Transfusion of red cells in all patients is primarily triggered by the need to increase oxygen delivery to tissues in the setting of blood loss or anemia. For patients with sickle cell disease (SCD), there are additional considerations for transfusion…
A variety of neonatal and pediatric patients require blood component transfusions. This chapter focuses on aspects of blood-bank laboratory testing, blood products and components, transfusion indications, and potential adverse events that are specifically relevant to neonates and children. Pediatric Blood…
Adverse reactions following blood transfusion reflect immunologic, pathophysiologic, and microbiologic events. This chapter presents information about transfusion-associated viral, bacterial, parasitic, and prion infections and discusses a number of emerging agents including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Transfusion-transmitted infection…
A transfusion reaction can be defined broadly as any adverse event that occurs in association with the infusion of a blood or cell therapy product. Transfusion reactions are classified by how close to transfusion they occur (timing), how much morbidity…
Therapeutic bloodletting is an ancient therapy that dates back to the Galenic conceptualization of illness caused by the imbalance of the four humors. The practice remained fashionable, albeit unproved, well into the 19th century. About the time that scientific skepticism…
Plasma and its derivatives are well-established clinical resources, but cost, risk of infectious disease transmission, although rare, and other adverse effects mandate their appropriate use. Even to this day, however, much still remains to be clarified regarding the appropriate clinical…
This chapter reviews human leukocyte antigen (HLA) and human neutrophil antigen (HNA) systems. A general background of the structure, function, and nomenclature of both systems and their relevance in clinical hematology is presented. Analysis of HLA gene products is applied…
Platelet Collection and Manufacturing Platelet components are either prepared from whole blood donations (platelet concentrates) or are collected by apheresis (single donor platelets). In the United States, whole blood–derived platelet concentrates are produced using the platelet-rich plasma (PRP) method. First,…
The clinical practice of transfusion medicine has evolved substantially since the discovery of the ABO system around 1900. Two technological advances set the stage for clinical practice through blood component therapy. First, the introduction of a safe and effective anticoagulant-preservative…
Pretransfusion testing includes ABO and Rhesus (Rh) type, and antibody screening to determine whether a patient has an unexpected red blood cell (RBC) antibody. If the antibody screen is positive, an identification panel is performed to identify the specificity. Unexpected…