Transfusion Science
Programme sponsor
Obstetric guidelines - what's new?
Obstetric guidelines - what's new?
Transfusion Science
Abstract
This presentation will:
- Summarise the key points within the BSH guideines for blood grouping and antibody testing in pregnancy
- Give an overview of the main updates to the BSH guideline for blood grouping and antibody testing in pregnancy
Speakers
David Bruce
Highlights from the 2022 Annual SHOT Report: lessons learnt and learning from excellence
Highlights from the 2022 Annual SHOT Report: lessons learnt and learning from excellence
Transfusion Science
Learning outcomes
Serious Hazards of Transfusion is the UK haemovigilance scheme and accepts reports on serious adverse events and reactions related to transfusion. This presentation covers the key highlights, messages and recommendations from the 2022 Annual SHOT Report, with a focus on laboratory practice. Delegates should expect some debate, with interactive case studies where discussion around improving and excellent practice can be expected. All learning will centre those at the heart of the processes and will consider how human factors influence patient safety at the laboratory level and beyond.
This presentation will:
- Summarise the main learning and recommendations from the 2022 Annual SHOT Report
- Give an overview of human factors and their importance in transfusion
- Summarise how learning from excellence can improve patient safety
Speakers
Nicola Swarbrick
Victoria Tuckley
Incident Management – MHRA expectations
Incident Management – MHRA expectations
Transfusion Science
Abstract
Reporting haemovigilance incidents is vital to the ongoing learning from errors and improvements of quality management systems in transfusion. It is a statutory reguirement of the Blood Safety and Quality Regulations (2005) (as amended) and the data collected is used by both MHRA and SHOT to analyse and demonstrate key learning opportunities.
This presentation will give an overview of the legal requirements of the BSQR and the Good Practice Guide. Common isnspection findings will be presented and practical learning from SABRE reports will be shown. Common issues associated from reports received will be discussed and tips given as to how to improve the reporting of haemovigilance data.
Learning outcomes
Delegates attending this presentation will gain knowledge on:
- Inspection findings and expectations
- SABRE reporting insights
- Practical reporting hints and tips
Speakers
Chris Robbie
Nuisance Antibodies
Kell Blood Group System
Kell Blood Group System
Transfusion Science
Abstract
If you're interested in blood groups, blood group serology, transfusion or just want to know "what the hell is Kell?" then this talk is for you...
This presentation on the Kell Blood group system will cover the following;
- An entertaining overview of the Kell blood group system
- Structure, function and molecular background of the most well-known Kell blood group system antigens
- Clinical significance of antibodies to Kell blood group system antigens
- The association with the Kx blood group system
- Interesting facts about the lesser known Kell Blood group system antigens
Learning outcomes
An entertaining overview of the Kell blood group system, delegates will learn about:
- Structure, function and molecular background of the most well-known Kell blood group system antigens
- Clinical significance of antibodies to Kell blood group system antigens
- The association with the Kx blood group system
- Interesting facts about the lesser known Kell Blood group system antigens
Speakers
Dr Tom Bullock DClinSci FRCPath FIBMS
Who lives in a papaya under the sea? SpongeBob Alloadsorption Pants! A Transfusion Laboratory Perspective of AIHA
International Blood Group Reference Laboratory (IBGRL) - Finding New Blood Groups
International Blood Group Reference Laboratory (IBGRL) - Finding New Blood Groups
Transfusion Science
Abstract
Explanation of the various serological and molecular techniques that are available to identify novel blood groups. Discussing how these cases may present within the hospital and RCI labortories through to publication and ratification at the International Society of Blood Transfusion.
Speakers
Shane Grimsley
Antibody Workshop
Antibody Workshop
Transfusion Science
Abstract
Join some of our panel members for our lunchtime session where we will be hosting an antibody workshop. Looking at different types of antibodies and how to positively identify or eliminate any suspected clincially significant antibodies, whilst testing your knowledge and skills.
The aim is to make the session fun and interactive, focusing on some top tips for solving those antibody mysteries.
Speakers
Managing blood stocks in a shortage
Managing blood stocks in a shortage
Transfusion Science
Abstract
In 2022 the unthinkable happened - NHSBT was forced to declare an Amber Alert for red cells in England. But does that tell the whole story? This presentation will briefly examine the build-up to the shortage declaration but also consider its impact, provide evidence of the response within hospitals and consider the opportunities for future change in practices.
Learning outcomes
Delegates will gain an appreciation of:
- Why an Amber alert was declared and what did this mean
- How management of hospital blood stocks could impact the alert
- What the Blood Stocks Management Scheme did to help guide hospitals
- What was the impact, what can the data tell us and what have we learned.
Speakers
Matthew Bend
CRYOSTAT 2 trial
CRYOSTAT 2 trial
Transfusion Science
Learning outcomes
Delegates will:
- Understand the rationale for the CRYOSTAT 2 randomized trial and the potential importance of fibrinogen in major bleeding
- Hear the results of the CRYOSTAT 2 trial
- Be able to discuss the implications for practice and future research
Speakers
Professor Simon Stanworth
Production of platelets and red cell in vitro for human transfusion
Production of platelets and red cell in vitro for human transfusion
Transfusion Science
Abstract
The idea of generating blood cells in vitro for transfusion is not new but only now we are reaching the point where the concept is reaching clinical trials. In vitro derived blood cells (namely platelets and red cells at this stage) are complementary to blood donor-derived products but with distinct advantages: biological safety, more resilient supply line and potentially less immunogenicity.
We have developed a forward programming approach relying on the overexpression of transcription factors in pluripotent stem cells to produce the platelet mother cells, the megakaryocytes, conferring added efficiency and purity to the culture system. The challenges that remain to be addressed are related to transition to GMP production, optimising platelet release in the culture and quality control of the final product. The power of genome editing has also allowed us to explore the production of platelets with added clinical benefit (immune silent, added thrombotic potential).
Red cell production from primary CD34+ progenitors has been demonstrated in academic laboratories about a decade ago. We are now mid-way through a first in human study to look at the potential of using in vitro derived red cells for transfusion. One of the main benefits would be a potentially longer survival of the manufactured red cells in the circulation than their donor-derived counterpart. This would allow spacing out transfusion intervals for patients on chronic transfusion programme, thereby reducing iron overload.
Learning outcomes
Delegates will gain knowledge on:
- Production of platelets and red cell in vitro for human transfusion, and
- Provisional results from recent trial.
Speakers
Professor Cedric Ghevaert
Coagulation for Blood Bankers: Help! I’ve lost the clot….
Coagulation for Blood Bankers: Help! I’ve lost the clot….
Transfusion Science
Abstract
Coagulation tests can be confusing, but correct interpretation is crucial to guide transfusion of blood products and haemostatic agents. Advantages and limitations of these tests will be discussed, using a variety of examples to demonstrate potential pitfalls.
Learning outcomes:
- Understand appropriate use and limitations of coagulation tests
- Interpretation of abnormal results
- How results can guide transfusion of blood products
- Recognise alternatives to blood products for haemostatic support
Learning outcomes
Delegates will understand:
- The basis of haemostasis
- Haemostatic abnormalities which require use of blood products
- The appropriate use of blood products in these disorders.
Speakers
Samatha Jones
Acute obstetric coagulopathy
Acute obstetric coagulopathy
Transfusion Science
Abstract
Postpartum haemorrhage is caused by obstetric complications but may be exacerbated by haemostatic impairment. It is a common observation that placental abruption and amniotic fluid embolism are associated with a severe and early coagulopathy characterised by hypofibrinogenaemia and increased fibrinolysis.
In Cardiff, a programme of research has been undertaken investigating the early detection and replacement of fibrinogen based on viscoelastic haemostatic assays. This culminated in the development of a care bundle for postpartum haemorrhage called the Obstetric Bleeding Strategy for Wales (OBS Cymru). Introduction of the OBS Cymru intervention across Wales resulted in fewer women experiencing massive postpartum haemorrhage (defined as >2500 mL) and decreased need for blood transfusion. The intervention is being investigated further in a NIHR supported study.
At term, women have increased levels of procoagulant clotting factors and reduced anticoagulants leading to a prothrombotic state. Our study confirmed these findings and demonstrated significantly raised thrombin generation. We identified two main types of coagulopathy; a dilutional coagulopathy with coagulation factors and platelets falling progressively with bleed size. However, clinically significant reductions in clotting factors were not seen until bleeds of 3000-4000 mL had occurred due to the high starting levels. Despite this, thrombin generation did not decrease due to increased levels of factor VIII during bleeds. Similar dilution-related falls were seen with fibrinogen levels. The exception was factor XIII which falls at term and decreases further with bleed size. The clinical significance of this finding has not been investigated but could suggest a role for cryoprecipitate.
In a subgroup of women we identified an early and severe consumptive coagulopathy caused by hyperfibrinolysis with very high D-dimer and plasmin/antiplasmin complexes which we termed acute obstetric coagulopathy (AOC). In addition, women with AOC had low levels of fibrinogen and evidence of an acquired dysfibrinogenaemia demonstrated by a reduced Clauss/antigenic ratio. The coagulopathy caused depletion of factor V and factor VIII but other clotting factors and thrombin generation was preserved. An increase in activated protein C was observed but no increase in soluble thrombomodulin demonstrating similarities and differences to trauma-induced coagulopathy.
AOC occurred in about 1/1000 deliveries and was associated with a high rate of fetal and neonatal deaths. It was most commonly associated with placental abruption but occurred with all underlying causes of postpartum haemorrhage.
Learning outcomes
Delegates will gain knowledge on:
- Underlying causes of major haemorrhage in obstetric cases
- How this can be identified and monitored using viscoelastic assays
- Intervention to include use of anti-fibrinolytic agents and blood products.
Speakers
Professor Peter Collins
Biomedical Scientist Empowerment, Education and Discussion Group: Improving access to CPD for hospital transfusion staff
Biomedical Scientist Empowerment, Education and Discussion Group: Improving access to CPD for hospital transfusion staff
Transfusion Science
Abstract
In response to the COVID-19 pandemic, the NHS Blood and Transplant (NHSBT) Patient Blood Management (PBM) team, with the support of the London Regional Transfusion Committee, created a remote, no-cost education group for biomedical scientists aimed at providing ongoing professional development for transfusion laboratory professionals. The popularity of the group led to the continuation of the group beyond the pandemic and membership being opened to all healthcare professionals interested in blood transfusion.
The group convenes monthly and invites professional/industry experts to deliver lectures on specialist areas of blood transfusion, followed by discussion. The curriculum is flexible and responsive to feedback, incorporating key recommendations, such as those found in the annual SHOT report. The group has covered a wide range of topics, including antibody identification, appropriate use of blood components, haemoglobinopathies, advances in information technology, inventory management, gender reassignment, provision of rare blood, transfusion delays, and emergency preparedness, among others.
Over 2800 healthcare professionals worldwide have joined the group, with an average attendance of 165 individuals per meeting. Survey results from 1390 delegates between April 2022 and April 2023 demonstrated high evaluation of the education provided during the sessions, with an average rating of 4.72 out of 5 for information quality and 4.58 out of 5 for information relevance to their day-to-day work. Furthermore, 99.1% of all respondents believed that the education enabled them to offer a better service to patients and service users.
The NHSBT PBM team's remote and accessible model has been successful in providing ongoing education and continuing professional development for blood transfusion professionals beyond the pandemic. This cost-effective model has become a regular feature in hospital transfusion continuing professional development, enhancing individual and service performance, and could be a valuable consideration for other healthcare disciplines.
Learning outcomes
To improve training and education during lockdown conditions, the Biomedical Scientist Empowerment, Education and Discussion Group was launched to provide virtual learning opportunities in blood transfusion. The group now successfully offers lectures to thousands of hospital transfusion laboratory staff, clinicians and students across the UK and internationally.
This presentation offers an update on the group, its plans for the future and how individuals and employers can benefit from being a member of the group.
Speakers
Danny Gaskin
From Biomedical Scientist to the Blood Stocks Management Scheme: Life after the laboratory!
From Biomedical Scientist to the Blood Stocks Management Scheme: Life after the laboratory!
Transfusion Science
Abstract
There are many job roles and opportunities available to biomedical scientists outside of the laboratory, but what does a biomedical scientist do working within the Blood Stocks Management Team?
Learn about a different role, the transferable skills that are required and how this role is different from working in a laboratory environment. Why is this role important to Blood Transfusion laboratories and is it beneficial having a biomedical scientist as part of the team?
Learning outcomes
This presentation will give those who attend an appreciation and understanding of:
- Different roles outside of the laboratory
- What the the presenters role entails
- How previous experience as a biomedical scientist has helped
- What the presenter has found surprising and interesting in this national role and how it differs from her previous biomedical scientist job.
Speakers
Jill Caulfield
Crossroads to a Compatible Career: From Pipette to Patient Blood Management
Crossroads to a Compatible Career: From Pipette to Patient Blood Management
Transfusion Science
Learning outcomes
This presentation will enable delegates to:
- Recognise their strengths and realise the diverse skills of a Biomedical Scientist.
- Understand the importance of having an open mindset. Every day is a school day!
- It’s good to be inquisitive. Seeking opportunities for improvement areas.
- Make a positive difference. How being proactive in all things Patient Blood Management optimises patient care.
Speakers
Anwen Davies
Meet the Examiner Session
Implementation of Blood on Board: A laboratory perspective
Implementation of Blood on Board: A laboratory perspective
Transfusion Science
Abstract
The Air Ambulance covering Derbyshire, Leicestershire and Rutland first approached Blood Transfusion in February 2021 to discuss the idea of them being able to carry blood on the aircraft so they can carry out lifesaving transfusions at the roadside. In the previous months the medics on board had been documenting those patients they had attended that they thought would have benefited from being transfused at the scene of an injury.
The majority of these were road traffic accidents and stabbings where blood loss had led to severe morbidity or even mortality. After months of meetings discussing what equipment was needed (e.g. blood boxes, temperature monitoring devices, storage etc.), finances, validation procedures and trialling the process we finally started providing blood on board in February 2022.
Learning outcomes
Delegates will understand:
- Why this was started
- How it was implemented it
- Where the project is now.
Speakers
Chloe Wilkes
Blood on Board
Blood on Board
Transfusion Science
Abstract
The lecture will include a basic introduction to a busy mixed urban and rural Helicopter Emergency Medical Service in the East of England and the logistics of carrying and administering blood products to multiply injured, major trauma patients. The types of patients that typically require a transfusion will be presented and we will hear from patients that have since recovered and how they feel about having received a prehospital transfusion.
Learning outcomes
Delegates attendint this presentation will learn about:
- Logistics of carrying blood in the prehospital setting
- Patient groups that require prehospital transfusion
- Frequency of prehospital transfusion
- How prehospital transfusion is benefitting patients
Speakers
Laurie Philipson
Resuscitation with Pre-Hospital Blood Products (RePHILL) trial
Resuscitation with Pre-Hospital Blood Products (RePHILL) trial
Transfusion Science
Learning outcomes
RePHILL (Resuscitation with Pre-Hospital Blood Products) was a multi-centre randomised controlled trial of pre-hospital blood product administration versus standard care for traumatic haemorrhage, funded by the National Institute for Health Research (NIHR) Efficacy & Mechanism Evaluation Programme.
The trial tested the hypothesis that Pre-Hospital Blood Products (PHBP) resuscitation with up to two units each of packed red blood cells (PRBC) and lyophilised plasma (LyoPlas N-w) will improve tissue perfusion (as measured by lactate clearance) and reduce mortality in trauma patients with haemorrhagic shock compared to the current standard practice of crystalloid (normal saline) resuscitation. This presentation will explore the outcomes of the trial.
