Practical Transfusion Medicine -- Contents -- List of contributors -- Preface to the Fourth Edition -- 1 Introduction: recent evolution of transfusion medicine -- Introduction to the introduction -- Basic principles of immunohaematology -- Complications of transfusion -- Practice in blood centres and hospitals -- Clinical transfusion practice -- Alternatives to transfusion -- Cellular and tissue therapy and organ transplantation -- Development of the evidence base for transfusion -- Afterthoughts -- Further reading -- PART ONE Basic Principles of Immunohaematology -- 2 Essential immunology for transfusion medicine -- Cellular basis of the immune response -- Innate immune cells -- Adaptive immune cells -- B-cell activation and T-cell-dependent antibody formation -- Humoral immune response -- Basis of antibody variability -- Antibody effector functions -- Red blood cell antibodies illustrating the above principles -- Antibody and complement-mediated blood cell destruction -- Clinical aspects related to alloimmunization against blood cell antigens -- Key points -- References -- Further reading -- 3 Human blood group systems -- Introduction -- The ABO system -- Clinical significance -- A and B subgroups -- Biosynthesis and molecular genetics -- Biochemically related blood group systems - H, Lewis and I -- The Rh system -- Rh genes and proteins -- D antigen -- Anti-D -- Prediction of fetal Rh genotype by molecular methods -- C and c, E and e -- Other Rh antigens -- Other blood group systems -- The Kell system -- The Duffy system -- The Kidd system -- The Diego system -- The MNS system -- The biological significance of blood group antigens -- Key points -- References -- Further reading -- 4 Human leucocyte antigens -- Introduction -- HLA class I genes -- HLA class II genes -- Genetic organization and expression of HLA class II genes.

Expression of HLA molecules -- Genetics -- Function of HLA molecules -- Identification of HLA gene polymorphism -- PCR sequence-specific priming -- PCR sequence-specific oligonucleotide probing -- DNA sequencing-based typing -- Formation of HLA antibodies -- Detection of HLA antibodies -- Complement-dependent cytotoxicity test -- Enzyme-linked immunosorbent assay -- Flow cytometry -- Luminex -- Clinical relevance of HLA antigens and antibodies -- Solid organ transplantation -- HLA and haemopoietic stem cell transplantation -- Blood transfusion -- HLA and disease -- Hereditary haemochromatosis -- Neonatal alloimmune thrombocytopenia -- Other diseases -- Key points -- References -- Further reading -- 5 Platelet and neutrophil antigens -- Antigens on platelets and granulocytes -- Human platelet antigens -- Inheritance and nomenclature -- Typing for HPAs -- Platelet isoantigens, autoantigens and hapten-induced antigens -- Detection of HPA alloantibodies -- Clinical significance of HPA alloantibodies -- Neonatal alloimmune thrombocytopenia -- History -- Definition and pathophysiology -- Incidence -- Clinical features -- Differential diagnosis -- Laboratory investigations -- Neonatal management -- Antenatal management -- Counselling -- HPA-typed donor panels -- Human neutrophil antigens -- HNA-1 system -- HNA-2 -- HNA-3 system -- Alloantigens on CD11a and CD11b -- Detection of neutrophil antibodies -- Clinical significance of HNA antibodies -- Neonatal alloimmune neutropenia -- FNHTR and TRALI (see Chapters 8 and 9) -- Transfusion-related alloimmune neutropenia (TRAIN) -- Autoimmune neutropenia -- Persistent post-bone marrow transplant neutropenia -- Key points -- References -- Further reading -- PART TWO Complications of Transfusions -- 6 Investigation of acute transfusion reactions -- Understanding the clinical presentation and differential diagnosis.

Patient history -- Medications -- Type of blood component being transfused -- Was fever present? -- Volume of component transfused -- Other considerations -- General approach for investigation and treatment of acute transfusion reactions -- Action to be taken on the clinical unit -- Action to be taken in the laboratory -- Algorithm -- Key points -- References -- Further reading -- 7 Haemolytic transfusion reactions -- Definition of a haemolytic transfusion reaction -- Pathophysiology of HTRs -- Antigen-antibody interactions -- The characteristics of the antibody and antigen -- Complement activation -- Fc receptor interactions -- Cytokines -- Antibody specificities associated with HTRs -- Acute HTRs -- Aetiology and incidence -- Symptoms and signs -- Complications -- Immediate management of suspected AHTR (see Chapter 6) -- Investigation of suspected AHTR -- Other reactions characterized by haemolysis -- Management of a confirmed AHTR -- Prevention of AHTRs -- Delayed HTRs -- Aetiology and incidence -- Signs and symptoms -- Management -- Investigation of suspected DHTR (see Chapter 6) -- Prevention -- Haemolysis resulting from haemopoietic stem cell transplantation (see Chapter 41) -- Delayed haemolysis following organ transplantation (passenger lymphocyte syndrome) -- Hyperhaemolytic transfusion reactions and haemolytic transfusion reactions in sickle cell disease -- Acute haemolysis from ABO-incompatible platelet transfusions -- Key points -- References -- Further reading -- 8 Febrile and allergic transfusion reactions -- Febrile nonhaemolytic transfusion reactions -- Clinical presentation -- Differential diagnosis -- Frequency -- Pathogenesis -- Patient susceptibility -- Management of FNHTRs -- Prevention of FNHTRs -- Allergic transfusion reactions -- Clinical presentation -- Differential diagnosis -- Incidence (frequency) -- Pathogenesis.

Management -- Prevention -- Key points -- References -- Further reading -- 9 Acute lung injury after transfusion -- Definition -- Incidence -- Clinical manifestations -- Types of blood components that can cause TRALI -- Pathogenesis -- Lung histology -- Differential diagnosis -- Management -- Outcome and morbidity -- TRALI mitigation strategies -- Key points -- References -- Further reading -- 10 Purported adverse effects of transfusion-related immunomodulation and of the transfusion of 'old blood' -- Clinical studies of adverse TRIM effects -- TRIM effects mediated by AMCs -- TRIM effects mediated by leucocyte-derived soluble mediators -- TRIM effects mediated by soluble molecules circulating in allogeneic plasma -- Association between non-leucocyte-reduced ABT and short-term mortality -- Adverse effects of the transfusion of 'old' RBCs -- Conclusions -- Key points -- References -- Further reading -- 11 Transfusion-associated graft-versus-host disease and microchimerism -- Transfusion-associated graft-versus-host disease -- Pathogenesis -- Clinical features -- Diagnosis -- Treatment -- Prevention -- Source and dose of ionizing radiation -- Adverse effects of irradiation -- Blood component factors -- Patients at increased risk -- Guidelines and requirements for irradiated products -- Universal irradiation -- Haemovigilance -- Transfusion-associated microchimerism -- Normal clearance of transfused lymphocytes -- Clinical data -- Testing for TA-MC -- Clinical consequences -- Key points -- References -- Further reading -- 12 Posttransfusion purpura -- Definition -- Incidence -- Clinical features -- Differential diagnosis -- Laboratory investigations -- Pathophysiology -- Management -- Prevention of recurrence of PTP -- Key points -- References -- Further reading -- 13 Transfusion-transmitted infections -- Introduction.

Transmission of infections by blood transfusion -- Transfusion-transmitted infections: detection and management -- Viruses -- Parasites -- Prions -- Interventions to minimize the impact of transfusion-transmitted infection -- Transfusion-transmitted infectious agents -- Viruses -- Bacteria -- Parasitic diseases -- Prions -- Key points -- References -- Further reading -- 14 Bacterial contamination -- Incidence of bacterial contamination -- Blood components implicated in adverse transfusion reactions -- Platelet concentrates -- Red blood cells -- Plasma and cryoprecipitate -- Contaminant bacterial species -- Platelet concentrates -- Red blood cells -- Plasma and cryoprecipitate -- Sources of contamination -- Blood donor -- Blood collection and production processes -- Investigation of transfusion reactions (also see Chapter 6) -- Prevention strategies -- Donor screening -- Skin disinfection -- First aliquot diversion -- Single donor apheresis versus pooled platelet concentrates -- Bacterial detection methods -- Pathogen reduction technologies -- Key points -- References -- Further reading -- 15 Variant Creutzfeldt-Jakob disease -- Variant CJD -- Aetiology and pathophysiology -- Assessing peripheral blood infectivity in animal models -- Clinical transmission of CJD from the peripheral blood of patients -- Strategies for risk containment -- Donor selection -- Importation of blood components -- Development of peripheral blood assays for donor screening -- Component processing -- Plasma products -- Optimal use of blood components -- Cell, tissue and organ transplantation -- Key points -- References -- Further reading -- 16 Emerging infections and transfusion safety -- Emerging infections -- Approaches to the management of transfusion-transmissible emerging infections -- Assessing the risk and threat of transfusion transmissibility.

Recognition of transfusion transmission of emerging infections.