianapolis Hospital Since 2001

29. The Collection and Processing of Hematopoietic Stem Cells
Scott A. Koepsell, MD, PhD; Eapen K. Jacob, MD; and
David H. McKenna Jr, MD
Clinical Utility
Determination of Graft Source
Collection/Sources of HSCs
Processing of HSCs
Specialized Cell-Processing Methods
Cryopreservation
Shipping and Transport of HSC Cellular Products
Patient Care
Other Regulatory Considerations
Conclusion
Key Points
References

30. Umbilical Cord Blood Banking
Aleksandar M. Babic, MD, PhD, and Donna M. Regan, MT(ASCP)SBB
Background
Donor-Related Issues
UCB Collection
UCB Processing
Shipment
Receipt of UCB for Transplantation
Thawing and Washing of UCB
Infusion of UCB
Economic Issues
Regulations and Standards
Key Points
References

31. Tissue-Derived Non-Hematopoietic Stem Cell Sources for Use in Cell-Based Therapies
Yameena Jawed, MD; Brian Johnstone, PhD;
Sreedhar Thirumala, PhD; and Keith March, MD, PhD
MSC Sources
Properties of Clinical Relevance
Isolation and Expansion
Standardization of Methods for Isolation and Expansion of
Clinical Product
Cell Product Banking and Management of Supply Chain and End Use
Therapeutic Applications of MSCs
Current Research and Development: Focus on Cell Culture and
Handling
Conclusions and Future Directions
Key Points
References

32. Human Allografts and the Hospital Transfusion Service
Lance D. Trainor, MD, and Rita A. Reik, MD
Tissue Transplantation
Regulations and Standards
Hospital Tissue Services
Transfusion Service Support for Organ Transplantation
Key Points
References

33. Blood and Marrow-Derived Nonhematopoietic Stem Cell
Sources and Immune Cells for Clinical Applications
Mickey B. C. Koh, MD, PhD; Edward R. Samuel, PhD, MSc; and
Garnet Suck, PhD, MSc
Immune Cells for Clinical Therapy
Induced Pluripotent Stem Cells
Regulatory and Oversight Activities
Conclusion
Key Points
References
Index

Contents on USB Flash Card

Methods Introduction

METHODS

1. General Laboratory Methods—Introduction
Method 1-1. Shipping Hazardous Materials
Method 1-2. Monitoring Temperature During Shipment of Blood
Method 1-3. Treating Incompletely Clotted Specimens
Method 1-4. Solution Preparation Procedure
Method 1-5. Serum Dilution Procedure
Method 1-6. Dilution of Percentage Solutions Procedure
Method 1-7. Preparing a 3% Red Cell Suspension
Method 1-8. Preparing and Using Phosphate Buffer
Method 1-9. Reading and Grading Tube Agglutination

2. Red Cell Typing Methods—Introduction
Method 2-1. Determining ABO Group of Red Cells—Slide Test
Method 2-2. Determining ABO Group of Red Cells and Serum—Tube Test
Method 2-3. Determining ABO Group of Red Cells and Serum—Microplate Test
Method 2-4. Initial Investigation of ABO Grouping Discrepancies Procedure
Method 2-5. Detecting Weak A and B Antigens and Antibodies by Cold Temperature Enhancement
Method 2-6. Confirming Weak A and B Antigens Using Enzyme-Treated Red Cells
Method 2-7. Confirming Weak A or B Subgroup by Adsorption and Elution
Method 2-8. Testing Saliva for A, B, H, Le
Method 2-9. Confirming Anti-A1 in an A2 or Weak A Subgroup
Method 2-10. Resolving ABO Discrepancies Caused by Unexpected Alloantibodies
Method 2-11. Determining Serum Group Without Centrifugation
Method 2-12. Determining Rh (D) Type—Slide Test
Method 2-13. Determining Rh (D) Type—Tube Test
Method 2-14. Determining Rh (D) Type—Microplate Test
Method 2-15. Testing for Weak D
Method 2-16. Preparing and Using Lectins
Method 2-17. Removing Autoantibody by Warm Saline Washes
Method 2-18. Using Sulfhydryl Reagents to Disperse Autoagglutination
Method 2-19. Using Gentle Heat Elution to Test Red Cells with a Positive DAT
Method 2-20. Dissociating IgG by Chloroquine for Antigen Testing of Red Cells with a Positive DAT
Method 2-21. Using Acid Glycine/EDTA to Remove Antibodies from Red Cells
Method 2-22. Separating Transfused from Autologous Red Cells by Simple Centrifugation
Method 2-23. Separating Transfused from Autologous Red Cells in Patients with Hemoglobin S Disease

3. Antibody Detection, Identification, and Compatibility Testing—Introduction
Method 3-1. Using Immediate-Spin Compatibility Testing to Demonstrate ABO Incompatibility
Method 3-2. Saline Indirect Antiglobulin Test Procedure
Method 3-3. Albumin or LISS-Additive Indirect Antiglobulin Test Procedure
Method 3-4. LISS-Suspension Indirect Antiglobulin Test Procedure
Method 3-5. PEG Indirect Antiglobulin Test Procedure
Method 3-6. Prewarming Procedure
Method 3-7. Detecting Antibodies in the Presence of Rouleaux—Saline Replacement
Method 3-8. Preparing Ficin Enzyme Stock, 1% w/v
Method 3-9. Preparing Papain Enzyme Stock, 1% w/v
Method 3-10. Standardizing Enzyme Procedures
Method 3-11. Evaluating Enzyme-Treated Red Cells
Method 3-12. One-Stage Enzyme Procedure
Method 3-13. Two-Stage Enzyme Procedure
Method 3-14. Performing a Direct Antiglobulin Test
Method 3-15. Antibody Titration Procedure
Method 3-16. Using Sulfhydryl Reagents to Distinguish IgM from IgG Antibodies
Method 3-17. Using Plasma Inhibition to Distinguish Anti-Ch and -Rg from Other Antibodies with Similar Characteristics
Method 3-18. Treating Red Cells Using DTT or AET
Method 3-19. Neutralizing Anti-Sda with Urine
Method 3-20. Adsorption Procedure
Method 3-21. Using the American Rare Donor Program

4. Investigation of a Positive DAT Result—Introduction
Method 4-1. Cold-Acid Elution Procedure
Method 4-2. Glycine-HCl/EDTA Elution Procedure
Method 4-3. Heat Elution Procedure
Method 4-4. Lui Freeze-Thaw Elution Procedure
Method 4-5. Cold Autoadsorption Procedure
Method 4-6. Determining the Specificity of Cold-Reactive Autoagglutinins
Method 4-7. Cold Agglutinin Titer Procedure
Method 4-8. Adsorbing Warm-Reactive Autoantibodies Using Autologous Red Cells
Method 4-9. Adsorbing Warm-Reactive Autoantibodies Using Allogeneic Red Cells
Method 4-10. Polyethylene Glycol Adsorption Procedure
Method 4-11. Performing the Donath-Landsteiner Test
Method 4-12. Detecting Drug Antibodies by Testing Drug-Treated Red Cells
Method 4-13. Detecting Drug Antibodies by Testing in the Presence of Drug

5. Hemolytic Disease of the Fetus and Newborn—Introduction
Method 5-1. Testing for Fetomaternal Hemorrhage—The Rosette Test
Method 5-2. Testing for Fetomaternal Hemorrhage—Modified Kleihauer-Betke Test
Method 5-3. Using Antibody Titration Studies to Assist in Early Detection of Hemolytic Disease of the Fetus and Newborn

6. Blood Collection, Component Preparation, and Storage—Introduction
Method 6-1. Screening Donors for Anemia—Copper Sulfate Method
Method 6-2. Preparing the Donor’s Arm for Blood Collection
Method 6-3. Collecting Blood and Samples for Processing and Compatibility Tests
Method 6-4. Preparing Red Blood Cells from Whole Blood
Method 6-5. Preparing Prestorage Red Blood Cells Leukocytes Reduced from Whole Blood
Method 6-6. Using High-Concentration Glycerol to Cryopreserve Red Cells—Meryman Method
Method 6-7. Using High-Concentration Glycerol to Cryopreserve Red Cells—Valeri Method
Method 6-8. Checking the Adequacy of Deglycerolization of Red Blood Cells
Method 6-9. Preparing Fresh Frozen Plasma from Whole Blood
Method 6-10. Preparing Cryoprecipitated AHF from Whole Blood
Method 6-11. Thawing and Pooling Cryoprecipitated AHF
Method 6-12. Preparing Platelets from Whole Blood
Method 6-13. Removing Plasma from Platelets (Volume Reduction)

7. Transplantation of Cells and Tissue—Introduction
Method 7-1. Infusing Cryopreserved Hematopoietic Cells
Method 7-2. Processing Umbilical Cord Blood
Method 7-3. Investigating Adverse Events and Infections Following Tissue Allograft Use

8. Quality Control Methods—Introduction
Method 8-1. Validating Copper Sulfate Solution
Method 8-2. Calibrating Liquid-in-Glass Laboratory Thermometers
Method 8-3. Calibrating Electronic Oral Thermometers
Method 8-4. Testing Refrigerator Alarms
Method 8-5. Testing Freezer Alarms
Method 8-6. Calibrating Centrifuges for Platelet Separation
Method 8-7. Calibrating a Serologic Centrifuge for Immediate Agglutination
Method 8-8. Calibrating a Serologic Centrifuge for Washing and Antiglobulin Testing
Method 8-9. Testing Automatic Cell Washers
Method 8-10. Monitoring Cell Counts of Apheresis Components
Method 8-11. Counting Residual White Cells in Leukocyte-Reduced Blood and Components—Manual Method

APPENDICES
Appendix 1. Normal Values in Adults
Appendix 2. Selected Normal Values in Children
Appendix 3. Typical Normal Values in Tests of Hemostasis and Coagulation (Adults)
Appendix 4. Coagulation Factor Values in Platelet Concentrates
Appendix 5. Approximate Normal Values for Red Cell, Plasma, and Blood Volumes
Appendix 6. Blood Group Antigens Assigned to Systems
Appendix 7. Examples of Gene, Antigen, and Phenotype Symbols in Conventional and International Society of Blood Transfusion Terminology
Appendix 8. Examples of Correct and Incorrect Terminology
Appendix 9. Distribution of ABO/Rh Phenotypes by Race or Ethnicity
Appendix 10. Example of a Maximum Surgical Blood Order Schedule
Appendix 11. Directory of Organizations

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