HAABB 52nd Annual Spring Meeting Preview
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CASE STUDY - The Highs and Lows of Working in an IRL
Pamela Hawkins
IRL Technologist III
American Red Cross, Missouri Illinois Region
Case studies will be presented that demonstrate the techniques commonly used in the Immunohematology Reference Laboratory (IRL) to investigate antibodies to both high and low prevalence antigens.
Pam has worked in the IRL at the American Red Cross in St. Louis for the last 15 years. Prior to that she worked at St. Louis Children's Hospital in the blood bank for 18 years.
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HOW DO I SUPPORT THE PLATELET REFRACTORY PATIENT
Justin Kreuter, MD
Medical Director
Mayo Clinic Blood Donor Program
Supporting patients who are refractory to platelet transfusion presents a challenge which requires a strong inter-professional practice. At the conclusion of this presentation, attendees will be able to: interpret the results of HLA/HPA antibody testing and platelet cross-matching to recommend platelet selection options; recognize the benefits of developing an algorithmic approach to supporting the platelet refractory patient; and discuss how aspects of a given platelet pipeline may impact platelet algorithms.
Dr. Justin Kreuter is a clinical pathologist with a sub-specialized practice in transfusion medicine and tissue typing. Justin was born and raised in Missouri. He completed undergraduate and medical school at the University of Missouri, Columbia. His residency training was at Dartmouth and transfusion medicine fellowship was at Mayo Clinic.
His primary passion is medical education, with interests in: teaching clinical judgement, frameworks for feedback, and reflection in medical practice. And today he will speak about his main clinical & research interest, improving the management of patients who are refractory to platelet transfusion!
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CASE STUDY - Family Ties: A Platelet Story
Gina Folk
Immunohematologist
Community Blood Center of Kansas City
This case study is about a Neonatal Alloimmune Thrombocytopenia (NAIT) workup CBC received. We will cover what NAIT is, how it is worked up and potential treatment options.
Gina received her Bachelor of Science in Biology and Clinical Laboratory Science from the University of Jamestown in Jamestown, ND. She obtained her Specialist in Blood Bank (SBB) training from the National Institutes of Health (NIH) in Bethesda, MD. She accepted a position 6 years ago as an Immunohematology Reference Technologist at the Community Blood Center here in Kansas City, MO. Gina currently keeps busy trying to keep up with her very active 2 year old son and is pursuing her Masters in Immunohematology and Biotechnology from George Washington University.
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PREOPERATIVE ANEMIA MANAGEMENT
Deborah Tolich
Cleveland Clinical Health System
Anemia is a potentially modifiable risk factor to patients undergoing surgical procedures. Treating prior to a procedure is complex and daunting to incorporate into well-established workflows. This presentation will discuss the initial steps involved to establish a preoperative anemia program.
Learning Objectives:
- Data analysis for current and future state
- Consider models for care delivery
- Constructing a workflow
Dr. Tolich is the director of blood management for the Cleveland Clinic Health System. She has 20 years’ experience in the field of blood management and is passionate about anemia identification and treatment. Other interests include the use of technology and data to drive outcomes, patient safety, high reliability, and research. She earned a Doctorate in Nursing Practice in 2014, is a long-standing member of AABB, serves on the PBM Standards Committee, and was an author in the recently released AABB Press publication “Preoperative Anemia Management”.
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CASE STUDY - Show Me the Rh46 Negative Units
Shay Jones
Immunohematologist
Community Blood Center of Greater Kansas City
This presentation will:
- Give a brief overview of the Sec (RH46) antigen and related workup
- Discuss transfusion options for individuals with anti-Sec
- Reinforce the importance of institutional collaboration
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. Shay has been with CBC for 7 years.
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CREATING CUSTOMIZED RED CELL REAGENTS FROM iPSC CELLS
Dr Connie M. Westhoff
Executive Scientific Director
New York Blood Center
This presentation will introduce advances in technology and culture methods to generate red blood cells in the laboratory. Although growing enough cells for transfusion is not yet possible, it is potentially feasible to generate enough cells to be used as reagents to identify complex antibody specificities. We have generated induce-pluripotent stem cells (iPSCs) from the buffy coat from routine blood donation of donors with rare blood types and characterized the RBCs grown in culture. A group O Rh null line has also been engineered to use as reagent RBCs and as proof of principal for future generation of RBCs for transfusion.
Learning Objectives:
- appreciate the challenges of growing RBCs in culture for future transfusion
- understand the technology of gene editing with CRISPR (clustered regularly interspaced short palindromic repeats)
- describe the use of genetic tools to make “designer” RBCs and how they might be useful
Dr. Westhoff is executive scientific director of the Laboratory for Immunohematology and Genomics for the New York Blood Center Enterprises and the National Center for Blood Group Genomics in Kansas City.
The primary focus of her research is to improve patient care and transfusion safety through the use of genomics with an emphasis on patients with Sickle Cell Disease. She is considered an expert on the Rh system, and has published more than 100 scientific papers and authored numerous book chapters.
She is an associate editor for the Genomics section of the journal Transfusion, an editor of the AABB technical manual, and has served on numerous AABB committees including the board of directors and has received numerous awards.
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CASE STUDY - TBD
Irene Calvin
Children's Mercy Hospital
Critical communication for trauma transports and antibody formation
Irene is happily a life-long bench tech on her second stint at Children’s Mercy after taking a hiatus to raise three children. She is also a long time PRN at Saint Luke’s South. She received her training at Wichita State. She is known in the lab for bursting into song in reply to any comment by a co-worker. Outside of the lab she's been married for 24 years. She enjoys doing almost any sort of logic puzzle and walking her West Highland Terriers.
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PREHOSPITAL AND HOSPITAL TRANSFUSION FOR TRAUMA
Dr. Jed Gorlin
Medical Director
Community blood Center of Greater Kansas City
At the conclusion of this talk participants should be able to:
- Cite findings supporting prehospital transfusion
- Identify Controversies in MTP including:Future options for plasma transfusion in this setting
- Fixed ratios of various components
- Role of Whole Blood
- Future options for plasma transfusion in this setting
Dr. Jed Gorlin is board certified in pediatrics and blood banking and transfusion medicine.
Dr. Gorlin is the VP of Medical and Quality Affairs for Innovative Blood Resources and Medical Director, Community Blood Center of Greater Kansas City.
His education includes a BS-Stanford, MD Yale, and MBA from U of MN Carlson School of Business.
He trained in Pediatrics and Pediatric Hematology/Oncology at Boston Children’s hospital, and completed research fellowships at Dana-Farber Cancer Institute, Mass. General, Brigham & Women’s Hospital, and the Puget Sound Blood Center.
Dr. Gorlin served on the boards of AABB and the National Blood Foundation. He is associate clinical professor of laboratory medicine at University of Minnesota.
He is currently the co-director of Transfusion Medicine at Hennepin County Medical Center, a level one trauma hospital in Minneapolis, and Children’s Hospitals and Clinics in Minneapolis and St. Paul, MN. He is a consultant to AABB, CDC and NIH for projects in Rwanda, Tanzania and Central Asia including Kazakhstan and Kyrgyzstan. He was the AABB liaison to ACOG, AWHONN and CMQCC for obstetric hemorrhage and ABC liaison to AABB TTD committee.
He makes great biscotti and pignoli cookies.
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CASE STUDY - Cold Antibody Blues
Jarrett Pierce
American Red Cross - Central Plains Region
The topic of the presentation will be Cold Antibodies. The presentation will cover various aspects of cold antibodies. Cold antibodies will be defined and distinguished from other antibodies. Their clinical significance will be discussed and the type of typical workup they require will be covered. Various testing methods such as a cold antibody screen and the prewarming technique will be presented. Two case studies will also be presented that involved patients with cold antibodies. The challenges and outcomes in those studies will be discussed. Final thoughts on cold antibodies and how they affect blood bank workups as well as physicians and their patients will be covered. A Q&A session will be opened to the audience if there are any questions on the presentation.
Jarrett is from Wichita, KS and works at the Red Cross in the Immunohematolgy Reference Laboratory. Previously, Jarrett served eight years in the US Air Force working in the aviation sector. After his military service, Jarrett attended the University of Cincinnati’s Medical Laboratory Science program and earned his Medical Laboratory Science degree. Jarrett first started working in blood banking overseas in Germany in 2015 as a Blood Bank Technician at the major US Army Hospital in Europe. Since then he has continued to work in the blood banking section in the Laboratory career field, and hopes to earn his SBB in the near future.
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USING AUTOMATED GEL METHOD FOR OBSTETRIC ANTIBODY TITERS: WHAT'S THE NEW NORMAL RANGE?
Dr. Emily Coberly
Medical Director, Transfusion Services
University of Missouri Health Care
The AABB Technical Manual currently recommends that tube methodology be used for obstetric antibody titers, since gel is more sensitive and can result in higher titer results. There is currently no known standard threshold associated with increased risk for HDFN when using gel methodology for obstetric titers, and clinical outcomes data is lacking. However, automated gel methodology is a convenient and efficient testing method for busy transfusion services.
Is it safe to use automated gel methods for obstetric antibody titers? If so, what is the “critical” limit? And what is the potential impact on our patients? In this presentation, we will answer these questions and share the results of our study to correlate the relationship between obstetric alloantibody titer results using automated gel versus tube method, and to evaluate corresponding neonatal outcomes.
The AABB Technical Manual currently recommends that tube methodology be used for obstetric antibody titers, since gel is more sensitive and can result in higher titer results. There is currently no known standard threshold associated with increased risk for HDFN when using gel methodology for obstetric titers, and clinical outcomes data is lacking. However, automated gel methodology is a convenient and efficient testing method for busy transfusion services.
Is it safe to use automated gel methods for obstetric antibody titers? If so, what is the “critical” limit? And what is the potential impact on our patients? In this presentation, we will answer these questions and share the results of our study to correlate the relationship between obstetric alloantibody titer results using automated gel versus tube method, and to evaluate corresponding neonatal outcomes.
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.
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CASE STUDY - TBD
Nicholas Yu
Medical Laboratory Scientist
The University of Kansas Health System
Nicholas Yu originally graduated with Bachelor’s Degrees in Biochemisty and Microbiology from the University of Kansas only to discover that his aptitudes were more aligned with applied sciences. Fueled by that and a post-Great Recession job market more barren than DI water washed cells, he went back to school for his Bachelor’s and certification in Medical Laboratory Science. Since then, he has worked in the Transfusion Service at the University of Kansas Health System where he enjoys the finer things in life, like MTPs, gunshot wound traumas, and everything else that being a blood banker brings. He is currently studying for his SBB via LifeShare Blood Center and is pursuing a Master’s Degree in Health Informatics.
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PLATELET ACTIVATION STATUS AND ITS IMPACT ON CLINICAL OUTCOMES
Dr. Elisabeth Maurer-Spurej
Chief Technology Officer, Clin. Assoc. Prof.
LightIntegra Technology Inc., University of British Columbia
Platelet transfusions are essential treatments for bleeding patients and patients with hematologic malignancies because of their important hemostatic and immune functions. Owing to donor variability and differences in processing, recent studies showed that about 36% of platelet transfusions in US hospitals contain activated platelets. It is known that activated platelets exhibit greater hemostatic function and are therefore effective in bleeding patients. In addition, non-activated platelets show significantly improved efficacy in the treatment of blood cancer patients. Personalized allocation of platelet transfusions based on platelet activation status allows optimized treatment of patients requiring therapeutic or prophylactic platelet transfusions. The gap between supply of platelet transfusions and the clinical demand is predicted to widen with new cancer treatments that prolong thrombocytopenia. Transfusing the right platelets to the right patient promises to close this gap.
Dr. Maurer has over twenty years of research experience devoting her career to understanding platelet function and the application of dynamic light scattering. She is the principal inventor of ThromboLUX and the founder of LightIntegra Technology. She was a scientist with Canadian Blood Services and has also held the position of Adjunct Scientist with CBS since 2010. Elisabeth also holds a position as Clinical Associate Professor with the University of British Columbia and is an active member of a number of organizations with a focus on blood transfusion. She received her Ph.D. in physical chemistry from the Karl-Franzens University in Graz, Austria.
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CASE STUDY - MANAGEMENT OF AN OBSTETRIC PATIENT WITH PLASMINOGEN ACTIVATOR INHIBITOR TYPE 1 DEFICIENCY
Dr. Jessica Kneib
Chief Resident
University of Missouri - Columbia
This case study will discuss an obstetric patient with plasminogen activator inhibitor type 1 deficiency (PAI-1), a rare inherited bleeding disorder. The presentation will include a review of the role of PAI-1 in coagulation and fibrinolysis together with treatment and transfusion management options available to support patients with this disorder.
Dr. Jessica Kneib went to medical school at Kansas City University of Medicine and Biosciences (KCUMB) and is currently a fourth year resident in anatomic and clinical pathology at the University of Missouri-Columbia. In July, she will be starting a fellowship in Transfusion Medicine at Vanderbilt University.
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UNDERSTANDING ABO MISMATCH IN HEMATOPOIETIC STEM CELL TRANSPLANTS: FROM TRANSPLANTATION TO TRANSFUSION
Dr. Daniela Hermelin
Transfusion Medicine Fellow
St. Louis University Hospital
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for a variety of malignant and non-malignant hematological and congenital diseases. Approximately 40-50% of all HSCTs are performed across the ABO blood group barrier. Both immediate and delayed hemolytic complications can occur in these instances. This lecture will cover the concepts of ABO mismatch HSCT, the ways we mitigate the complications in collection and manufacturing the product and ways to provide extended support to these patients in the blood bank setting.
Dr. Daniela Hermelin is originally from South Florida. She graduated from Brandeis University in Boston with a combined degree in music and biology. After medical school at St. George’s University, she started a nutritional and wellness program called Wellness to Be, M.D., which she ran for five years while raising her growing family and before starting our residency program in in 2014. Although her original excitement to pursue pathology was for the anatomic pathology, she was exposed to Blood Banking and Apheresis therapy during her first year and “fell in love”. She is passionate about Transfusion Medicine with particular interests in thrombotic microangiopathies, building integrative clinical pathology consultations, and as a clinician-teacher using social media to expand and transform medical education. She is, a member of the AABB eLearning Committee, a member of the Social Media Transfusion Journal Working Group and a Board Member of the Heart of American Blood Bank Association. Dr. Hermelin will join the faculty of St. Louis University Hospital as an Associate Medical Director of Transfusion Medicine and Medical Director of Apheresis Therapies this July.
When not engaged in pathology, Dr. Hermelin keeps busy at home with her husband raising their six children, who ages range from four through thirteen years.
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CAN WE TALK?
Peggy Baker
Transfusion Services Supervisor
North Kansas City Hospital
With the many choices in healthcare and laboratory services, improved communication is needed between facilities for optimal patient care.
Peggy has been a blood banker her entire career, 30+ years.
- Reference tech
- Lead tech of paternity lab (really interesting stories)
- Hospital blood bank tech
- Supervisor of hospital based donor center, staffed by RNs who also collected stem cells and performed therapeutic apheresis procedures
- Supervisor of donor center distribution/reference lab
- Supervisor of hospital transfusion service
- Currently Supervisor of hospital transfusion service
Raised in St. Louis, 2 grown sons, 6 granddaughters/1 grandson
Moved to KC 4 years ago for husband’s job
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VASCULAR ACCESS FOR APHERESIS
Dr. Gagan Mathur
Medical Director, Transfusion Medicine
Saint Luke's Health System
This presentaion will:
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Provide overview of vascular access for apheresis procedures.
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Discuss common options and issues.
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Present result of study on various anticoagulants to maintain patency of lines.
Dr. Mathur is a transfusion medicine physician and Medical director of lab at Saint Luke’s health System in KC.
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