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WEDNESDAY AM SESSION
Case Study: An Unusual Case of Anti-Jka Alloantibody and Implications for Pregnancy Management
Chris Cunningham
Post-sophomore Fellow
University of Missouri Hospital and Clinics Department of Pathology and Anatomical Science, Columbia, MO
Here we describe an unusual presentation of an anti-Jk3 alloantibody in a patient undergoing prenatal care for her tenth pregnancy. We will discuss the incidence of anti-Jk3 and risks for hemolytic disease for the fetus and newborn, review the patient's clinical course. We will explain the tolls and information used in our decision making for various therapies, and the interaction between the patient, the clinical team, and the blood bank. In addition, we will touch on the methods used to obtain extremely rare blood products to adequately provide for the needs of the patient and her baby. Finally, we will present the outcome of treatment in this case and the implications for future cases.
Chris is a medical student at the University of Missouri, Columbia. This academic year is a post-sophomore fellow in the department of pathology and anatomical science at the University of Missouri. He plans to enter pathology residency program after graduation. He lives in Columbia, MO with his wife and their two sons. He enjoys spending as much of his limited free time as possible with his family, participating in outdoor activities including honing his wilderness survival skills, and volunteering as an assistant scout master for a local Boy Scout troop.
Maternal Hemorrhage - Massive Treatment Protocol
Dr. Guy Venezia
Medical Director Obstetrics, Chair SSM System Ob Governance, Medical Director Informatics, SSM Network Director Simulation Program, Chair SSM System Ob Clinical Pathway Team
St. Clare Hospital
Maternal Hemorrhage remains one of the leading causes of Maternal Morbidity and Mortality. Recent data has demonstrated that early recognition of the warning signs and implementation of new transfusion regiments can improve patient outcomes. The California Collaborative, American College of Obstetrics & Gynecology, and Association of Women's Health, Obstetric and Neonatal Nurses have all supported guidelines for the assessment and management of maternal hemorrhage. This presentation reviews the current recommendations and guidelines for the assessment and preparation of patients at moderate to high risk for maternal hemorrhage. Attendees will also learn the new treatment modalities and transfusion guidelines for the OB Massive Transfusion Protocol. We will also update the participants on the current SSM Pilot Program at St. Mary's Hospital / St. Louis University that has implemented the Maternal
Hemorrhage Emergency Management Plan and Massive Transfusion Protocol. At the completion of this Pilot, there is a SSM System Wide roll out planned to implement these new clinical pathways and intiatives at all SSM Hospitals during the Summer of 2016.
Dr. Venezia attended Medical School and OB/GYN Residency at St. Louis University, is a commissioned Officer in the United States Army and served in the Army Medical Corps. He is currently employed as Medical Director and Clinician with SSM for 10 years. He enjoys both the clinical work as a House OB Physician and the administrative work as a Medical Director. He has a passion for Patient Safety, Quality and OB Simulation.
Case Study: A Case Study of HDN??
Lindsay Peters
Reference Laboratory Supervisor
Mississippi Valley Regional Blood Center
An interesting case study involving the importance of patient history and investigative serology. A look at HDN. Review principles of HDN and testing. Evaluation of clinical data to help answer questions about serologic testing.
Lindsay graduated in 2013 from University of Texas Medical Branch SBB program. She has worked since 2009 in the Reference Laboratory solving complex serologic antibody IDs. She enjoys the thought process and problem solving of blood bank and looks forward to the innovation to be discovered in the future.
Granulocyte Transfusion: Promises and Problems
Dr. Chang Liu
Assistant Professor
Washington University School of Medicine, Department of Pathology and Immunology
Objectives:
To understand the rationale of and evidence in support of granulocyte transfusion.
To understand the challenges that affect the efficacy of granulocyte transfusion.
To be familiar with potential adverse events associated with granulocyte transfusion.
Dr. Liu is an assistant professor in the Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine. He is one of the attending physicians on the transfusion service at Barnes-Jewish Hospital. He also serves as the director of the HLA laboratory. I am interested in immunohematology, transplant diagnostics and next-generation sequencing.
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WEDNESDAY PM SESSION
Case Study - Bad to the Bone
Kelly Winkhart
Lead Technologist
Community Blood Center of Greater Kansas City
Objectives:
- Discuss the need for an accurate patient history.
- List the benefits of genotyping BMT recipients and donors prior to transplantation.
After graduating with a degree in Biology and desperate for employment, Kelly took a job at Heartland Blood Centers in the Chicago area. After beginning in the donor testing lab and moving into the Education department, she received her BB. Then Kelly took position at Bonfils Blood Center in Denver where she worked in the Transfusion Service Lab and the IRL. After 8 years in Denver, Kelly went to ARUP Laboratories in Salt Lake City where she started in the Reference Laboratory and later became a Training Specialist. While in Utah, she spent her spare time as an adjunct professor for Weber State University. After her tenure in Salt Lake City, Kelly came to Community Blood Center to work in the IRL; and this is where she finally took the SBB exam.
DNA analysis is our ally: tales from the Immunohematology front lines
Christine Lomas-Francis
New York Blood Center
DNA-based assays are a valuable tool in our arsenal of procedures to resolve complex serological investigations, unusual findings and discrepancies. Their application saves time and resources and can aid clinical decision making. This presentation will demonstrate, through case studies, the power of combining DNA analysis with hemagglutination and will include investigations and surprising discoveries involving the Rh, Kidd and Kell blood group systems.
Christine Lomas-Francis is the Technical Director of the Laboratory of Immunohematology and Genomics at the New York Blood Center. Christine received her training at the Blood Group Unit of the Medical Research Council in London, England and originally relocated to the USA to join the Consultation and Education department at Gamma Biologicals. She is a member of the AABB, the British Blood Transfusion Society, and the International Society of Blood Transfusion among others and currently serves on the ISBT working party for Red Cell Immunogenetics and Blood Group Terminology, and is chair of the Rare Donor working party. She has coauthored many peer reviewed publications and 3 editions of the Blood Group Antigen FactsBook
Case Study: Serological Interference Caused by Monoclonal Antibody Drug Therapy
Christina Barron
IRL Director
American Red Cross Blood Services
This presentation describes the use of monoclonal antibody therapy and its interference in serological testing.
Christina is the IRL Director for the Missouri-Illinois and Greater Ozarks-Arkansas Regions, with laboratories in St. Louis, MO, Little Rock, AR, and Lenexa, KS. She began her IRL career with the American Red Cross in 1988 and also serves as an AABB IRL assessor.
What You Need to Know About Zika Virus
Dr. Emily Schindler
Mercy Hospital St. Louis
This presentation will familiarize the attendee with the epidemiology
and natural course of Zika virus infection, as well as available laboratory
diagnostics. The impact on blood
donation will be discussed in detail.
Dr. Schindler graduated from the University of Iowa Medical Scientist
Training Program, earning combined MD/PhD degrees. She completed a residency in clinical
pathology at Barnes Hospital/ Washington University in St. Louis. She is fellowship trained in blood banking
and transfusion medicine. Currently Dr.
Schindler serves as the medical director of the clinical laboratories at Mercy
Hospital St. Louis, with direct oversight of transfusion medicine operations
and blood donor services.