Christopher A. Tormey

Evidence-based practice guidelines for plasma transfusion

BACKGROUND: There is little systematically derived evidence‐based guidance to inform plasma transfusion decisions. To address this issue, the AABB commissioned the development of clinical practice guidelines to help direct appropriate transfusion of plasma.

Red blood cell alloantibody frequency, specificity, and properties in a population of male military veterans

BACKGROUND: The prevalence of red blood cell (RBC) alloantibodies among general, hospital‐based patients typically has averaged approximately 1 percent in various studies. The frequency and properties of RBC alloantibodies in military veterans has never been examined.

The persistence and evanescence of blood group alloantibodies in men

BACKGROUND: Non‐ABO blood group (BG) alloantibodies can disappear over time, confounding compatibility testing and predisposing patients to delayed hemolytic transfusion reactions. The goal of this study was to analyze BG antibody disappearance after transfusion‐related alloimmunization in men.

Educating medical students in laboratory medicine: a proposed curriculum.

As the 100th anniversary of the Flexner report nears, medical student education is being reviewed at many levels. One area of concern, expressed in recent reports from some national health care organizations, is the adequacy of training in the discipline of laboratory medicine (also termed clinical pathology). The Academy of Clinical Laboratory Physicians and Scientists appointed an ad hoc committee to review this topic and to develop a suggested curriculum, which was subsequently forwarded to the entire membership for review. The proposed medical student laboratory medicine curriculum defines goals and objectives for training, provides guidelines for instructional methods, and gives examples of how outcomes can be assessed. This curriculum is presented as a potentially helpful outline for use by medical school faculty and curriculum committees.

Immunogenicity of blood group antigens: a mathematical model corrected for antibody evanescence with exclusion of naturally occurring and pregnancy-related antibodies.

Blood group antigen immunogenicity is a crucial factor in red blood cell alloimmunization. Previous calculated estimates of immunogenicity suffered from several key shortcomings. To address these issues we have (1) introduced a correction factor for antibody persistence rates into traditional immunogenicity calculations, (2) calculated immunogenicities only in men to eliminate pregnancy-related antibodies, and (3) excluded antibodies reactive only at room temperature to minimize the contribution of naturally occurring antibodies. With these corrections, we have calculated the immunogenicities of common blood group antigens using data collected on clinically significant alloantibodies (n = 452) in a male patient population. We observed a 3- to 5-fold increase in immunogenicity for some antigens (ie, Jk(a), C(w), Lu(a)) and smaller changes in others compared with traditionally calculated estimates. In addition, we have calculated the transfusion-related immunogenicities of antigens traditionally associated with naturally occurring antibodies (eg, anti-Le(a), -Le(b), -M, and -P(1)).

Bridging channel dendritic cells induce immunity to transfused red blood cells

Calabro et al. show that 33D1+ dendritic cells present in the bridging channel of the spleen are essential for alloantibody response to transfused red blood cells.

Pathology Consultation on Reporting of Critical Values

Among the most important functions of a pathology or laboratory medicine service is the clear, accurate, and rapid communication of critical test results (critical values) to patient care providers. Pathologists and laboratory professionals are often confronted with many obstacles in the reporting of such critical values, including establishing clinically relevant criteria for critical values, resolving difficulties in locating an ordering provider when a critical value is obtained, and ensuring that the provider understands the severity and implications of a critical result when he or she has questions. This article presents a hypothetical (yet fairly common) clinical case scenario regarding critical values and then provides an up-to-date discussion and review of the literature on the reporting of critical results.

Rapid clearance of transfused murine red blood cells is associated with recipient cytokine storm and enhanced alloimmunogenicity

BACKGROUND: Fourteen‐day stored red blood cells (RBCs) containing an RBC‐specific transgenic antigen (HOD) induce a recipient proinflammatory cytokine storm and are significantly more immunogenic compared to fresh RBCs. Given that recipient mice clear transfused stored RBCs more rapidly than fresh RBCs, we hypothesized that rapid RBC clearance was associated with adverse transfusion outcomes.

Analysis of transfusion reactions associated with prestorage-pooled platelet components

BACKGROUND: The goal of this study was to assess transfusion reactions arising from prestorage‐pooled platelet (PSPP) infusions compared with apheresis single‐donor platelets (SDPs) and poststorage‐pooled, whole blood–derived random‐donor platelets (RDPs).

Improved plasma removal efficiency for therapeutic plasma exchange using a new apheresis platform

BACKGROUND: The Spectra Optia (SPO; CaridianBCT) is a new apheresis device based on the COBE Spectra (CSP; CaridianBCT) platform. This study was designed to evaluate the safety and efficiency of the SPO in comparison to the predicate CSP device.