Answers to Commonly Asked Questions
I have included answers of varying levels of detail to many of the common questions I receive from our contact page as well as from review courses. A few previews are below, and the full list is on the right side of the page.
NOTE: Names and specific hospitals have been removed for confidentiality purposes, and most questions have been edited for clarity and brevity.
Antibody Panels! I'm Lost!
"Please help me! I really don't understand antibody panels, and I have an exam coming up."
When I look back at the scores of e-mails I have received at the BBGuy site, the question that eclipses all others, by a mile, is a variation on the question above! Antibody panels scare people, especially students of blood banking, and especially students of blood banking that are about to take their exams!...CLICK FOR MORE
"If a patient is at risk for transfusion-transmitted CMV, can leukocyte-reduced and products from CMV-seronegative donors be used interchangeably?"
The short answer, to most blood bankers, is "Yes," but the long answer is not quite that simple. Cytomegalovirus (CMV) is a white blood cell-based DNA virus that causes a mild, transient illness in people that have normal immune systems...CLICK FOR MORE
Fever During Transfusion
"Recently a patient came to ER with active GI bleeding and 18% hematocrit. RBCs were ordered. Patient body temperature was 35C, and warm blanket was applied. During transfusion of first unit the patient develop fever up to 37C. The ER doctor wanted to continue the transfusion because the patient has a life-threatening condition, and shows no other sign of a hemolytic transfusion reaction. Is this ok?"
The scenario that you describe illustrates a very common issue that we face in transfusion medicine: What to do with the patient who is having a temperature increase while receiving a transfusion? Most of these are pretty straightforward and easily managed. However, in some situations (Heme-Onc patients and others with major infections especially), we are confronted with the challenge of the patient who is having temperature instability even before the transfusion...CLICK FOR MORE
"Hey, BBGuy, can you help me understand the indications for irradiation of blood products?"
OK, I have to admit it: irradiation really is one of my favorite topics in all of transfusion medicine (which either tells you that I am really a tremendous nerd or that I am very easily amused!). A discussion about irradiation and why we do it must first involve a quick blurb on Transfusion-associated Graft versus Host Disease (TA-GVHD for short). Any time someone gets a transfusion of blood from someone who is not genetically identical to them (in other words, the donor and recipient have different HLA types), a fairly predictable series of events occurs...CLICK FOR MORE