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TUESDAY AM SESSION
Case Study: Just a Simple Antibody, J/K...
Lindsay Peters
Supervisor, Reference Laboratory
Mississippi Valley Regional Blood Center
Case Study Objectives:
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Discuss the investigation of high incidence antibodies
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Discuss the importance of investigating discrepancies
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Discuss benefits of molecular testing
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Discuss use of molecular testing in further investigation and decision making about appropriate products
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Discuss hyper responders
Lindsay Peters graduated in 2008 with a bachelor's degree in Clinical Laboratory Science. She began working in blood bank right away. In 2013, she obtained SBB Certification. Currently, she is working with a mentor through a Protege/Mentor program to develop Immunohematology Knowledge and Leadership skills. Attending and speaking at educational meeting is one of her favorite things to do.
Emerging Transfusion-Transmitted Infectious Diseases
Dr. Scott Koepsell
Assistant Professor
University of Nebraska Medical Center
New and old infectious diseases are constantly presenting a threat to our blood supply. The objective of this presentation is to review emerging transfusion-transmitted diseases, discuss the current regulatory response to current disease threats, and outline future strategies to prevent transfusion-transmitted diseases.
Dr. Scott Koepsell is the Medical Director for the Division of Transfusion and Transplantation Services a Nebraska Medicine, and Assistant Professor in the Department of Pathology and Microbiology at the University of Nebraska Medical Center. He has served on the Transfusion-Transmitted Disease Committee of the AABB since 2012
Case Study: DAT Negative Autoimmune Hemolytic Anemia
Christina Barron
IRL Director
American Red Cross, Missouri-Illinois Region and Greater Ozarks-Arkansas Region
In this case, we will examine the serological investigation of DAT negative autoimmune hemolytic anemia.
Christina Barron is the IRL Director for the Missouri-Illinois and Greater Ozarks-Arkansas Regions, with laboratories in Lenexa, Kansas; St. Louis, Missouri; and Little Rock, Arkansas. She began her career with the American Red Cross in 1988 and also serves as an AABB IRL assessor.
Transfusion Medicine Practice in the Genomics Era
Dr. Connie Westhoff
Executive Scientific Director, Immunohematology and Genomics
New York Blood Center and National Center for Blood Group Genomics, KC
Pre-transfusion testing, i.e. performing ABO, Rh typing and an antibody screen, has not fundamentally changed in 60 years despite the identification of more than 300 blood group antigens. In the last decade, red cell and platelet antigen determination by DNA methods (genotyping) has become an important part of transfusion medicine practice and has the potential to change our approach to pre-transfusion testing. In addition, next generation sequencing (NGS) is rapidly being applied in many areas of medicine. Individuals with hematologic malignancies and chronic illness may soon get routine whole genome sequencing for diagnosis or treatment. This data can also be used in clinical decision making for transfusion medicine.
Objectives:
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Discuss how to change our approach to pre-transfusion testing for patients receiving chronic transfusion and for patients for whom compatibility cannot be determined by routine methods.
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Illustrate the process used to determine red cell and platelet antigens from whole genome sequence.
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Review cases illustrating how genomic information aids management of pregnant women and transfusion support following transplantation.
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Discuss cost-benefit and reimbursement for genotyping for blood group antigens.
Dr. Westhoff directs the Laboratory for Immunohematology and Genomics at the New York Blood Center, and the National Center for Blood Group Genomics in KC. She is an expert on the Rh blood group system and has published more than 90 scientific papers and authored numerous book chapters.
The primary focus of the laboratory is to improve blood transfusion through the use of genomics to bring personalized medicine and genetic matching to transfusion medicine, with a focus on patients with Sickle Cell Disease. A second research focus involves the production of cultured RBCs (cRBCs) from stem and iPS cells in sufficient quantities to generate clinically useful cRBCs as laboratory reagents. This research work is funded by Doris Duke Foundation and by NIH.
She is an associate editor for the Genomics section of the journal Transfusion, an editor of the AABB technical manual, has served on numerous AABB and ASH committees, and is a reviewer for numerous journals and abstracts for U.S. and international meetings in hematology and transfusion medicine.
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TUESDAY PM SESSION
Case Study: Thinking Outside the (GATA) Box
Gina Folk
Immunohematologist
Community Blood Center of Kansas City
Objectives:
- List the enzymes used to aid in the identification of additional alloantibodies.
- Discuss the benefits of genomic testing in antibody identification and provision of red blood cells.
Gina received her Bachelor of Science in Biology and Clinical Laboratory Science from the University of Jamestown in Jamestown, ND. She previously worked as a Blood Bank Technologist at the University of Colorado Hospital in Denver, CO, before being selected as a student for the Specialist in Blood Bank (SBB) program offered at the National Institutes of Health (NIH) in Bethesda, MD. After completing the program and working for an additional year in the Blood Bank at NIH, she felt it was time for another big move. She accepted her current position 4 years ago as an Immunohematology Reference Technologist at the Community Blood Center here in Kansas City, MO.
Resolving Typing Discrepancies using All the Tools in the Toolbox
Dr. Margaret Keller
Director, National Molecular Laboratory
American Red Cross
Sandra Nance
Senior Director of Immunohematology Laboratories
American Red Cross
Problem solving in the Immunohematology area relies on effective use of test methods and experience of the technologist and supervisor as well as critical evaluation of the case history and serologic and molecular test results. This program will discuss key points of testing and through case studies will put it all together using the Tools in the Immunohematology Toolbox and journey the participants from start of serologic testing, identification of a typing discrepancy and means of resolution including molecular methods. Cases will include discrepancies between historic and current typings, serologic typings with different reagents or methods, and discrepancies between genotype-predicted phenotype and serologic phenotype. This comprehensive presentation will illustrate effective interpretation and translation of the findings along the way, and will provide recommendations to solving the most difficult cases.
Dr. Margaret Keller is the director of the AABB-accredited American Red Cross National Molecular Laboratory in Philadelphia where she is involved in both donor and patient testing for red blood cell and platelet antigens. Dr. Keller received her bachelor’s degree in biochemistry from Rutgers University and her PhD in molecular genetics from the University of Pennsylvania. She has a background in the molecular genetics of hemoglobinopathies. Dr Keller is molecular editor of the journal Immunohematology. She is American Red Cross liaison to the Molecular Testing Standards Unit of the AABB and a member of the ISBT Working Party on Red Cell Immunogenetics.
Sandra Nance is Senior Director of Immunohematology Reference Laboratories, American Red Cross providing leadership to the National Reference Laboratory for Blood Group Serology and over 45 Immunohematology Reference Laboratories across the United States, and the American Rare Donor Program. She is an Adjunct Assistant Professor at the University of Pennsylvania, Division of Transfusion Medicine & Therapeutic Pathology Department of Pathology and Laboratory Medicine. She has a master’s degree in Pathology from the University of Maryland and received her SBB from the Johns Hopkins Medical Institutions.
Ms Nance held leadership positions in the AABB, ASCP, ICII, and ISBT. Among other roles, she was on four nominating committees for AABB and ASCP. She chaired the ISBT Working Party on Rare Donors and conceptualized and implemented the new ISBT Working Party on Immunohematology.
She is Editor in Chief of the Immunohematology Journal of Blood Group Serology and Molecular Genetics and is a reviewer for several journals. She has authored or co-authored over 45 papers, 120 abstracts and edited 9 books.
Her career positions include Lead Technologist at Johns Hopkins Medical Institutions with Dr. Paul Ness and Immunohematology Research Associate in Dr. George Garratty’s Research Laboratory. Active in education, she has had faculty positions at the University of Maryland, Johns Hopkins, University of Pennsylvania, and American Red Cross. She provides leadership for the Clinical Fellowship Rotation at Red Cross for University of Pennsylvania, the National Institutes of Health SBB School, Johns Hopkins Medical Institutions SBB School as well as giving invited lectures for local, national and international societies.
Case Study
Cynthia Cruz
IRL Technologist II
American Red Cross
Case studies involving ABO/RH discrepancies.
Cynthia Cruz graduated from Wichita State University in 2012 with a Bachelor’s degree in Medical Technology. She worked four years as a Reference Technologist at the American Red Cross in Wichita, KS. She is currently working towards my SBB certification.
When Selfies Go Bad: A Look at Autoantibodies and Autoimmune Hemolysis
Dr. Joe Chaffin
LifeStream Blood Bank
Attendees will be able to:
- Develop and implement strategies for choosing appropriate blood products for transfusion
Dr. Joe Chaffin is a graduate of the Loma Linda University School of Medicine and the Walter Reed Army Medical Center Anatomic and Clinical Pathology Residency Program. He is board-certified in Blood Banking/Transfusion Medicine as well as Anatomic/Clinical Pathology. During his over 20-year career, Dr. Chaffin has served in leadership roles for hospitals and blood centers, including his current position as Chief Medical Officer for LifeStream Blood Bank in Southern California. Education is his great passion and professional mission, and most know him best by his Internet persona, "The Blood Bank Guy." Dr. Chaffin founded bbguy.org in 1998, and today, over 100,000 students from around the world visit the site every year.
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WEDNESDAY AM SESSION
Case Study - An Interesting Case of IgA Deficiency on a Saturday Afternoon
Dr. Emily Coberly
Assistant Professor of Clinical Pathology, Medical Director Transfusion Services
University of Missouri, Columbia
This presentation will
Dr. Emily Coberly completed medical school and Internal Medicine residency at the University of Missouri Columbia, then practiced inpatient and outpatient Internal Medicine for 5 years.
She then completed a residency in Clinical Pathology at MU, followed by a Transfusion Medicine fellowship at Vanderbilt University. She is board certified in Internal Medicine, Clinical Pathology, Clinical Informatics, and Transfusion Medicine and is currently the Medical Director of Transfusion Services at MU.
Antibody identification Using All the Tools in the Toolbox
Dr. Margaret Keller
Director, National Molecular Laboratory
American Red Cross
Sandra Nance
Senior Director of Immunohematology Laboratories
American Red Cross
Problem solving in the Immunohematology area relies on effective use of test methods and experience of the technologist and supervisor as well as critical evaluation of the case history, serologic and molecular test results, as well as careful consideration of the clinical features of the case. This program will discuss key points of antibody identifications, and through case studies ranging from simple to complex, will put it all together using the Tools in the Immunohematology Toolbox and journey the participants from start of serologic testing and evaluation to further diagnostic and molecular testing to determine transfusion recommendations and discuss product procurement. This comprehensive presentation will illustrate effective interpretation and translation of the findings along the way, including integration of molecular testing with varying levels of resolution, to solve the most difficult cases.
Dr. Margaret Keller is the director of the AABB-accredited American Red Cross National Molecular Laboratory in Philadelphia where she is involved in both donor and patient testing for red blood cell and platelet antigens. Dr. Keller received her bachelor’s degree in biochemistry from Rutgers University and her PhD in molecular genetics from the University of Pennsylvania. She has a background in the molecular genetics of hemoglobinopathies. Dr Keller is molecular editor of the journal Immunohematology. She is American Red Cross liaison to the Molecular Testing Standards Unit of the AABB and a member of the ISBT Working Party on Red Cell Immunogenetics.
Sandra Nance is Senior Director of Immunohematology Reference Laboratories, American Red Cross providing leadership to the National Reference Laboratory for Blood Group Serology and over 45 Immunohematology Reference Laboratories across the United States, and the American Rare Donor Program. She is an Adjunct Assistant Professor at the University of Pennsylvania, Division of Transfusion Medicine & Therapeutic Pathology Department of Pathology and Laboratory Medicine. She has a master’s degree in Pathology from the University of Maryland and received her SBB from the Johns Hopkins Medical Institutions.
Ms Nance held leadership positions in the AABB, ASCP, ICII, and ISBT. Among other roles, she was on four nominating committees for AABB and ASCP. She chaired the ISBT Working Party on Rare Donors and conceptualized and implemented the new ISBT Working Party on Immunohematology.
She is Editor in Chief of the Immunohematology Journal of Blood Group Serology and Molecular Genetics and is a reviewer for several journals. She has authored or co-authored over 45 papers, 120 abstracts and edited 9 books.
Her career positions include Lead Technologist at Johns Hopkins Medical Institutions with Dr. Paul Ness and Immunohematology Research Associate in Dr. George Garratty’s Research Laboratory. Active in education, she has had faculty positions at the University of Maryland, Johns Hopkins, University of Pennsylvania, and American Red Cross. She provides leadership for the Clinical Fellowship Rotation at Red Cross for University of Pennsylvania, the National Institutes of Health SBB School, Johns Hopkins Medical Institutions SBB School as well as giving invited lectures for local, national and international societies.
Case Study: Intrauterine Transfusion in a Mother with Anti-Vel
Karen Rubio
Lead Technologist Transfusion Services Laboratory
Children's Mercy Hospital, Kansas City, Missouri
Karen Rubio is originally from Bismarck ND. She graduated with a BS in MT from Minot State University in 1993. It wasn’t her first choice in careers, but turned out to be a good one that really hit its mark for her type A personality and love for puzzles.
After working in exotic places like Cameron MO and Rapid City SD, she landed at Children’s Mercy Hospital. She had never worked that kind of blood banking before. It was scary and engaging all at the same time. Transfusion in pediatrics was a whole different ball game. It was so cool to use all of those "Go Go" gadgets and make small packages from big ones.
In 2016, she obtained her SBB certification from the on line program through UTMB. That adventure was so very interesting and extremely challenging. She learned a lot. Thank you to all of my co workers at Children’s, the very intelligent and patient folks at CBC and KU, as well as at the ARC in St. Louis, which was a mind blowing operation to just observe for the few days she was there.
Blood Banking and Risk Management: Understanding Your Risk and the Tools to Manage It
Maggie Neustadt
Director of Risk Management
Saint Luke's Hospital, Kansas City, Missouri
- Understand what drives a patient to sure for medical negligence
- What are the basic elements of a medical negligence lawsuit
- What are high areas of risk and liability for blood banks
- What tools are available to mitigate and manage your risk
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WEDNESDAY PM SESSION
Case Study: Test Me Baby, One More Time
Shay Jones
Community Blood Center of Kansas City
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Describe the testing involved when Neonatal alloimmune thrombocytopenia (NAIT) is suspected.
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Describe typical results of testing in NAIT cases.
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Explain how clinical presentation of NAIT may not correlate with laboratory test results.
Shay Jones received his undergraduate degree in Biology from Franklin College in Franklin, Indiana and his Medical Technologist training from St. Francis Hospital in Beech Grove, Indiana. Upon completion of Medical Technology training, he was hired on as an Immunohematologist at Community Blood Center. Last year Shay received his Technologist in Blood Banking certification, Shay has been with CBC for 5 years.
Training and Education in the Blood Bank; From Student to New Employee to Seasoned Veteran
Lorraine Blagg
Education & Development Coordinator
The John Hopkins Hospital
Description: Training is a term that encompasses the education that we do in the laboratory, but not all training is considered equal. Would you train a student the same way you would train a new employee? Would you provide the same education to a seasoned veteran as you do a new employee? This session will help differentiate training and education for the student, new employee, and the seasoned veteran.
Objectives:
At the end of the session, the attendee will be able to:
- Differentiate the goals of a student, a new employee, and a seasoned veteran
- Identify at least two methods to increase cognitive and psychomotor performance in students and New Employees
- Integrate onboarding into new employee training
- Create opportunities for continued education at your organization
Lorraine Blagg is the Education & Development Coordinator for The Johns Hopkins Hospital Division of Transfusion Medicine and the Program Director for The Johns Hopkins Hospital Specialist in Blood Banking Technology Program. She co-chairs the Johns Hopkins Medicine Continuing Education Committee and is an assistant editor for Transfusion News. Her responsibilities encompass education of MLT students, MLS students, residents, fellows, & SBB students; training, continuing education and competency of Blood Bank personnel; and community activities with elementary and high school students.
Case Study: When Hemoglobinopathies Collide
Candice Wize
University of Kansas Health System
Sickle cell patient with crisis and an antibody to high incidence antigen needs an exchange; post exchange, patient had spike in Hgb C.
Candice graduated from KU in 2011. She is a Kansas City native, and loves hanging out with her husband and two dogs.
Antibody Detection Test Negative? Don't Be Fooled! - Understanding When Antibody Detection Tests Don't Detect Alloantibodies
Janis Hamilton
Manager, Immunohematology Reference Laboratory
American Red Cross, Southeast Michigan Region
Have you ever gotten a negative antibody detection test on a patient’s sample, only to be surprised when crossmatches with donor units are incompatible or the patient’s clinical response suggests red cell destruction? It does happen! Is it an antibody? Is the antibody detection test result wrong? Do you know where to start your investigation? Using a case study format where you choose the next move, you will learn strategies for resolution by working through scenarios where this can be found. Armed with this information, you won’t be fooled again.
The participant will be able to:
- Describe at least two situations where the antibody detection test is negative but alloantibody is present in a plasma.
- Describe factors that may impact differences in antibody detection and crossmatch results.
- Given a situation that suggests a red cell antibody is present following a negative antibody detection test, outline additional studies to be performed.
Jan Hamilton is the Manager of the Immunohematology Reference Laboratory (IRL) at the American Red Cross-Southeastern Michigan Region in Detroit, Michigan. She received her Bachelor’s Degree in Allied Medical Professions from The Ohio State University and Master of Science in Medical Technology/Immunohematology from Wayne State University, Detroit. Specialist in Blood Banking training was done at William Beaumont Hospital, Royal Oak, Michigan. She is past chair of the AABB IRL Accreditation Program Unit and the ACSP Board of Registry Blood Bank Examination Committee and is currently serving on the ASCP Workshop and On-Demand Webcast committee. Jan co-authored the chapter "Identification of Antibodies to Red Cell Antigens" in both the 18th and upcoming 19th editions of the AABB Technical Manual. She also is co-author of Antibody Identification: Art or Science? A Case Study Approach and the recently released companion volume Investigating Positive DAT Results: A Case Study Approach. Her special interest is performing and teaching about serological problem solving. Along with a small group of colleagues, she is part of the Indian Immunohematology Initiative which focuses on hands-on immunohematology education in India and neighboring South Asian countries.