Table Of ContentTRIGGER FACTORS IN TRANSFUSION MEDICINE
DEVELOPMENTS IN HEMATOLOGY AND IMMUNOLOGY
Volume 31
The titles published in this series are listed at the end of this volume.
Trigger Factors
in Transfusion Medicine
Proceedings of the Twentieth International Symposium on Blood Transfusion,
Groningen 1995, organized by the Red Cross Blood Bank Noord-Nederland
edited by
C. Th. SMIT SmINGA and P. C. DAS
Red Cross Blood Bank Noord-Nederland, The Netherlands
and
E.L.SNYDER
Yale New Haven Hospital Blood Bank, New Haven, CT, U.S.A .
...
"
KLUWER ACADEMIC PUBLISHERS
DORDRECHT / BOSTON / LONDON
A C.I.P. Catalogue record for this book is available from the Library of Congress.
ISBN-13: 978-1-4612-8550-2 e-ISBN-13: 978-1-4613-1287-1
DOl: 10.1007/978-1-4613-1287-1
Published by Kluwer Academic Publishers,
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© 1996 Kluwer Academic Publishers
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Baxter
Acknowledgement
This publication has been made possible through the support of Baxter, which is
gratefully acknowledged.
VII
CONTENTS
Moderators and Speakers ...................... ................................................ ...... IX
Foreword ........ ....... ............ ................... ....... .......... ......... ........ .... ..... ..... ........ XI
I. Demand and Supply
Customer-oriented Quality Systems in Transfusion ...... ............ .......... ........ 3
D.E. Nevalainen
Communication Mechanisms Between the Bedside and the Blood Bank.. 13
A.W.M. Koopman-Van Gernert
Informed Consent for Transfusion Recipients: How much is enough? ...... 17
P.V. Holland
Factors That Influence the Demand for Transfusion .................................. 25
D.B.L. McClelland
The Process of Clinical Decision making in Blood Transfusion ................ 35
L.T. Goodnough
Discussion ......... .......... ....... ....... .............. ........ .... .......... ....... ....... .......... ........ 47
II. Product Qualities and Characteristics
Factors defining the clinical needs for supportive haemotherapy .. ............. 57
J.Th.M. de Wolf
Factors Effecting the Clinical Efficacy of Blood Transfusion .. ............ ...... 65
W.G. Murphy
The Clinical Relevance and Biological Effects of Leukocytes Present in 73
Cellular Blood Components ....................................................................... ..
M. Blajchman
Platelets: What Qualities and Characteristics Do Justify the Need for 83
Transfusion? ................................................................................................. .
S. Murphy
VIII
The Clinical Relevance of Clotting Factor Characteristics ......................... 91
C.A. Ludlam
Discussion ........... ........................ ................................................ .................. 103
III. Transfusion Policies and Clinical Pratice
Fears, Facts and Formulas About Blood Transfusion: On the Perception, 113
Acceptance and Communication of Risks ................................................. .
C.A.]. Vlek
Surgical Criteria for Blood Transfusion: How Far Should We Go? .......... 133
H.I. ten Duis
Transfusion Policies and Clinical Practice in a Tertiary Academic 143
Medical Centre: The Role of Protocols and Documentation ..................... .
M. Petrides and E.L. Snyder
Choice of Transfusing Single Donor Apheresis vs Random Pooled 161
Platelets - Its Costs ..................................................................................... .
A. Westerterp-Maas
Ethical Aspects of the Transfusion of Blood .............................................. 169
C.R. Macpherson
What Triggers the Initiative of Developments in Transfusion Medicine: 177
Advances in Ex Vivo Haematopoietic Cell Therapy and Next Generation
Transfusion Products ................................................................................... .
D.E. van Epps
Discussion .... ....... ............ ............................. ........................................... ...... 193
IV. Evaluation and Feed-Back of Transfusion Policies
Evaluation of Bedside Transfusion Practice: Benefits vs Risks .... ....... ...... 199
R.S. Eisenstaedt
The Clinical Consultative Role of the Blood Bank in Transfusion 213
Medicine ....................................................................................................... .
C.Th. Smit Sibinga
Audits in Transfusion Medicine: A Trigger Mechanism to Optimise 219
Clinical Practice ........................................................................................... .
Ch.H. Wallas
Legislative and Regulative Impact on Transfusion Medicine Practices ..... 235
K. Sazama
Discussion 245
Index ............................................................................................................. 253
IX
MODERATORS AND SPEAKERS
Moderators
E.L. Snyder, chairman - Yale New Haven Hospital Blood Bank,
New Haven, cr, USA
P.e. Das - Red Cross Blood Bank Noord Nederland,
Groningen, NL
L.T. Goodnough - Washington University School of Medicine,
St. Louis, MO, USA
W. Murphy - Royal College of Physicians, Edinburgh, UK
C.Th. Smit Sibinga - Red Cross Blood Bank Noord Nederland,
Groningen, NL
H.J.C. de Wit - Red Cross Blood Bank Noord Nederland,
Groningen, NL
I.Th.M. de Wolf - Academic Hospital Groningen, Groningen, NL
Speakers
M. Blajchman - McMaster University, Hamilton, Ontario, C
H.J. ten Duis - Academic Hospital Groningen, Groningen, NL
R.S. Eisenstaedt - Temple University, Philadelphia, PA, USA
D. van Epps - Baxter Healthcare Corporation,
Round Lake, IL, USA
P.V. Holland - Sacramento Medical Foundation Blood Center,
Sacramento, CA, USA
A.W.M.M. Koopman- - Academic Medical Centre, Amsterdam, NL
van Gernert
x
C.A. Ludlam - Royal Infirmary of Edinburgh, Edinburgh, UK
c.R. Macpherson - U.C. Medical Center, Cincinnati, OH, USA
D.B.L. McClelland - Edinburgh & South East Scotland Blood
Transfusion Service, Edinburgh, UK
S. Murphy - American Red Cross Blood Services,
Philadelphia, P A, USA
D.E. Nevalainen - Abbott Quality Institute, Abbott Park, IL, USA
K. Sazama - Medical College Hospitals, Philadelphia, P A, USA
CAl Vlek - University of Groningen, Department of
Psychology, Groningen, NL
Ch.H. Wallas - American Red Cross Headquarters,
Charlotte, NC, USA
A. van der Wiel - General Christian Hospital Eernland,
Amersfoort, NL
Prepared Discussants
A. Westerterp-Maas - Red Cross Blood Bank Noord Nederland,
Groningen, NL
XI
FOREWORD
It is an honour and a pleasure to welcome you all at this 20th annual International
Symposium on Blood Transfusion in the Netherlands. This year you celebrate
its 20th anniversary and I congratulate the Staff of the Blood Bank Noord
Nederland and especially Dr. Smit Sibinga for this great achievement. As most
of you know, the name of the person of Dr. Smit Sibinga is unbreakably con
nected with the annual symposium in Groningen which he has organized each
year from the very start, 20 years ago.
The reputation of any symposium depends heavily on the quality of the
lectures. I think it is not possible to organize 20 symposia in a row if the topics
lack actual relevance and the speakers are not of excellent reputation. Dr. Smit
Sibinga has proven to have a keen eye for selecting interesting themes and
eminent speakers. Although a lot of different topics have been dealt with in the
past 20 years, which each attracted the attention of a different group in the field
of blood transfusion, it is not surprising that after a tradition of 20 years several
speakers but also a lot of attendees are not for the first time in Groningen to
participate in this event. It gives the symposium a unique atmosphere of intimacy.
It is not hard to admit that most of the newer developments in transfusion
medicine take place outside the Netherlands. Knowing that and in order to keep
our position among the nations with the safest blood supply, we have to focus
our view on the international field. Therefore, the Groningen symposium is of
national importance. It not only established the extraordinary reputation of the
Blood Bank in Groningen, but it also creates an international forum where the
latest developments in Transfusion Medicine are exchanged.
For yet another reason this 20th symposium is a memorable one. Earlier this
year the Red Cross Blood Bank Groningen-Drenthe, the organizer of the sympo
sium over the last 19 years, merged with its neighbour, the Blood Bank Friesland
to form the new Blood Bank Noord Nederland. It has a total of about 90.000
donations per year and is now one of the largest Blood Banks in the Netherlands.
I am sure that the medical knowledge of Dr. Smit Sibinga combined with the
pharmaceutical knowledge of Mr. De Wit guarantee a winning team and a strong
Blood Bank in the north of our country. This strong Blood Bank should co-operate
in a cordial way with the other Dutch Blood Banks and with the Central Labora
tory in Amsterdam. On the necessity of this co-operation I shall come back later.
