It was a quiet Saturday afternoon in Geelong when Catherine received a call from St John of God Hospital. Due to surgical complications, two patients were bleeding out on the operating table. Surgeons urgently needed blood transfusions to save their lives.

Not long afterwards, Catherine received a second call from another local hospital – a patient was found unconscious at home in a pool of blood and brought into casualty for an emergency blood transfusion. It was a race against the clock and Catherine needed to act fast. With the help of her team, Catherine cross-matched the patients’ blood samples with available blood supplies and screened them for antibodies. The blood supplies were selected, processed and delivered in less than an hour.

The next day, Catherine was delighted to receive the news that all three patients had survived. She credits her team with the success: “Managing the blood bank is a team effort; it’s not just one person, you rely on couriers and colleagues to cope in emergencies.”

In her 26 years as a medical scientist, Catherine has experienced  blood shortages due to trauma and excessive usage, but with careful monitoring and ordering, it’s possible to keep on top of stock.

“We have a lot of interaction with the hospitals to determine how much blood is needed in the lab. If patients are undergoing complex surgeries, it’s our responsibility to order sufficient blood supplies in case of complications. It’s my duty to regularly monitor the supply and ensure that we never run out.”

Catherine reserves special praise for the Australian Red Cross who provides a vital service to pathology labs. “If there’s ever an emergency, the Australian Red Cross can deliver blood by taxi within an hour. In Australia, we’re very fortunate to have a solid infrastructure which equips us to save countless lives.”

The post Speedy cross-matching saves three lives in one afternoon first appeared on Know Pathology Know Healthcare.

Last week on call started with simultaneously juggling two young male patients with severe anaemia from autoimmune haemolysis.

This is a condition where antibodies produced by the person’s body attack their own red blood cells and cause them to burst. This means that red blood cells that usually last in the bloodstream for 100-120 days have a shorter lifespan, sometimes only a few days. Low red blood cell count (anaemia) is serious and can cause symptoms including tiredness and breathlessness, and in severe cases could be fatal.

Severe anaemia can be treated with a blood transfusion.

‘Both patients were first presentations at Accident and Emergency Departments in separate regional and metropolitan hospitals. The first had such strong antibodies that it was proving difficult even for our established blood bank scientists to analyse the patient’s blood and find an accurate match.

Meanwhile the hospital staff needed to know what to do next, as they were not allowed to transport any patient with severe anaemia to the ward without available blood, and did not want to hear that it may take hours’.

Finding an accurate match for a blood transfusion is essential as providing the wrong blood could cause serious illness and even death.

‘Patient number 2 had an almost identical presentation and was going to be transferred to a public hospital but when it came to the crunch, no bed was available. Meanwhile, to expedite his care, his specimens were sent to his intended destination, so they could process and provide blood on his arrival.

We were then in the difficult scenario of having to provide blood support in our hospital without the benefit of our own investigations, but working in concert with scientists across 2 organisations in the late hours of the evening’.

The next challenge was a major post-partum (after birth) haemorrhage in a Jehovah’s witness at 5:30 am.

Blood transfusions are thought to go against the teachings of the Jehovah’s Witness religion, and most patients of this faith will refuse them.

‘This is a challenging scenario physically, technically and emotionally for all staff involved. Respecting the individual’s choice to potentially die only 24 hours after delivery of a live, healthy infant is so hard for family and staff, those there with her physically in theatre and those with her emotionally in the lab.

Then came notification of a patient, with total knee surgery underway, whose simple group and screen request provided by the anaesthetist was far from simple.  A pan reacting antibody raised alarm bells.’

Patients having surgery will have blood samples sent to the lab for blood typing in case of complications in surgery that mean the patient would require blood. The cross matching process is designed to find blood that mirrors the patient’s own and so will not be rejected by their body. A ‘pan reacting antibody’ is a protein that shows multiple reactions making it difficult to find a match.

‘Quick thinking from the local scientist led to interrogation of the Blood Service records to reveal the patient had been tested through another laboratory earlier in the week and had an antibody to a common antigen: one that would be present and potentially reactive in every red cell unit we selected for the patient.  In short, we had no compatible blood.

Despite the low likelihood of transfusion in this surgical scenario of a total knee replacement, judicious management of the patient, care and carefully planning for potential unexpected outcomes are mandatory in this circumstance.

To top it off I was asked on Friday afternoon to provide technical advice to a medical support team overseas, imminently expecting civilian casualties, but hamstrung by the delayed arrival of blood banking equipment and staff to perform vital cross matching procedures. There’s a question I’ve never had to field before!

So, this week was a real mix of dramatic scenarios and diagnoses, and made me consider what expertise we offer when life and results are not straightforward.  This week my worth was valued in units of sage advice not units of red cells; in fact, I’ve never worked so hard to not give blood in my career to date’.

The post Lab tales: a week providing life saving blood first appeared on Know Pathology Know Healthcare.

A California-based startup, Ambrosia, is enrolling volunteers for the first US clinical trial to investigate the anti-aging effects of injecting adults’ veins with the blood of young people.

Now, we all know that blood transfusions are life-saving.

A regular blood transfusion, which involves pumping the plasma of a healthy person into the veins of a patient via an IV, is an invaluable procedure for surgery patients, women giving birth, cancer patients and trauma victims. But anti-aging? We’re not convinced…

Jesse Karmazin, founder of Ambrosia, claims he has performed the procedure on 30 people and they’re already seeing benefits including renewed focus, improved appearance and more muscle tone. He is aiming to enroll 600 people in the wider trial.

But there is no evidence to suggest this kind of transfusion will have any benefit to the recipient and experts are skeptical that the trial will produce any kind of significant data.

One Stanford University neuroscientist, Tony Wyss-Coray, who lead his own study looking at young plasma in mice in 2014, said;

“There’s just no clinical evidence [that the treatment will be beneficial], and you’re basically abusing people’s trust and the public excitement around this.”

Because that’s the other issue here; the trial procedure, which involves getting 1.5 litres of plasma from a donor between the ages of 16 and 25 over the course of two days, costs each volunteer US$8,000.

Before and after the infusion, participants’ blood will be tested for ‘biomarkers’, a variety of measurable biological substances and processes which are thought to provide a snapshot into health and disease.

Where is the evidence?

Karmazin’s leading motivation was a series of mouse studies that involved connecting the veins of two living mice. Wyss-Coray’s own such study in 2014 suggested that this procedure could rejuvenate a part of the mouse brain where memories are made and stored.

But other researchers on Wyss-Coray’s team were hesitant to suggest the results showed any kind of anti-aging effect.

“We’re not de-ageing animals,” Amy Wagers, a stem-cell researcher at Harvard University told Nature in 2014. Instead of turning old tissues into young ones, Wagers said they were simply helping to repair damage.

Nevertheless, Karmazin remains enthusiastic.

“I’m really happy with the results we’re seeing,” he said.

As for us? We’ll wait and see – the proof is in the plasma after all.

Read the full story on Business Insider. 

The post Blood transfusions save lives but are they anti-aging? first appeared on Know Pathology Know Healthcare.

You’d never know to look at him running around, but 6 year old Riley came within a whisker of death just over a year ago. A spooked horse kicked him square in the chest and Riley collapsed instantly. His his mother Carolyn recalls:

“It was one of the most awful moments of my life. He was just lying there, completely still.”

Medical staff at the Wagga Base Hospital worked furiously to stem massive blood loss from a cut in his liver. Supporting the frontline team was pathology.

Samples of Riley’s blood were rushed to the lab every few minutes, where laboratory manager Naomi and her team worked frantically to get results quickly. Riley’s ability to clot blood, his blood oxygen levels and other vital information was fed back to the trauma team.

Most importantly, pathology staff ensured that all 60 units of donated Red Cross blood given to Riley matched his own blood type. Ultimately, Riley had 5 times more than his natural blood supply pumped back into him.

These days, the cranky horse is a distant memory for Riley, who recently took a behind-the-scenes tour of the pathology lab at Wagga Base Hospital. You can see news coverage of Riley’s tour here.

This short video from an Emergency Department Director explains how reliant trauma centres are on fast, accurate pathology:

Carolyn says, “I’m so thankful for the wonderful staff at Wagga Base Hospital, including the pathology team, for helping save Riley’s life. You may not even realise pathology is happening in the background, but when you really need it, you’ll appreciate it!”

If you or a loved one has undergone a life-saving blood transfusion like Riley, you’ll have a reason to value pathology. If you haven’t already, sign up to show your support in the sign-up boxes on this website.

The post Saving lives – fast first appeared on Know Pathology Know Healthcare.