Blood Transfusion in Human Introduction, Uses, Indications, others

1. An introduction to the
“Transfusion Medicine Module”
Dana Ahmed Abdullah
MBChB, MSc, PhD (hematopathology)
University of Sulaimani - College of Medicine
Department of Pathology
dr_dana73@hotmail.com
dana.abdullah@univsul.edu.iq
September 2022
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2. Key Topics
 Definition
 Range of transfusion medicine
 Two centuries progress in transfusion medicine
1. Historical background
2. Blood donation worldwide
3. Changing landscape of transfusion risks
4. Evolution in clinical use of blood components
5. Hemostasis and transfusion
6. Cellular therapies, transplantation
 Transfusion medicine module syllabus
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3. Transfusion Medicine Module
 Transfusion medicine is composed of a diverse range of
disciplines including:
 The provision of a safe blood supply
 The fields of hemostasis
 Immunohematology
 Transplantation and cellular engineering
 Apheresis technology
 Treatment using recombinant and plasma‐derived proteins
 Daily use of blood components in clinical medicine
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4. Range of Transfusion Medicine
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5. Two centuries progress in
“transfusion medicine”
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6. ▪ Dr. James Blundell established the origins
of transfusion medicine as a clinical
discipline.
• He was a prominent London obstetrician
whose interest in transfusion had begun as
early as 1817 during his medical education
in Edinburgh.
• Transfusion at that time lacked the
understanding of ABO blood groups, a
barrier that would not be resolved for
another century.
Historical Background
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Dr. James Blundell
December 27, 1790, London (UK)
January 15, 1878, London (UK)

7.  Karl Landsteiner in 1901 established the primacy of ABO blood
group compatibility and set the stage for safer transfusion
practice.
Transfusion Medicine Module
Historical Background
Vienna: June 14, 1868
June 26, 1943
Awarded: Nobel Prize for Physiology/Medicine, 1930
Published a paper on:
“the influence of diet on the composition of blood ash”.
University of Vienna – College of Medicine (1891)
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8. Transfusion Medicine Module
Historical Background
Vienna: June 14, 1868
June 26, 1943
Nobel Prize for Physiology/Medicine, 1930
In 1875 Landois had reported that, when man is given
transfusions of the blood of other animals, these foreign
RBCs are clumped and broken up in the blood vessels of man
with the liberation of Hb. In 1901-1903 Landsteiner pointed
out that a similar reaction may occur when the blood of one
human individual is transfused to another human being as
well, might be the cause of shock, jaundice, and Hb-uria.
His suggestions, however, received little attention until, in
1909, he classified the bloods of human beings into the
now well-known (A, B, AB, and O groups) and showed that
transfusions between individuals of groups A or B do not
result in the destruction of new blood cells and that this
catastrophe occurs only when a person is transfused with
the blood of a person belonging to a different group.
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9. • Dr. Patrick Mollison during the Second World
War found that the addition of (ACD) to
blood can prolong the storage time from a
short period preservation to 30 days.
• Dr. Mollison highlighted the importance of
both laboratory practice
(immunohematology, hemostasis,
complement biology) and clinical medicine in
blood banking and transfusion fields.
• His textbook in transfusion medicine became
the standard of its era.
Transfusion Medicine Module
Historical Background
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10. • Each year, approximately 100 million blood
donations are made worldwide .
• A safe and adequate blood supply is now an
essential infrastructure requirement of any
modern national healthcare system.
• The recruitment and retention of healthy blood
donors is a vital activity of the field with its
challenges and responsibilities .
Transfusion Medicine Module
Blood donation “worldwide”
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11.  During the last century, intense focus on screening blood donations for
infectious diseases led to progress in blood safety and a significant drop in
the risk of transfusion‐transmitted diseases.
 The landscape of transfusion risks shifted its emphasis towards
non‐infectious hazards:
- Transfusion‐related acute lung injury (TACO)
- Circulatory overload from excessive transfusion
- Haemolytic reactions remain as serious hazard of transfusion
Transfusion Medicine Module
Challenging landscapes of
transfusion risks:
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12.  Proper use of blood components has been effectively adopted .
 Investigators have repeatedly challenged the traditional 10.0 g/dL Hb
threshold for RBC transfusion. As a result, in hospitals worldwide, RBCs use
is more conservative, and transfusions are now withheld in non-bleeding
patients until Hb falls to 7.0 g/dL.
 Refinements in the indication for platelet transfusion were done .
 It was found that Leucocytes reduced blood was key to preventing HLA
allo-immunisation.
Transfusion Medicine Module
Evolutions in the clinical use of
“blood components”
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13.  Hemostasis greatly advanced in the
current years, aided by innovations in
laboratory hematology techniques.
 The evolution ranges from plasma
replacement to the targeted use of a
growing number of plasma‐derived or
recombinant products that influence
hemostasis.
Transfusion Medicine Module
Hemostasis and transfusion
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14. Bone marrow transplantation:
the ability to mobilize hematopoietic stem cells, then harvest them safely,
process, freeze and successfully reinfuse them as a stem cell transplant .
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Cellular therapies and transplantation
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15. Transfusion Medicine
Syllabus
Based Partly on the British
society for haematology
guidelines for UK Medical
Schools
(2018, updated in 2020)
Week 2 hours lecture Name of the tutor
2 hours small
group teaching
1 Introduction: Two centuries
of progress in transfusion
medicine
Dr Sana Dlawar Jalal ---------------------
2 Blood group systems Dr Ali Ibrahim Muhammad Pathology Lab
3 Blood groups identification Dr Ali Ibrahim Muhammad Pathology Lab
4 Management of blood
donation
Dr Sana Dlawar Jalal Pathology Lab
5 Blood collection
procedures and screening
for infectious.
Dr Sana Dlawar Jalal Pathology Lab
6 Pre-transfusion testing -I:
Basic procedures and
techniques for compatibility
testing.
Dr Sana Dlawar Jalal General Blood Bank
7 Pre-transfusion testing -II
Emergency and elective
techniques.
Dr Sana Dlawar Jalal Pathology Lab
8 Transfusion of blood and
blood components
Dr Dana Ahmed Abdullah General Blood Bank
9 Apheresis Dr Dana Ahmed Abdullah General Blood Bank
10 Hazards of blood transfusion
and their managements.
Dr Hisham Arif Getta General Blood Bank
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16.  Denise M Harmening .Modern Blood banking and transfusion practices.7th edition, 2019.
 A .Victor Hoffbrand , Paul A. H. Moss. Hoffbrand’s Essential Haematology, 7th edition,
2016.(Your undergraduate textbook)
 Michael F. Murphy. Practical Transfusion Medicine, 5th edition, 2017.
 Paula R. Howard. Basic & Applied Concepts of Blood Banking and Transfusion Practices, 4th
edition, 2017.
 Harvey G. Klein, David J. Anstee. Mollison’s Blood Transfusion in Clinical Medicine, 12th
edition, 2014.
 Jeffrey McCullough. Transfusion Medicine, 4th edition ,2017
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Readings (references)
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17. All pictures were taken from:
Michael F. Murphy. Practical Transfusion Medicine, 5th edition, 2017.
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