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TUESDAY AM SESSION
The Changing Face of Massive Transfusion
Dr. John R. Hess
Professor of Laboratory Medicine and Hematology
University of Washington
Massive transfusion is a response to massive bleeding. Its goals are the restoration of circulating blood volume, oxygen transport, and the correction of coagulopathy. Recent changes in massive transfusion protocols appear to have reduced mortality and blood use in trauma, cardiac surgery, and liver transplantation while reducing blood use. This talk will address the clinical justification for balanced resuscitation, the blood bank issues in providing balanced resuscitation, and the clinical evidence of its success.
Dr. John R. Hess, MD, MPH, FACP, FAAAS, is Professor Laboratory Medicine and Hematology at the University of Washington in Seattle. He serves as a Medical Director of the Transfusion Services at Harborview Medical Center and Chief of Transfusion Medicine for the Department of Laboratory Medicine. He attended medical school at the University of Washington, earned his Master in Public Health at the University of Hawaii, and is board certified in internal medicine, hematology, medical oncology, blood banking and transfusion medicine, and general preventive medicine and public health. He is an associate editor of Transfusion and the author of more than 275 papers and book chapters, inventor of hemorrhage control systems and methods for extending RBC storage, and the holder of six U.S. patents. He has served as Special Advisor on Blood Safety to the Director General of the World Health Organization and on the WHO Expert Panel on Blood Transfusion Medicine. Dr. Hess is retired after 24 years of active service in the U.S. Army and U.S. Public Health Service and had previously served as Director of Health of the Territory of American Samoa. Dr. Hess’s current research involves blood product development, hemorrhage control, and clinical blood use.
Disaster Planning and Recovery
Marc Lewis
Gulf Coast Regional Blood Center
This presentation will encompass dealing with weather related issues specifically Hurricane preparedness and recovery.
The objective is to establish a process before, during and after a hurricane crisis to ensure patient, donor, and staff safety. The importance of an emergency, communication, resources and recovery plan will be the focus of the discussion.
Marc Lewis is the Vice-President of Operations and responsible for Production Management, Regional Operations, Neighborhood Donor Centers and Business Development. Marc began his standing career in the blood industry in 1992 as a Hospital Services Representative before moving into various roles within Hospital Services management team. Marc was promoted to the Director of Hospital Services in 2004, with responsibilities of managing the regional blood supply, ensuring patient safety. In 2008 Marc’s responsibilities increased when he took on the Director of Production Management role, which included Hospital Services and Component Production. His work in this role increased the efficiency of the organization by establishing a direct line of manufacturing blood and blood products designated for distribution. Marc’s responsibilities increased again when he took on a new combined role in 2016 as the Director of Production Management, Neighborhood Donor Centers and Regional Operations, overseeing 240 employees. Marc was recently promoted in 2017 to the position of VP of Operations that has a multi-prong approach to increase efficiency and successful patient outcomes.
It's in the Details: Problems with Blood Bank Testing You Never Saw Coming
Rebecca Bullock
Technical Director
Quotient
This presentation examines unexpected variables that factor into Immunohematology testing, including antisera source, saline pH, tube type, and testing temperature, and possible effects these variables have on test results. Actual cases studies will be discussed, of results obtained when standard protocols were altered resulting in testing problems for blood bank staff.
Objectives:
1. Understand how simple, basic items, such as supplies and standard protocols that we choose to use, affect the
results we obtain in testing, particularly in the Blood Bank.
2. Describe the historical, scientific origins of our current standard testing protocols in the blood bank.
3. Discuss unusual case studies where unexpected variables caused problems in blood bank testing, as well as the
techniques and logic used in the resolution of the cases presented.
Becky Bullock is the Technical Director for Quotient. She came to this position in January of 2012 from the American Red Cross, Carolinas Region, Durham Center, where she was the Manager of the Immunohematology Reference Laboratory and the Freezing Laboratory for 23 years.
Continuing education of laboratory technologists has been a focus for her, having been active in the North Carolina Association of Blood Bankers for over 20 years, serving as a Professional Association Representative on The Council for Allied Health of North Carolina, and with the Education Committee of the South Central Association of Blood Banks. Blood banking and Immunohematology have encompassed almost her entire career, but she reports that she still finds red cell antibody identification, and the body’s serologic response fascinating.
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TUESDAY PM SESSION
Case Study: Cold Enough For You?
Bernie Graves
Lead Technologist
Community Blood Center of Greater Kansas City
There are cold autoantibodies and then there are COLD autoantibodies!
This will be a case review of a patient with a particularly troublesome cold autoantibody. There will be a discussion of techniques that can be used to determine the ABORh grouping and presence of underlying alloantibodies in a patient with a strong cold autoantibody. The clinical significance of cold reactive autoantibodies will be addressed.
Bernie is a blood banking “lifer.” She did her Med Tech training at the University of Nebraska Medical Center long before there was PEG. She did her SBB training at Johns Hopkins Hospital in Baltimore long before there was gel testing. She’s been at Community Blood Center long enough to have done ether eluates and serologic testing for A & B subgroups. She claims she will not retire until she finds a Bombay patient/donor.
Massive Transfusion in Severe Trauma: A Review and Summary of TMC Experience
Hana Hamdan
Director of Blood Bank
Truman Medical Center
This presentation is about the use of liquid
plasma in massive transfusion. Dr. Hamdan will also summarize her center experience.
Dr. Hamdan is an Assistant Professor of
Pathology at University of Missouri-Kansas City. She is the director of blood
bank at Truman Medical Center. She earned her medical degree from University of
Jordan. She completed her anatomical and clinical pathology residency at UMKC
and fellowship in Cytology at Kansas University Medical Center
Case Study
Lauren Deady
IRL Technologist II
American Red Cross, Missouri Illinois Region
Lauren attended Truman State University and graduated with a BS in Biology in 2009. She worked in immunology research at Washington University School of Medicine in St. Louis, Missouri before attending the Clinical Lab Science program at Mercy Hospital. She obtained her MLS certification in 2014 and has been working at the American Red Cross Immunohematology Reference Laboratory since then. In her free time, Lauren enjoys bike riding, cooking, and aerial fitness.
TRALI, TACO, TNT, Triple A of Transfusion Medicine
Dr. Eric Senaldi
Medical Director
Community Blood Center of Greater Kansas City
TRALI – Risk, clinical picture, pathophysiology, treatment and prevention
TACO – Risk, management, etiology, prevention
Dr.Senaldi is board certified in anatomic and clinical pathology and transfusion medicine. He has over 25 years experience in various blood centers. Now, he is the medical director at New York Blood Center and Medical Director of the Community Blood Center in Kansas City.
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WEDNESDAY AM SESSION
Case Study: Goldie Locks and the Three Bone Marrows
Julie Kirkegaard
IRL Technical Supervisor
CommunityBlood Center of Greater Kansas City
Aaron Gottschalk
Genomics Supervisor
The National Center for Blood Group Genomics
This presentation will
- List the antibodies that cannot be ruled out using dithiothreitol treated cells or trypsin treated cells.
- Discuss your institution’s policy for transfusion of patients receiving anti-CD38 treatment.
- List technical complications encountered when genotyping patients that have received bone marrow transplants.
- Describe technical strategies to genetically determine a patient’s predicted phenotype for patients with bone marrow transplants.
- Discuss best treatment “policy” for patients needing transfusion post bone marrow/stem cell transplant.
Julie got her medical technology training from Research Medical Center in Kansas City and her specialist in blood bank training at Memorial Blood Center in Minnesota. She has worked at the Community Blood Center for 26 year and is currently the technical supervisor of the Immunohematology Reference Laboratory at Community Blood Center of Kansas City.
Aaron completed his doctorate in Biochemistry and Molecular biology at the University of Kansas Medical Center and his post-doctoral fellowship at The Stowers Institute for Medical Research. He has 15 years of experience working in the field of transcriptional regulation and epigenetics, and has used genomics approaches to study the pathobiology of cancer and developmental diseases. With a growing interest to move into the clinical side of genomics; Aaron joined the fine folks at Community Blood Center of Kansas City in 2016 to help start up the National Center for Blood Group Genomics.
It's time to think about using whole blood in trauma again
Dr. Mark Yazer
Professor of Pathology
University of Pittsburgh
1. Understand why whole blood is the ideal pre-hospital and early hospital resuscitation fluid
2. Appreciate some of the civilian and military uses of whole blood
3. Appreciate the safety of using whole blood in massively bleeding patients
Dr. Mark Yazer graduated from medical school at the university of Ottawa in 2000 and completed his residency in hematological pathology at the university of alberta in 2004. He is currently a professor of pathology at the university of Pittsburgh, and the medical director of the RBC serology laboratory at the centralized transfusion service in Pittsburgh, one of the largest transfusion services in north America. He is also an adjunct professor of clinical immunology at the university of southern Denmark. He has published nearly 170 peer reviewed papers, and is an associate editor of the journal Transfusion medicine and the journal Hematology. He is on the editorial board of 4 other journals. He is the chairman of the AABB's molecular testing standards unit, and the co-chairman of the AABB/THOR working group. He has received grant funding from the American National Institutes of Health, the American department of defense, and the American military based DARPA group. He is currently a co-principle investigator of NIH R01 and R34 grants and is a collaborator on two department of defense grants. He is on the scientific advisory/speakers board of 7 corporations, and he has given more than 200 lectures on his research worldwide. His research interests include patient blood management, blood utilization in trauma, electronic enhancements for patient safety.
Case Study
Eric Rosa
Medical Laboratory Scientist
University of Kansas Health System
Blood and Marrow Transplantation, the MLS Role
Dean Merkel
BMT Apheresis and Cell Processing Lab Manager
The University of Kansas Hospital
The blood or marrow transplant, what is it? Why, when, and how is I done? The MLS role in blood and marrow transplantation. Where we have come from and what is in store for the future.
Dean Merkel is an apheresis and cell processing lab technologist with over 30 years of experience at the University of Kansas Hospital. Dean has helped evolve a blood and marrow transplant program from a small program to a cutting edge BMT program with a large future in many new cellular immunotherapies. He is also involved in the review of many standards for the Foundation of Cellular Therapy (FACT) apheresis and cell process accreditation.
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WEDNESDAY PM SESSION
Case Study
TBD
TBD
How and why we implemented a preop anemia service as part of our patient blood management program
Dr. Emily Coberly
Medical Director Transfusion Services
University of Missouri Health Care
Katie Dattenwanger
Transfusion Safety Officer
University of Missouri Health Care
In this presentation we will discuss the importance of identifying and treating preoperative anemia as part of a patient blood management program, and the potential impact it can have on transfusion rates as well as patient outcomes. We will share our story of the multidisciplinary process we used to implement our preop anemia program (including setbacks and unintended consequences!) and share our patient results.
Dr. Emily Coberly completed medical school and Internal Medicine residency at the University of Missouri Columbia, then practiced as an Internist 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.
Katie Dettenwanger completed her Clinical Laboratory Science degree at the University of Missouri in partnership with the University of Nebraska Medical Center. She sat for her Board of Certification in 2013 and has since worked in all areas of the laboratory in both the hospital and reference laboratory setting. She has been working with Dr. Coberly as the Transfusion Safety Officer at MU Health Care since February 2017.
Case Study: "You're Stuck with Me Baby"
Carla Lavery
Lead Technologist, Blood Bank
Shawnee Mission Medical Center
Hereditary persistance of fetal hemoglobin.
Carla is currently the blood bank lead technologist at Shawnee Mission Medical Center. She has been with SMMC for 16 years. She relocated to Kansas from Chicago, IL where her blood banking career was established. She is currently a student at RUSH University for Specialist in Blood Banking/Masters of Science program where some of the same instructors she had 22 years ago for her undergraduate degree are now her current instructors. She spends her free time with her three children, Aidan, Colin, and Madison, running with her Goldendoodle, Wilson, and volunteering as an 8th grade Science Olympiad mentor.
Platelets: Always Bugging the Blood Bank
Gabriel Metzler
Blood Bank Supervisor
Children's Mercy Hospital
Jovona Powelson
Director of Laboratories
Community Blood Center of Kansas City
Our experience in implementing Verax PGD bacterial detection in Platelet Pheresis units at our facility to include our decision making in why, how, and when to test.
Gabriel Metzler graduated from the University of Kansas in 2008 with a Bachelor of Science degree in Microbiology. He went on to attend the University of Kansas Medical Center to obtain a Bachelor of Science degree in Clinical Laboratory Science in 2010. He completed his clinical rotation at Children’s Mercy Hospital and was hired on full time upon completion of the program. Gabe worked 3 years as a generalist on night shift before transitioning to blood bank full time on the day shift. He obtained his Specialist in Blood Banking Certification in 2016 after completing a 1 year program at UTMB in Galveston. He was promoted to Blood Bank Supervisor at Children’s Mercy Hospital in March 2017.
Jovona has been with Community Blood Center of Kansas City for nearly 10 years. Jovona currently oversees the testing laboratories at Community Blood Center. Prior to joining the Community Blood Center, Jovona spent 2 years with the American Red Cross and 12 years in the Hospital Laboratories.