Spring 2009 HAABB Meeting

Umbilical Cord Blood Banking and Transplantation
William G. Ward, Saint Luke's Cancer Institute, Kansas City, MO

Bill Ward gave an interesting and comprehensive presentation on the new public Cord Blood Banking program set up at Saint Luke's Hospital in Kansas City, Missouri. He covered the potential of cord blood as a source for clinical transplantation, the regulatory requirements and stages of cord blood banking and the current research utilizing cord blood. Two interesting facts were pointed out comparing bone marrow versus cord blood transplantation in regards to HLA typing: Cord blood can be used even at a 4/6 match level due to the immaturity of the cells; and mismatches with cord blood are better tolerated and less likely to cause GVHD. The Saint Luke's program works jointly with the St Louis Cord Blood Bank. Currently, Saint Luke's is collecting, labeling, and freezing the product which is then shipped to the St Louis Cord Blood Bank. The St Louis Cord Blood Bank is the second largest independent, public cord blood bank in the world.

A Case Study of an HBOC in the setting of Extreme Anemia due to Autoimmune Hemolytic Anemia
Dr. Gary Thompson, Saint Luke's Hospital, Kansas City, MO

Dr. Thompson presented a fascinating case study involving a young JW female admitted to the ER after she was found collapsed on her bathroom floor. Her medical history indicated that she had endured flu-like symptoms during the previous week. Her admitting Hgb was 3.2, and by the time she was admitted to the ICU it had declined to 1.8. Due to her rapid clinical deterioration and her religious beliefs, the decision was made to try Hemopure, an oxygen therapeutic based on chemically stabilized bovine hemoglobin. The patient's primary disease and critical care management were discussed day by day, including the dosage, positive immediate effect of the drug, a setback involving Hospital Acquired Pneumonia, surgery performed on an embolized spleen, pancytopenia, GI bleed, and the suspected cause of final death being DIC. The conclusion was that this product was effective for at least 16 days in delivering oxygen to all the tissues, and that a rare condition called Hemophagocytic Syndrome (a secondary event in AIHA) was established after review of her bone marrow.

"A2" New Look at ABO and Platelet Transfusion Support
Dr. Laura Cooling, University of Michigan, Ann Arbor, MI

Market Withdrawal, Recall, and Lookback
Dr. Judy Grishaber, St Louis University Department of Pathology, St Louis, MO.

Adventures in Blood Banking
James Riggio, St John's Mercy Medical Center, St Louis, MO

Torridly Tantalizing Transfusion Trivia (a.k.a. Blood Bank Quiz Bowl)
Beth Jones, Saint Luke's Hospital, Kansas City, MO

Beth designed a quiz bowl game for all the HAABB attendees to participate in. First, 8 teams were formed: the Tube Shakers, Warm Reactors, Cold Distractors, Donor Moaners, Rh Renegades, Look-back Legion, NAT Frat and the Inspection Connection. Five to six multiple choice questions from each of the following categories were read aloud: Blood Bank History, Basic Blood Banking Serology, Component Therapy, Donor Requirements, Transfusion Reactions, Problem Workups and HAABB Trivia. The questions were read twice and team members were encouraged to discuss and select their answer. When the answer sheets were gathered and tallied, the "Look-back Legion" was proclaimed the winner, with the "Tube Shakers" coming in a close second! Since the theme was "Don't flush your knowledge down the toilet", the members of the winning team were awarded a special trophy, a mini toilet plunger with the HAABB logo and date printed on it. First and second place teams also received candy treats and CBC of Kansas City T-shirts. This was a fun way to end the Thursday afternoon session!

Rhesus Pieces: An Rh Case Study
Elaine J Scott, American Red Cross Biomedical Services, St Louis, MO

Dr Plapp from St Luke's Hospital in Kansas City presented five interesting case studies including management of an OB patient with both hemolytic disease of the fetus and neonatal thrombocytopenia due to antibodies to HPA-1, sample misidentification in a multiple trauma situation, post transfusion hepatitis, autoimmune hemolytic anemia, and management of a patient with an acquired factor inhibitor.

Warm Autoantibody with an Underlying Anti-f
Kathryn Harrison, American Red Cross Biomedical Services, Wichita, KS

Dr. Jay Menitove, President of the AABB, gave an overview of the AABB Strategic Plan. He discussed how the AABB plans to meet its members needs in the areas of medicine, science and technology, management and quality, legality, regulations and standards, operations, logistics, and services.

Maureen is the 2009 HAABB Scholarship winner. She presented her paper at the annual spring meeting. Please click on the link to read Maureen's paper: Baby Steps by Maureen O'Dowd.

Nancy presented a case study from a Critical Access Hospital involving a patient that repeatedly presented with anemia and suffered delayed hemolytic transfusion reactions. The first presentation was a classic case of no history, negative antibody screen, and a post transfusion sample that yielded the anti- Jk(b) and E. The second presentation (3 years later) had the same hemolytic results with antigen negative blood. This time, no serologic incompatibilities in the serum or eluate could be found. The cause was never resolved. This patient later planned to have elective surgery at a larger hospital. Nancy emphasized the importance of communication for the sake of patient care. The patient blood bank history was shared with the larger hospital, and they were able to avoid further transfusion by coordination with the surgeon.

Janet Vincent’s talk “Where have all the SBB’s gone?” w41as a review of the problems of recruiting into the medical technology and blood banking fields. Janet reviewed the steady decline in accredited schools of Medical Technology in the last 20 years, the aging of the medical technologist population, and the outlook for the need for more schools. She also discussed the new predominance of “virtual” schools with computer outreach and discussed some of the issues both positive and negative with this type of professional training.

Sean Tucker presented an interesting as well as informative case study describing the difficulty in obtaining compatible platelets for a patient at the University of Kansas Hospital. This cancer patient presented many obstacles for the Blood Bank to overcome, thus the title "Mission Impossible: Platelet Incompatibility Due to HLA Antibodies". Sean gave insight into the various steps and methods involved in the search for the suitable platelets that were so vital to this patient's treatment. Sean's clinical background and his knowledge of the subject, plus his communication style, resulted in an enjoyable and easy to follow presentation.

Bloody Murder!
Steve R. Pierce, Retired from Community Blood Center, Kansas City, MO

Steve's presentation looked at the use of blood groups in forensic investigations in the days prior to DNA testing. Challenges to investigators included being able to identify a stain as blood, whether it was animal or human, and finding out exactly who's blood it might be. Steve reviewed some interesting murder cases and how blood typing was used to help solve them.