Handbook> Electives > Pathology > Blood Bank and Transfusion Medicine

Electives - Pathology


Blood Bank and Transfusion Medicine

Elective Number: 2307 (arranged)

Rotation Supervisors: Dr. James Gorham

Rotation Coordinator: Kim Knotts

Duration: 2 weeks

Available: Email Kim Knotts or Dr. Gorham to arrange/schedule

Report to: Blood Bank

Time to Report: 9:30 am

Place to Report: Blood Bank

Typical day: 9:30 am - 4:30 pm

Attendance: Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation:

Course Description: The student will participate in the consultative activities of the Blood Bank / Transfusion Medicine Service (BBTMS) including investigation of transfusion reactions, immunohematology problems, and blood component therapy. The student will have the opportunity to learn about the collection, preparation, processing, and storage of blood and blood components, pretransfusion testing, red cell/platelet alloantibody and autoantibody identification, and other specialized laboratory evaluations. Learning occurs through a blend of interactive teaching sessions, daily rounds, handling cases under supervision from fellows and residents, and at the bench time with highly skilled blood bank technologists.
BBTMS Rounds: Monday - Friday ~Mid-day in the Blood Bank. Lasts 30 minutes to 120 minutes, depending on case load and teaching considerations.  Specific start time varies each day, as the day’s attending physician sets the specific start time.


  1. Serology and Compatibility Testing: Understand basic serologic tests and their use in compatibility testing
    1. Understand ABO testing and be able to interpret results
    2. Understand Rh typing and be able to interpret results
    3. Understand the purpose and application of the indirect antiglobulin test in relation to the antibody screen, antibody panel and crossmatch
    4. Understand the basic immunologic principles of compatibility
      1. identify situations associated with the formation of antibodies to red cell antigens
      2. describe the clinical importance of antibodies to red cell antigens
      3. be able to interpret laboratory findings related to compatibility
    5. Understand the principles of the direct antiglobulin test (DAT) and how to interpret results. Know clinical situations where the DAT is applied
    6. Know basic procedures associated with compatibility testing
      1. understand procedures for type specific and emergency release of blood
      2. understand procedures for elective selection of blood and routine crossmatch
      3. distinguish testing procedures for red cell and red cell free components
  2. Blood Component Therapy: Describe indications for the major blood components
      1. packed red blood cells
      2. platelet concentrates
        1. understand issues of alloimmunization and platelet refractoriness
        2. understand uses and limitations of platelet crossmatch and HLA matched platelets
      3. fresh frozen plasma and FP 24
      4. cryoprecipitate
      5. specialized components - leukocyte reduced, irradiated and CMV reduced risk
      6. Miscellaneous (depending upon interest) – whole blood; granulocytes
  3. Transfusion Reactions: understand the different kinds of transfusion reactions, how the laboratory is used to investigate them and therapy for each
    1. Describe acute intravascular hemolytic transfusion reactions, their cause, pathogenesis and potential clinical outcomes
    2. Describe delayed hemolytic transfusion reactions, their cause, pathogenesis and potential clinical outcomes
    3. Outline steps to be taken including laboratory tests in response to suspected hemolytic transfusion reactions and describe the test results that would be expected in immediate and delayed hemolytic reactions
    4. Describe febrile transfusion reactions and their cause; outline steps to prevent and treat these reactions
    5. Describe allergic and anaphylactic transfusion reactions and outline steps to prevent and treat these reactions
    6. Describe transfusion related acute lung injury, its proposed pathogenesis and outline steps to treat this reaction
    7. Understand the etiology of bacterial contamination of a blood component
    8. Outline steps to be taken including laboratory tests in response to suspected transfusion reactions
  4. Blood Component Preparation, Processing and Administration: understand the need for testing and processing of donor blood prior to its release to the hospital transfusion service. Understand practical aspects of blood administration
    1. Describe the disease tests required before blood can be released from a donor center to the transfusion service
    2. Understand health history questions used for selection of donors in order to prevent potentially infectious units from entering the blood supply
    3. Describe parts of the physical examination used to determine donor eligibility
    4. List the major infectious complications that can result from transfusion
    5. Understand the importance of proper recipient identification in the process of blood transfusion
    6. Understand all steps necessary to provide a compatible unit of blood
    7. Understand all steps necessary to properly identify a patient prior to transfusion
    8. Understand proper pretransfusion patient assessment, including evaluation of venous access and vital signs prior to transfusion
    9. Understand all aspects of blood administration, including compatible fluids, patient monitoring and infusion devices
  5. Special topics in transfusion medicine: additional teaching to be tailored to the student's specific interests, which may include:
    1. pediatric transfusion therapy
    2. massive hemorrhage and the MTP
    3. microangiopathic hemolytic anemia
    4. sickle cell anemia
    5. therapeutic apheresis
    6. treatment of hemostatic disorders