BBDash: An Electron-based tool for analyzing blood product utilization.

Blood transfusions can be associated with side effects ranging from occasional febrile reactions to extremely rare fatal reactions. Monitoring blood product orders and ensuring appropriate utilization is therefore an important strategy to ensure patient safety. However, data extracted from laboratory information systems can be difficult to interpret.

Differentiating patient characteristics between platelet refractory patients with and without antibodies to human leukocyte antigens.

Background: Predicting whether a patient's platelet refractoriness (PR) is due to immune or nonimmune causes can be challenging. This study compared the demographics and clinical history of PR patients with human leukocyte antigen (HLA) antibodies (HLA-PR) versus PR patients without HLA antibodies.

Materials And Methods: A retrospective review of all patients with PR consults at a single institution over a 3-year period was performed.

A Single-Center Description of Pediatric Transfusion Reactions and Preventable Patient Harm.

Background And Objectives: In previous studies, researchers highlight that children have higher rates of transfusion reactions than adults. However, little is known about the pediatric populations that experience reactions, and there are no reports that consider appropriateness of pediatric transfusions in relation to preventable harm. With this study, we aim to describe pediatric transfusion reactions occurring at an academic institution and to quantify transfusion reactions that resulted from inappropriate transfusion indications, thereby identifying an area of potentially preventable patient harm (PPH).

Modeling global transfusion medicine education.

This document provides an analysis and oversight of the necessary educational infrastructure at national level needed for successful and sustainable education programs undergraduate and post-graduate and is focused on desired outcomes needed to secure general Transfusion Medicine (TM) competence and basic skills when appointed in a professional TM position. It provides a global model framework for TM education allowing individual countries to tailor the context and contents of the institutional curriculum. Education in transfusion medicine is a complex set of intimately interrelated and interconnected components that allow student and fellow exposure to knowledge and skills, the ultimate curriculum.

Transfusion medicine and blood banking education and training for blood establishment laboratory staff: A review of selected countries in Africa.

Background: Avoidable human error is a significant cause of transfusion adverse events. Adequately trained, laboratory staff in blood establishments and blood banks, collectively blood facilities, are key in ensuring high-quality transfusion medicine (TM) services. Gaps in TM education and training of laboratory staff exist in most African countries.

CRISPR/Cas9 for the Clinician: Current uses of gene editing and applications for new therapeutics in oncology.

Precise genomic editing has given rise to treatments in previously untreatable genetic diseases and has led to revolutions in treatment for cancer. In the past decade, the discovery and development of clustered regularly interspaced short palindromic repeats (CRISPR) technologies has led to advances across medicine and biotechnology. Specifically, the CRISPR/Cas9 system has improved translational discovery and therapeutics for oncology across tumor types.

Global survey of transfusion medicine curricula in medical schools: Challenges and opportunities.

Background: Physician's knowledge in transfusion medicine (TM) is critical for patient safety. Therefore, ensuring that medical schools provide adequate education in TM is important. The aim of this study was to assess the status of TM education at a global level.

Overtransfusion of Autologous Blood Identifies Opportunities for Improving Patient Blood Management.

Background Preoperative autologous blood donation (PABD) has been declining in use nationally. A subset of patients scheduled for elective surgery, however, continue to be offered and choose this option. Our study aimed to understand the current impact of PABD before scheduled surgical procedures.

Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost.

Objectives: Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT.

PIFA PLUSS P4 Assay for Screening of Heparin-Induced Thrombocytopenia.

Background: The PIFA PLUSS PF4 Rapid Assay (PIFA) is a rapid screening test used for the diagnosis of heparin-induced thrombocytopenia (HIT).

Objective: To determine the usefulness of this assay as a screening method in our institution.

Methods: A total of 159 specimens from patients with suspected HIT were included in our study.

Acute autoimmune hemolytic anemia due to anti-En autoantibody successfully treated with rituximab.

Background: Autoimmune hemolytic anemia (AIHA) due to anti-En has been previously reported in association with massive intravascular hemolysis, disseminated intravascular coagulation, and fatal outcomes. Here we report a case of successfully treated AIHA due to anti-En .

Case Report: A 69-year-old male with a past medical history of cirrhosis due to nonalcoholic steatohepatitis status post-orthotopic liver transplant presented with 1-month history of progressive anemia.

Short-Term Experience with Off-Pump Versus On-Pump Implantation of the HeartWare Left Ventricular Assist Device.

Implantation of left ventricular assist devices while avoiding cardiopulmonary bypass (CPB) may decrease bleeding and improve postoperative recovery. To understand the effectiveness of this approach, we reviewed the charts of 26 patients who underwent HeartWare left ventricular assist device (HVAD) implantation without use of CPB (off-CPB group) and 22 patients who had HVAD implanted with CPB (CPB group) with an emphasis on the 30 day postoperative period. Preoperatively, both groups had similar demographic, functional, and hemodynamic characteristics.

Bioinformatics Analysis to Determine Prognostic Mutations of 72 de novo Acute Myeloid Leukemia Cases from the Cancer Genome Atlas (TCGA) with 23 Most Common Mutations and no Abnormal Cytogenetics.

Objectives: Up to 40% of acute myeloid leukemia (AML) patients have normal cytogenetics (CN-AML) but they may have gene mutations. An important issue in the treatment of CN-AML is how gene mutation patterns may help with patient management. The Cancer Genome Atlas (TCGA) database has data from 200 cases of de novo AML including cytogenetics, gene mutations, and survival duration (prognosis).

Post-operative bleeding risk stratification in cardiac pulmonary bypass patients using artificial neural network.

The prediction of bleeding risk in cardiopulmonary bypass (CPB) patients plays a vital role in their postoperative management. Therefore, an artificial neural network (ANN) to analyze intra-operative laboratory data to predict postoperative bleeding was set up. The JustNN software (Neural Planner Software, Cheshire, England) was used.

Interpretation of coagulation test results using a web-based reporting system.

Background: Web-based synoptic reporting has been successfully integrated into diverse fields of pathology, improving efficiency and reducing typographic errors. Coagulation is a challenging field for practicing pathologists and pathologists-in-training alike.

Objective: To develop a Web-based program that can expedite the generation of a individualized interpretive report for a variety of coagulation tests.

How do we manage cardiopulmonary bypass coagulopathy?

Background: Patients who undergo cardiopulmonary bypass (CPB) are at risk for coagulopathy. Suboptimal turnaround time (TAT) of laboratory coagulation testing results in empiric administration of blood products to treat massive bleeding. We describe our initiative in establishing the coagulation-based hemotherapy (CBH) service, a clinical pathology consultation service that uses rapid TAT coagulation testing and provides comprehensive assessment of bleeding in patients undergoing CPB.

Mobile computing platform with decision support modules for hemotherapy.

Objectives: We describe the development of a mobile computing platform (MCP) with a decision support module (DSM) for patients in our coagulation-based hemotherapy service.

Methods: The core of our MCP consists of a Microsoft Excel spreadsheet template used to gather and compute data on cardiopulmonary bypass (CPB) patients intraoperatively. The DSM is embedded into the Excel file, where the user would enter in laboratory results, and through our 45 embedded algorithms, recommendations for transfusion products would be displayed in the Excel file.

Abdominal aortic calcification and renal resistive index in patients with chronic kidney disease: is there a connection?

Background: We aimed to evaluate the relationship between abdominal aortic calcification (AAC) and renal resistive index (RRI), parameters associated with cardiovascular outcome, in non-dialysis chronic kidney disease (CKD) patients.

Methods: Seventy-seven stable patients mainly in CKD stages 3B and 4 (44 and 28%), median age 69 years, with a positive history of systemic atherosclerosis were prospectively enrolled. RRI, carotid intima-media thickness (IMT), Kauppila score for AAC (AACs), cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) were assessed.

Comparison between 1-needle technique versus 2-needle technique for bone marrow aspiration and biopsy procedures.

Context: Bone marrow examination is essential for diagnosis and staging of hematologic disorders. Traditionally, the bone marrow biopsy and aspirate are obtained with 2 needles at 2 separate sites. This approach is associated with significant discomfort, procedural time, and occasionally, morbidity.

Standardized protocol to identify high-risk patients undergoing therapeutic apheresis procedures.

As the scope of therapeutic apheresis (TA) expands and more procedures are requested for critically ill patients, adverse reactions (AR) associated with TA become a major concern for physicians, nurses, patients and their families. To assess the risks for ARs associated with patients' underlying diseases, we developed a preprocedure assessment tool with a set of high-risk criteria which included: (1) unstable vital signs, (2) active nonphysiological bleeding, (3) evidence of severe bronchoconstriction, (4) severe anemia, (5) projected extracorporeal volume (ECV) >15% of total blood volume (TBV) in adults or >10% of TBV in pediatric patients, (6) pregnancy, and (7) conditions requiring continuous nursing support. A standard operating procedure with a "Request for Apheresis Procedure on High-Risk Patient" form and protocol were developed to identify patients as high-risk before initiation of a TA procedure.

Exclusive use of acid citrate dextrose for anticoagulation during extracorporeal photopheresis in patients with contraindications to heparin: an effective protocol.

Extracorporeal photopheresis (ECP) routinely uses heparin for anticoagulation. For patients with contraindications to heparin, alternative anticoagulation using acid citrate dextrose (ACD-A) has been reported to be safe and effective. However, detailed ECP protocols that exclusively use ACD-A anticoagulation and minimize citrate toxicity have not yet been published.

Thrombopoietin enhances generation of CD34+ cells from human embryonic stem cells.

The role of thrombopoietin (TPO) in adult hematopoiesis is well-established. A recent report suggests that TPO and vascular endothelial growth factor (VEGF) play a role in promoting formation of early erythropoietic progenitors in a nonhuman primate embryonic stem cell (ES) model. No such report exists for human ES cells as yet.

Chimerism and tolerance post-in utero transplantation with embryonic stem cells.

Background: Clinical application of in utero transplantation (IUT) in human fetuses with intact immune systems resulted in a very low level of donor chimerism. In this study, we examined whether the fetal immune system early in the second trimester of pregnancy (13.5 dpc) can initiate immune tolerance for major histocompatibility complex (MHC)-mismatched embryonic stem (ES) cells.