Transfusion Medicine: Practical Issues

Abstract

The name change from “blood bank” to “transfusion medicine” has been implemented in many institutions (especially those that are hospital-based) to reflect the broadening scope of activities now included in the repertoire of such entities. Twenty-five years ago, blood banks recruited blood donors, collected and separated their blood into a handful of components, and performed a few simple tests on patients and donors, such as ABO/Rh typing, red cell crossmatching, and Coombs (antiglobulin) testing. Collected blood also was tested for hepatitis B surface antigen and for evidence of syphilis exposure. Currently, departments of transfusion medicine collect blood and other products from a much broader spectrum of donors, fractionate it into many more components, test each donation for a broad range of potentially transmissible agents, and perform many more direct services for patients such as therapeutic apheresis, intraoperative blood salvage, and histocompatibility testing and matching for bone marrow, stem cells, and solid organ transplants. In addition, many establishments are already involved in the manipulation of stem cell populations, and some are beginning to extend those manipulations to include gene transfection and gene therapy. To avail of these services for one’s patients, it behooves the clinician to investigate the “repertoire” of his or her hospital’ s transfusion medicine department and, if it does not collect blood, the range of services provided by the institution’ s chief blood supplier.