Blood Bank Guy Essentials Podcast

Dr. Jeff Carson is lead author of the 2016 AABB RBC Transfusion Threshold Guidelines published online in JAMA in October 2016. This article updates the 2012 AABB Guidelines, and incorporates lots of new information from recently published studies. He joins Dr. Chaffin to discuss how to use these guidelines in everyday practice.

Red blood cells, in most countries, can be stored for up to 42 days. In the last ten years, there have been numerous observational studies suggesting that "older" blood may be harmful to recipients. In one of my favorite interviews, Nancy Heddle, lead author of the INFORM study (NEJM Oct 24, 2016) tells us why we shouldn't worry!

Despite having possibly the silliest acronym in the history of medicine (in Dr. Chaffin's opinion!), TACO is a very serious disease. It is responsible for the second-most number of deaths from transfusion every year in the United States (and is #1 in the United Kingdom). TACO is not something to mess around with, but far too many clinicians and blood bankers fail to give it the respect it deserves. Dr. Garrett Booth joins Dr. Chaffin in an energetic and fast-moving discussion of the "ins and outs" of TACO.

Most would agree that today's transfusions are really safe from potential infectious disease transmission. There are still a few situations that worry blood bankers, like the risk of bacterial contamination of platelets (despite our best efforts) and emerging infections like Zika virus. One potential solution to these issues is called "pathogen inactivation" (also called pathogen reduction by many). Dr. McCullough tells us all about it! (Note: This is an updated version that eliminates the 15 second gap left in the first version at 45 minutes or so)

Cryoprecipitate is easily the most misunderstood blood product, and lots of confusion surrounds it (not just among clinical folks!). Dr. Chaffin and co-host Dr. Heidi Shafi give you five "Essentials" of cryoprecipitate to set record straight!

Many, many clinicians routinely order premedication of their patients with acetaminophen and diphenhydramine before transfusion, believing that using those medications will prevent allergic and febrile transfusion reactions, respectively. Maybe not! Dr. Heidi Shafi discusses the available data that says that this practice may not make sense.

It's easy to push the panic button when a suspected transfusion reaction occurs! Blood bank doctors and lab scientists interact with clinical staff more than at any other time when dealing with suspected and confirmed transfusion reactions. Dr. Mark Fung from University of Vermont (editor of the AABB Technical Manual) takes us through a detailed look at how to manage these situations calmly and systematically.

In July 2016, I updated you on the current U.S. strategy on preventing Zika transmission by blood. As expected, things have changed, and this is a short update to let you know what is happening as of September 2016.

Plasma transfusion is not as easy as it sounds! Over half of transfusions have been shown to be unnecessary. Dr. Jeannie Callum from Toronto joins Dr. Chaffin for this extensive discussion designed to dispel some myths and show you how it SHOULD be!

Talk of Zika virus has been all over the news for months, and especially so in the last few days of July 2016. Dr. Chaffin and co-host Dr. Heidi Shafi take a look at how the identification of local transmission of Zika in South Florida impacts blood donation and transfusion in the United States.

Dr. Emily Volk from the Baptist and Tenet Health Systems joins Dr. Chaffin to discuss Patient Blood Management (PBM). It seems like everyone today is talking about PBM, from hospital administrators to clinicians to laboratory scientists to pathologists. This episode is a big picture look at some things to consider when thinking about implementing or improving a PBM program. Dr. Volk has been a part of two very successful PBM programs, and she shares some of what she has learned with us.

Joined by my new "Ask the BBGuy" co-host, Dr. Heidi Shafi, I take a detailed look at Transfusion-associated Graft-vs-Host Disease (TA-GVHD). This transfusion complication is by far one of the most dangerous, fatal in over 90% of cases. I start from the basics and outline the details of TA-GVHD, and discuss the implications of a game-changing 2015 article on the topic.

In transfusion medicine, infants and children are NOT just "little adults!" Dr. Cassandra Josephson joins Dr. Chaffin to discuss 5 things you should know about pediatric transfusion today!

Drug-induced Immune Hemolytic Anemia challenges both established blood bankers and beginners alike! It's tough, but Pat Arndt from American Red Cross Southern California joins Dr. Chaffin in a conversation to outline the basics and give you a way to understand how drugs and antibodies and red cells interact. 

Since U.S. FDA approval of the multiple myeloma drug with the funny name, "daratumumab," in late 2015, blood bankers have had a lot to learn and still can be confused about the drug's effect on testing. Dr. Kaufman is an international expert on this topic, and he helps clear the mysteries of DARA with practical strategies you can learn right away!

Dr. Kristine Krafts from the University of Minnesota and pathologystudent.com joins Dr. Chaffin to discuss her "Top Five Tips to Make Your Next Presentation Awesome!" Great presentations don't just happen. They take planning, preparation, and practice. If you want your next lecture to be great, Dr. Krafts shares five very practical tips for setting yourself up for success as a presenter!

Dr. Kevin Land from Blood Systems International joins Dr. Chaffin for an interesting and sometimes hilarious look at common blood bank beliefs, including viral disease risk, O-negative blood use, transfusion and mortality, and "young vs. old" blood.

Dr. Minh-Ha Tran from University of California Irvine joins Dr. Chaffin to discuss the "Who, Where, What, Why, When, and How of Massive Transfusion!" Dr. Tran offers tons of great tips, data, and discussions. See example slides on BBGuy.org.

Dr. Chaffin opens the "Ask the BBGuy" mailbag to discuss D variants, Liquid Plasma, transfusion choices when warm autoantibodies are present, and directed donor unit management.

Dr. Connie Westhoff from the New York Blood Center outlines D variant types (weak and partial D in particular) and describes a way to manage pregnant ladies and transfusion recipients with this serologic type.