Blood Banking/Transfusion Medicine Page 1 of 26
Revised 8/2017
Blood Banking/Transfusion Medicine Major Category Code Headings
1 Clinical Practice 10004
2 Cell and Tissue Therapy 10500
3 RBCs and RBC Components 10800
4 Apheresis 11400
5 Hazards of Transfusion: Specific Adverse Events 11800
6 Plasma Components and Derivatives 12200
7 Infectious Hazards of Transfusion 12400
8 Blood Donors and Blood Collection 13000
9 13200
10 Surgery Patients 13500
11 Biovigilence & Transfusion-Related Immunomodulation 13900
12 Platelets 14000
13 Neutrophils 14100
14 Intravascular Cell Kinetics 14200
15 Obstetric and Pediatric Patients 14300
16 Hematopoietic Progenitor Cell (HPC) Transplantation 14500
Quality, Legal and Regulatory Issues in Transfusion Medicine and Transplantation
Blood Banking/Transfusion Medicine Page 2 of 26
Cat Code
Blood Banking/Transfusion Medicine 10000
1 Clinical Practice 10004
A Autoimmune Hemolytic Anemia 10008
1 Classification, Epidemiology, and Causes 10012
2 Warm autoimmune hemolytic anemia 10016
a Pathophysiology 10020
b Autoantibodies and Specificity 10024
c Clinical Features 10028
d Laboratory Features 10032
e Treatment 10036
3 Cold Hemagglutinin Disease 10040
a Pathophysiology 10044
b Autoantibodies and Specificity 10048
c Clinical Features 10052
d Laboratory Features 10056
e Treatment 10060
4 Paroxysmal Cold Hemoglobinuria 10064
a Pathophysiology 10068
b Autoantibodies and Specificity 10072
c Clinical Features 10076
d Laboratory Features 10080
e Treatment 10084
5 Drug-Induced Immune Hemolytic Anemia 10088
a Drug Adsorption Mechanism 10092
b Drug-Dependent Antibody Mechanism 10096
c Autoimmune Induction Mechanism 10100
B Paroxysmal Nocturnal Hemoglobinuria 10104
1 Clinical Picture and Course 10108
2 Causes and Pathogenesis 10112
3 Laboratory Features 10116
4 Treatment 10120
5 Transfusions 10124
C Anemia in Oncology Patients 10128
1 Causes 10132
2 Clinical Features 10136
3 Management 10140
a Growth Factors 10144
b Transfusion Therapy 10148
D Immune Thrombocytopenia 10152
1 General Tests to Investigate Thrombocytopenia 10156
2 Platelet Antibody Assays (non-HIT) 10160
3 Tests for Heparin-Induced Thrombocytopenia 10164
4 Platelet genotyping 10168
5 Idiopathic (Immune) Thrombocytopenic Purpura 10172
a Pathogenesis 10176
b Clinical Features 10180
c Laboratory Features 10184
d Treatment 10188
Blood Banking/Transfusion Medicine Page 3 of 26
e 10192
f 10196
g 10200
h 10204
6 Drug-Induced Immune Thrombocytopenia 10208
a Heparin-Induced Thrombocytopenia 10212
i Pathogenesis 10216
ii Treatment and Management 10220
b 10224
c 10228
d 10232
7 Alloimmune Thrombocytopenia 10236
a 10240
b Neonatal Alloimmune Thrombocytopenia 10244
i 10248
ii Neonatal Treatment 10252
iii Prenatal Management 10256
c Posttransfusion Purpura 10260
i Pathophysiology and Clinical Features 10264
ii Treatment 10268
d Passive Alloimmune Thrombocytopenia 10272
e 10276
i Hematopoietic Transplantation 10280
ii Solid organ Transplantation 10284
f 10288
E 10292
1 Liver Disease 10296
a Pathophysiology 10300
b Laboratory Features 10304
c Management of Bleeding 10308
2 Vitamin K Deficiency 10312
a Role of Vitamin K in Hemostasis 10316
b Hemorrhagic Disease of the Newborn 10320
c Other Causes of Vitamin K Deficiency 10324
d Treatment 10328
3 Disseminated Intravascular Coagulation 10332
a Pathophysiology 10336
b Clinical Features 10340
Drug-Induced Thrombotic Thrombocytopenic Purpura and
Hemolytic Uremic Syndrome
Typical Drug-Induced Immune Thrombocytopenia
Atypical Drug-Induced Thrombocytopenic Purpura
Platelet Alloantigens , Immunogenetics and Frequency of
Alloimmune Thrombocytopenia
Pathophysiology and Clinical Features
Immune Thrombocytopenic Purpura in Pregnancy
Acute Immune Thrombocytopenic Purpura of Childhood
Chronic Immune Thrombocytopenic Purpura of Childhood
Secondary Immune Thrombocytopenic Purpura
Transplantation-Associated Alloimmune Thrombocytopenia
Platelet Transfusion Refractoriness – Causes, Mechanisms
and Management
Bleeding From Congenital and Acquired Coagulation Defects and
Antithrombotic Therapy
Blood Banking/Transfusion Medicine Page 4 of 26
c Laboratory Features 10344
d Treatment 10348
4 Coagulation Factor Inhibitors 10352
a Factor VIII Inhibitors 10356
b Lupus Anticoagulants 10360
c Acquired von Willebrand Syndrome 10364
d Factor V Inhibitors 10368
e Acquired Factor X Deficiency 10372
f Other Coagulation Inhibitors 10376
5 Acquired Platelet Function Disorders 10380
a Drug-Induced Platelet Dysfunction 10384
b Uremia 10388
c Cardiopulmonary Bypass 10392
6 Antithrombotic Therapy 10396
a Warfarin 10400
b Heparin 10404
c Low Molecular Weight Heparins 10408
d Factor Xa Inhibitors 10412
e Direct Thrombin Inhibitors 10416
f Fibrinolytic Agents 10420
7 Congenital Coagulopathies/Thrombophilias 10421
a Von Willebrand Disease 10422
b Factor Deficiencies, At III, Protein C, Protein S Deficiencies 10423
F Granulocyte Transfusion (Primarily Donor Issues) 10424
1 Indications and Patient Selection 10428
2 Donor Selection and Criteria 10432
3 Donor Stimulation – Corticosteroids and G-CSF 10436
4 Product Collection 10440
5 Product Storage and Transport 10444
6 Product Selection – Special Needs 10448
7 Infusion and Monitoring 10452
8 Adverse Events (Donor and Recipient) 10456
9 Clinical Outcomes 10460
G Transfusion Risks and Reactions in Oncology 10464
1 Infectious 10468
2 Graft-Versus-Host Disease 10472
3 Alloantibodies 10476
4 Iron Overload 10480
2 Cell and Tissue Therapy 10500
A HLA Antigens and Alleles 10504
1 Major Histocompatibility Complex 10508
2 Class I and II Antigens and Their Function 10512
3 Polymorphism of HLA System and Nomenclature 10516
4 Identification of HLA Antigens, Antibodies and Alleles 10520
a Serologic Methods 10524
b Cellular Methods 10528
c Nucleic Acid-Based Methods 10532
d Crossmatching 10534
5 Genotypes, Phenotypes and Haplotypes 10536
6 Medical and Biological Significance of HLA 10540
Blood Banking/Transfusion Medicine Page 5 of 26
a Transplantation 10544
i Hematopoietic Progenitor Cell 10548
ii Solid Organ 10552
b Disease Association 10556
B Tissue banking 10560
1 Human Allograft Applications 10564
2 Tissue Donation 10568
a Living Donors 10572
b Deceased Donors 10576
c Referral for Donation 10580
3 Organization of Tissue Banking in the United States 10584
4 Public Attitudes Regarding Organ and Tissue Donation 10588
5 Tissue Transplant-Transmissible Diseases 10592
6 10596
a Donor History Screening 10600
b Donor Physical Assessment 10604
c Tissue Recovery Methods 10608
d Infectious Disease Testing 10612
e Tissue Sterilization 10616
7 10620
a Bone 10624
b 10628
c Skin 10632
d Ocular Tissue 10636
e Cardiovascular Tissue 10640
f Peripheral Nerve 10644
g Parathyroid 10648
h Reproductive Tissue 10652
i Semen 10656
ii Oocytes and Embryos 10660
ii Extraembryonic 10664
8 Transfusion Service Support of Tissue Transplantation 10668
9 Tissue Banking and Transplantation Oversight 10672
C Adoptive Immunotherapy 10676
1 Immunotherapy Targets for Cancer 10680
2 T-Cell Immunotherapy Targets for Infections 10684
3 Types of Adoptive Immunotherapy 10688
a Non-specific T Cells 10692
b Antigen-Specific T Cell Therapies 10696
c Genetically-Modified T Cells 10700
4 Approaches to Improving Cellular Immunotherapy 10704
5 Adoptive Immunotherapy regulatory Issues 10708
D Gene Therapy in Transfusion Medicine 10712
1 Targeted Genes 10716
2 Vector Design 10720
3 Viral Vectors 10724
4 Adeno-Associated Virus 10728
Cartilage, Meniscus, Tendon, Ligament and Dura Mater
Tissue Donor Suitability and Tissue Transplant Risk Reduction
General Principles of Tissue Preservation and Clinical Use
Blood Banking/Transfusion Medicine Page 6 of 26
5 Adenoviral vectors 10732
6 Non-Viral Gene Therapy 10736
7 Clinical Protocols and Trials 10740
E Tissue Engineering and Regenerative Medicine 10744
1 Overview 10748
2 Skin 10752
3 Blood Vessel 10756
4 Bone 10760
5 Cartilage 10764
6 Urology 10768
7 Cardiac 10772
8 Corneal 10776
3 RBCs and RBC Components 10800
A Red Cell Production and Kinetics 10804
1 Erythropoietin 10808
a Regulation of Production 10812
b 10816
2 Nutritional Requirements for Erythropoiesis 10820
3 Influence of Pathologic States on Erythropoiesis 10824
B 10828
1 Regulation of Systemic Oxygen Delivery 10832
2 Regulation of Regional Oxygen Delivery 10836
3 Regulation of Oxygen Delivery in the Microcirculation 10840
a Red Cell Transfusion and the Microcirculation 10844
b 10848
4 Oxygen carrying Red Cell Substitutes 10852
a Hemoglobin-Based 10856
b Perfluorocarbon-Based 10860
C Red Cell Metabolism and Preservation 10864
1 Metabolism 10868
a Glucose 10872
b Alternative Substrates 10876
c Regulation of Energy Metabolism 10880
d Synthetic Processes 10884
e Membrane Metabolism 10888
2 Red Cell Preservation in Transfusion Medicine 10892
a General Principles 10896
b Collection and Separation Procedures 10900
c Anticoagulant-Nutrient Solutions 10904
d Additive Solutions 10908
e Additional Factors Influencing RBC Quality 10912
f Functionality 10916
g Rejuvenation 10920
h Frozen Storage 10924
i Validation of RBC Storage Systems 10928
D Red Cell Immunology and Compatibility Testing 10932
1 Red Cell Immunology 10936
Interaction with and Effects on Erythroid Progenitor Cells
Oxygen Delivery and Use of Red Cells and Red Cell Substitutes for Oxygen
Delivery
Effect of Red Cell Storage Changes on the Microcirculation
(N Oxide)
Blood Banking/Transfusion Medicine Page 7 of 26
a 10940
b 10944
c Red Cell Antigen-Antibody Interactions 10948
i Direct Agglutination 10952
ii Hemolysis 10956
iii Antiglobulin test (DAT) 10960
2 Compatibility Testing 10964
a Donor Testing 10968
b Patient testing 10972
i Sample Collection 10976
ii ABO Typing 10980
iii Rh Typing 10984
iv Tests for Unexpected Antibodies 10988
v 10992
vi Automated Pretransfusion testing 10996
vii Additional Techniques 11000
viii Molecular Techniques 11002
c Principles of Antibody Identification 11004
d Donor-Recipient Testing 11008
i Prior Records Check 11012
ii Selection of Blood for Transfusion 11016
iii Serologic Crossmatch 11020
iv Electronic Crossmatch 11024
v Labeling 11028
vi Issue 11032
vii Emergency Release 11036
viii Bedside Check 11040
ix Hemovigilance 11044
E Carbohydrate Blood Groups and Blood Group Systems 11048
1 ABH Antigens 11052
a Biochemistry 11056
b Antigenic variants 11060
c Secretion 11064
d Se and H genes 11068
e H-Deficient Phenotypes and Genotypes 11072
f 11076
i 11080
ii 11084
2 Lewis System 11088
3 Ii System 11092
4 P System 11096
F Rh and LW Blood Group Systems 11100
1 11104
Immune Response – Components and Characteristics
Blood Group Antibodies - Physical Properties and
Characteristics
Reagents Red Cells for Antibody Detection
Medical Implications of the ABH and Secretor Systems
ABO-Incompatible Solid Organ Transplantation
ABO-Incompatible Hematopoietic Progenitor Cell
Transplantation
Rh Blood Group System - General Information and Nomenclature
Blood Banking/Transfusion Medicine Page 8 of 26
2 Rh Genes and Their Expressed Proteins 11108
3 Molecular Basis for Rh Antigen Expression 11112
a D Antigen 11116
b C/c and E/e Antigens 11120
c RH Genotyping 11124
4 Rh-membrane Complex 11128
5 Rh Function 11132
6 Immune Response to Rh 11136
a Medical Aspects 11140
b Serologic Aspects 11144
c Molecular Aspects 11148
7 LW Blood Group System 11152
a General information 11156
b Genes and Their Expressed Proteins 11160
c Molecular Basis for Antigen Expression 11164
d LW Function 11168
G Other Protein Blood Group Systems 11172
1 Kell and Kx Blood 11176
a 11180
b Kell - Transfusion Medicine Aspects 11184
i Transfusions 11188
ii 11192
c Kell Variants 11196
2 Duffy 11200
a Structure and Function of the Duffy Protein 11204
b Duffy - Transfusion Medicine Aspects 11208
i Transfusions 11212
ii 11216
3 Kidd 11220
a Structure and Function of the Kidd Protein 11224
b Kidd - Transfusion Medicine Aspects 11228
i Transfusions 11232
ii 11236
4 MNS 11240
a 11244
b MNS - Transfusion Medicine Aspects 11248
5 Diego 11252
6 Gerbich 11256
7 Colton and GIL 11260
8 Lutheran 11264
9 Indian, Xg, and Scianna 11268
10 Chido/Rodgers 11272
11 Knops 11276
12 Cartwright, Dombrock, Cromer and JMH 11280
13 OK and RAPH 11284
Hemolytic Disease of the Fetus and Newborn
Hemolytic Disease of the Fetus and Newborn
Hemolytic Disease of the Fetus and Newborn
Structure and Function of Glycophorins A and B
Structure, Function, and Interaction of the Kell and XK
Proteins
Blood Banking/Transfusion Medicine Page 9 of 26
H Anemia and Red Blood Cell Transfusion 11288
1 Physiologic Adaptations to Blood Loss and Anemia 11292
a Oxygen Transport Principles and Mechanisms 11296
b Adaptive Mechanisms in Anemia 11300
c 11304
d 11308
2 Clinical Outcomes of Anemia and Red Cell Transfusion 11312
a Risks of Anemia 11316
b Efficacy of Transfusion 11320
i Adults 11324
ii Children 11328
3 Transfusion Guidelines 11332
4 Red Cell Transfusions - Decision Making 11336
a Bleeding Patient 11340
b Surgical Patient 11344
c Chronic Anemia 11348
d Transfusion Threshold 11352
e Dose and Administration 11356
4 Apheresis 11400
A Apheresis: Principles and Technology of Hemapheresis 11404
1 General Information and Principles 11408
2 Current Devices and Technology 11412
3 Donor Apheresis 11416
a Donor Care 11420
b Specific Products and Procedures 11424
c Adverse Effects on Donors and Recipients 11428
4 Therapeutic Apheresis 11432
a Procedural and Technical Aspects 11436
i Substances Removed 11440
ii Volume Removed 11444
iii 11448
iv 11452
v Equipment 11456
vi Vascular access 11460
vii Anticoagulant 11464
viii Oversight 11468
ix Adverse Effects 11472
B Therapeutic Plasma Exchange 11476
1 General Principles 11480
a Mathematic Principles 11484
b Regulation of IgG Metabolism 11488
c Replacement Fluids (Clinical Aspects) 11492
d Selective Extraction of Plasma Components 11496
e Indication and Treatment Intensity Categories 11500
2 Neurologic Disorders 11504
a Guillain-Barré Syndrome 11508
Microcirculatory Effects of Anemia and Red Cell Transfusion
Pathophysiologic Processes and Anemia – Interactions
Replacement Fluids (Technical and Composition
Details)
Schedule of Procedures (Timing, Number,
Location)
Blood Banking/Transfusion Medicine Page 10 of 26
b 11512
c 11516
d Myasthenia Gravis 11520
e Lambert-Eaton Myasthenic Syndrome 11524
f Neuromyotonia and Limbic Encephalitis 11528
g Stiff-Person Syndrome 11532
h Paraneoplastic Neurologic Syndromes 11536
i 11540
j Multiple Sclerosis 11544
3 Hematologic and Oncologic Disorders 11548
a Monoclonal Proteins 11552
b Blood Cell Alloantibodies 11556
c Thrombotic Thrombocytopenic Purpura 11560
d Hemolytic Uremic Syndrome 11564
e Posttransfusion Purpura 11568
f 11572
g Autoimmune Hemolytic Anemia 11576
h Pure Red Cell Aplasia and Aplastic Anemia 11580
i Coagulation Factor Inhibitors 11584
4 Rheumatic and Other Immunologic Disorders 11588
a Cryoglobulinemia 11592
b Rheumatoid Arthritis 11596
c Systemic Lupus Erythematosus 11600
d 11604
e Goodpasture Syndrome 11608
f 11612
g Solid Organ Transplantation 11616
i Rejection 11620
ii Disease Recurrence 11624
5 Toxic and Metabolic Disorders 11628
a Hypercholesterolemia 11632
b Refsum’s Disease 11636
c Drug Overdose and Poisoning 11640
d Acute Liver Failure 11644
C Specialized Therapeutic Hemapheresis and Phlebotomy 11648
1 Red Cell Exchange 11652
a Principles and Techniques 11656
b Sickle Cell Disease 11660
c 11664
d 11668
e Malaria 11672
2 Erythrocytapheresis and Therapeutic Phlebotomy 11680
Systemic Vasculitis Polymyositis and Dermatomyositis
Rapidly Progressive Glomerulonephritis – Other
Acute and/or Emergent Complications – Indications and
Management
Chronic Conditions or Preventive Strategies – Indications
and Management
Chronic Inflammatory Demyelinating Polyneuropathy
Peripheral neuropathy and Monoclonal Gammopathy
Nonneoplastic Disorders with Central nervous System
Antibodies
Idiopathic (Immune) Thrombocytopenic Purpura
Blood Banking/Transfusion Medicine Page 11 of 26
a Polycythemia Vera 11684
b Secondary Erythrocytosis 11688
c Hereditary Hemochromatosis 11692
3 Therapeutic Platelet Apheresis 11696
a Primary Thrombocytosis 11700
b Secondary Thrombocytosis 11704
4 Therapeutic White Cell Apheresis 11708
a Hyperleukocytosis 11712
b Inflammatory Bowel Disease 11716
5 Extracorporeal Photochemotherapy 11720
a Techniques and Mechanisms 11724
b Cutaneous T-Cell Lymphoma 11728
c Cardiac Allograft Rejection 11732
d Graft-Versus-Host Disease 11736
6 Selective Extraction of Low-Density Lipoproteins 11740
a Principles, Indications, and Techniques 11744
5 Hazards of Transfusion: Specific Adverse Events 11800
A Hemolytic Transfusion Reactions 11804
1 Incidence 11808
2 Signs and Symptoms 11812
3 Complications 11816
4 Causes 11820
5 Differential Diagnosis 11824
6 Laboratory Investigation 11828
7 Pathophysiology 11832
8 Treatment 11836
9 Prevention 11840
B Febrile, Allergic, and Nonimmune Transfusion Reactions 11844
1 Febrile Nonhemolytic 11848
a Description and Characteristics 11852
b Causes 11856
c Diagnosis 11860
d Treatment 11864
e Prevention 11868
2 Allergic 11872
a Description and Characteristics 11876
b Causes 11880
c Diagnosis 11884
d Treatment 11888
e Prevention 11892
3 Anaphylactic and Anaphylactoid 11896
a Description and Characteristics 11900
b Causes 11904
c Diagnosis 11908
d Treatment 11912
e Prevention 11916
4 Massive and Rapid Transfusion - Complications 11920
a Definitions and Description 11924
b Citrate Toxicity 11928
c Electrolyte and Acid/Base Disorders 11932
Blood Banking/Transfusion Medicine Page 12 of 26
d Hypothermia 11936
e Microaggregate Reactions 11940
5 Circulatory Overload 11944
a Description and Characteristics 11948
b Causes 11952
c Diagnosis 11956
d Treatment 11960
e Prevention 11964
6 11968
a Hypotensive 11972
b Ocular 11976
c Plasticizer Toxicity 11980
d 11984
7 Special Transfusion Settings 11988
a Granulocyte Transfusion 11992
b Autologous Transfusion 11996
C Transfusion-Associated Graft-Versus-Host Disease 12000
1 Pathophysiology 12004
2 Incidence 12008
3 Risk Factors - General 12012
4 Fetuses and Neonates 12016
5 Patient Populations At Risk 12020
a Congenital Immunodeficiency Syndromes 12024
b Malignancies 12028
c Hematopoietic Progenitor Cell Transplants 12032
d Solid Organ Transplants 12036
6 Immunocompetent Patients – Risk Factors 12040
7 Clinical Presentation and Diagnosis 12044
8 Treatment 12048
9 Prevention 12052
D Transfusion-Induced Iron Overload 12056
1 Pathophysiology 12060
2 Iron Burden of Transfusions 12064
3 Clinical Features 12068
4 Measurement of Iron Burden 12072
5 Management 12076
a Goals 12080
b Chelation Therapy 12084
E Transfusion-Related Acute Lung Injury 12088
1 Incidence and Epidemiology 12092
2 Clinical Features 12096
3 Pathophysiology 12100
a Acute Lung Injury - Features 12104
b Causes 12108
c Mechanisms of Lung Damage 12112
d Multiple Hit/Threshold Theory 12116
4 Diagnosis and Differential Diagnosis 12120
Toxic Reactions Resulting From Blood Manufacture or Processing
Dimethyl Sulfoxide Toxicity and Cryopreserved Progenitor
Cells
Blood Banking/Transfusion Medicine Page 13 of 26
a 12124
b Consensus Definition 12128
5 Treatment and Management 12132
6 Donor Investigation 12136
7 Prevention 12140
F Posttransfusion Purpura 12160
1 Pathophysiology and Clinical Features 12164
2 Treatment 12168
G Transfusion-Associated Dyspnea 12180
6 Plasma Components and Derivatives 12200
A Plasma Composition 12204
1 12208
2 Von Willebrand Factor Cleaving Protease 12228
3 12232
B Preparation of Plasma Derivatives 12236
1 Plasma Procurement 12240
2 Plasma Manufacture 12244
3 Pathogen Inactivation/Removal 12248
4 Plasma Products – Indications and Clinical Use 12252
a. Prothrombin Complex Concentrate (PCC) 12253
5 Adverse Effects 12256
6 Industry Safety Programs 12260
7 Recombinant DNA Technology and Manufacturing 12264
a. Recombinant Factor Viia 12265
C 12268
1 12272
a Manufacture and Features 12276
b 12280
i Surgery 12284
ii 12288
iii Intensive care 12292
iv Liver Disease 12296
v Warfarin Reversal 12300
vi Therapeutic Apheresis 12304
c Dosing 12308
d Risks and Adverse Effects 12312
e Pathogen-Inactivated Plasma 12316
2 Cryoprecipitate 12320
a Manufacture and Features 12324
b 12328
c Risks and Adverse Effects 12332
3 Albumin 12336
a Manufacture and Features 12340
Massive Transfusion, Trauma, and Disseminated
Intravascular Coagulation
Clinical Use, Indications and Guidelines for Use
Clinical, Physiologic, Radiologic, and Laboratory Features
General Features and Factors Influencing Plasma Composition
Coagulation Factors, Coagulation Factor Inhibitors, and von
Willebrand Factor e.g. description, half-life
Plasma Transfusion and Use of Albumin and Rh Immune Globulin
Fresh Frozen, Frozen, Cryo-Poor, Thawed, and Stored Plasma
Clinical Use, Indications and Guidelines for Use
Blood Banking/Transfusion Medicine Page 14 of 26
b 12344
c Risks and Adverse Effects 12348
4 Rh Immune Globulin 12350
a Manufacture and Features 12354
b 12358
c Risks and Adverse Effects 12362
5 IVIG 12370
6 12380
a Alpha-1-Antitrypsin 12385
b C1 Inhibitor 12390
7 Infectious Hazards of Transfusion 12400
A Transfusion-Transmitted Hepatitis 12404
1 Incidence 12408
2 Hepatitis B Virus 12412
a Epidemiology 12416
b Transmission 12420
c Clinical Features 12424
i Acute Infection 12428
ii Chronic Infection 12432
d Serologic and Molecular Markers of Infection 12436
e Donor Testing and Counseling 12440
f Prevention 12444
g Treatment 12448
3 Hepatitis C Virus 12452
a Epidemiology 12456
b Transmission 12460
c Clinical Features 12464
i Acute Infection 12468
ii Chronic Infection 12472
d Donor Testing and Counseling 12476
e Prevention 12480
f Treatment 12484
4 Hepatitis A Virus 12488
a Epidemiology 12492
b Transmission 12496
c Clinical Features 12500
d Donor Testing and Counseling 12504
e Prevention 12508
f Treatment 12512
5 Hepatitis D and Hepatitis E Virus 12516
a Epidemiology 12520
b Diagnosis 12524
c Transmission 12528
d Clinical Features 12532
e Prevention 12536
6 Non-A, Non-B, Non-C Hepatitis 12540
B Retroviruses 12544
Clinical Use, Indications and Guidelines for Use
Clinical Use, Indications and Guidelines for Use
Other Plasma Derivatives, e.g. CMV, IG, HBV,IG, ISG, Rabies IG
Blood Banking/Transfusion Medicine Page 15 of 26
1 Overview 12548
2 Human Immunodeficiency Virus 12552
a General Information and Epidemiology 12556
b 12560
c Window Period and Risk of Transmission 12564
d Donor Testing and Counseling 12568
e Clinical Features 12572
f Prevention 12576
g Treatment 12580
3 Human T-Cell Lymphotropic Viruses (HTLV) 12584
a General Information and Epidemiology 12588
b 12592
c Window Period and Risk of Transmission 12596
d Donor Testing and Counseling 12600
e Clinical Features 12604
f Prevention 12608
g Treatment 12612
C Cytomegalovirus (CMV) 12616
1 General Information and Epidemiology 12620
2 Incidence and Prevalence Among Blood Donors 12624
3 Window Period and Risk of Transmission 12628
4 Donor Testing and Counseling 12632
5 Clinical Features 12636
6 Prevention 12640
7 Treatment 12644
8 Other herpesviruses 12646
D Other Viruses 12648
1 Parvovirus B19 12652
a General Information and Epidemiology 12656
b Transmission 12660
c Clinical Features 12664
2 West Nile Virus 12668
a General Information and Epidemiology 12672
b Transmission 12676
c Donor Testing and Counseling 12680
d Clinical Features 12684
e Prevention 12688
f Zika, Dengue and Chikungunya 12690
E Transfusion Transmission of Parasites 12692
1 Chagas’ Disease 12696
a General Information and Epidemiology 12700
b Transmission 12704
c Donor Testing and Counseling 12708
d Clinical Features 12712
e Prevention 12716
2 Malaria 12720
a General Information and Epidemiology 12724
b Transmission 12728
Incidence and Prevalence Among Blood Donors
Incidence and Prevalence Among Blood Donors
Blood Banking/Transfusion Medicine Page 16 of 26
c Donor Testing and Counseling 12732
d Clinical Features 12736
e Prevention 12740
3 Babesiosis 12744
a General Information and Epidemiology 12748
b Transmission 12752
c Donor Testing and Counseling 12756
d Clinical Features 12760
e Prevention 12764
f Treatment 12766
4 Leishmaniasis 12768
a General Information and Epidemiology 12772
b Transmission 12776
c Donor Testing and Counseling 12780
d Clinical Features 12784
e Prevention 12788
F Bacterial Contamination of Blood Products 12792
1 Red Blood Cells – Overview and Epidemiology 12796
2 Allogeneic RBCs – Agents and Incidence 12800
3 Autologous RBCs – Agents and Incidence 12804
4 12808
5 Platelets 12812
a Source of Contamination 12816
b Agents and Incidence 12820
c Clinical Features 12824
d Treatment 12828
e Prevention 12832
6 12836
a Donor Screening 12840
b Skin Preparation 12844
c Diversion 12848
d 12852
e Storage Time and Temperature 12856
f Bacterial Detection 12860
g Bacterial Elimination 12864
7 Syphilis 12868
8 Lyme Disease 12872
G Prion Diseases 12876
1 General Information and Epidemiology 12880
2 Transmission 12884
3 Clinical Features 12888
4 Risk Management – Donor Selection 12892
5 Blood Component Processing 12896
6 Plasma Derivative manufacture 12900
7 Cellular, Tissue, and Organ Transplantation 12904
H Pathogen Inactivation 12908
1 Overview and description 12912
Plasma, Cryoprecipitate and Derivatives - Agents and Incidence
Strategies to Reduce the Risk of Posttransfusion Sepsis
Apheresis Versus Whole Blood-Derived Platelets
Blood Banking/Transfusion Medicine Page 17 of 26
2 Plasma 12916
a Solvent/Detergent Treatment 12920
b Methylene Blue Light Treatment 12924
c Psoralen Ultraviolet Light Treatment 12928
d Riboflavin Light Treatment 12932
3 Platelet 12936
a Psoralen Ultraviolet Light Treatment 12940
b Riboflavin Light Treatment 12944
c Thionine Light Treatment 12948
4 Red Cell 12952
a Alkylating Agents 12956
b Photosensitizers 12960
c Riboflavin Light Treatment 12964
5 Emerging Technologies 12968
8 Blood Donors and Blood Collection 13000
A 13004
1 Organization of Blood Services 13008
a United States 13012
b Outside United States 13016
2 Blood Donor Recruitment 13020
3 Collection Process 13024
a Donor Evaluation 13028
i Consent 13032
ii History and Physical Examination 13036
iii Laboratory Testing 13040
iv Deferral Criteria 13044
b Blood Collection 13048
i Whole Blood 13052
ii Component Separation 13056
iii Leukocyte Reduction 13060
iv Automated Collection 13064
c Blood Component Testing 13068
i ABO/Rh 13072
ii Antibody Screening 13076
iii Infectious Disease 13080
d Distribution 13084
e Source Plasma 13088
4 Blood Donor Adverse Events 13092
a Donor Reactions 13096
i Categories 13100
ii Incidence 13104
iii Clinical Features 13108
iv Risk Factors 13112
v Treatment 13116
vi Prevention 13120
b Phlebotomy-Related 13124
i Categories 13128
ii Incidence 13132
iii Clinical Features 13136
Recruitment and Screening of Donors and the Collection, Processing and
testing of Blood
Blood Banking/Transfusion Medicine Page 18 of 26
iv Risk Factors 13140
v Treatment 13144
vi Prevention 13148
c Long-Term Effects of Donation 13152
i Iron 13156
ii Platelets 13160
iii Plasma Proteins 13164
9 13200
A Current Legal Issues 13204
1 Blood Transfusion Injury Claims 13208
a Blood Shield Laws 13212
b Negligence 13216
c Standard of Care 13220
d Causation 13224
e Informed Consent 13228
2 Donor Injury 13232
3 Cord Blood 13236
4 Tissue Banking 13240
5 HIPAA Privacy Rule 13244
B Current Good Manufacturing Practice 13248
1 General Overview 13252
2 Licensing Products and Establishments 13256
3 Recalls and FDA Enforcement Activities 13260
4 Safety Initiatives 13264
5 Enforcement Options 13268
6 Rationale 13272
a Standard Operating Procedures 13276
b Record Keeping 13280
c Personnel and Training 13284
d Calibration 13288
e Validation 13292
f Labeling 13296
g Error Management 13300
h Quality Control Unit and Internal Audits 13304
i Facilities and Equipment 13308
j Process and Production Controls 13312
7 Information Management 13316
8 Common Violations 13320
C 13324
1 Hematopoietic Progenitor Cells 13328
a Sources 13332
b Indications 13336
c HLA Matching 13340
d Donor Registries and Networks 13344
e 13348
f Accrediting Organizations 13352
2 Other Cellular Therapies 13356
Outcomes Registries, Professional Associations and
Networks
Quality, Legal and Regulatory Issues in Transfusion Medicine and Transplantation
Transplant Organizations and Networks in the Regulation of Cellular and
Tissue Therapy Programs
Blood Banking/Transfusion Medicine Page 19 of 26
a Organizational Aspects 13360
b Accreditation and Regulation 13364
3 Tissue Banks 13368
a Organizational Aspects 13372
b Accreditation and Regulation 13376
D 13380
1 Role of the Medical Director 13384
a Administrative 13388
b Clinical 13392
c Education 13396
2 Quality Assurance 13400
a Process Control 13404
b Error Management 13408
c Improving Transfusion Practice 13412
3 Regulatory and Accreditation Requirements 13416
a Food and Drug Administration 13420
b AABB 13424
c Joint Commission 13428
d College of American Pathologists 13432
4 Transfusion Committee 13436
a Membership 13440
b Functions 13444
c 13448
d Education 13452
E Other Administrative Issues 13455
10 Surgery Patients 13500
A Alternatives to Transfusion: Perioperative Blood Management 13504
1 Preoperative 13508
a Autologous Blood Donation 13512
b Anemia optimization 13516
i Iron 13520
ii Erythropoietin 13524
2 Intraoperative/Postoperative 13528
a Acute Normovolemic hemodilution 13532
b 13536
c 13540
B Hemostasis for Surgery/Invasive Procedures 13544
1 Preprocedure Blood Components 13548
a 13552
b Procedure-Related Bleeding 13556
i Central Venous Catheter 13560
ii Liver Biopsy 13564
iii Thoracentesis and Paracentesis 13568
iv 13572
Hospital Transfusion Services, Transfusion Committee and Quality Assurance
Oversight of Transfusion Policies, Procedures, and
Guidelines
Intraoperative autologous blood recovery and reinfusion (cell
salvage)
Postoperative autologous blood recovery and reinfusion
Common Laboratory tests of Hemostasis and Their
Relationship With Procedure-related Bleeding
Gastrointestinal Endoscopy and Biopsy
Blood Banking/Transfusion Medicine Page 20 of 26
v 13576
vi Renal Biopsy 13580
vii 13584
viii Angiography 13588
2 Treatment of Bleeding 13592
a Local 13596
i 13600
ii Topical Agents 13604
iii Topical Sealants 13608
iv Topical Thrombin 13612
v Topical Antifibrinolytics 13616
b Generalized 13620
i Skin and Membrane 13624
ii Purpura and Soft Tissue 13628
iii 13632
iv DDAVP 13634
C Transfusion Therapy for Trauma and Burn Patients 13636
1 Shock 13640
a General Information and Definition 13644
b Hemorrhagic Shock and Classification 13648
i Acidosis 13652
ii Hypothermia 13656
iii Coagulopathy 13660
c Trauma Patient 13664
i Initial Resuscitation 13668
aa Damage Control 13672
ab Blood Component Therapy 13676
ac Hemostatic Agents 13680
ad Pharmacologic Agents 13684
ii Intraoperative 13688
aa Damage Control 13692
ab Temperature 13696
ac Blood Component Therapy 13700
ad Autotransfusion 13704
ae Solid Organ Injury 13708
af Hemostatic Agents 13712
ag Pharmacologic Agents 13716
iii Recovery Phase 13720
aa Blood Component Therapy 13724
iv Massive Transfusion 13728
aa Definition 13732
ab Blood Component Therapy 13736
ac Complications 13740
d Burn Patient 13744
i Initial Resuscitation 13748
aa Fluid Therapy 13752
1 Colloid 13756
Procedures on Upper Airway, Bronchoscopy, and
Transbronchial Lung Biopsy
Epidural Anesthesia, Lumbar Puncture, and
Neurosurgical Procedures
Physical – Sutures, Electrocautery, Compression,
Direct Packing, etc
Small Vessel Bleeding During Surgery
Blood Banking/Transfusion Medicine Page 21 of 26
2 Crystalloid 13760
ab Transfusion Therapy 13764
ac Hemostatic Agents 13768
ad Pharmacologic Agents 13772
D Transfusion Therapy in Solid Organ Transplantation 13776
1 Organ Procurement and Transplants 13780
2 Immunologic Barriers – ABO and HLA 13784
a Management Across Immunologic Barriers 13788
b Organ Selection 13792
c Plasma Exchange 13796
d Pharmacologic Agents 13800
3 Immunohematology 13804
a Patient Alloantibodies 13808
b Passenger Lymphocyte Antibodies 13812
4 Transfusion Therapy 13816
a Liver 13820
b Heart 13824
c Lung 13828
d Kidney 13832
e Pancreas 13836
f Other 13840
5 Special Needs 13844
a CMV Low Risk 13848
b Leukocyte Reduction 13852
c Irradiation 13856
11 Biovigilence & Transfusion-Related Immunomodulation 13900
A Biovigilance/Hemovigilance 13904
1 Requirements for Effective Program 13908
2 Scope 13912
a What Should Be Reported 13916
i Adverse Reactions 13920
ii Adverse Incidents 13924
iii Near Misses 13928
b Biovigilance 13932
i 13936
ii Traceability 13940
c Blood Donors 13944
d Transfusion Recipients 13948
B 13952
1 Concepts and Overview 13956
2 Laboratory Features 13960
3 Beneficial Clinical Effects 13964
a Enhanced Survival of Renal Allografts 13968
b 13972
c 13976
4 Deleterious Clinical Effects 13980
Passive Reporting Versus Active Surveillance
Immunomodulatory and Proinflammatory Effects of Allogeneic Blood
Transfusion
Reduced Risk of Recurrent Spontaneous Abortions
Reduced Risk of recurrence of Crohn’s Disease
Blood Banking/Transfusion Medicine Page 22 of 26
a 13984
b 13988
c Increased Risk of Short-Term Mortality 13992
12 Platelets 14000
A Platelet Production (Thrombopoiesis) 14004
1 14008
2 14012
3 Genetic and Cellular Regulation of Thrombopoiesis 14016
4 Platelet Production/Shedding/Release 14020
B Platelet immunology 14024
1 Platelet Antigens (ABO, HLA, Platelet Specific) 14028
2 Disorders of Platelet Alloimmunization 14032
3 Platelet Autoimmunity 14036
C Platelets in the Bloodstream 14040
1 Platelet Circulation/Distribution/Destruction 14044
2 Platelet Survival/Kinetics in Health and Disease 14048
D Platelets and Hemostasis 14052
1 Normal Platelet Plug and Clot Formation 14056
2 Genetic/Congenital Platelet Disorders 14060
3 Acquired Platelet Disorders 14064
E Platelet Transfusions 14068
1 14072
2 14076
3 14080
13 Neutrophils 14100
A Neutrophil Production (Myelopoiesis) 14104
1 Neutrophil Development, Maturation and Differentiation 14108
2 Myelopoietic/Hematopoietic Growth Factors 14112
3 Genetic and Cellular Regulation of Myelopoiesis 14116
4 14120
B Neutrophil Immunology 14124
1 Neutrophil Antigens (ABO, HLA, Neutrophil Specific) 14128
2 14132
C Neutrophils and Infections 14136
1 Neutrophil Response to Infections 14140
2 Neutrophil Antimicrobial Functions 14144
3 Neutrophil Congenital and Acquired disorders 14148
D Neutrophil/Granulocyte Transfusions (Primarily Clinical Issues) 14152
1 Neutrophil Collection, Storage and Transfusion 14156
2 14160
Increased Recurrence of Resected Malignancies
Neutrophil Release, Compartments and Circulating Kinetics
Disorders of Neutrophil Alloimmunization and Autoimmunity
Alternatives to Neutrophil Transfusions (Myelopoietic Factors)
Increased Risk of Postoperative Bacterial Infection
Megakaryocyte Development, Maturation, and Differentiation
Thrombopoietic/Megakaryocyte/Hematopoietic Growth Factors
Collection and Storage of Platelet Preparations/Concentrates
Clinical Platelet Transfusions (Indications, Dose and Schedule)
Alternatives to Platelet Transfusions (Thrombopoietic and
Pharmacologic agents)
Blood Banking/Transfusion Medicine Page 23 of 26
14 Intravascular Cell Kinetics 14200
A 14204
B 14208
C Use of Non-Radioactive Cellular Labels 14212
D Methods/Calculations for Determining Intravascular Cell Kinetics 14216
E Cell Kinetic Applications in Health and Disease 14220
15 Obstetric and Pediatric Patients 14300
A Obstetric Transfusion Practices 14304
1 Maternal Hematologic Disorders During Pregnancy 14308
2 14312
3 Fetal (Intrauterine) Transfusions 14316
B Hemolytic Disease of the Fetus and Newborn 14320
1 ABO Incompatibility 14324
2 Rh(D) and Other Fetal-Maternal RBC Incompatibilities 14328
3 14332
4 Management 14336
a Diagnostic and Surveillance Tests 14340
b 14344
C Congenital Disorders of Clotting and Anticoagulant Proteins 14348
1 Developmental Physiology of Plasma Proteins 14352
2 14356
a stet 13634
3 14360
4 14364
D Congenital Hemoglobinopathies and Hemolytic Anemias 14368
1 Sickle Cell Disease (Pathophysiology and Treatment) 14372
2 Non-Sickle Cell Hemoglobinopathies 14376
3 Thalassemias (Pathophysiology and Treatment) 14380
4 Congenital Red Cell Membrane and Enzyme Defects 14382
E Neonatal Transfusions 14384
1 Anemia of Prematurity (Pathophysiology and Treatment) 14388
2 14392
3 14396
4 14400
F Congenital Disorders of Hematopoiesis 14404
16 Hematopoietic Progenitor Cell (HPC) Transplantation 14500
A 14504
1 Autologous 14508
Concepts of Post-Transfusion Recovery and Tracking Labeled/Tracer cells
Techniques of Radiolabeling Blood Cells (RBCs, Platelets and Leukocytes)
Maternal Hemorrhage and Transfusions During Pregnancy
Neonatal Blood Banking Practices (Dedicated Units, WBC-Reduction,
Irradiation, etc)
Neonatal/Infant Plasma, Cryoprecipitate and Neutrophil Transfusions
Biology of Marrow Transplantation – Indications, Methods, Results, Adverse
Effects
Fetal RBC Membrane/Metabolic or Hemoglobin Abnormalities
Fetal and Neonatal Transfusions, Phototherapy, etc)
Hemophilia A, B and von Willebrand Disease (Pathophysiology and
Treatment)
Congenital Disorders of Non-Hemophilia Clotting Proteins
Congenital Disorders of Anticoagulant/Prothrombotic Proteins
Thrombocytopenia of Prematurity (Pathophysiology and Treatment)
DDAVP
Blood Banking/Transfusion Medicine Page 24 of 26
2 Allogeneic / Syngeneic 14512
B Biology of HPC and HPC Transplantation 14516
1 HPC Biology 14520
2 Identification and Measurement of HPC 14524
3 14528
4 HLA Typing for HPC Transplantation 14532
5 Processing Requirements for HPC 14536
a General 14540
b Patient-Specific 14544
6 Regulatory, Compliance, Accreditation 14548
C HPC Sources and Collection 14552
1 HPC - Marrow 14556
a Methods of Harvesting 14560
b Characteristics, 14564
c Adverse Effects 14568
2 14572
a Biology of Stem Cell Mobilization 14576
b 14580
i Chemotherapy 14584
ii Growth Factors – G-CSF, GM-CSF 14588
iii Adhesion blockers – Plerixafor 14592
c 14596
d Monitoring Mobilization and HPC Collection 14600
e 14604
f 14608
3 14612
a 14616
b Cord Blood Unit Characteristics 14620
c 14624
4 14628
D 14632
1 HPC for Autologous Transplants 14636
2 14640
3 14644
4 Cord Blood 14648
5 14652
Allogeneic/Syngeneic Donor Selection, Qualification, Eligibility
HPC – Apheresis – Characteristics and Adverse effects
Donor Selection for Transplant (Unrelated and Related)
Selection of the Appropriate HPC Source for a Given Patient
HPC Processing - Goals, Guidelines, and Methods (preparation for infusion)
HPC for Allogeneic Transplant – Indications for Plasma, RBC
Reduction,
Preparation of Cells for Donor Lymphocyte Infusion (DLI)
Processing of Other CT Products (eg Antigen-Directed T cells,
Marrow Stromal Cells)
Mobilization Regimens (Indications, Dose, Schedule,
Efficacy, Adverse Effects)
Scheduling Mobilization and Apheresis Collection
Collection of Lymphocytes for Infusion (Donor Lymphocyte
Infusion; DLI)
Apheresis Considerations – Techniques, Vascular Access,
Donor Management, and Adverse Effects (Allogeneic vs
HPC - Cord Blood -
Characteristics, and Methods
Cord Blood Banking - Donor Eligibility, Collection Methods,
Processing, Testing, Cryopreservation
Blood Banking/Transfusion Medicine Page 25 of 26
E HPC Storage and Preservation 14656
1 14660
2 Rationale for Cryopreservation 14664
3 Cryopreservation Theory and Practice 14668
a Cryoprotectants 14672
b 14676
c 14680
F 14684
1 14688
2 Patient Transfusion Management 14692
a 14696
b 14700
3 14704
4 Pediatric Considerations for Graft Manipulation 14708
G HPC Assessment - Pre- and Post-Processing and Post-Thaw 14712
1 Cell Counts and Methods 14716
2 HPC Measurement and Enumeration 14720
a 14724
b Non-Flow Methods 14728
3 HPC Viability Assessment Techniques 14732
4 HPC Cell Culture Assays 14736
5 HPC Functional and Differentiation Assays 14740
6 14744
H Cell Selection Methods and Applications 14748
1 14752
2 CD34 Cells and Others (eg Treg) 14756
3 Tumor Purging and T Cell Depletion 14760
I 14764
1 Direct HPC Infusion vs Pre-Infusion Cell Washing 14768
2 14772
J HPC and CTP infusion 14776
1 14780
2 14784
3 Management and Infusion of Contaminated Products 14788
K Engraftment 14792
Flow Cytometry CD34+ Cells and Other Markers (Single vs
Dual platform)
HPC Microbial Assessment - Gram Stain, Cultures - Aerobic,
Anaerobic, Fungal
Positive and Negative Selection - Techniques, Results, Indications
HPC and CTP Thawing and Post-Thaw Processing (Apheresis, Marrow, Cord
Blood, etc)
Special Considerations for Preparation of Cord Blood HPC for
infusion
Liquid Storage and Transport - Anticoagulant, Time, Temperature,
Preservative, Cell Concentration
Cryopreservaton Techniques – Controlled Rate, "Dump
Freeze"
Storage - Mechanical and Liquid Nitrogen (Vapor vs Liquid),
Management of RBC Antigen Incompatibility in Allogeneic Transplantation -
ABO/Rh, HLA, Other
Graft Management - Depletion of RBC (Major), Plasma (Minor)
Major or Minor ABO Incompatibility – Immediate vs Delayed
Hemolysis
Passenger Lymphocyte Syndrome (PLS), Cause, Diagnosis,
Course, Therapy, Prevention
Ablative vs Non-Ablative (Immunosuppressive) Conditioning
General Guidelines – Filters, No Irradiation, Infusion Rate, DMSO
Limits, Infusion Pumps
Adverse Effects and Infusion Reactions – Incidence, Causes,
Diagnosis, Management
Blood Banking/Transfusion Medicine Page 26 of 26
1 14796
2 14800
3 Engraftment failure – Causes, Management 14804
4 Immune Reconstitution Post-Transplant 14808
5 Donor Lymphocyte Infusion – Rationale, Efficacy 14812
L 14816
1 14820
M 14824
N Experimental Cell Therapies 14828
1 Institutional vs Commercially Sponsored 14832
2 14836
3 14840
4 Regulatory Considerations 14844
Laboratory Administration - Staff Hiring and Training, Facilities, Equipment,
Supplies, Laboratory Development, Deviations, Non-Conforming HPC and
Types (eg Marrow Stromal, Adoptive Therapy with T Cells, Gene-
Modified Cells)
Special Requirements for Processing (Clean Room, etc)
Definition, Chimerism, Relationship to CD34+ Cell Doses
Rates - Autologous vs Allogeneic, Related vs MUD, HPC Source,
Conditioning
HPC Lab quality assurance and accreditation - AABB, FACT, CAP, NMDP
Regulatory Considerations – Federal GMP, GTP; State
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