Blood Bank Guy Essentials Podcast

Transfusion-associated Graft-versus-Host Disease (TA-GVHD) is a notoriously deadly but thankfully rare transfusion complication. Blood banks have used irradiation of cellular blood products for decades to prevent TA-GVHD, but clinicians and laboratorians still sometimes misunderstand what irradiation does and does not do. Dr. Chris Tormey from Yale details the past, present, and future of blood product irradiation in this practical and timely interview. NOTE: CE credit has expired for this episode.

David Oh, Chief Medical Officer of Hoxworth Blood Center, and Mike Goodman, Associate Professor of Surgery at the University of Cincinnati, dive into the implementation of low-titer, cold-stored whole blood for trauma care. They share insights on transitioning from traditional transfusion methods to modern practices affecting patient outcomes. The duo discusses the intricacies of blood type selection, storage expiration adjustments, and the role of clinician-led committees in decision-making. They even explore future applications of trauma whole blood in other medical fields!

For decades, neonates (especially in the United States) have been given platelet transfusions at considerably higher platelet counts than thresholds used in adults. New data suggests, however, that "less may be more" when it comes to transfusing platelets to these tiny and vulnerable patients! Dr. Martha Sola-Visner, a neonatologist from Boston, joins me to discuss the results of a recent large study that challenges our assumptions about neonatal platelet transfusion. NOTE: CE credit has expired for this episode.

Dr. Nancy Dunbar, co-editor of the American Society for Apheresis Guidelines, discusses the newly released therapeutic apheresis guidelines and their impact on clinical practice. The podcast covers the evolution of apheresis guidelines, understanding the grade system and category recommendations, and the changes in the 2019 special issue. It also highlights the updated indications and criteria for creating new fact sheets in the guidelines.

Alloimmunization after red blood cell (RBC) transfusion is a huge challenge in the treatment of sickle cell disease (SCD). Even when donors and patients are "matched," anti-Rh antibodies in patients with sickle cell disease are formed way often than we would like or expect. Further, Dr. Stella Chou has shown that nearly a third of patients with those new antibodies actually have hemolytic transfusion reactions! It's a huge problem. In this interview, Dr. Chou, a pediatric hematologist from Philadelphia, shows that the problem comes in part from widespread genetic RH variations in both Black blood donors and patients with sickle cell disease. She models a future direction that may help us finally solve this problem once and for all: Genotype matching of donors and patients! NOTE: CE credit has expired for this episode.

Beth Shaz, distinguished researcher investigating TRALI prevention, discusses transfusion-related acute lung injury (TRALI) and its diagnosis, the importance of ruling out heart issues, activating neutrophils, differentiating HLA and HNA antibodies, and strategies for preventing TRALI. The podcast also explores residual risk and future prospects in TRALI prevention, decreasing rates of TRALI, and the importance of continued progress.

Dr. Pierre Tibi, a cardiac surgeon from Arizona and Patient Blood Management advocate, shares insights into the evolving practices of transfusion in cardiac surgery. He discusses his transformative journey influenced by Jehovah's Witness patients and emphasizes the importance of minimizing unnecessary transfusions. The conversation covers anticoagulation management, the exciting potential of platelet-rich plasma in surgeries, and the role of antifibrinolytics in optimizing blood management. Tibi highlights teamwork's critical role in enhancing patient care and outcomes.

It feels like everyone is talking about patient blood management. That's a GOOD thing, but does it really mean what they think it means? Dr. Carolyn Burns joins me to discuss "Five Things Patients and Physicians Should Question" regarding blood management, and what she has to say may show you that you are NOT doing everything you can or should with PBM in your facility. NOTE: CE credit has expired for this episode.

In this engaging discussion, Dr. Jerry Sandler, a Professor of Pathology at Georgetown University and a transfusion medicine expert, reveals surprising insights into IgA deficiency and its link to anaphylactic transfusion reactions. He emphasizes the rarity of true anaphylaxis in individuals with IgA deficiency and challenges long-held beliefs in the medical community. The conversation also highlights the importance of mentorship and the need for safe transfusion practices, particularly around effective products like Octoplas for patients with anaphylactic histories.

Jehovah's Witnesses refuse transfusion based on strong religious beliefs, but the "rules" can be confusing. Transfusion Medicine professionals are often called to help clinicians manage Witnesses' care (despite the fact that these patients will not accept most of what we supply!). In this interview, Jed Gorlin details how to be helpful, respectful, and a great team member in the care of Jehovah's Witnesses who refuse transfusion.