The Transfusion Service, formerly known as the Blood Bank, provides Red Blood Cells, Plasma, Apheresis Platelets, Cryoprecipitated AHF and other blood products to support medical care, including surgeries, bone marrow and solid organ transplants. The hospital’s computerized blood order entry (CPOE) program supports blood orders in compliance with national guidelines for Patient-Centered Blood Management. A daily Blood Utilization Review including all transfusions of Red Blood Cells and Apheresis Platelets is conducted by a specialist in Transfusion Medicine. The Transfusion Service is partnered with the American Red Cross, supporting Red Cross blood drives at the Georgetown University School of Medicine and at the Medical Center for MGUH staff. All blood components issued by the Transfusion Service are collected by the Red Cross from volunteer donors. In 2017, the Transfusion Service issued approximately 10,000 units Red Blood Cells, 4,500 units of Plasma, 1,100 units of Cryoprecipitate and 2,200 units of Apheresis Platelets.
The Transfusion Service provides immunohematology laboratory services 24/7/365. Blood typing and screening for blood group antibodies is performed using two ultra-sensitive, state-of-the-art automated solid phase immunohematologic analyzers. For patients requiring transfusions of red blood cells, but who have allergies to plasma, the Transfusion Service removes plasma by saline washing using automated cell washing centrifuges. For patients with a requirement for red blood cells of a rare type, typically for multi-transfused patients with sickle cell disease, the Transfusion Service maintains an inventory of red blood cells of rare types frozen at -80C. This inventory of frozen red cells is selected to match the requirements of patients who require lifelong transfusions of red cells of rare types. The frozen red cells, which are viable for more than 10 years, are obtained prospectively from the American Rare Donor File. The Transfusion Service provides in-hospital laboratory services for antibody identification, immunohematologic studies for the diagnosis of autoimmune hemolytic anemia and antibody titers for women whose pregnancy is at risk for hemolytic disease of the fetus/newborn. The laboratory performs serologic titers of anti-A1 and anti-A2 (Asub) for kidney transplant patients, increasing the number of cadaver kidneys available for transplantation. The Transfusion Service partners with the American Red Cross Reference Laboratory, Baltimore, MD, for provision of specialized immunohematologic testing, and with the National Molecular Laboratory, Philadelphia, for molecular diagnostics. Representatives from the Transfusion Service participate in the MedStar Work Group on Transfusion Services, supporting MedStar’s efforts to standardize laboratory services. In 2017, the Transfusion Service performed 29,000 ABO/Rh typings, 20,000 antibody screens and 20,000 crossmatches.
The Transfusion Service supports the training of Pathology residents and medical students in the subspecialty of Transfusion Medicine. During the prior 5 years, the Transfusion Service has supported scientific journal publications in medical journals on the subjects of non-hemolytic passenger lymphocyte syndrome, the DEL phenotype, serologic weak D phenotype, Rh immunoprophylaxis, and blood group genotyping.
The Transfusion Service is registered with the US Food and Drug Administration and accredited by the AABB (formerly, American Association of Blood Banks) and the College of American Pathologists. Oversight of regulatory and accreditation requirements is provided by the Blood Utilization Review Committee composed of representatives from Anesthesia, Surgery, Transplantation, Medicine, Pediatrics, Obstetrics, Nursing, Pharmacy and Administration.
The Transfusion Service maintains a consultation service for physicians. Patients with autoimmune hemolytic anemia, refractoriness to platelet transfusions, difficulty locating rare blood, pregnancy complicated by blood group antibodies or a history of transfusion reactions may request a consultation with a Transfusion Medicine specialist who will join their physician for consultation.