Article by by Robert W. Maitta, MD, PhD, author of Immunologic Concepts in Transfusion Medicine, 1st Edition

Indeed if one takes time to look back over the last one hundred years it is hard to come to the conclusion that these two disciplines have had an ephemeral relationship. On the contrary, from the moment that isoagglutinins were first described in the earlier part of the twentieth century, when the ABO blood group was first discovered, it has become clear that immunological responses are at the center of today’s transfusion medicine practices. From the time when a specimen is received at a blood bank and it undergoes investigation for the presence of antibodies to blood antigens, immunologic reactions are used to establish the presence or absence of these antibodies. Moving beyond this, not infrequently, blood exposure can lead to changes in the recipient that results in less severe cases in the appearance of urticaria and in those more severe as changes to vital signs that when significant evolve into patients’ decompensation. These unfortunate adverse events have an immunological basis and are discussed in this work.

Immunologic Concepts in Transfusion Medicine, 1st Edition has attempted to discuss and present in great detail those areas in immunology that closely impact transfusion medicine. This work begins with a review of basic immunology concepts to bring the reader up to speed with those reactions which are relevant to transfusion medicine. Similarly, contributors to this book have gone into the most up to date basic science literature, clinical literature and present these in topic-specific chapters that stresses how these findings affect current transfusion approaches. Alloimmunization to erythrocytes, platelets, and even to human leukocyte antigen determinants are discussed in the context of patients who are being transfused or undergoing transplantation to inform the reader not only how they occur but how they can be addressed by the laboratory in order to provide appropriate blood components. This discussion also approaches immune responses in specific patient populations such as pregnant patients, pediatric patients, and chronically transfused such as sickle cell patients and those with malignancies requiring prolonged transfusion support.

Likewise, in light of the advent of modern therapeutic approaches such as monoclonal antibody therapies for treatment of an ever growing list of diseases and chimeric antigen receptor therapies for hematopoietic and some solid organ malignancies, contributors of this book have also explained these revolutionary approaches and even provide a comprehensive list of those therapies currently approved by different government agencies or undergoing clinical trials to establish efficacy. These exciting clinical news help exemplify how bench-driven discoveries are being utilized today to continue to improve clinical outcomes.

Finally, we have sought to present current thinking supported by the literature seeking to explain immunological processes leading to complications such as transfusion-related acute lung injury and transfusion-related immunomodulation among others; furthermore, since bacterial contamination of blood components still occurs, contributors also discuss how microbial contamination of blood components has changed over the years and specifically what are the means currently in use or being implemented by blood collection facilities and blood banks in order to provide the safest blood components.

We hope that this book serves as a forum to inform clinicians in practice or in training, and interested researchers that immunological questions are being asked daily in the field of transfusion medicine and will undoubtedly continue to motivate those of us who practice in the field.

Learn more about Immunologic Concepts in Transfusion Medicine, 1st Edition or buy your copy here.