Transfusion medicine (or transfusiology) is the branch of medicine that encompasses all aspects of the
transfusion of blood and
blood component
Whole blood (WB) is human blood from a standard blood donation. It is used in the treatment of massive bleeding, in exchange transfusion, and when people donate blood to themselves. One unit of whole blood (~517 mls) brings up hemoglobin level ...
s including aspects related to hemovigilance. It includes issues of
blood donation,
immunohematology Immunohematology is a branch of hematology and transfusion medicine which studies antigen-antibody reactions and analogous phenomena as they relate to the pathogenesis and clinical manifestations of blood disorders. A person employed in this field ...
and other laboratory testing for transfusion-transmitted diseases, management and monitoring of clinical transfusion practices,
patient blood management, therapeutic
apheresis
Apheresis ( ἀφαίρεσις (''aphairesis'', "a taking away")) is a medical technology in which the blood of a person is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation ...
,
stem cell
In multicellular organisms, stem cells are undifferentiated or partially differentiated cells that can differentiate into various types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type o ...
collections,
cellular therapy
Cell therapy (also called cellular therapy, cell transplantation, or cytotherapy) is a therapy in which viable cells are injected, grafted or implanted into a patient in order to effectuate a medicinal effect, for example, by transplanting T-c ...
, and
coagulation
Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism o ...
. Laboratory management and understanding of state and federal regulations related to blood products are also a large part of the field.
Overview
In most countries,
immunohematology Immunohematology is a branch of hematology and transfusion medicine which studies antigen-antibody reactions and analogous phenomena as they relate to the pathogenesis and clinical manifestations of blood disorders. A person employed in this field ...
and transfusion medicine specialists provide expert opinion on
massive transfusions, difficult/incompatible transfusions and rational use of specialised blood product therapy like
irradiated blood/
leukodepleted/washed blood products.
The blood donor center is the facility that collects blood components from screened blood donors, either whole blood or separate components such as plasma or platelets only via apheresis. These blood components are then transported to a central location for processing such as fractionation, testing and redistribution. The testing includes determining blood type and testing for infectious diseases. Whole blood is fractionated into red blood cells, platelets and plasma whilst plasma can be further refined into separate components such as albumin, clotting factor concentrates and immunoglobulin.
The
blood bank
A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a department of a hospital usually within a Clinical Pathology laborat ...
is the section of the clinical laboratory where
laboratory scientists store and distribute
blood component
Whole blood (WB) is human blood from a standard blood donation. It is used in the treatment of massive bleeding, in exchange transfusion, and when people donate blood to themselves. One unit of whole blood (~517 mls) brings up hemoglobin level ...
s. Both areas are typically overseen by a specialist in transfusion medicine. Transfusion medicine was earlier a branch of
clinical pathology
Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates or extracts using the tools of chemistry, microbiology, h ...
, however the field has now expanded into a clinical, hospital-based specialty. The practice of transfusion medicine involves both laboratory and clinical aspects of transfusion as communication between blood bank and patients, treating specialists and other medical staff is vital in situations such as massive transfusions or
transfusion reactions
Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mod ...
.
To ensure the safety of blood components, regimented procedures and quality assurance systems must be in place covering all aspects of the transfusion chain, from donation to transfusion outcomes. Within hospitals, transfusion committees are established to ensure safe hospital transfusion practice such as compliance with standards and guidelines, reviewing transfusion reactions and management of blood supply. These multidisciplinary committees are composed of transfusion medicine specialists,
transfusion nurses, laboratory scientists, clinicians and staff from hospital management and the quality team.
History
In 1628,
English
English usually refers to:
* English language
* English people
English may also refer to:
Peoples, culture, and language
* ''English'', an adjective for something of, from, or related to England
** English national ide ...
physician
William Harvey
William Harvey (1 April 1578 – 3 June 1657) was an English physician who made influential contributions in anatomy and physiology. He was the first known physician to describe completely, and in detail, the systemic circulation and propert ...
discovered that blood circulates around the body. Soon thereafter, the first blood transfusion was attempted. In 1665 another English doctor
Richard Lower successfully used blood transfusion between dogs to keep them alive.
Karl Landsteiner
Karl Landsteiner (; 14 June 1868 – 26 June 1943) was an Austrian-born American biologist, physician, and immunologist. He distinguished the main blood groups in 1900, having developed the modern system of classification of blood groups from ...
is recognized as the father of transfusion medicine. Landsteiner is credited with the first classification of human blood into the four types (A, B, AB, O) of the
ABO blood group system
The ABO blood group system is used to denote the presence of one, both, or neither of the A and B antigens on erythrocytes. For human blood transfusions, it is the most important of the 43 different blood type (or group) classification system ...
.
National differences and how to specialise
Australia
In Australia, transfusion medicine is a sub-specialty of haematology. Training in transfusion medicine is covered by the Royal College of Pathologists of Australasia (RCPA).
Australia has national blood services operated by the
Australian Red Cross Blood Service
Australian Red Cross Lifeblood, simply known as Lifeblood, is a branch of the Australian Red Cross responsible for the collection and distribution of blood and biological products in Australia. Lifeblood employs around 3,700 employees across ...
. There are a series of guidelines and standards relevant to the laboratory released by the National Association of Testing Authorities, Australia (NATA), Australian and New Zealand Society of Blood Transfusion (ANZSBT) and RCPA. Similarly, there are a series of clinical practice
patient blood management guidelinesby the National Blood Authority.
In Australia, the Serious Transfusion Incident Reporting (STIR) system is in place to capture serious transfusion incidents and near-miss incidents.
;Denmark
In Denmark, the subject is covered by the specialty, "Clinical Immunology".
;Germany
In Germany, transfusion medicine is an independent specialty. Physicians complete a three-year residency in transfusion medicine and two years in another relevant clinical settings like internal medicine or surgery.
;India
In India, Immunohematology and Transfusion Medicine is a medical post graduate specialty (MD) recognized by Medical Council of India since 2009.
;Malaysia
Physicians completing their internship may pursue a four-year Master of Medicine (Transfusion Medicine) programme to specialize in transfusion medicine in Malaysia. They are eligible for registration with National Specialist Registry as transfusion medicine specialists after completion of gazettement upon graduation. Transfusion medicine specialists in Malaysia may further their sub-specialty training in the field of immunohaematology, cord blood, patient blood management, cellular therapy, and regenerative medicine.
;Norway
In Norway, the subject is covered by the specialty, "Immunology and Transfusion medicine"
;United Kingdom
In the United Kingdom, transfusion medicine is a sub-speciality of
hematology
Hematology ( always spelled haematology in British English) is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood. It involves treating diseases that affect the produc ...
.
Serious Hazards of Transfusion
Serious Hazards of Transfusion (SHOT) is the United Kingdom's haemovigilance scheme.
It collects and analyses anonymized information on adverse events and blood transfusion reactions. When SHOT has identified risks related to transfusion, it produ ...
(SHOT) collects and analyses reports of adverse events related to transfusion, aiming to improve patient safety. Its reports have led to wider training for medical staff in the UK and a central reporting scheme to allow errors to be reported.
There is the Better Blood Continuing Education Programme, which is organised by the
EUB which is part of the
SNBTS. The EUB consists of many specialist
healthcare professionals. The programme's aim is to improve transfusion medicine practise. The programme is reviewed each annually in January.
In the UK, there are restrictions in place to decrease the risk of the transmission of
Creutzfeldt–Jakob disease
Creutzfeldt–Jakob disease (CJD), also known as subacute spongiform encephalopathy or neurocognitive disorder due to prion disease, is an invariably fatal degenerative brain disorder. Early symptoms include memory problems, behavioral changes, ...
.
;United States
Physicians from a wide range of backgrounds, including
pathology
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
,
internal medicine,
anesthesiology
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...
and
pediatrics
Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until th ...
, are eligible for board certification in Transfusion Medicine following a 1–2 year fellowship. It is a board-certified sub-specialty recognized by the
American Board of Pathology
The American Board of Pathology (ABPath) is one of 24 member boards of the American Board of Medical Specialties. This organization was assembled in May 1936, under the approval of the Advisory Board for Medical Specialties (ABMS) and the American ...
.
These specialists are often considered consultants for physicians who require expert advice on the subjects listed above. Transfusiology is not a recognized term in the US.
See also
*
Blood transfusion
Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...
*
List of blood donation agencies
This is a list of blood donation agencies in different countries.
Australia
* Australian Red Cross Lifeblood
Bangladesh
* Bangladesh Red Crescent Society
* Sandhani
* Roktodane Sirajganj (RS)
Belgium
* Belgian Red Cross
Canada
* ...
Notes and references
External links
Professional Organization: International Society of Blood TransfusionProfessional Organization: AABB
{{DEFAULTSORT:Transfusion Medicine