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Handbook of Blood Banking & Transfusion Medicine
Gundu HR Rao, Ted Eastlund, Latha Jagannathan
BLOOD BANKING
1:
Transfusion Medicine of Today and the Future
TRANSFUSION MEDICINE AND BLOOD BANKING RESEARCH
TRANSFUSION MEDICINE/ BLOOD BANK PHYSICIANS
TRANSFUSION MEDICINE AND BLOOD BANKING WORLDWIDE
CONCLUSION
2:
WHO Initiatives on Safe Blood Programs in the Developing Countries
ISSUES AND CHALLENGES IN BLOOD SAFETY IN DEVELOPING COUNTRIES
WHO BLOOD SAFETY PROGRAM
Advocacy for Nationally-Coordinated Blood Transfusion Programs
Costing Blood Transfusion Services
Global Collaboration for Blood Safety
WHO Quality Management Program
External Quality Assessment Schemes (EQAS)
Distance Learning Material: Safe Blood and Blood Products
Additional WHO Learning Materials on Blood Safety
Safe Blood Collection and Blood Components Production
Clinical Use of Blood
WHO Blood Cold Chain Project
Promotion of Voluntary Blood Donation and World Blood Donor Day
WHO Schemes for the Evaluation and Bulk Procurement of HIV Test Kits
Hemoglobin Color Scale
CONCLUSIONS
3:
Organization and Operation of a Regional Blood Transfusion Center in India
ORGANIZATION OF A REGIONAL BLOOD TRANSFUSION CENTER
Legal and Regulatory Authority
Planning for a Regional Blood Transfusion Center
Infrastructure Requirements
Building
Equipment and Spares
Staffing
DONOR RECRUITMENT AND BLOOD COLLECTION
Recruitment of Voluntary Donors
Blood Donor Retention
Blood Donor Screening and Selection
Blood Collection
RED CELL SEROLOGY TESTING
Quality Control of Blood Group Reagents and Cells
REDUCING THE RISK OF TRANSFUSION-TRANSMISSIBLE INFECTIONS
Malarial Parasite
Human Immunodeficiency Virus
Hepatitis B Virus
Hepatitis C Virus
Principle of Indirect Sandwich ELISA for Donor Screening Tests
Notification of Donors with Reactive Test Results
Preparation, Storage and Use of Blood Components
COMPONENT PREPARATION FROM WHOLE-BLOOD DONATIONS
QC in Blood Component Preparation
Donor Selection and Blood Collection
Calibration of Blood Bank Refrigerated Centrifuges
Optimal Preparation of Plasma Components
Quality Control of Blood Components
Leucocyte Reduction of Blood Components
Febrile and Pulmonary Reactions
Cytomegalovirus—Free Blood Components
Irradiated Cellular Blood Components
BLOOD COMPONENT PREPARATION BY APHERESIS
Monitoring Apheresis Donor Eligibility
ISSUE AND TRANSPORTATION OF BLOOD COMPONENTS
AUTOLOGOUS BLOOD TRANSFUSION
INFECTION PREVENTION AND DISPOSAL OF BIOHAZARDOUS WASTE
QUALITY MANAGEMENT PROGRAM
Quality Control Program
Documentation Systems
Reporting of Test Results
Recordkeeping
Quality Tools
Automation in Blood Banking
Inventory Management
Inventory Control of Consumables
FINANCIAL SUPPORT ISSUES FOR BLOOD BANKS
RESEARCH AND DEVELOPMENT
4:
Blood Donor Suitability and Donation Complications
BLOOD DONATIONS IN THE UNITED STATES
BLOOD DONOR SUITABILITY
Blood Donor Suitability Criteria for Vital Signs and Inspection of the Arms
Blood Donor Suitability Criteria for Hemoglobin
Blood Donor Suitability Criteria for Diseases, Conditions, and Behaviors
Deferral Rate
Confidential Unit Exclusion
Postdonation Tests
BLOOD DONATION PROCESS
BLOOD DONATION ADVERSE EVENTS
Incidence of Blood Donor Injuries and Reactions
Vasovagal Reaction
Nerve Injury or Irritation
Accidental Arterial Puncture
Iron Depletion in the Donor
Postdonation Hospitalization or Death
CONCLUSIONS
5:
Leukoreduction of Blood Components
LEUKOCYTE REMOVAL
Mechanisms, Timing, and Potential Adverse Effects
FEVER AND RIGORS IN RECIPIENTS AND LEUKOREDUCTION
HLA ANTIBODIES AND REFRACTORINESS TO PLATELET TRANSFUSION
PREVENTING CYTOMEGALOVIRUS TRANSMISSION BY LEUKOREDUCTION
Infection with a Second-Strain of CMV
Reactivation of Latent CMV Infection
TRANSFUSION ASSOCIATED IMMUNE SUPPRESSION AND LEUKOREDUCTION
LEUKOREDUCTION AND BACTERIAL CONTAMINATION OF BLOOD COMPONENTS
LEUKOCYTE REDUCTION AND GRAFT-VERSUS-HOST DISEASE
Reperfusion Injury
SUMMARY AND RECOMMENDATIONS
6:
Platelets in Health and Disease
PLATELET MORPHOLOGY
Light Microscopy
PLATELET ULTRASTRUCTURE
PLATELET ORIGIN AND DEVELOPMENT
PLATELET FUNCTION
Shape Change
Secretion
Aggregation
NEW ADVANCES IN MEASURING PLATELET FUNCTION
Thromboelastography and Sonoclot
Lumiaggregometry
Impedance Platelet Aggregometry
Single Platelet Counting
PLATELET PROCOAGULANT ACTIVITY
PLATELET MEMBRANE GLYCOPROTEINS
Glycoprotein IIb/IIIa (Receptor/CD 41a)
Glycoprotein Ib-IX Receptor/CD42
P-Selectin (CD 62-P)
PLATELET DISORDERS
Pathophysiological Classification of Thrombocytopenias
THROMBOCYTOPENIAS
Idiopathic Thrombocytopenic Purpura
Diagnosis
Differential Diagnosis of Idiopathic Thrombocytopenic Purpura
Management
Initial Management of ITP in Children
Initial Management of ITP in Adults
Management of Children and Adults with Chronic, Refractory ITP
Emergency Treatment
Management of Women during Pregnancy, and of their Newborn Infants
Gestational Thrombocytopenia
Thrombocytopenia with Infection
Drug-induced Thrombocytopenia
Heparin-induced Thrombocytopenia
Inherited Thrombocytopenia
DISORDERS OF PLATELET FUNCTION
Classification
Glanzmann's Thrombasthenia
Bernard-Soulier Syndrome
Acquired Disorders
Drugs, Foods, and Spices
Systemic Conditions
VON WILLEBRAND'S DISEASE
Testing for vWD
Type 1 vWD
Type 2 vWD
Type 2A vWD
Type 2B vWD
Type 2M vWD
Type 2N vWD
Type 3 vWD
Treatment of vWD
Pseudo-vWD
Acquired vWD
PLATELET TRANSFUSION THERAPY
Platelet Concentrates and Apheresis Platelets
Cryopreserved Platelets
Lyophilized Platelets
Plasma Products
Platelet Transfusions
Platelet Transfusion Dose
EVALUATION OF PLATELETS
Quantitation of Platelets
Platelet Function Tests
Detailed Evaluation of Platelet Function
Platelet Aggregation
Platelet Function Analyzers
Template Bleeding Time
Assays for Platelet Antibodies
Assays for Heparin-Induced Thrombocytopenia
7:
Recent Advances in Platelet Preservation and Testing
ABSTRACT
INTRODUCTION
PLATELET BIOCHEMISTRY AND FUNCTION
In Vitro Evaluation of Platelet Biochemistry and Function
FDA RECOMMENDATIONS AND GUIDELINES FOR EVALUATION OF PLATELET FUNCTION
In Vitro Evaluation of Platelet Biochemistry and Function
PLATELET SURVIVAL IN CIRCULATION
CLINICAL HEMOSTATIC EFFICACY
STUDIES ON PLATELET PRESERVATION
Results
Platelet Activation
Adenine Nucleotide (ATP Secretion)
Platelet Aggregation
DISCUSSION OF PLATELET PRESERVATION METHODS
Device for Monitoring Platelet Function
Detection of Platelet Function and Platelet Function Inhibition
CONCLUSION
8:
The HLA System and Transfusion Medicine
THE HLA SYSTEM
Genomic Organization of the Human MHC
HLA Haplotypes
Tissue Expression of HLA
Structure and Polymorphism of HLA Molecules
Peptide Presenting Role of HLA Molecules
CLINICAL HLA TESTING
Serologic Typing of HLA Antigens
Molecular Typing of HLA Alleles
The HLA Antibody Screening and Lymphocyte Crossmatch
THE HUMAN MINOR HISTOCOMPATIBILITY ANTIGENS
THE HLA SYSTEM AND TRANSPLANTATION
Solid Organ Transplantation
Allogeneic Hematopoietic Stem Cell Transplantation
Transfusion Practice in Stem Cell Transplantation
THE HLA SYSTEM IN TRANSFUSION THERAPY
HLA Alloimmunization
Refractoriness to Platelet Transfusion
Transfusion-Associated Graft-versus-Host Disease
Febrile Nonhemolytic Transfusion Reaction
Transfusion-Related Acute Lung Injury
Neonatal Alloimmune Thrombocytopenia
HLA AND DISEASE ASSOCIATION
HLA AND PARENTAGE TESTING
SUMMARY
9:
Transfusion-associated Graft-versus-Host Disease
HISTORY OF TA-GVHD
CLINICAL MANIFESTATIONS
GENETIC DOCUMENTATION OF TA-GVHD
TREATMENT OF TA-GVHD
IRRADIATION OF BLOOD COMPONENTS AS A PREVENTIVE STEP
Types of Irradiator Units
Dosage of Irradiation to Prevent TA-GVHD
Adverse Effects of Irradiation on Blood Components and Storage
Quality Control and Quality Assurance
General Indications for Irradiation of Blood Components
INDICATIONS FOR IRRADIATING CELLULAR BLOOD COMPONENTS
Absolute Indications
Congenital Cellular Immunodeficiency
Hematopoietic Stem Cell Transplant Recipients
Hodgkin's Disease
Granulocyte Transfusions
Intrauterine Transfusions and Transfusions to Neonates who have Received Intrauterine Transfusions
Transfusions from Biologic Relatives
Probable Indications
Transfusions to Premature Infants Weighing Less than 1,500 g
Patients with Hematologic Malignancies (other than Hodgkin's disease) Treated with Cytotoxic Agents
Patients Receiving High-Dose Chemotherapy, Radiation Therapy, and/or Aggressive Immunosuppressive Therapy
Platelet Donors Chosen for HLA Matching or Crossmatch Compatibility
Controversial Indications
Solid Organ Transplantation
Aplastic Anemia Patients not on Aggressive Immunosuppressive Therapy
Term Neonates Undergoing Extracorporeal Membrane Oxygenation
Nonindications
Human Immunodeficiency Virus Infection
Small-Volume Transfusions to Term Neonates who did not Receive Intrauterine Transfusion
Elderly Patients
Patients Receiving Immunosuppressive Medications
POSSIBLE ALTERNATIVES TO IRRADIATION
Leukocyte Reduction
Ultraviolet Pathogen Inactivation Methods
CONCLUSION
CLINICAL USE OF BLOOD COMPONENTS
10:
Blood Component Administration and Initial Management of Transfusion Reactions
PHYSICIAN'S ORDER AND INFORMED CONSENT
PATIENT BLOOD SAMPLE COLLECTION AND LABELING
LABORATORY TESTING
Red Cell ABO Typing and Compatibility Testing
TIMING OF THE PRE-SURGICAL BLOOD GROUP TYPING AND COMPATIBILITY TESTING
THAWING AND POOLING COMPONENTS
SPECIAL PROCESSING
Release of Blood Components from the Blood Bank Laboratory
Blood Administration Steps
Patient Education
Venous Access
Prophylactic Medications Given Prior to the Transfusion
Infusion Supplies and Sets
Blood Warmers
Immediate Pre-Infusion Identification Steps
Infusion Steps
Post-Infusion Steps
RECOGNITION AND MANAGEMENT OF REACTIONS
Auditing Blood Component Transfusions
11:
Blood Component Transfusion Guidelines for Transfusing Physicians
RED BLOOD CELLS
RBC TRANSFUSION GUIDELINES — ADULTS
RBC TRANSFUSION GUIDELINES — INFANTS AND CHILDREN
FROZEN DEGLYCEROLIZED RED CELLS — ADULTS AND CHILDREN
WASHED RED CELLS — ADULTS AND CHILDREN
PLATELETS
PLATELET TRANSFUSION GUIDELINES — ADULTS AND CHILDREN
WASHED PLATELETS — ADULTS AND CHILDREN
GUIDELINES FOR PLATELET TRANSFUSION OF MORE THAN ONE DOSE PER DAY
GUIDELINES FOR PLATELET TRANSFUSIONS IN REFRACTORY PATIENTS (Fig. 11.1)
FROZEN PLASMA
PLASMA TRANSFUSION GUIDELINES — ADULTS AND CHILDREN
CRYOPRECIPITATE-REDUCED (CRYO-POOR) PLASMA
CRYOPRECIPITATED ANTIHEMOPHILIC FACTOR (CRYOPRECIPITATE)
CRYOTRANSFUSION GUIDELINES — ADULTS AND CHILDREN
GRANULOCYTE CONCENTRATES
GRANULOCYTE CONCENTRATE TRANSFUSION GUIDELINES — ADULTS AND CHILDREN
LEUKOCYTE-REDUCED BLOOD COMPONENTS
LEUKOCYTE-REDUCED BLOOD COMPONENT TRANSFUSION GUIDELINES —ADULTS AND CHILDREN
COMPONENTS WITH REDUCED CMV RISK
PATIENTS AT PARTICULAR RISK FOR CMV
IRRADIATED CELLULAR BLOOD COMPONENTS
GUIDELINES FOR IRRADIATED CELLULAR BLOOD COMPONENTS — ADULTS AND CHILDREN
COMPATIBILITY TESTING PRIOR TO TRANSFUSION (Tables 11.2 and 11.3)
SOURCE OF BLOOD FOR TRANSFUSIONS
TRANSFUSING PHYSICIAN'S RESPONSIBILITY TO REPORT ADVERSE OUTCOMES OF BLOOD COMPONENT TRANSFUSION
RECOGNITION AND MANAGEMENT OF TRANSFUSION REACTIONS
MANAGEMENT OF ACUTE HEMOLYTIC TRANSFUSION REACTIONS (HTR)
REPORTING TRANSFUSION REACTIONS
RECOGNIZING TRANSFUSION-TRANSMITTED DISEASE
REPORTING TRANSFUSION-TRANSMITTED INFECTION
RECOGNIZING TRANSFUSION-ASSOCIATED GRAFT-VS-HOST DISEASE
Reporting TA-GVHD
Reporting Transfusion-Related Fatalities
INFORMED CONSENT
RISKS OF BLOOD TRANSFUSIONS — USA
12:
Transfusions in Critically Ill Patients
PATHOGENESIS OF ANEMIA
Impairment of Red Cell Production
Erythropoietin Expression and Responsiveness
Iron Metabolism
Nutritional Deficiencies
Enhanced Red Cell Consumption
Red Cell Aging
Apoptosis
Deformability
Red Cell Destruction
Blood Loss
OXYGEN DELIVERY REQUIREMENTS
Oxygen Demand
Critical Oxygen Delivery
APPROPRIATE TRANSFUSION
Mortality
Selected Outcomes
Special Situations
Cardiac Disease
Hypoxia
Hypotension and Bleeding
Lactic Acidosis
Acute Respiratory Distress Syndrome
SPECIAL TOPICS
Stored Red Cells
Pediatric Critically Ill
Blood Conservation
Erythropoietin Administration
CURRENT TRANSFUSION PRACTICES
13:
Blood Transfusion in the Operating Room
GUIDELINES FOR TRANSFUSION
Standard Precautions Taken in the Operating Room
Recognition of ABO Incompatible Transfusion
Problems Related to the Storage Lesion
Blood Product Replacement Protocol in the Operating Room
Transfusion of Blood Components during Surgery in Infants and Children
When does one use Plasma?
SUMMARY
14:
Massive Transfusion
PHYSIOLOGY OF BLOOD LOSS
STORAGE LESION OF BLOOD COMPONENTS
Citrate Effect
Acid-Base Balance
Hemoglobin Function
Coagulation Abnormalities
Potassium
IMMUNOSUPPRESSION
NEW TREATMENTS: FACTOR VIIA
RED CELL SUBSTITUTES
INTRAOPERATIVE AUTOLOGOUS TRANSFUSION
SURVIVAL AFTER A MASSIVE TRANSFUSION
MASSIVE TRANSFUSION PROTOCOL
SUMMARY
15:
Transfusion Therapy for Hemoglobinopathies
PRINCIPLES OF BLOOD TRANSFUSION IN SICKLE CELL DISEASE
Indications for Transfusions
Acute Transfusions
Chronic Transfusions
Equivocal Indications
Nonindications
Transfusion Methods
Simple Transfusions
Exchange Transfusion
Recommended Manual Scheme
Rapid Partial Exchange
Automation
Subacute Partial Exchange Transfusion
Chronic Transfusion Programs
Transfusion Complications
Volume Overload
Iron Overload
Alloimmunization to Red Cell Antigens
Autoimmune Anemia following Allosensitization
Alloantibodies to White Cells, Platelets, and Serum Proteins
Infection
Alternatives to Blood Transfusion
PRINCIPLES OF BLOOD TRANSFUSION IN BETA-THALASSEMIA MAJOR
Blood Transfusion Therapy
Donor Selection
When to Start Blood Transfusions
What to Transfuse
Recommended Blood Product
Blood Products for Special Patient Populations
Compatibility Testing
Transfusion Regimens
How much Blood to Transfuse?
Adverse Reactions
Hepatitis C Infection
16:
Hemorrhagic Disorders in the Surgical Patient
PHYSIOLOGY OF HEMOSTASIS
Role of Platelets
Role of the Coagulation Proteins
Role of Vascular Endothelium
BLEEDING DISORDERS
Preoperative and Postoperative Management of a Patient with Hemostatic Defect
SPECIAL HEMOSTATIC CHALLENGES
Cardiopulmonary Bypass Surgery
Liver Disease
Renal Disease
DISSEMINATED INTRAVASCULAR COAGULATION
17:
Thrombotic Disorders in the Surgical Patient
PATHOPHYSIOLOGY OF THROMBOSIS
POSTSURGICAL VENOUS THROMBOEMBOLISM
PREVENTION OF VENOUS THROMBOEMBOLISM
TREATMENT OF VENOUS THROMBOEMBOLISM
HEPARIN-ASSOCIATED THROMBOCYTOPENIA
18:
Plasma Transfusion Therapy
PRODUCTS, PREPARATION AND STORAGE
Fresh Frozen Plasma, Frozen Plasma and Thawed Plasma
Plasma Cryoprecipitate Reduced (Cryosupernatant)
Plasma: Liquid Plasma
Solvent/detergent-treated Plasma
FFP, Methylene Blue-treated (MBFFP), and FFP, Methylene Blue-treated and removed6,10
CLINICAL USES
Coagulopathy due to Multiple Factor Deficiencies, with Bleeding or before Invasive/surgical Procedures5
Liver Dysfunction with Significant Coagulation Abnormalities
Warfarin-induced Coagulopathy
Dilutional Coagulopathy
Disseminated Intravascular Coagulation
Selected Single Factor Deficiencies
Thrombotic Thrombocytopenic Purpura
Other Indications
CONTRAINDICATIONS AND PRECAUTIONS1,6-8
Adverse Effects1,6,7,24
ALTERNATIVES TO PLASMA TRANSFUSION1,7,8
19:
Use of Cryoprecipitate
INDICATIONS FOR USE
Hypofibrinogenemia
von Willibrand's Disease
Factor VIII Deficiency (Hemophilia A)
Factor XIII Deficiency
Fibrin Sealant
Uremic Bleeding
Reversal of Fibrinolytic Therapy
ADMINISTRATION AND DOSAGE
20:
Coagulation Therapy in Hemophilia
EVOLUTION OF COAGULATION FACTOR REPLACEMENT THERAPY
Hemophilia A
Hemophilia B
CLINICAL APPLICATION OF COAGULATION FACTOR REPLACEMENT THERAPY
Product Choice
Dosing and Duration of Therapy
Prophylactic Coagulation Factor Replacement Therapy
Complications of Coagulation Factor Replacement Therapy
Desmopressin
Antifibrinolytic Agents
MANAGEMENT OF PATIENTS WITH INHIBITORS
Treatment of Acute Hemorrhage
Suppression of Inhibitors
Inhibitors in Hemophilia B
FUTURE DIRECTIONS
HEMATOPOIETIC STEM CELL TRANSPLANTATION
21:
Hematopoietic Stem Cell Transplantation for Malignant Diseases
SCIENTIFIC BACKGROUND
High-dose Therapy Rationale
Graft-versus-Tumor Effect
Indications for High-dose Therapy with Hematopoietic Stem Cell Transplantation (SCT)
Diseases Treated
Stem Cell Sources
PATIENT ELIGIBILITY
Host Factors
Disease Factors
CHEMOTHERAPEUTIC AGENTS FOR DOSE-INTENSIVE STRATEGIES
TOTAL-BODY IRRADIATION
Preparative Regimens
Allogeneic Transplant
Reduced Intensity (Non-myeloablative) Allogeneic Transplant
Autologous Transplant
HEMATOPOIETIC STEM CELLS
Hematopoietic Growth Factors and Cytokines
RESPONSE AND LONG-TERM OUTCOMES
Acute Myelogenous Leukemia
Acute Lymphoblastic Leukemia
Chronic Myelogenous Leukemia
Chronic Lymphocytic Leukemia
Hodgkin's Disease
Non-Hodgkin's Lymphoma
Multiple Myeloma
Myelodysplastic Syndrome
Myelofibrosis
Solid Tumors
Breast Cancer
Ovarian Cancer
Germ Cell Cancers
Renal Cell Cancer
FUTURE DIRECTIONS
22:
Unrelated Donor Stem Cell Transplantation: The Role of the National Marrow Donor Program
THE NMDP REGISTRY
The NMDP Cord Blood Program
The NMDP Office of Patient Advocacy
The NMDP Research Program
The NMDP and Unrelated Donor Stem Cell Transplantation
Obtaining an NMDP-facilitated Stem Cell Transplant
THE HLA SYSTEM
Impact of HLA match on Transplant Outcome
SEARCHING THE NMDP REGISTRY FOR AN UNRELATED DONOR
Selection of Donors/Stem Cell Source
Blood Stem Cell Procurement
Marrow Harvest
PBSC Collection
Cord Blood
Unrelated Donor Stem Cell Transplantation Outcomes
Post-transplant Follow-up
SUMMARY
23:
Umbilical Cord Blood Banking
DONOR RECRUITMENT
OBTAINING CONSENT
MEDICAL EVALUATION OF THE DONOR
Medical History Sources
Medical History Issues
Obtaining the Medical History
INFECTIOUS DISEASE SCREENING
COLLECTION
Ex utero Collection Method
Liquid Preservation of Cord Blood
PROCESSING, CRYOPRESERVATION AND STORAGE
Shipment to Processing Facility
Receipt at Processing Facility
Initial Processing Criteria
Processing, Cryopreservation and Storage
TRANSPORTATION OF CORD BLOOD FOR TRANSPLANTATION
THAWING AND WASHING OF UMBILICAL CORD BLOOD UNITS
TRANSFUSION OF CORD BLOOD
Side Effects and Adverse Reactions and Premedication
Administration of Cord Blood Units
QUALITY ASSURANCE AND QUALITY CONTROL IN CORD BLOOD BANKING
24:
Hematopoietic Stem Cell Processing
SOURCES OF HEMATOPOIETIC STEM CELLS
Bone Marrow
Peripheral Blood
Umbilical Cord Blood
PROCESSING METHODS
Routine Methods
Specialized Methods
CRYOPRESERVATION
QUALITY CONTROL TESTING TECHNIQUES
QUALITY ASSURANCE (QA) AND REGULATORY ISSUES
ACKNOWLEDGMENT
25:
Infusion of Hematopoietic Stem Cells
HPC CRYOPRESERVATION
SIDE EFFECTS OF INFUSING CRYOPRESERVED BM/PBPC
Patient Premedication
Preparing for the Transplant and Thawing of the HPCs
INFUSION OF HEMATOPOIETIC STEM CELLS
Patient Monitoring During and After the Infusion
SIDE EFFECTS OF NON-CRYOPRESERVED PBPC/BM INFUSION
PREMEDICATION, INFUSION OF NON-CRYOPRESERVED STEM CELLS AND PATIENT MONITORING
INFUSION OF UMBILICAL CORD BLOOD HEMATOPOIETIC STEM CELLS
Patient Identification and Inspection of the Product
CLINICAL MANAGEMENT OF MICROBIALLY CONTAMINATED HPC PRODUCTS
REPORTING AND INVESTIGATION OF ADVERSE EVENTS RELATED TO THE INFUSION OF HPC
CONCLUSION
26:
Bone Marrow Transplantation: Procedures and Practices in a Developing Country
TRANSFUSION SUPPORT FOR THE BONE MARROW HARVEST
ABO MISMATCHED TRANSPLANTS
Major ABO Mismatch
Minor ABO Mismatch
CHOICE OF ABO GROUP OF BLOOD PRODUCTS IN ABO AND RHESUS (D) MISMATCHED BMT
STEM CELL COLLECTION
Bone Marrow
Peripheral Blood Stem Cells
Umbilical Cord Blood
STEM CELL INFUSION
Marrow Infusion
Complications of Marrow Infusion
BLOOD PRODUCT SUPPORT FOR THE RECIPIENT
Irradiation
Indications for Blood Product Transfusion
Platelet Transfusions
Red Cell Transfusions
Fresh Frozen Plasma
Granulocyte Transfusions
Transfusion Support for Veno-Occlusive Disease of the Liver
Pathophysiology and Clinical Diagnostic Criteria
Hemorrhagic Cystitis
Transfusion and CMV Status of Recipient and Donor
POST-TRANSPLANT TRANSFUSION SUPPORT
INDEX
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