“This patient is having a transfusion reaction!!”OK, take it easy! Dr. Mark Fung is here to give us a rational way to approach these panic-inducing events.

Dr. Mark Fung

Dr. Mark Fung

It’s easy to push the panic button when a suspected transfusion reaction occurs, but it’s extremely important to approach possible reactions in a calm, systematic manner. Dr. Mark Fung from The University of Vermont and editor-in-chief of the AABB Technical Manual joins me and takes us through a way to evaluate transfusion reactions wisely. He shares his modified categorization by dominant sign/symptom template developed from an original idea by Nancy Heddle (you can see it in the images below and download it at the bottom of the page!).

Why It Matters

It is essential that anyone working in or overseeing a transfusion service understands how to approach suspected transfusion reactions, because they can seem scary. In fact, the current version of AABB Standards includes a statement that the definitions of those reactions should be standardized in accordance with international criteria, in part to make things easier to manage [NOTE: At the time this interview was recorded, those following AABB Standards had to standardize only within their facility]. Dr. Fung has been deeply involved in those discussions in his work with AABB, and his approach is very useful and practical.

Dr. Mark Fung

Dr. Mark Fung

It’s easy to push the panic button when a suspected transfusion reaction occurs, but it’s extremely important to approach possible reactions in a calm, systematic manner. Dr. Mark Fung from The University of Vermont and editor-in-chief of the AABB Technical Manual joins me and takes us through a way to evaluate transfusion reactions wisely. He shares his modified categorization by dominant sign/symptom template developed from an original idea by Nancy Heddle (you can see it in the images below and download it at the bottom of the page!).

Why It Matters

It is essential that anyone working in or overseeing a transfusion service understands how to approach suspected transfusion reactions, because they can seem scary. In fact, the current version of AABB Standards includes a statement that the definitions of those reactions should be standardized in accordance with international criteria, in part to make things easier to manage [NOTE: At the time this interview was recorded, those following AABB Standards had to standardize only within their facility]. Dr. Fung has been deeply involved in those discussions in his work with AABB, and his approach is very useful and practical.

About My Guest:

Mark Fung, MD PhD, is a Professor of Pathology and Laboratory Medicine at the University of Vermont. He is vice chair of quality and clinical affairs for Pathology and Laboratory Medicine at the University of Vermont Health Network, and director of clinical laboratories at University of Vermont Medical Center. Dr. Fung has served in a number of leadership capacities within the AABB and other related organizations. His work includes collaboration with the Biomedical Excellence for Safer Transfusion (BEST) research collaborative and the International Collaborative for Transfusion Medicine Guidelines (ICTMG). Mark has participated in the development of multiple guidelines and the implementation of transfusion reaction reporting using standardized definitions. He is the editor-in-chief for the 18th and 19th editions of the AABB Technical Manual, and is on the editorial board for the journal Transfusion. In addition, Mark is the director of the University of Vermont Medical Center’s HLA/histocompatibility laboratory and has a long abiding interest in the selection of HLA-compatible platelets for transfusion-refractory patients.

DISCLAIMER: The opinions expressed on this episode are those of Dr. Fung and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Mark nor I have any relevant financial disclosures.

The images below are generously provided by Dr. Fung (with express permission from Nancy Heddle for the modified template).

Fung slide 1-Signs/symptoms for different reactions
Fung slide 2-Tests to consider given different signs/symptoms
Fung slide 3 - Case #1 Description
Fung slide 4 - DDx for dominant symptom (skin findings)
Fung slide 5 - Case #2 description
Fung slide 6 - DDx for dominant symptom (pain)
Fung slide 7 - Case #3 description
Fung slide 8 - DDx for dominant symptom (respiratory)
Fung slide 9 - Case #4 description
Fung slide 10 - Case #4 further info

Further Reading:

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