Blood Bank Guy Essentials Podcast

Dr. Will Savage, an assistant professor at Harvard University and medical director at Brigham and Women's Hospital, dives into the nuances of Allergic Transfusion Reactions (ATRs). He challenges the perception of ATRs as mere nuisances, revealing their complexities and potential severity. The discussion covers the differences between mild and severe reactions, the surprising links between hay fever and transfusion allergies, and critiques common management practices. Savage emphasizes the critical importance of education and individualized patient care in transfusion medicine.

Dr. Jeff Carson is lead author of the 2016 AABB RBC Transfusion Threshold Guidelines published online in JAMA in October 2016. This article updates the 2012 AABB Guidelines, and incorporates lots of new information from recently published studies. He joins Dr. Chaffin to discuss how to use these guidelines in everyday practice.

Red blood cells, in most countries, can be stored for up to 42 days. In the last ten years, there have been numerous observational studies suggesting that "older" blood may be harmful to recipients. In one of my favorite interviews, Nancy Heddle, lead author of the INFORM study (NEJM Oct 24, 2016) tells us why we shouldn't worry!

Despite having possibly the silliest acronym in the history of medicine (in Dr. Chaffin's opinion!), TACO is a very serious disease. It is responsible for the second-most number of deaths from transfusion every year in the United States (and is #1 in the United Kingdom). TACO is not something to mess around with, but far too many clinicians and blood bankers fail to give it the respect it deserves. Dr. Garrett Booth joins Dr. Chaffin in an energetic and fast-moving discussion of the "ins and outs" of TACO.

Most would agree that today's transfusions are really safe from potential infectious disease transmission. There are still a few situations that worry blood bankers, like the risk of bacterial contamination of platelets (despite our best efforts) and emerging infections like Zika virus. One potential solution to these issues is called "pathogen inactivation" (also called pathogen reduction by many). Dr. McCullough tells us all about it! (Note: This is an updated version that eliminates the 15 second gap left in the first version at 45 minutes or so)

Cryoprecipitate is easily the most misunderstood blood product, and lots of confusion surrounds it (not just among clinical folks!). Dr. Chaffin and co-host Dr. Heidi Shafi give you five "Essentials" of cryoprecipitate to set record straight!

Many, many clinicians routinely order premedication of their patients with acetaminophen and diphenhydramine before transfusion, believing that using those medications will prevent allergic and febrile transfusion reactions, respectively. Maybe not! Dr. Heidi Shafi discusses the available data that says that this practice may not make sense.

Dr. Mark Fung, blood bank doctor and editor of the AABB Technical Manual, discusses the management of transfusion reactions. They explore the importance of rational utilization in blood banking, standardized definitions for adverse events, and diagnosing hypotensive transfusion reactions and dyspnea. The podcast also covers the NHSN criteria for assigning transfusion reactions, considerations for hemolysis workup, allergic symptoms, pain during transfusion, and risk-benefit discussions in thrombocytopenia, pancytopenia, and hemolysis cases.

In July 2016, I updated you on the current U.S. strategy on preventing Zika transmission by blood. As expected, things have changed, and this is a short update to let you know what is happening as of September 2016.

Plasma transfusion is not as easy as it sounds! Over half of transfusions have been shown to be unnecessary. Dr. Jeannie Callum from Toronto joins Dr. Chaffin for this extensive discussion designed to dispel some myths and show you how it SHOULD be!