Policy: Division Head Transfusion Medicine Role in Policy Making

Principle:

The Division Head, Transfusion Medicine and Blood Banks, is responsible for all aspects of transfusion medicine at HMC for the State of Qatar.  The following policy documents some of those roles.

Policy:

  1. The Division Head, Transfusion Medicine HTM, serves as a member of the Corporate Transfusion Committee
  2. The HTM through the CTC establishes criteria for transfusion of blood components and passes these through the HMC corporate process for establishing official guidelines.
  3. The HTM reviews blood component requests, especially in times of shortage to triage in conjunction with the Medical Director and Chairperson, DPLM
  4. The HTM establishes transfusion practices through the interim policies, which are in turn used to prepare processes and procedures through corporate transfusion medicine.
  5. The HTM serves as Project Manager for the Medinfo Hematos IIG computer system and prepares policies, processes, and procedures for Transfusion Laboratory Information Systems.

References:

Standards for Blood Banks and Transfusion Services, Current Edition AABB, Bethesda, MD, USA

Policy: Extended Rh and Kell Phenotyping

Principle:

Based on recent cases of rare phenotypes in the Rh system, we will proactively detect such patients and donors most likely for this.

Policy:

Extended Rh (C, c, E, e) and Kell (K1) typing should be done on all donors and patients meeting the any of the following criteria:

  1. D-negative phenotype
  2. Patients with positive antibody screens

References:

Standards for Blood Banks and Transfusion Services, AABB, Current Edition, Bethesda, MD, USA

Anecdote: Serial Panels Reactivity

When I review nonspecific reactions on an antibody panel, I always check the outdate of the reagents and the age of the specimen.  Outdating reagents may show weak reactivity.  Old specimens may get contaminated and bacteria may alter the RBC surfaces (e.g. T-activation).

Here is an example of weakened reactions with an outdating antibody panel.  This panel was used one-week before its expiration:

Here is the same patient with the new panel with 5 weeks before its expiration:

Rh Discrepancy Workup

This is an old lecture I gave to medical technologists at National Guard Health Affairs in Jeddah. This was prepared in the pre-molecular blood bank era, but there is good common sense in it to deal with many interferences.