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Neil Blumberg

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  1. Neil Blumberg's post in Critical values was marked as the answer   
    We have no critical values in the Blood Bank and we have a cancer center that sees thousands of patients per month.
    And it is my recommendation that critical values be restricted to truly life threatening conditions that require treatment within minutes to hours (e.g., very high or low potassium).  I would most definitely NOT have critical values for things like creatinine/BUN, liver function tests, MCV, white count, etc.  Provides no clinically actionable information acutely, and wastes a lot of time in the lab and amongst practitioners.
  2. Neil Blumberg's post in RBC Unit Cell Washer was marked as the answer   
    I'd also add that none of the cell washers are FDA approved for washing platelets. We've been washing platelets on the 2991 for about 40 years :).  I believe there may be a paper on using the ACP-215 to wash platelets but as yet we do not have any hands on experience.  We have developed a manual method of platelet washing using a Sorvall centrifuge.  If your volume isn't too high, you might consider a manual wash method.  It takes a bit longer, but actually has higher recoveries (>90% vs. about 80-85% with the 2991). 
     
    Folks will tell you that washed platelets don't work clinically and the count increment is Washed Tx Leukemia.pdfWashed Tx Leukemia.pdflower.  The increment is indeed lower, but if you employ platelets that aren't ABO incompatible with the recipient and remove the supernatant, the clinical results are actually better than the clueless advice to give ABO major incompatible platelets routinely (e.g., group A to group O recipients).  The PLADO study had a bleeding rate using this abominable practice of about 70%.  Our bleeding rate avoiding infusion of ABO incompatible antigen or antibody is 5%, with or without washing.  A fourteen fold difference. So by all means give washed platelets to patients with severe or recurrent reactions, or avoid infusion of ABO incompatible plasma, and, if you believe our randomized trial data, to improve the survival of younger patients with acute myeloid leukemia. References attached if anyone is interestedWashing AML Greener_et_al-2017-American_Journal_of_Hematology.pdf.
    Washing Review IJCTM-101401-the-clinical-benefit-of-washing-red-blood-cells-before-transfusion.pdf Washing AML Greener Am J Hemat AML Washing Supplementary Figures and Tables.pdf Jill's washing paper.pdf Plt Washing Vo.pdf
  3. Neil Blumberg's post in Respiratory Syncytial Virus (RSV) Vaccine was marked as the answer   
    Not in a blood collection center, so no policy.  But scientifically there is no rationale for donor deferment.  The vaccines are not live/attenuated but rather just protein with no potentially infectious material of concern to recipients.  The virus, in any case, should only infect respiratory mucosa and thus would represent minimal to no risk to recipients even if present in donor blood (similar to coronavirus and influenza).
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