Practical Transfusion Medicine

Michael F. Murphy, David J. Roberts, Mark H. Yazer, Michael F. Murphy, David J. Roberts, Mark H. Yazer

• Publisher: Wiley-Blackwell
• Year: 2017
• Print ISBN: 9781119129417
• eBook ISBN: 9781119129424
• Edition: 5
• Topic: Medicine
• Subtopic: Hematology

The fifth edition of this practical textbook on transfusion medicine has been thoroughly revised with the latest in scientific and technological developments and edited by a leading team of international expert haematologists, including new co-editor Mark H. Yazer MD.

• A succinct and user-friendly resource of transfusion medicine for clinicians, scientists and trainees with key points, charts and algorithms
• Discusses practice in blood centres and hospitals including regulatory aspects, transfusion safety, production and storage, donor care, and blood transfusion in a global context
• Coverage of cellular and tissue therapies and organ transplantation including stem cell collection and haematopoietic stem cell processing and storage
• Review of the development of the evidence-base for transfusion medicine
• Content on the clinical practice for transfusion and alternatives to transfusion

1
Introduction: Two Centuries of Progress in Transfusion Medicine

Walter H. (Sunny) Dzik¹ and Michael F. Murphy²

¹Department of Pathology and Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA

²University of Oxford; NHS Blood and Transplant and Department of Haematology, Oxford University Hospitals, Oxford, UK

‘States of the body really requiring the infusion of blood into the veins are probably rare; yet we sometimes meet with cases in which the patient must die unless such operation can be performed’. So begins James Blundell’s ‘Observations on transfusion of blood’ published in The Lancet, marking the origins of transfusion medicine as a clinical discipline. Blundell (Figure 1.1) was a prominent London obstetrician who witnessed peripartum haemorrhage and whose interest in transfusion had begun as early as 1817 during his medical education in Edinburgh. He established that transfusions should not be conducted across species barriers and noted that resuscitation from haemorrhage could be achieved using a volume of transfusion that was smaller than the estimated blood loss. Despite life‐saving results in some patients, clinical experience with transfusion was restricted by lack of understanding of ABO blood groups – a barrier that would not be resolved for another century.

Figure 1.1 James Blundell.

The Nobel Prize‐winning work of Karl Landsteiner (Figure 1.2) established the primacy of ABO blood group compatibility and set the stage for safer transfusion practice. Twentieth‐century transfusion was advanced by the leadership of many physicians, scientists and technologists and repeatedly incorporated new diagnostics (monoclonal antibodies, genomics) and new therapeutics (plasma fractionation, apheresis and recombinant proteins) to improve patient care.

Figure 1.2 Karl Landsteiner.

Today, the field of transfusion medicine is composed of a diverse range of disciplines including the provision of a safe blood supply; the fields of haemostasis, immunology, transplantation and cellular engineering; apheresis technology; treatment using recombinant and plasma‐derived plasma proteins; and the daily use of blood components in clinical medicine (Figure 1.3). Without transfusion resources, very little of modern surgery and medicine could be accomplished.

Figure 1.3 The range of transfusion medicine.

For decades, the challenge of transmitting new information in transfusion fell to Dr Patrick Mollison (Figure 1.4) whose textbook became the standard of its era. Mollison highlighted the importance of both laboratory practice (immunohaematology, haemostasis, complement biology) and clinical medicine in our field. Practical Transfusion Medicine, here in its fifth edition, seeks to build on that tradition and to give readers the foundation knowledge required to contribute both academically and clinically to our discipline. For readers about to enjoy the content of this book, the following provides a sampling of the topics presented within the text by leading experts in our field.

Figure 1.4 Patrick Mollison.

Source: Garratty, Transfusion 2012;52:684–85. Reproduced with permission of John Wiley & Sons.

Blood Donation Worldwide

Each year, approximately 100 million blood donations are made worldwide (Figure 1.5). A safe and adequate blood supply is now an essential infrastructure requirement of any modern national healthcare system. The recruitment and retention of healthy blood donors is a vital activity of the field and the challenges and responsibilities faced by stewards of the blood supply are presented to readers in Chapters 18–22. Whilst the economically advantaged nations of the world have established all volunteer donor programmes with great success, data from the World Health Organization presented in Chapter 24 document that blood donation rates per capita in many low‐income nations are insufficient to meet their needs. More research and investment is required so that all regions of the world can rely upon an adequate supply of safe blood.

Figure 1.5 Blood donation.

Changing Landscape of Transfusion Risks

During the final two decades of the twentieth century, intense focus on screening blood donations for infectious diseases led to substantial progress in blood safety and a significant reduction in the risk of transfusion‐transmitted diseases (Figure 1.6). Chapters 15–17 present an authoritative summary of this success. We currently enjoy a grace period when the risk of transfusion‐transmitted infections is at an all‐time low. However, progressive encroachment of humans upon the animal kingdom is expected to result in the emergence of new infections that cross species barriers. Haemovigilance, robust screening technologies and chemical pathogen inactivation are all being applied to address this concern and are reviewed within the text.

Figure 1.6 Risks of transfusion‐transmitted infections over time.

With the advent of the twenty‐first century, the landscape of transfusion risk shifted its emphasis towards non‐infectious hazards (Figure 1.7). Recent years have focused on improved understanding ...

Table of contents

• Cover
• Title Page
• Table of Contents
• List of Contributors
• Preface
• 1 Introduction
• Part I: Basic Principles of Immunohaematology
• Part II: Complications of Transfusions
• Part III: Practice in Blood Centres and Hospitals
• Part IV: Clinical Transfusion Practice
• Part V : Patient Blood Management
• Part VI: Cellular and Tissue Therapy and Organ Transplantation
• Part VII: Development of the Evidence Base for Transfusion
• Index
• End User License Agreement