Transfusion Update 2009

Transfusion Update 2009 will be held 6 - 8 May in Sydney. Information on how to register will be available in the next few weeks. If you would like to receive information about this annual conference, please send an email to lreid@arcbs.redcross.org.au

The same email address can be used to register to receive Med e-News, or to send your postal address for Medilink.

An on-line education resource designed to improve the practice and knowledge of transfusion was publicly launched by Hon John Hill, South Australian Minister for Health, on Monday 1 December.

Minister Hill acknowledged the hard work that had gone into creating BloodSafe e-Learning, and the adoption of it already by many hospitals and universities across Australia.

Developed by BloodSafe, a collaborative transfusion improvement program between SA Health, ARCBS, South Australian hospitals and their transfusion service providers, this tool is a free, interactive, guide to clinical transfusion practice.

Aimed at all staff who are part of the transfusion chain, it covers the decision to transfuse, the steps involved in safe collection of blood specimens, appropriate handling and transport, and the administration of blood, including the recognition and management of transfusion reactions.

The resource utilises a range of media, including video, interactive games and interviews with transfusion experts, to engage the user in the learning process. Participation and completion reports are available to assist hospitals to fulfil their accreditation requirements.

Feedback from users has been overwhelmingly positive with one user stating that this is, "...truly e-learning and not just a workbook type of approach. The video clips enhance the process and the quality of the presenters and their content (all experts in their field) help provide authenticity to the message of patient safety."
 

Human granulocytic anaplasmosis (HGA) [formerly known as human granulocytic ehrlichiosis] is a tick-borne infectious disease caused by Anaplasma phagocytophilum, a Gram-negative, obligate intracellular bacterium of neutrophils.

The disease was first recognised in the USA in 1990, subsequently in Europe in 1997 and most recently in Asia (China and Korea) (1). The pathogen is spread to humans by the bite of certain Ixodes (hard tick) species that feed on vertebrate hosts.

A single case of transfusion transmitted anaplasmosis was reported in a US RBC recipient in 1999 (2) followed by a second case report in November 2008 (3). In the latter, the transfusion transmission of Anaplasma phagocytophilum was confirmed by testing of the recipient and a positive donor.

These two cases, along with a recent report from China of likely nosocomial transmission from direct contact with blood or respiratory secretions (4), provide strong presumptive evidence for the pathogen’s transmissibility by blood. Notably, though, even in high risk countries, donor testing is currently not performed because of the lack of a suitable, licensed screening test.

Despite the strengthening evidence for transfusion as a mode of transmission, ARCBS assesses the current risk in Australia to be negligible based on the following;
• There is no documented case of locally acquired HGA; and
• Although Australia has a number of Ixodes ticks, none of the four species associated with recorded Anaplasma phagocytophilum transmission worldwide have an established presence.

Nonetheless, ARCBS will continue to monitor for relevant developments and regularly re-evaluate the risk to the blood supply.

References

1. Dumler JS, Madigan JE, Pusterla N, Bakken JS. Ehrlichioses in humans: epidemiology, clinical presentation, diagnosis, and treatment. Clin Infect Dis 2007; 45 Suppl 1: S45-51.
2. Eastlund T, Persing D, Mathiesen D, et al. Human granulocytic ehrlichiosis after red cell transfusion. Transfusion 1999;39: 117S.
3. Kemperman M, Neitzel D, Gorlin J, et al. Anaplasma phagocytophilum Transmitted Through Blood Transfusion --- Minnesota, 2007. MMWR 2008; 57: 1145-8.
4. Zhang L, Liu Y, Ni D, et al. Nosocomial transmission of human granulocytic anaplasmosis in China. JAMA 2008; 300: 2263-70.
 

The 14th Edition of the Council of Europe Guide to the Preparation, Use and Quality Assurance of Blood Components (CoE14) has now been mandated as the minimum standard for Australia by the Therapeutic Goods Administration.

The legislative instrument prescribing CoE14 is a new Therapeutic Goods Order (TGO81).

New version of Blood Component Labelling

The Blood Component Labelling document provides information relating to the labelling of all blood components manufactured by ARCBS.

This was previously known as the Clinical Blood Users' Information Kit, and was revised late 2008 following the implementation of 100% red cell leucodepletion.

The updated document can be downloaded from the ARCBS clinical transfusion website.

5th European Congress on Hematologic Malignancies
13 - 15 February, Munich, Germany

11th European Haemovigilance Seminar
26 - 27 February, Rome, Italy

Pathology Update 2009
13 - 15 March, Sydney, Australia

XIXth Regional Congress of ISBT (Eastern Mediterranean & Europe)
21 - 25 March, Cairo, Egypt

Transfusion Update 2009
6 - 8 May, Sydney, Australia

European Congress of Clinical Microbiology & Infectious Diseases
16 - 19 May, Helsinki, Finland

International Congress on Transfusion Practice & Transfusion Alternatives
20 - 22 May, Prague, Czech Republic

JFICM/ANZICS Annual Scientific Meeting
12 - 14 June, Brisbane, Australia