Transfusion Therapy: Clinical Principles and Practice, 2nd Edition. Edited by Paul D. Mintz, M.D. Bethesda, MD, American Association of Blood Banks Press, 2005. Pages: 690. Price: $185.00.
Since the first edition of this book was published in 1999, Transfusion Therapy: Clinical Principles and Practice , edited by Paul D. Mintz, M.D., has been considered a source of valuable and practical information for practitioners in transfusion medicine. However, the content and scope of this book extends to all those who are involved in administering blood products to their patients. The book fills a niche between the voluminous textbooks and an assortment of handbooks that have been published on clinical transfusion practice. The primary aim of the editor and the contributors is to provide assistance to the clinician in appropriate selection and usage of blood products. As transfusion practices continue to evolve, the updated second edition of this book is a welcome addition.
As the title of the book suggests, the emphasis continues to be on the clinical principles and practices of transfusion. In this edition, although five chapters have been added, it is still organized into four major sections, making it user-friendly. Most chapters are supported by tables and algorithms helping the reader to focus on essential information. Guidance on significant developments involving West Nile virus testing, Creutzfeldt-Jakob disease, and viral nucleic acid testing have been provided. New chapters address transfusion therapy in therapeutic apheresis, medical–legal issues in transfusion medicine, administration of blood components, European hemovigilance programs, and an assessment of the risks and benefits of transfusion.
The first chapter, by Dr. Dzik, is a real treat to read. Of special note is his critical analysis of the three common assumptions: (1) Abnormal results of commonly used laboratory tests such as prothrombin time, activated partial thromboplastin time, or platelet count have predictive value to identify which patients to treat; (2) blood components administered before procedures effectively correct hemostatic abnormalities; and (3) prophylactic transfusions preprocedure are of greater benefit than therapeutic transfusions after the procedure. The rest of the chapters in the first section provide a comprehensive overview of transfusion practices in common clinical conditions such as autoimmune hemolytic anemia, congenital hemolytic anemia, acquired hemolytic anemia, congenital coagulopathies, solid organ transplantation, hematopoietic stem cell transplantation, therapeutic apheresis, and the pediatric population. Although each of the distinguished authors adds his or her own flavor to the chapters, the editor links the chapters together very well.
The second section deals with blood components and derivatives. Entire chapters are devoted to discuss the acceptable indications and clinical uses for erythrocytes, platelets, granulocytes, fibrin sealant, Rh immune globulin, and hematopoietic growth factors. Each author has worked diligently in providing and summarizing the available data for appropriate use of a blood component.
A major part of third section is devoted to discussing the adverse events associated with transfusion of blood products. The presenting signs and symptoms of transfusion reactions have been nicely classified and summarized into tables. The author also discusses transfusion-related hyperkalemia and acid–base abnormalities which might be of special interest to the anesthesiologists. The next chapter discusses the use of leukocyte-reduced blood products and the potential advantages associated with their use. An entire chapter in this section has been devoted to transfusion-associated graft-versus -host disease and is well worth a careful reading.
The fourth section deals with issues of quality control in transfusion medicine and is therefore of most immediate interest to transfusion medicine specialists. However, even nonspecialists will find items of interest here, especially in how careful standardization of procedures can minimize errors. Most of these chapters are new in this edition. Important information is provided on the history and evolution of a quality system for better and safer transfusion practices. The editor gives a nice ending to the book with the last chapter, To Transfuse or Not to Transfuse: An Assessment of Risks and Benefits. The argument that the best transfusion is the one not given might not be true all the time. The author compares the blood components with drugs and advises the clinician to make an informed decision before administering blood products to a patient.
Of interest, many blood banks were run by anesthesiologists in the olden days, and anesthesiologists are still responsible for the transfusion of many of the blood products used today. For this reason, it is imperative that every anesthesiology resident and fellow learn about the practical aspects of blood products; this book represents a very useful tool to do so.
Mayo Clinic, Rochester, Minnesota. katipamula.rajini@mayo.edu
