Thread by @TransfusionWM

In the transplantation and transfusion setting. First Dr Claire Wiggins on what transfusionists need to know about stem cells #bbts2017

NHSBT will start screening allogeneic stem cells for Hepatitis E this month #bbts2017

Next Maria Kaisar on transplantation science in solid organ transplant #bbts2017

First transplant unit established in Edinburgh in 1965 #bbts2017

Allogeneic SOT can be from Donation after brain death (DBD), circulatory arrest (DCD) or living donor #bbts2017

Factors affecting success of transplant #bbts2017

ABO incompatible SOT can lead to hyperacute rejection due to donor ab causing intravascular inflammation #bbts2017

Reperfusn injury leads to pathological immunological activatn w subsequnt necrosis, complement activatn &activatn of coag cascade #bbts2017

And now Dora Foukaneli on transfusion support for transplantation #bbts2017

ABO incompatible BMT now account for 25-50% of allografts. Allows for wider donor selection.... 1/2

2/2... Robust lab processes needed to ensure compatible blood #bbts2017

Outcomes following ABO incompatible HSCT are very confused! ?increased chronic GVHD, ?increased TRM, ?incr transfusion requirement #bbts2017

Consequences include acute delayed haemolysis, pure red cell aphasia and passenger lymphocytes #bbts2017

Hallmark of PRCA is low reticulocyte count #bbts2017

Passenger lymph syndrome can occur post BMT or SOT, for ABO groups or minor blood groups #bbts2017

PLS usually self limiting after a few weeks, but can still contribute significant morbidity in already v sick patients #bbts2017

AIHA can also occur irrespective of PLS #bbts2017

ABO incompat SCT and ABO incompat SOT require manual XM for 3/12 #bbts2017

RBC transfusion thresholds cant be recommended in haemonc as no evidence. PBM still applies. Oxford &Cambridge (&Bham!) use 80g/L #bbts2017

Single unit then reassess #bbts2017

First ABO incompatible liver happened by mistake! Now relatively commonplace #bbts2017

Ex vivo normothermic perfusion to optimise ischaemic organs pretransplant. Expanding nos of trials -causing transfusn headaches! #bbts2017

Selection of ABO and Rh blood groups is key, and need robust methods for traceability #bbts2017

And finally Ines Ushiro-Lumb on donor derived infection in SOT #bbts2017

HepB,C,HIV are NOT absolute contraindications for transplantation either in donor or recip #bbts2017

Risk of missing Hep C, HIV and Hep B in blood donors will occur every 49, 7 & 1 years respectively #bbts2017

Different story in SOT due to time constraints, NOK completes donor health Q'aire and infection not contraindication to donation #bbts2017

Less NAT testing in SOT but more mandatory testing #bbts2017

Transfusing organ donors in ITU brings its own microbiological dilemmas! #bbts2017

Positive CMV serology due to passive acquisition causing problems in this setting too #bbts2017

As always, results need to be interpreted in light of type and volume of recent transfusion #bbts2017

Pre transfusion testing should be undertaken where at all possible #bbts2017

markers in red may be found in recips of blood transfusion as not tested routinely in blood donors #bbts2017