Transfusion Medicine Text Serves Diverse Intere

book review

Transfusion Medicine Text Serves Diverse Interests

Reviewed by: Shannon N. Schrier, BS, MT(ASCP)

Designed for medical students in general practice as well as specialists in need of a basic introduction to transfusion medicine, Introduction to Transfusion Medi-cine: A Case Study Approach is a concise, detailed book which serves equally well for experienced immunohematologists and generalists.

Each of the nine chapters of the text begins with learning objectives for the topics to be discussed, followed by two-three descriptive case studies and associated questions designed to illustrate the key points as well as provide practical applications for them. Tables, diagrams and figures elucidate the text and simplify the more complex descriptions.

The first two chapters describe the derivation of the various components of the whole blood donation and the clinical significance of the ABO and Rh systems of identification. To the experienced technologist this material may seem elementary, but the clear, detailed explanations of these basic topics should not be underrated, especially for the reader to whom this information is new. The second chapter includes an especially interesting section on the HLA (human leukocyte antigens) system and its part in the assessment of compatibility for transfusion recipients, organ transplantation patients, parentage testing or disease-associated conditions.

Chapter 3, on pre-transfusion testing, describes the basic laboratory testing required to confirm compatibility between donated blood and potential recipient. The theory and procedures for ABO grouping, Rh typing, antibody testing and direct and indirect antiglobulin testing are discussed.

Selective clinical conditions requiring transfusion therapy are discussed in Chapter 4, including patients with various types of anemia, oncology patients, bone marrow transplant recipients, uremic patients and those with abnormal hematopoietic growth factors.

Chapter 5 presents techniques for blood conservation during surgery and transplantation procedures. Autologous and directed donations are discussed as well as the complications incurred by the massively transfused patient. This chapter also addresses the very real scenario of an accident victim and the minimal turnaround time for the availability of components, as well as the procedures necessary to re-establish and maintain oxygen-carrying capacity for the exsanguinating patient.

Chapter 6 covers Hemolytic Disease of the Newborn and Perinatal Blood Trans-fusion, beginning with a fascinating des-cription of the condition, its causative factors and laboratory testing required to determine the necessity for maternal administration of antenatal Rh immune globulin or intervention in utero for the fetus at risk.

Chapter 7 introduces therapeutic hemapheresis, the techniques by which venous blood is extracted by the use of pumps, desired components are separated and collected and remaining components, along with fluids to compensate for volume loss, are returned to the patient.

It can be argued that the general laboratorian, or even the immunohematologist, may not have the final responsibility for determining how or which components will be used for a particular patient’s therapy. But doctors are best served when they take advantage of the blood-banking specialist. And the laboratory specialist in turn often best serves the patient by preparing for the physician’s request for treatment. Introduction to Transfusion Medicine: A Case Study Approach will serve them both well.

Shannon N. Schrier is a registered medical technologist in the Quality Control Department at Research Testing Laboratories, a pharmaceutical clinical research organization in Great Neck, NY.

Introduction to Transfusion Medicine: A Case Study Approach

By Elaine K. Jeter, MD, and Mary Ann Spivey, MHS, MT(ASCP)SBB

Published by AABB Press, Bethesda, MD, 1996, 191 pages