Editing Transfusion medicine

{{short description|Medical specialty}}
'''Transfusion medicine''' (or '''transfusiology''') is the branch of medicine that encompasses all aspects of the [[Blood transfusion|transfusion]] of blood and [[blood component]]s including aspects related to hemovigilance. It includes issues of [[blood donation]], [[immunohematology]] and other laboratory testing for transfusion-transmitted diseases, management and monitoring of clinical transfusion practices, [[Blood management|patient blood management]], therapeutic [[apheresis]], [[stem cell]] collections, [[cellular therapy]], and [[blood coagulation|coagulation]]. Laboratory management and understanding of state and federal regulations related to blood products are also a large part of the field.

==Overview==
In most countries, [[immunohematology]] and transfusion medicine specialists provide expert opinion on [[massive transfusions]], difficult/incompatible transfusions and rational use of specialised blood product therapy like irradiated blood/[[leukodepleted]]/washed blood products.

The blood donor center is the facility that collects blood components from screened blood donors, either whole blood or separate components such as plasma or platelets only via apheresis. These blood components are then transported to a central location for processing such as fractionation, testing and redistribution. The testing includes determining blood type and testing for infectious diseases. Whole blood is fractionated into red blood cells, platelets and plasma whilst plasma can be further refined into separate components such as albumin, clotting factor concentrates and immunoglobulin.

The [[blood bank]] is the section of the clinical laboratory where [[clinical laboratory scientist|laboratory scientist]]s store and distribute [[blood product|blood component]]s. Both areas are typically overseen by a specialist in transfusion medicine. Transfusion medicine was earlier a branch of [[clinical pathology]], however the field has now expanded into a clinical, hospital-based specialty. The practice of transfusion medicine involves both laboratory and clinical aspects of transfusion as communication between blood bank and patients, treating specialists and other medical staff is vital in situations such as massive transfusions or [[transfusion reactions]].

To ensure the safety of blood components, regimented procedures and quality assurance systems must be in place covering all aspects of the transfusion chain, from donation to transfusion outcomes. Within hospitals, transfusion committees are established to ensure safe hospital transfusion practice such as compliance with standards and guidelines, reviewing transfusion reactions and management of blood supply. These multidisciplinary committees are composed of transfusion medicine specialists, [[Transfusion practitioner|transfusion nurses]], laboratory scientists, clinicians and staff from hospital management and the quality team.

==History==
In 1628, [[England|English]] physician [[William Harvey]] discovered that blood circulates around the body. Soon thereafter, the first blood transfusion was attempted. In 1665 another English doctor [[Richard Lower (physician)|Richard Lower]] successfully used blood transfusion between dogs to keep them alive.<ref name="aabbhighlights">{{cite web|url=http://www.aabb.org/tm/Pages/highlights.aspx/|title=  Highlights of Transfusion Medicine History |publisher=aabb.org|access-date=2009-01-01}}</ref>

[[Karl Landsteiner]] is recognized as the father of transfusion medicine. Landsteiner is credited with the first classification of human blood into the four types (A, B, AB, O) of the [[ABO blood group system]].

==National differences and how to specialise==
'''Australia'''

In Australia, transfusion medicine is a sub-specialty of haematology. Training in transfusion medicine is covered by the Royal College of Pathologists of Australasia (RCPA).

Australia has national blood services operated by the [[Australian Red Cross Blood Service]]. There are a series of guidelines and standards relevant to the laboratory released by the National Association of Testing Authorities, Australia (NATA),<ref>{{Cite web|url=https://www.nata.com.au/|title=NATA - Home|website=www.nata.com.au|access-date=2019-09-12}}</ref> Australian and New Zealand Society of Blood Transfusion (ANZSBT)<ref>{{Cite web|url=https://anzsbt.org.au/|title=ANZSBT|website=anzsbt.org.au|access-date=2019-09-12}}</ref> and RCPA.<ref>{{Cite web|url=https://www.rcpa.edu.au/Home|title=Royal College of Pathologists of Australasia}}</ref> Similarly, there are a series of clinical practice, [https://www.blood.gov.au/pbm-guidelines patient blood management guidelines] by the National Blood Authority.

In Australia, the Serious Transfusion Incident Reporting (STIR) system is in place to capture serious transfusion incidents and near-miss incidents.<ref>{{Cite web|url=https://www2.health.vic.gov.au:443/hospitals-and-health-services/patient-care/speciality-diagnostics-therapeutics/blood-matters/serious-transfusion-incidents|title=Serious Transfusion Incidents Reporting system|last=Services|first=Department of Health & Human|website=www2.health.vic.gov.au|language=en|access-date=2019-09-12}}</ref>

;Denmark

In Denmark, the subject is covered by the specialty, "Clinical Immunology".

;Germany
In Germany, transfusion medicine is an independent specialty. Physicians complete a three-year residency in transfusion medicine and two years in another relevant clinical settings like internal medicine or surgery.

;India

In India, Immunohematology and Transfusion Medicine is a medical post graduate specialty (MD) recognized by Medical Council of India since 2009.

;Malaysia

Physicians completing their internship may pursue a four-year Master of Medicine (Transfusion Medicine) programme to specialize in transfusion medicine in Malaysia.<ref>{{Cite web|url=https://www.amdi.usm.my/MMedTM|title=Master of Medicine in Transfusion Medicine|publisher=Advanced Medical & Dental Institute, University of Science Malaysia|access-date=2019-01-11|archive-date=2022-01-11|archive-url=https://web.archive.org/web/20220111080209/https://www.amdi.usm.my/MMedTM|url-status=dead}}</ref> They are eligible for registration with National Specialist Registry as transfusion medicine specialists after completion of gazettement upon graduation.<ref>{{Cite web|url=https://www.nsr.org.my/Specialties.html|title=Specialties - NSR|publisher=National Specialist Registry, Malaysian Medical Council|access-date=2019-01-11}}</ref> Transfusion medicine specialists in Malaysia may further their sub-specialty training in the field of immunohaematology, cord blood, patient blood management, cellular therapy, and regenerative medicine.

;Norway

In Norway, the subject is covered by the specialty, "Immunology and Transfusion medicine"

;United Kingdom

In the United Kingdom, transfusion medicine is a sub-speciality of [[hematology]].

[[Serious Hazards of Transfusion]] (SHOT) collects and analyses reports of adverse events related to transfusion, aiming to improve patient safety.<ref>{{cite web|url=http://www.shotuk.org/Aims,scope&TOR.htm|title=Serious Hazards of Transfusion – Aims, Scope and Terms of Reference|access-date=2008-12-30|url-status=dead|archive-url=http://webarchive.nationalarchives.gov.uk/20100201103254/http%3A//www.shotuk.org/Aims%2Cscope%26TOR.htm|archive-date=2010-02-01}}</ref> Its reports have led to wider training for medical staff in the UK and a central reporting scheme to allow errors to be reported.<ref>{{cite journal|url=http://www.bmj.com/cgi/content/full/325/7356/143|title=Clinical review Recent developments Blood transfusion medicine |author=Fiona Regan |author2=Clare Taylor |journal=BMJ (Clinical Research Ed.) |date=2002 |volume=325 |issue=7356 |pages=143–147 |doi=10.1136/bmj.325.7356.143 |pmid=12130612 |pmc=1123672 |name-list-style=amp|access-date=2008-12-30}}</ref>

There is the Better Blood Continuing Education Programme, which is organised by the [[Effective Use of Blood|EUB]] which is part of the [[Scottish National Blood Transfusion Service|SNBTS]]. The EUB consists of many specialist [[healthcare professionals]]. The programme's aim is to improve transfusion medicine practise. The programme is reviewed each annually in January.<ref name="learnbloodtransfusion">{{cite web|url=http://www.learnbloodtransfusion.org.uk/about.htm|title=Better Blood Transfusion continuing education programme|publisher=SNBTS|access-date=2009-01-01|url-status=dead|archive-url=https://web.archive.org/web/20090126053953/http://learnbloodtransfusion.org.uk/about.htm|archive-date=2009-01-26}}</ref>

In the UK, there are restrictions in place to decrease the risk of the transmission of [[Creutzfeldt–Jakob disease]].

;United States

Physicians from a wide range of backgrounds, including [[pathology]], [[internal medicine]], [[anesthesiology]] and [[pediatrics]], are eligible for board certification in Transfusion Medicine following a 1–2 year fellowship.  It is a board-certified sub-specialty recognized by the [[American Board of Pathology]].<ref>{{cite web |title=American Board of Pathology |url=https://www.abpath.org/ |website=abpath.org |access-date=5 August 2020}}</ref>  These specialists are often considered consultants for physicians who require expert advice on the subjects listed above. Transfusiology is not a recognized term in the US.

== See also ==
* [[Blood transfusion]]
* [[List of blood donation agencies]]

== Notes and references ==
{{Reflist|30em}}

==External links==
* [https://www.isbtweb.org Professional Organization: International Society of Blood Transfusion]
* [https://www.aabb.org Professional Organization: AABB]

{{Pathology}}
{{Transfusion medicine}}
{{Authority control}}

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[[Category:Transfusion medicine| ]]