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Technical Manual, 20th Edition (AABB)
 

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ÃâÆÇ»ç AABB
ÀúÀÚ Claudia S. Cohn, MD, PhD; Meghan Delaney, DO, MPH; Susan T. Johnson, MSTM, MT(ASCP)SBB; and Louis M. Katz, MD
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[ Preface ]

ON BEHALF OF THE EDITORS, AUthors, and many reviewers I am pleased to introduce the 20th edition of the AABB Technical Manual. The Technical Manual conveys the latest information in blood banking/transfusion medicine along with well-established material. Using the model developed by previous editorial teams, when possible we paired new authors with seasoned veterans to bring a fresh perspective to the content. This also allows for ontinuity
as new authors in the current edition move into the role of primary author for the next edition. I am grateful for the steady guidance and hard work of Associate Editors Meghan Delaney, DO, MPH; Sue Johnson, MSTM, MT(ASCP)SBB; and Louis Katz, MD. All of us were first-time editors of the Technical Manual and learned a great deal from AABB staff and the editors of past editions.

The Technical Manual¡¯s excellence is ensured by a stringent peer-review process. Each chapter underwent an initial review by the editors for content and style, followed by reviews from numerous AABB committee members who provided focused expertise as well as comments on readability. Compliance experts then conducted a final check to make sure we provided the most up-to-date information on the standards, guidance, and regulations that help govern the activities readers engage in. These extra steps provide a high level of confidence that the Technical Manual is a reliable resource for our community.

The overall structure and content of the Technical Manual is adjusted periodically bysurvey responses and feedback from AABB membership. For the 19th edition several key measures were taken to focus the content and reduce redundancy. These measures were very successful and, as a result, few structural changes were necessary for this edition.

However, improvements in content continued unabated. Sue Johnson and the authors of the chapters on blood groups worked diligently to bring the book¡¯s terminology for blood group antigens more closely in line with official ISBT nomenclature. In fact, their work is already being used as an exemplar for other AABB publications. Chapters addressing topics that have evolved significantly since publication of the 19th edition underwent major revision. These expanded updates include content on massive transfusion, patient blood management, molecular testing, and relevant transfusion-transmitted disease. Other key updates involving several chapters resulted from the April 2020 release of new federal regulations on donor deferrals and subsequent revision of the donor history questionnaire.

The Technical Manual was in the final stages of production when the COVID-19 pandemic swept across the world. Not surprisingly, the pandemic had an impact on the book. First, we considered adding material about disaster preparedness, blood shortages, and convalescent plasma. However, the information was changing so rapidly that we felt
pandemic-related content would be out of date by the time we went to press. Second, the final review meeting at the AABB office was converted to a virtual remote process. It
took longer, but I believe the results are equal in quality of outcome. The third impact also relates to remote working. Our community as a whole has developed and improved ways to benefit from access to online resources. Accordingly, the methods and appendices are now posted online, rather than loaded onto a USB flash card in a pocket adhered to the inside back cover. Readers who turn to the table of contents page for the methods will find the access code there. We hope that the pandemic will be resolved well before publication of the 21st edition, and that information on the virus, treatment, blood collection challenges, and lessons learned can be included in that edition.

It has been a privilege to work with the talented and dedicated staff at AABB and the transfusion medicine/blood banking community that helped to produce this edition. On behalf of the editors, authors, and reviewers we hope you enjoy using the 20th edition of the Technical Manual and find it a useful reference tool.


Claudia S. Cohn, MD, PhD
Editor in Chief

 
 
 
Preface¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡ix


Q U A L I T Y A N D R E L A T E D I S S U E S
1. Quality Management Systems: Principles and Practice
¡¡¡¡¡¡Background¡¡¡¡¡¡1
¡¡¡¡¡¡Concepts in Quality¡¡¡¡¡¡2
¡¡¡¡¡¡Quality Management Systems Approach¡¡¡¡¡¡4
¡¡¡¡¡¡Evaluation of the Quality Management System¡¡¡¡¡¡5
¡¡¡¡¡¡The Quality Management System in Practice¡¡¡¡¡¡5
¡¡¡¡¡¡Key Points¡¡¡¡¡¡23
¡¡¡¡¡¡References¡¡¡¡¡¡24
Appendix 1-1. Glossary of Commonly Used Quality Terms¡¡¡¡¡¡26
Appendix 1-2. Code of Federal Regulations Quality-Related References¡¡¡¡¡¡28
Appendix 1-3. Suggested Quality Control Performance Intervals for Equipment and Reagents¡¡¡¡¡¡29

2. Facilities, Work Environment, and Safety
¡¡¡¡¡¡Safety Program¡¡¡¡¡¡35
¡¡¡¡¡¡Fire Prevention¡¡¡¡¡¡39
¡¡¡¡¡¡Electrical Safety¡¡¡¡¡¡40
¡¡¡¡¡¡Biosafety¡¡¡¡¡¡41
¡¡¡¡¡¡Chemical Safety¡¡¡¡¡¡48
¡¡¡¡¡¡Radiation Safety¡¡¡¡¡¡53
¡¡¡¡¡¡Shipping Hazardous Materials¡¡¡¡¡¡56
¡¡¡¡¡¡General Waste Management¡¡¡¡¡¡56
¡¡¡¡¡¡Key Points¡¡¡¡¡¡57
¡¡¡¡¡¡References¡¡¡¡¡¡57
Appendix 2-1. Safety Regulations and Recommendations Applicable to Health-Care Settings¡¡¡¡¡¡61
Appendix 2-2. General Guidance for Safe Work Practices, Personal Protective Equipment, and Engineering Controls¡¡¡¡¡¡63
Appendix 2-3. Biosafety Level 2 Precautions¡¡¡¡¡¡66
Appendix 2-4. Sample List of Hazardous Chemicals That May Be Encountered in a Blood Bank¡¡¡¡¡¡67
Appendix 2-5. Chemical Categories and How to Work Safely with Them¡¡¡¡¡¡69
Appendix 2-6. Incidental Spill Response¡¡¡¡¡¡71
Appendix 2-7. Managing Hazardous Chemical Spills¡¡¡¡¡¡74

3. Regulatory Considerations in Transfusion Medicine and Cellular Therapies
¡¡¡¡¡¡FDA Oversight of Blood Establishments¡¡¡¡¡¡78
¡¡¡¡¡¡Medical Laboratory Laws and Regulations¡¡¡¡¡¡84
¡¡¡¡¡¡Local Laws, Hospital Regulations, and Accreditation¡¡¡¡¡¡85
¡¡¡¡¡¡Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/PS)¡¡¡¡¡¡86
¡¡¡¡¡¡Immune Effector Cells¡¡¡¡¡¡89
¡¡¡¡¡¡Key Points¡¡¡¡¡¡90
¡¡¡¡¡¡References¡¡¡¡¡¡90

4. National Hemovigilance: The Current State
¡¡¡¡¡¡International Hemovigilance¡¡¡¡¡¡96
¡¡¡¡¡¡US Hemovigilance¡¡¡¡¡¡97
¡¡¡¡¡¡Recipient Hemovigilance in the United States¡¡¡¡¡¡100
¡¡¡¡¡¡Blood Donor Hemovigilance in the United States¡¡¡¡¡¡103
¡¡¡¡¡¡Next Steps in US Hemovigilance¡¡¡¡¡¡106
¡¡¡¡¡¡Key Points¡¡¡¡¡¡112
¡¡¡¡¡¡References¡¡¡¡¡¡113
Appendix 4-1. Protocol for Hospital Reporting Adverse Events to Blood Suppliers¡¡¡¡¡¡116
Appendix 4-2. Severity Grading Tool for Blood Donor Adverse Events¡¡¡¡¡¡124


B L O O D C O L L E C T I O N A N D T E S T I N G
5. Allogeneic and Autologous Blood Donor Selection
¡¡¡¡¡¡Overview of Blood Donor Screening¡¡¡¡¡¡127
¡¡¡¡¡¡Selection of Allogeneic Blood Donors¡¡¡¡¡¡128
¡¡¡¡¡¡Abbreviated DHQ for Frequent Donors¡¡¡¡¡¡132
¡¡¡¡¡¡Blood-Center-Defined Donor Eligibility Criteria¡¡¡¡¡¡133
¡¡¡¡¡¡Recipient-Specific ¡°Designated¡± or ¡°Directed¡± Blood Donation¡¡¡¡¡¡135
¡¡¡¡¡¡Key Points¡¡¡¡¡¡137
¡¡¡¡¡¡References¡¡¡¡¡¡137

6. Whole Blood and Apheresis Collection of Blood Components Intended for Transfusion
¡¡¡¡¡¡Donor Preparation and Care¡¡¡¡¡¡141
¡¡¡¡¡¡Blood Collection¡¡¡¡¡¡145
¡¡¡¡¡¡Blood Component Storage¡¡¡¡¡¡153
¡¡¡¡¡¡Postcollection Processing/Blood Component Modification¡¡¡¡¡¡158
¡¡¡¡¡¡Quarantine of Blood Components¡¡¡¡¡¡164
¡¡¡¡¡¡Labeling of Blood Components¡¡¡¡¡¡164
¡¡¡¡¡¡Key Points¡¡¡¡¡¡165
¡¡¡¡¡¡References¡¡¡¡¡¡166

7. Infectious Disease Screening
¡¡¡¡¡¡Historical Overview of Blood Donor Screening¡¡¡¡¡¡173
¡¡¡¡¡¡Donor Screening Tests¡¡¡¡¡¡177
¡¡¡¡¡¡Residual Infectious Risks of Transfusion¡¡¡¡¡¡196
¡¡¡¡¡¡Screening for Specific Agents¡¡¡¡¡¡199
¡¡¡¡¡¡Pathogen Inactivation Technology¡¡¡¡¡¡215
¡¡¡¡¡¡Summary¡¡¡¡¡¡217
¡¡¡¡¡¡Key Points¡¡¡¡¡¡217
¡¡¡¡¡¡References¡¡¡¡¡¡218


B L O O D G R O U P S
8. Molecular Biology and Immunology in Transfusion Medicine
¡¡¡¡¡¡Analysis of DNA¡¡¡¡¡¡229
¡¡¡¡¡¡Analysis of Protein¡¡¡¡¡¡238
¡¡¡¡¡¡Basic Immunology¡¡¡¡¡¡243
¡¡¡¡¡¡Key Points¡¡¡¡¡¡251
¡¡¡¡¡¡References¡¡¡¡¡¡251

9. Blood Group Genetics
¡¡¡¡¡¡Genomic Organization and Gene Regulation¡¡¡¡¡¡256
¡¡¡¡¡¡Genetic Variation¡¡¡¡¡¡262
¡¡¡¡¡¡Inheritance of Genetic Traits¡¡¡¡¡¡266
¡¡¡¡¡¡Structural Variation¡¡¡¡¡¡270
¡¡¡¡¡¡Chimerism¡¡¡¡¡¡273
¡¡¡¡¡¡Gene Position Effects¡¡¡¡¡¡274
¡¡¡¡¡¡Genetic Modifiers of Blood Group Antigen Expression¡¡¡¡¡¡274
¡¡¡¡¡¡Population Genetics¡¡¡¡¡¡275
¡¡¡¡¡¡Relationship Testing¡¡¡¡¡¡278
¡¡¡¡¡¡Blood Group Gene Mapping¡¡¡¡¡¡279
¡¡¡¡¡¡Gene, Protein, and Blood Group Terminology¡¡¡¡¡¡280
¡¡¡¡¡¡Blood Group Genomics¡¡¡¡¡¡281
¡¡¡¡¡¡Summary¡¡¡¡¡¡291
¡¡¡¡¡¡Key Points¡¡¡¡¡¡292
¡¡¡¡¡¡References¡¡¡¡¡¡293

10. ABO and Other Carbohydrate Blood Group Systems
¡¡¡¡¡¡The ABO system (001)¡¡¡¡¡¡297
¡¡¡¡¡¡The H System (018)¡¡¡¡¡¡310
¡¡¡¡¡¡The LE System (007)¡¡¡¡¡¡313
¡¡¡¡¡¡I and i Antigens of the I Blood Group System (027) and I Blood Group Collection¡¡¡¡¡¡315
¡¡¡¡¡¡P1PK (003) and GLOB (028) Blood Group Systems¡¡¡¡¡¡318
¡¡¡¡¡¡The FORS Blood Group System (031)¡¡¡¡¡¡323
¡¡¡¡¡¡The SID Blood Group System (038)¡¡¡¡¡¡323
¡¡¡¡¡¡Key Points¡¡¡¡¡¡323
¡¡¡¡¡¡References¡¡¡¡¡¡324

11. The Rh System
¡¡¡¡¡¡Historical Perspective¡¡¡¡¡¡329
¡¡¡¡¡¡Terminology¡¡¡¡¡¡332
¡¡¡¡¡¡Rh Locus¡¡¡¡¡¡333
¡¡¡¡¡¡RHD Genotype¡¡¡¡¡¡334
¡¡¡¡¡¡Antigens¡¡¡¡¡¡337
¡¡¡¡¡¡Rh Genotyping¡¡¡¡¡¡346
¡¡¡¡¡¡Rh Syndrome and the RhAG (030) Blood Group System¡¡¡¡¡¡347
¡¡¡¡¡¡Antibodies to Rh Blood Group System Antigens¡¡¡¡¡¡347
¡¡¡¡¡¡Technical Considerations for Rh Typing¡¡¡¡¡¡348
¡¡¡¡¡¡Key Points¡¡¡¡¡¡349
¡¡¡¡¡¡References¡¡¡¡¡¡350

12. Other Blood Group Systems and Antigens
¡¡¡¡¡¡The MNS System (002)¡¡¡¡¡¡359
¡¡¡¡¡¡The LU System (005)¡¡¡¡¡¡363
¡¡¡¡¡¡The KEL (006) and Xk (019) Systems¡¡¡¡¡¡364
¡¡¡¡¡¡The FY System (008)¡¡¡¡¡¡368
¡¡¡¡¡¡The JK System (009)¡¡¡¡¡¡370
¡¡¡¡¡¡The DI System (010)¡¡¡¡¡¡372
¡¡¡¡¡¡The YT System (011)¡¡¡¡¡¡373
¡¡¡¡¡¡The XG System (012)¡¡¡¡¡¡374
¡¡¡¡¡¡The SC System (013)¡¡¡¡¡¡374
¡¡¡¡¡¡The DO System (014)¡¡¡¡¡¡374
¡¡¡¡¡¡The CO System (015)¡¡¡¡¡¡375
¡¡¡¡¡¡The LW System (016)¡¡¡¡¡¡375
¡¡¡¡¡¡The CH/RG System (017)¡¡¡¡¡¡377
¡¡¡¡¡¡The GE System (020)¡¡¡¡¡¡377
¡¡¡¡¡¡The CROM System (021)¡¡¡¡¡¡378
¡¡¡¡¡¡The KN System (022)¡¡¡¡¡¡378
¡¡¡¡¡¡The IN System (023)¡¡¡¡¡¡379
¡¡¡¡¡¡The OK System (024)¡¡¡¡¡¡379
¡¡¡¡¡¡The RAPH System (025)¡¡¡¡¡¡379
¡¡¡¡¡¡The JMH System (026)¡¡¡¡¡¡379
¡¡¡¡¡¡The GIL System (029)¡¡¡¡¡¡380
¡¡¡¡¡¡The RHAG System (030)¡¡¡¡¡¡380
¡¡¡¡¡¡The JR System (032)¡¡¡¡¡¡380
¡¡¡¡¡¡The LAN System (033)¡¡¡¡¡¡380
¡¡¡¡¡¡The VEL System (034)¡¡¡¡¡¡381
¡¡¡¡¡¡The CD59 System (035)¡¡¡¡¡¡381
¡¡¡¡¡¡The AUG System (036)¡¡¡¡¡¡381
¡¡¡¡¡¡The KANNO System (037)¡¡¡¡¡¡382
¡¡¡¡¡¡The SID System (038)¡¡¡¡¡¡382
¡¡¡¡¡¡The CTL2 System (039)¡¡¡¡¡¡382
¡¡¡¡¡¡Antigens that Do Not Yet Belong to a Blood Group System¡¡¡¡¡¡382
¡¡¡¡¡¡Erythroid Phenotypes Caused by Mutations in Transcription Factor Genes¡¡¡¡¡¡384
¡¡¡¡¡¡Key Points¡¡¡¡¡¡384
¡¡¡¡¡¡References¡¡¡¡¡¡385

13. Identification of Antibodies to Red Cell Antigens
¡¡¡¡¡¡Basic Concepts in Red Cell Antigen Expression¡¡¡¡¡¡390
¡¡¡¡¡¡Initial Antibody Identification Consideration¡¡¡¡¡¡391
¡¡¡¡¡¡Basic Antibody Identification¡¡¡¡¡¡394
¡¡¡¡¡¡Complex Antibody Identification¡¡¡¡¡¡402
¡¡¡¡¡¡Selected Procedures¡¡¡¡¡¡414
¡¡¡¡¡¡Considerations Following Antibody Identification¡¡¡¡¡¡421
¡¡¡¡¡¡Immunohematology Reference Laboratories¡¡¡¡¡¡424
¡¡¡¡¡¡Key Points¡¡¡¡¡¡424
¡¡¡¡¡¡References¡¡¡¡¡¡425
¡¡¡¡¡¡Suggested Readings¡¡¡¡¡¡428

14. The Positive Direct Antiglobulin Test and Immune-Mediated Hemolysis
¡¡¡¡¡¡The DAT¡¡¡¡¡¡430
¡¡¡¡¡¡Autoimmune Hemolytic Anemia¡¡¡¡¡¡434
¡¡¡¡¡¡Drug-Induced Immune Hemolytic Anemia¡¡¡¡¡¡445
¡¡¡¡¡¡Key Points¡¡¡¡¡¡449
¡¡¡¡¡¡References¡¡¡¡¡¡449
Appendix 14-1. Drugs Associated with Immune Hemolytic Anemia¡¡¡¡¡¡452

15. Platelet and Granulocyte Antigens and AntibodiesPlatelet Antigens and Antibodies
¡¡¡¡¡¡Granulocyte Antigens and Antibodies¡¡¡¡¡¡469
¡¡¡¡¡¡Key Points¡¡¡¡¡¡473
¡¡¡¡¡¡References¡¡¡¡¡¡473

16. The HLA System
¡¡¡¡¡¡Biochemistry, Tissue Distribution, and Structure¡¡¡¡¡¡479
¡¡¡¡¡¡Genetics of the MHC¡¡¡¡¡¡484
¡¡¡¡¡¡HLA Typing¡¡¡¡¡¡488
¡¡¡¡¡¡Other Non-HLA Histocompatibility Determinants¡¡¡¡¡¡489
¡¡¡¡¡¡Crossmatching and Detection of HLA Antibodies¡¡¡¡¡¡490
¡¡¡¡¡¡The HLA System and Transfusion¡¡¡¡¡¡491
¡¡¡¡¡¡HLA Testing and Transplantation¡¡¡¡¡¡493
¡¡¡¡¡¡Other Clinically Significant Aspects of HLA¡¡¡¡¡¡495
¡¡¡¡¡¡Clinical Consultation in HLA¡¡¡¡¡¡497
¡¡¡¡¡¡Regulatory Aspects of Clinical Histocompatibility¡¡¡¡¡¡498
¡¡¡¡¡¡Future Directions¡¡¡¡¡¡498
¡¡¡¡¡¡Summary¡¡¡¡¡¡499
¡¡¡¡¡¡Key Points¡¡¡¡¡¡499
¡¡¡¡¡¡References¡¡¡¡¡¡499


E S S E N T I A L S O F T R A N S F U S I O N P R A C T I C E
17. Transfusion-Service-Related Activities: Pretransfusion Testing and Storage, Monitoring, Processing, Distribution, and Inventory Management of Blood Components
¡¡¡¡¡¡Samples and Requests¡¡¡¡¡¡503
¡¡¡¡¡¡Pretransfusion Testing of Recipient Blood¡¡¡¡¡¡504
¡¡¡¡¡¡Blood and Blood Component Storage and Monitoring¡¡¡¡¡¡509
¡¡¡¡¡¡Pretransfusion Processing¡¡¡¡¡¡518
¡¡¡¡¡¡Distribution¡¡¡¡¡¡522
¡¡¡¡¡¡Issuing of Components¡¡¡¡¡¡523
¡¡¡¡¡¡Inventory Management¡¡¡¡¡¡527
¡¡¡¡¡¡Key Points¡¡¡¡¡¡529
¡¡¡¡¡¡References¡¡¡¡¡¡530
Appendix 17-1. Sources of False-Positive Results in Antiglobulin Testing¡¡¡¡¡¡533
Appendix 17-2. Sources of False-Negative Results in Antiglobulin Testing¡¡¡¡¡¡534
Appendix 17-3. Causes of Positive Pretransfusion Test Results¡¡¡¡¡¡535

18. Administration of Blood Components
¡¡¡¡¡¡Events and Considerations Before Dispensing Components¡¡¡¡¡¡537
¡¡¡¡¡¡Blood Component Transportation and Dispensing¡¡¡¡¡¡542
¡¡¡¡¡¡Blood Administration¡¡¡¡¡¡543
¡¡¡¡¡¡Documentation of the Transfusion¡¡¡¡¡¡547
¡¡¡¡¡¡Unique Transfusion Settings¡¡¡¡¡¡548
¡¡¡¡¡¡Conclusion¡¡¡¡¡¡549
¡¡¡¡¡¡Key Points¡¡¡¡¡¡549
¡¡¡¡¡¡References¡¡¡¡¡¡550

19. Hemotherapy Decisions and Their Outcomes
¡¡¡¡¡¡Red Blood Cell Transfusion¡¡¡¡¡¡553
¡¡¡¡¡¡Platelet Transfusion¡¡¡¡¡¡561
¡¡¡¡¡¡Plasma Transfusion¡¡¡¡¡¡567
¡¡¡¡¡¡Cryoprecipitate Transfusion¡¡¡¡¡¡569
¡¡¡¡¡¡Granulocyte Transfusion¡¡¡¡¡¡570
¡¡¡¡¡¡Massive Transfusion Protocols¡¡¡¡¡¡571
¡¡¡¡¡¡Key Points¡¡¡¡¡¡573
¡¡¡¡¡¡References¡¡¡¡¡¡573

20. Patient Blood Management
¡¡¡¡¡¡Definition and Scope of Patient Blood Management¡¡¡¡¡¡583
¡¡¡¡¡¡Resources to Support a PBM Program¡¡¡¡¡¡584
¡¡¡¡¡¡Patient Blood Management Standards and Certification¡¡¡¡¡¡585
¡¡¡¡¡¡Methods of Patient Blood Management¡¡¡¡¡¡585
¡¡¡¡¡¡Data Collection¡¡¡¡¡¡600
¡¡¡¡¡¡Extremes of Transfusion¡¡¡¡¡¡605
¡¡¡¡¡¡Summary¡¡¡¡¡¡606
¡¡¡¡¡¡Key Points¡¡¡¡¡¡607
¡¡¡¡¡¡References¡¡¡¡¡¡607

21. Approaches to Blood Utilization Auditing
¡¡¡¡¡¡The Auditing Process¡¡¡¡¡¡614
¡¡¡¡¡¡Defining Audit Criteria¡¡¡¡¡¡615
¡¡¡¡¡¡Types of Blood Utilization Review¡¡¡¡¡¡617
¡¡¡¡¡¡Blood Utilization Review of Transfusions to High-Risk Patients¡¡¡¡¡¡620
¡¡¡¡¡¡The Role of a Computerized Provider Order Entry System in Blood Utilization Review¡¡¡¡¡¡620
¡¡¡¡¡¡Use of ¡°Big Data¡± to Assess Performance and Progress Measures in Transfusion Medicine¡¡¡¡¡¡621
¡¡¡¡¡¡Key Points¡¡¡¡¡¡623
¡¡¡¡¡¡References¡¡¡¡¡¡624

22. Noninfectious Complications of Blood Transfusion
¡¡¡¡¡¡Hemovigilance¡¡¡¡¡¡627
¡¡¡¡¡¡Recognition and Evaluation of a Suspected Transfusion Reaction¡¡¡¡¡¡627
¡¡¡¡¡¡Acute or Immediate Transfusion Reactions¡¡¡¡¡¡634
¡¡¡¡¡¡Delayed Transfusion Reactions¡¡¡¡¡¡648
¡¡¡¡¡¡Fatality Reporting Requirements¡¡¡¡¡¡652
¡¡¡¡¡¡Key Points¡¡¡¡¡¡653
¡¡¡¡¡¡References¡¡¡¡¡¡653


S P E C I A L P A T I E N T S A N D S I T U A T I O N S
23. Perinatal Issues in Transfusion Practice
¡¡¡¡¡¡Hemolytic Disease of the Fetus and Newborn¡¡¡¡¡¡659
¡¡¡¡¡¡Pregnancy-Related Thrombocytopenia¡¡¡¡¡¡665
¡¡¡¡¡¡Key Points¡¡¡¡¡¡668
¡¡¡¡¡¡References¡¡¡¡¡¡668

24. Neonatal and Pediatric Transfusion Practice
¡¡¡¡¡¡Hematopoiesis, Coagulation, and Physiology¡¡¡¡¡¡673
¡¡¡¡¡¡RBC Transfusion in Neonates¡¡¡¡¡¡675
¡¡¡¡¡¡RBC Transfusion in Infants Older than 4 Months and Children¡¡¡¡¡¡682
¡¡¡¡¡¡Platelet Transfusion in Neonates and Children¡¡¡¡¡¡685
¡¡¡¡¡¡Plasma and Cryoprecipitate Transfusion in Neonates and Children¡¡¡¡¡¡687
¡¡¡¡¡¡Granulocyte Transfusion in Neonates and Children¡¡¡¡¡¡688
¡¡¡¡¡¡Other Considerations Common to Transfusion of Neonates and Children¡¡¡¡¡¡689
¡¡¡¡¡¡Adverse Effects and Prevention¡¡¡¡¡¡694
¡¡¡¡¡¡Key Points¡¡¡¡¡¡695
¡¡¡¡¡¡References¡¡¡¡¡¡696

25. Therapeutic Apheresis
¡¡¡¡¡¡General Principles¡¡¡¡¡¡705
¡¡¡¡¡¡Device Modalities¡¡¡¡¡¡706
¡¡¡¡¡¡Patient Evaluation and Management¡¡¡¡¡¡707
¡¡¡¡¡¡Vascular Access¡¡¡¡¡¡709
¡¡¡¡¡¡Anticoagulation¡¡¡¡¡¡711
¡¡¡¡¡¡Adverse Effects¡¡¡¡¡¡711
¡¡¡¡¡¡Pediatric Apheresis¡¡¡¡¡¡713
¡¡¡¡¡¡Therapeutic Apheresis Indications¡¡¡¡¡¡713
¡¡¡¡¡¡Therapeutic Apheresis Procedure Documentation, Payment, and Provider Credentialing¡¡¡¡¡¡727
¡¡¡¡¡¡Key Points¡¡¡¡¡¡729
¡¡¡¡¡¡References¡¡¡¡¡¡730

26. The Collection and Processing of Hematopoietic Progenitor Cells
¡¡¡¡¡¡Clinical Utility¡¡¡¡¡¡737
¡¡¡¡¡¡Histocompatibility, Donor Type, and Graft Source¡¡¡¡¡¡741
¡¡¡¡¡¡HPC Collection¡¡¡¡¡¡743
¡¡¡¡¡¡Processing Human Progenitor Cells¡¡¡¡¡¡748
¡¡¡¡¡¡Specialized Cell-Processing Methods¡¡¡¡¡¡750
¡¡¡¡¡¡Cryopreservation¡¡¡¡¡¡751
¡¡¡¡¡¡Quality Control¡¡¡¡¡¡752
¡¡¡¡¡¡Shipping and Transporting HPC Cellular Products¡¡¡¡¡¡754
¡¡¡¡¡¡Patient Care¡¡¡¡¡¡754
¡¡¡¡¡¡Regulatory and Accreditation Considerations¡¡¡¡¡¡756
¡¡¡¡¡¡Conclusion¡¡¡¡¡¡757
¡¡¡¡¡¡Key Points¡¡¡¡¡¡757
¡¡¡¡¡¡References¡¡¡¡¡¡758

27. Transfusion Support for Hematopoietic Stem Cell Transplant Recipients
¡¡¡¡¡¡ABO Compatibility for Blood Component Selection Following HSCT¡¡¡¡¡¡768
¡¡¡¡¡¡Blood Component Support for HSCT Patients¡¡¡¡¡¡772
¡¡¡¡¡¡Pediatric Considerations¡¡¡¡¡¡773
¡¡¡¡¡¡Key Points¡¡¡¡¡¡774
¡¡¡¡¡¡References¡¡¡¡¡¡774

28. Human Tissue Allografts and the Hospital Transfusion Service
¡¡¡¡¡¡Tissue Donation and Transplantation¡¡¡¡¡¡777
¡¡¡¡¡¡Federal Regulations, State Laws, and Professional Standards¡¡¡¡¡¡782
¡¡¡¡¡¡Hospital Tissue Services¡¡¡¡¡¡784
¡¡¡¡¡¡Key Points¡¡¡¡¡¡789
¡¡¡¡¡¡References¡¡¡¡¡¡790


Index¡¡¡¡¡¡793
 
 
 
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