Blood transfusion is considered a life-saving therapy since ancient times, but, at the same time, a high-risk procedure. Nowadays the common perception is that infection is the greatest risk, even if the blood has never been safer from this point of view. Currently, the residual risk of transfusion must be related mainly to immunological mechanisms underlying to AB0 and minor blood systems, to compatibility of blood transfused and to development of irregular antibodies in transfused patients.
"Transfusion Medicine and Patient Safety" aims to provide the basic of immunohematology to readers and to analyze the transfusional process highlighting the most critical points, thus more exposed to errors.
Screening on blood and blood components for infectious diseases along with the surveillance action on emerging viruses results in the drastic reduction of post-transfusion infection, together with the potential to further increase the level of security from infection through the inactivation of blood components.
The text also describes the major diagnostic systems and organizational models that modern technology provides us with a correct immunohematological diagnosis and an appropriate trasfusional therapy.
Inhaltsverzeichnis
1;Introduction;7 2;1 Basics of transfusion medicine;11 2.1;1.1 The ABO and Rh blood group systems;11 2.2;1.2 Other blood group systems;20 2.2.1;1.2.1 The MNSs system;21 2.2.2;1.2.2 The P system;21 2.2.3;1.2.3 The Lutheran system;21 2.2.4;1.2.4 The Kell system;22 2.2.5;1.2.5 The Lewis system;22 2.2.6;1.2.6 The Duffy system;22 2.2.7;1.2.7 The Kidd system;23 2.2.8;1.2.8 The Diego system;23 2.2.9;1.2.9 The Xg-a system;24 2.2.10;1.2.10 The Dombrock system;24 2.2.11;1.2.11 The Colton system;24 2.2.12;1.2.12 The Chido/Rodgers system;24 2.2.13;1.2.13 The Cromer system;24 2.2.14;1.2.14 The I/i system;24 2.3;1.3 Natural and immune antibodies;25 2.4;1.4 Transfusion guidelines;27 2.4.1;1.4.1 Indications for the transfusion of concentrated red blood cells;28 2.4.2;1.4.2 Indications for the transfusion of platelet concentrates;31 2.4.3;1.4.3 Indications for the transfusion of fresh frozen plasma;32 2.4.4;1.4.4 Indications for the transfusion of leukodepleted blood components;33 2.4.5;1.4.5 Indications for the transfusion of irradiated blood components;35 2.4.6;1.4.6 Indications for granulocyte transfusions;36 2.4.7;1.4.7 Virus-inactivated blood components;36 2.4.8;1.4.8 Complications of transfusion therapy;38 3;2 The transfusion process;45 3.1;2.1 Blood donation;45 3.2;2.2 Donating multiple blood components;47 3.3;2.3 Preparation of blood and blood components;48 3.4;2.4 The immunohematology laboratory;49 3.5;2.5 The immunohematology laboratory;54 3.5.1;2.5.1 Studying the Rh system;54 3.5.2;2.5.2 Detecting allo-antibodies to red cell antigens;56 3.6;2.6 Transfusion request forms and the administration of blood and blood components;60 4;3 Automation and computerization of the transfusion process;65 4.1;3.1 Automation as a safety factor;65 4.2;3.2 Computerization of the transfusion process: from donor to patient;70 4.3;3.3 The computerized transfusion network;75 4.4;3.4 Hemovigilance;77 4.5;3.5 What can be improved in the future?;81 5;4 Biological validation of blood components;83 5
.1;4.1 Molecular and serological methods;83 5.1.1;4.1.1 Serological investigations;84 5.1.2;4.1.2 Molecular investigations;85 5.1.3;4.1.3 Structure of the DNA;85 5.1.4;4.1.4 Real-time PCR;88 5.1.5;4.1.5 PCR-TMA;90 5.2;4.2 Decision-making and the quality system;94 5.3;4.3 Risk management versus patient safety: medicolegal considerations;105 6;5 Error in transfusion medicine;115 7;Index;119
