Technical Manual, 19th Edition

  • ID: 4465639
  • Book
  • 766 pages
  • AABB
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The Technical Manual is a top-notch resource that gives both newcomers and seasoned professionals the information needed to succeed in the rapidly changing field of transfusion medicine. Experts provide the benefit of their knowledge and experience in 28 chapters and approximately 100 procedures - all of which have been reviewed by standing committees.

In this edition:

  • More inclusive of practices outside the United States.
  • Enhanced suite of chapters on patient-centered care.
  • Consolidation of several topics for easier reference.
  • Methods provided in SOP format on accompanying USB flash card for easy adoption and customization.

Edited by Mark K. Fung, MD, PhD; Anne F. Eder, MD, PhD; Steven L. Spitalnik, MD; and Connie M. Westhoff, PhD, MT(ASCP)SBB

Note: Product cover images may vary from those shown
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Preface

QUALITY AND RELATED ISSUES

1. Quality Management Systems: Principles and Practice
Eva D. Quinley, MS, MT(ASCP)SBB
Background
Concepts in Quality 
Quality Management Systems Approach
Evaluation of the Quality Management System
The Quality Management System in Practice
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
J. Wade Atkins, MS, MT(ASCP)SBB, CQA(ASQ), and Leslie P. Taylor, 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 Considerations in Transfusion Medicine and Cellular Therapies
Joseph Schwartz, MD, MPH, and Orieji Illoh, MD
FDA Oversight of Blood Establishments
Medical Laboratory Laws and Regulations
Local Laws, Hospital Regulations, and Accreditation
Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps)
Key Points
References

4. National Hemovigilance: The Current State
Kevin J. Land, MD; Barbee I. Whitaker, PhD; and Lynne Uhl, MD International Hemovigilance
US Hemovigilance
Recipient Hemovigilance in the United States
Blood Donor Hemovigilance in the United States
Conclusion
Key Points.
References

BLOOD COLLECTION AND TESTING

5. Allogeneic and Autologous Blood Donor Selection
Debra A. Kessler, RN, MS, and Susan N. Rossmann, MD, PhD
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 and Apheresis Collections for Blood Components Intended for Transfusion
Stephen J. Wagner, PhD
Donor Preparation
Blood Collection Process
Adverse Donor Reactions
WB for Component Preparation or Transfusion
Descriptions of Major Blood Components
Blood Component Modification
Quarantine
Labeling
Key Points
References

7. Infectious Disease Screening
Susan L. Stramer, PhD, and Susan A. Galel, MD
Historical Overview of Blood Donor Screening
Donor Screening Tests
Residual Infectious Risks of Transfusion
Screening for Specific Agents
Pathogen Inactivation Technology
Summary
Key Points
References

BLOOD GROUPS

8. Molecular Biology and Immunology in Transfusion
Medicine
James D. Gorham, MD, PhD
Analysis of DNA
Analysis of Protein
Basic Immunology
Key Points
References

9. 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

10. ABO and Other Carbohydrate Blood Group Systems
Julia S. Westman, PhD, and Martin L. Olsson, MD, PhD
The ABO System
The H System
The Lewis System
The I Blood Group System and Ii Collection
P1PK and Globoside Blood Group Systems and the GLOB Collection
The FORS Blood Group System
Key Points.
References

11. The Rh System
Gregory A. Denomme, PhD, FCSMLS(D)
Historical Perspective
Terminology
Rh Locus
RHD Genotype
Antigens
Rh Genotyping
Rh
Syndrome and RhAG Blood Group System
Rh Antibodies
Technical Considerations for Rh Typing
Key Points
References

12. 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
The CD59 System
The Augustine System
Antigens that Do Not Yet Belong to a Blood Group System
Erythroid Phenotypes Caused by Mutations in Transcription
Factor Genes
Key Points
References

13. Identification of Antibodies to Red Cell Antigens
Janis R. Hamilton, MS, MT(ASCP)SBB, and Debra J. Bailey, MT(ASCP)SBB
Basic Concepts in Red Cell Antigen Expression
Initial Antibody Identification Considerations
Basic Antibody Identification
Complex Antibody Identification
Selected Procedures
Considerations Following Antibody Identification
Immunohematology Reference Laboratories
Key Points
References
Suggested Readings

14. The Positive Direct Antiglobulin Test and Immune-Mediated Hemolysis
Regina M. Leger, MSQA, MT(ASCP)SBB, CMQ/OE(ASQ), and P. Dayand Borge Jr, MD, PhD
The DAT
Autoimmune Hemolytic Anemia
Drug-Induced Immune Hemolytic Anemia
Key Points
References
Appendix 14-1. Drugs Associated with Immune Hemolytic Anemia

15. Platelet and Granulocyte Antigens and Antibodies
Ralph R. Vassallo, MD, FACP, and Brian R. Curtis, PhD, D(ABMLI), MT(ASCP)SBB
Platelet Antigens and Antibodies
Granulocyte Antigens and Antibodies
Key Points.
References

16. The HLA System
Arthur B. Eisenbrey III, MD, PhD, and Patricia M. Kopko, MD
Biochemistry, Tissue Distribution, and Structure
Genetics of the MHC
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

ESSENTIALS OF TRANSFUSION PRACTICE

17. Transfusion-Service-Related Activities: Pretransfusion
Testing and Storage, Monitoring, Processing,
Distribution, and Inventory Management of
Blood Components
Sarah K. Harm, MD, and Nancy M. Dunbar, MD
Samples and Requests
Pretransfusion Testing of Recipient Blood
Blood and Blood Component Storage and Monitoring
Pretransfusion Processing
Distribution
Issuing of Components
Inventory Management
Key Points.
References
Appendix 17-1. Sources of False-Positive Results in Antiglobulin
Testing
Appendix 17-2. Sources of False-Negative Results in Antiglobulin
Testing
Appendix 17-3. Causes of Positive Pretransfusion Test Results

18. Administration of Blood Components
Melanie Jorgenson, RN, BSN, LSSGB
Events and Considerations Before Dispensing Components
Blood Component Transportation and Dispensing
Administration
Documentation of the Transfusion
Unique Transfusion Settings
Conclusions
Key Points
References

19. Hemotherapy Decisions and Their Outcomes
Richard M. Kaufman, MD, and Nadine Shehata, MD, FRCP
Red Blood Cell Transfusion
Platelet Transfusion
Plasma Transfusion
Cryoprecipitate Transfusion
Granulocyte Transfusion
Key Points
References

20. Patient Blood Management
Kathleen E. Puca, MD, MT(ASCP)SBB
Definition and Scope of Patient Blood Management
The Rationale for PBM
Basic Elements of a PBM Program
Key Points
References
Appendix 20-1. Pharmacologic Therapies for Supporting Patient
Blood Management
Appendix 20-2 . Responsibilities for Activity Levels 1, 2, and
PBM Programs

21. Approaches to Blood Utilization Auditing
Irina Maramica, MD, PhD, MBA, and Ira A. Shulman, MD
The Auditing Process
Types of Blood Utilization Review
Blood Utilization Review of Transfusions to High-Risk Patients
The Role of a Computerized Provider Order Entry System in
Blood Utilization Review
Use of “Big Data” to Assess Performance and Progress Measures in
Transfusion Medicine
Key Points
References

22. Noninfectious Complications of Blood Transfusion
William J. Savage, MD, PhD, and Eldad A. Hod, MD
Hemovigilance
Recognition and Evaluation of a Suspected Transfusion Reaction
Acute or Immediate Transfusion Reactions
Delayed Transfusion Reactions
Fatality Reporting Requirements
Key Points.
References

SPECIAL PATIENTS AND SITUATIONS

23. Perinatal Issues in Transfusion Practice
Meghan Delaney, DO, MPH; Annika M. Svensson, MD, PhD;
Lani Lieberman, MD, MSc
Hemolytic Disease of the Fetus and Newborn
Thrombocytopenia
Key Points
References

24. Neonatal and Pediatric Transfusion Practice
Edward C.C. Wong, MD, and Rowena C. Punzalan, MD
Transfusion in Infants Younger than 4 Months
Transfusion in Infants Older than 4 Months and Children
Prevention of Adverse Effects of Transfusion in the Pediatric
Population
Key Points
References

25. Therapeutic Apheresis
Chester Andrzejewski Jr, PhD, MD, and Robertson D. Davenport, MD
General Principles
Device Modalities
Patient Evaluation and Management
Vascular Access
Anticoagulation
Adverse Effects
Therapeutic Apheresis Indications
Therapeutic Apheresis Procedure Documentation, Payment, and
Provider Credentialing
Key Points.
References

26. The Collection and Processing of Hematopoietic
Progenitor Cells
Eapen K. Jacob, MD, and Scott A. Koepsell, MD, PhD
Clinical Utility
Determination of Graft Source
Collection/Sources of HPCs
Processing HPCs
Specialized Cell-Processing Methods
Cryopreservation
QC
Shipping and Transporting HPC Cellular Products
Patient Care
Other Regulatory Considerations
Conclusion
Key Points
References

27. Transfusion Support for Hematopoietic Stem Cell
Transplant Recipients
Melissa M. Cushing, MD, and Jeanne E. Hendrickson, MD
ABO- and Non-ABO-Red-Cell-Antigen-Incompatible Transplantation
Blood Component Considerations
Neutropenic Patients with Infections Unresponsive to
Antimicrobial Therapy
Special Processing of Blood Components for Recipients of HSCT
Special Considerations for Transfusing Pediatric HSCT Recipients
Information Portability for HSCT Recipients
Key Points
References

28. Human Tissue Allografts and the Hospital
Transfusion Service
Annette J. Schlueter, MD, PhD; Cassandra D. Josephson, MD; and
Scott A. Brubaker, CTBS
Tissue Donation and Transplantation
Federal Regulations, State Laws, and Professional Standards
Hospital Tissue Services
Key Points
References
Index

Contents on USB Flash Card

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, Lea, and Le Antigens
Method 2-9. Confirming Anti-A1 in an A2b 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 ResuMethod 2-20. Dissociating IgG by Chloroquine for Antigen Testing of Red Cells with a Positive DAT Result
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 Female Donors for Acceptable Hemoglobin Level-Copper Sulfate Method
Method 6-2. Preparing the Donor’s Arm for Blood Collection
Method 6-3. Collecting Blood and Samples for Processing and Testing
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



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