Transfusion Medicine and Patient Safety (eBook)

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Giustina de Silvestro, Azienda Ospedaliera di Padova, Padua, Italy; Arianna Veronesi, Azienda U.L.S.S. 15 "Alta Padovana", Padua, Italy; Maria Vicarioto, Azienda Ospedaliera di Padova, Padua, Italy.

Introduction 7
1 Basics of transfusion medicine 11
1.1 The ABO and Rh blood group systems 11
1.2 Other blood group systems 20
1.2.1 The MNSs system 21
1.2.2 The P system 21
1.2.3 The Lutheran system 21
1.2.4 The Kell system 22
1.2.5 The Lewis system 22
1.2.6 The Duffy system 22
1.2.7 The Kidd system 23
1.2.8 The Diego system 23
1.2.9 The Xg-a system 24
1.2.10 The Dombrock system 24
1.2.11 The Colton system 24
1.2.12 The Chido/Rodgers system 24
1.2.13 The Cromer system 24
1.2.14 The I/i system 24
1.3 Natural and immune antibodies 25
1.4 Transfusion guidelines 27
1.4.1 Indications for the transfusion of concentrated red blood cells 28
1.4.2 Indications for the transfusion of platelet concentrates 31
1.4.3 Indications for the transfusion of fresh frozen plasma 32
1.4.4 Indications for the transfusion of leukodepleted blood components 33
1.4.5 Indications for the transfusion of irradiated blood components 35
1.4.6 Indications for granulocyte transfusions 36
1.4.7 Virus-inactivated blood components 36
1.4.8 Complications of transfusion therapy 38
2 The transfusion process 45
2.1 Blood donation 45
2.2 Donating multiple blood components 47
2.3 Preparation of blood and blood components 48
2.4 The immunohematology laboratory 49
2.5 The immunohematology laboratory 54
2.5.1 Studying the Rh system 54
2.5.2 Detecting allo-antibodies to red cell antigens 56
2.6 Transfusion request forms and the administration of blood and blood components 60
3 Automation and computerization of the transfusion process 65
3.1 Automation as a safety factor 65
3.2 Computerization of the transfusion process: from donor to patient 70
3.3 The computerized transfusion network 75
3.4 Hemovigilance 77
3.5 What can be improved in the future? 81
4 Biological validation of blood components 83
4.1 Molecular and serological methods 83
4.1.1 Serological investigations 84
4.1.2 Molecular investigations 85
4.1.3 Structure of the DNA 85
4.1.4 Real-time PCR 88
4.1.5 PCR-TMA 90
4.2 Decision-making and the quality system 94
4.3 Risk management versus patient safety: medicolegal considerations 105
5 Error in transfusion medicine 115
Index 119