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Kip Kuttner

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Kip Kuttner last won the day on March 28 2020

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  • Birthday 09/26/1955

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  1. ...Also perhaps the “numbness” was related to tongue swelling related to the allergic reaction.
  2. There are many plasma proteins that can cause allergic reactions. Transfusing washed cellular products frequently prevents additional reactions. In addition, there have been several case reports of a donor consuming an allergen (peanut butter is classic) before donating. The recipient who is sensitive subsequently has an allergic reaction. One that comes to mind was well documented in the NEJM. And of course don’t forget the controversial IgA deficient patient allergic reactions.
  3. Your institution will still need to file an eIND
  4. You would need to research available studies or file your own eIND. Approval can take as little as 4 hour I am told. Then you would either collect it yourself, or work with you blood supplier to collect appropriate donors. Requires excellent communication. You can only use it for your study. It is not an off-the-shelf product.
  5. Really sick patients needing ECMO will use blood. I don’t have a way to gauge the utilization at this time though. All the best.
  6. Platelets are in adequate supply largely due to hospitals (in my service area) enforcing restrictive transfusion measures and postponing elective surgeries. Most blood centers except in New York, Washington state, and California are treading water with respect to RBCs. As usual Rh neg units are in short supply. Most of the hospitals in my service area are also freeing up beds to treat respiratory infections. These will require fewer transfusions, although patients needing ECMO are of concern. Looking ahead, it is difficult to predict what will happen. This is a long term e
  7. There are many facets to this question. I would think each institution has a disaster plan. It is an AABB requirement and I am sure a requirement for many other accreditation firms. From the blood supplier point of view: About 60% of the blood we distribute comes from mobile collections. Businesses, churches, schools and so forth permit us to hold collection events. If the local health departments discourage "gatherings" or even isolating parts of a community, this will adversely affect the blood supply. While the FDA encourages blood donation, the local messaging is what really
  8. What are your institutions doing in the blood bank to prepare for the COVID-19 challenge?
  9. Cliff, thank you for your kind remarks. I think We are in this together to take care of patients. What ever we can do to do the very best care we can in spite of the limitations is the approach we should take. Working together we can do that! Review Donor exclusion factors US Transfusion 0120.pdf
  10. David and Cliff, I appreciate your frustration. Blood suppliers are well aware of the critical nature of their products and cringe each time they are compelled to supply less than the request number of units. Does your facility have an active part in the acquisition and stewardship of these DONATED gifts? I would think working with your supplier to find a way to increase the available inventory would be of benefit to all. For example does your facility help publicize blood drives and or encourage staff to donate. Does your facility hold successful blood drives? Do you monitor the
  11. With attention to blood utilization, the overall red blood cell usage has gone down. Consequently blood suppliers have had to pair down the number of overall units they collect in order to avoid out dating products. Since we are drawing a population, the proportion of desired units in that population (All Rh negs and all group Os) has not changed, but the absolute number of the desired we can acquire units has dropped. Transfusion practices are still demanding nearly the same number of desired units as before blood utilization practices were implemented. About half of the Rh neg units dist
  12. With regard to PI with platelets, it is true you do not need to test the PI products but Babesia testing still needs to be done for RBCs collected in the 13 states of interest. Regarding test strategies, some hospitals,eg Johns Hopkins, has opted to do secondary bacterial testing on day 4 rather than the PGD test. Attached is a recent study covering the cost effectiveness of the approaches believed to be acceptable by the FDA. However, as noted the Guidance is not Final. This paper is a good starting point though. platelets Cost effectiveness methods bacteria testing Transfusion 041
  13. Because your blood counts will generate "patient Data" they fall under CLIA. Proficiency testing, competency assessment, training, and operator qualifications all apply. You can meet the requirements by having a qualified laboratorian general supervisor, oversee all of the instrument maintenance, calibration, linearity and QC review. The laboratory Director will need to follow some of these things as in traditional patient-based lab. Who will be your "CLIA assessor" for this activity, AABB, CAP, Other? If you are going to be AABB accredited then AABB will assess your operation again
  14. In response to LabIon: 1) Currently, the most experience with Low titer group O whole blood is in massively bleeding trauma patients. There is ongoing investigation to see if this product can be used in massive obstetric bleeding, cardiac surgery or other. It is important to remember that the utilization of this whole blood came from military experience. In addition much of the Whole blood used was group specific and warm. This is because refrigeration in some theaters is non-existent. the military does HIV, HCV and HBV testing on all service people periodically (every 3-4 months) in
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