Robert W Maitta, MD, PhD discusses Transfusion Medicine and his new book, Clinical Principles of Transfusion Medicine.
Blood components are without a doubt some of the most utilized tools in a clinician’s arsenal to tackle a number of complications of hospitalized patients and of late a growing number of transfusion-dependent outpatients. At times, the use of blood seems driven by automation based on older concepts that do not appear accurate based on newer clinical evidence. In this changing environment there is a need to continuously reach out to clinicians as a whole to give them in a succinct manner not only an overview of Transfusion Medicine, but an overall update of best utilization of blood components, and to initiate a frank conversation of challenges facing blood utilization presently and in the future.
With this goal in mind we have put Clinical Principles of Transfusion Medicine together to summarize topics that clinicians will benefit from to be better informed when making decisions on proper blood utilization. The chapters included in this book discuss in a straightforward approach topics that clinicians face which go beyond deciding when to transfuse a patient but putting transfusions in context of many of their associated complexities and complications. Alloimmunization to blood components, to ABO and non-ABO antigens on red blood cells, and platelet alloimmunization mostly driven by antibodies to HLA epitopes are at the center of some of the most common complications secondary to transfusions of blood components. These are discussed presenting them in ways that improve awareness through comprehensive description of mechanisms leading to these processes and explain the difficulties in finding compatible blood components once these antibodies are generated.
Transfusion reactions are perhaps one of the most common challenges facing clinicians who may not be fully aware how to differentiate them or put them in the proper context based on clinical laboratory evidence. These are well described and presented so that clinicians promptly increase their clinical suspicion and begin the process to work them up so that appropriate steps are taken to treat patients reacting to blood components. Specifically, description of the type of specimen needed while stressing the importance of timely notification to the blood bank, and when applicable blood suppliers, is explained when components associated with the one who led to a potential severe reaction need to be recalled from other medical facilities prior to being transfused to prevent potential complications to additional patients.
Transfusion recommendations for obstetric patients, pediatric patients subdivided according to age and weight, those requiring massive transfusion support, patients undergoing hematopoietic stem cell transplantation, or blood components meeting a patient’s special needs are discussed in detail with easy-to-read tables and charts to the benefit of clinicians using the most up-to-date evidence and clinical guidelines. Additionally, a succinct discussion of ABO and some non-ABO antigenic structure and function are provided; also basic immunologic concepts leading to antibody formation, a brief review of quality concepts and accreditation requirements of blood transfusion services, testing methodologies and processes, transfusion complications both infectious and non-infectious, and most important clinical indications requiring apheresis are also covered.
Finally, the book brings about newer concepts in Transfusion Medicine not limited to laboratory-derived blood components, both red cells and platelets, and begins to present the potential difficulties facing transfusion practices in an environment of a declining blood inventory and donations. Finally, brief introductions to newer technologies such as pathogen reduction and data of potentially extending the shelf-life of platelets to day 7 are also presented.
Learn more about Clinical Principles of Transfusion Medicine here.
Medicine’s Robert W. Maitta publishes textbook about transfusion