Patients with liver disease receive almost 1 of every 5 blood products transfused in hospitals! Dr. Jeannie Callum thinks that is too much, and she shares how we can improve our practice in these complex patients.

Dr. Jeannie Callum

Dr. Jeannie Callum

Most lab scientists in hospital transfusion services will tell you that they seem to issue a disproportionate amount of blood to patients with liver disease. These patients have wild-appearing abnormalities of their basic coagulation tests, very commonly appear short on platelets, and in general, just appear to really, REALLY need transfusion!

But Wait!

Dr. Jeannie Callum, an outstanding Transfusion Medicine physician who also happens to be a clinician, says that the laboratory picture usually doesn’t tell us the whole story! She explains the complex coagulation disturbance seen in patients with liver disease, and helps us understand that these patients are actually better than their lab tests make them seem (in fact, they may actually be at risk of clotting if we transfuse them!). Jeannie explains the “rebalanced” coagulation system and the reasons why these patients get thrombocytopenic (and why just looking at the platelet count would lead you to be overly pessimistic). She then takes us on a tour of non-transfusion and transfusion choices for patients with liver disease. This interview is guaranteed to open your eyes to things you may not have known!

Speaker Bio:

Jeannie L. Callum, MD, FRCPC, is a Transfusion Medicine Specialist and Hematologist at Sunnybrook Health Sciences Center in Toronto and associate professor of the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She is the Director of Utilization for the Department of Laboratory Medicine and Molecular Diagnostics. She also serves as the sponsor lead for the Ontario Regional Blood Coordinating Network for Central Ontario.

Dr. Callum earned her medical degree and completed a fellowship in internal medicine at the University of Toronto. In addition, she received transfusion medicine fellowship training with Canadian Blood Services. She has written extensively about issues in Transfusion Medicine, publishing more than 100 peer-reviewed articles and authoring numerous book chapters. She also was the lead author on the Provincial (Ontario) transfusion handbook titled “Bloody Easy,” now in its fourth edition (if you don’t have it already, go to transfusionontario.org and get a free download!). In addition, she is on the editorial board for the “Transfusion Medicine Reviews” and “Transfusion” journals.

Free CE

This podcast episode offers a FREE continuing education activity where you can earn the following types of credit: 1 AMA PRA Category 1 CreditTM, 1 ASCLS P.A.C.E. ® Contact Hour (including Florida Clinical Laboratory Credit), and American Board of Pathology Self-Assessment Modules (SAMs) for Maintenance of Certification MOC).

To receive credit, review the accreditation information and related disclosures, please visit Transfusion News Continuing Education on Wiley Health Learning.

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DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. See the Wiley Health Learning site for Dr. Callum’s disclosures. Dr. Chaffin has no relevant financial disclosures.

The images below are generously provided by Dr. Callum.

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Music Credit

Music for this episode includes “Cuando te invade el temor” and “Reflejo,” both by Mar Virtual via the Free Music Archive. Click the image below for permissions and license details.
Creative Commons license and link

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