Laboratory: Blood Bank and Transfusion Services, Cell Therapy Processing and Neely Cell Therapy and Collection Center
Blood Bank and Transfusion Service
Blood Product Shortages:
In 2022 due to the pandemic blood centers and hospitals in the USA are experiencing significant decreases in blood donations leading to widespread shortages of blood products. The local Red Cross cannot fill our standing orders. On 12/10/21 Tufts adopted a new policy to deal with blood product shortages titled “Notification and Management Strategies for Periods of Blood Product Shortages” (see Policy Tech). The situation has worsened since then. For the foreseeable future we will be triaging all orders for blood products.
Iron-deficiency is the primary cause of anemia in hospital patients. To surgical services we recommend pre-admission testing to include CBC and, when appropriate, iron studies as well as adherence to intra-operative blood conservation practices. To other services we recommend evaluations for iron-deficiency in anemic patients and hematology consults for guidance. Intravenous iron preparations and erythroid stimulating agents can be used effectively to reduce the need for transfusion. The use of antifibrinolytic agents, as is routine to minimize bleeding in orthopedic and obstetric surgery, should also be considered in both surgical and medical patients.
Please be kind in your communications with the front-line blood bank technologists who are always actively trying to secure additional products 24 hours a day 7 days a week and with the clinical pathology residents who are trying to manage a very scarce resource as equitably as possible.
Location: Proger 8
Summary of Services Provided:
Routine and STAT 24/7 Testing:
- ABO/Rh
- Antibody screen
- Antibody identification
- Crossmatch
- Transfusion reaction work-up
Other services:
- Antigen phenotyping
- Direct antiglobulin testing (DAT)
- Isohemagglutinin and prenatal antibody titration studies
- Platelet refractoriness investigation.
Blood Products Available:
- Leukoreduced, irradiated packed red blood cells
- Leukoreduced, irradiated single donor apheresis platelets
- Plasma
- Cryoprecipitate
Thresholds:
Routine orders for blood products must satisfy the transfusion threshold described below:
Red Blood Cells
- Hemoglobin < 7 g/dL
- Hemoglobin < 8 g/dL with heart disease
- Active bleeding
- If other, state reason
Platelets
- Platelet count < 100,000 with bleeding in the brain/skull/retina/lung or in a neonate
- Active bleeding
- If other, state reason
Thawed Plasma
- INR > 1.4 and requiring an invasive procedure
- Prolonged INR due to coumadin and active bleeding
- If other, state reason
Cryoprecipitate
- Fibrinogen < 200 mg/dL
- If other, state reason
Emergency Release:
The Blood Bank will release blood products prior to completion of pre-transfusion testing when deemed medically necessary by a physician.
Massive Transfusion Protocol:
Amidst trauma/massive bleed situations, the Blood Bank will emergently release a cooler with 6 group O red cells and 6 group AB or A thawed plasma. A room-temperature platelet will accompany the cooler. OB massive bleeds will additionally receive a cryoprecipitate pool. (See Policy Tech).
Hours of Operation: 24 hours per day, 7 days per week
Laboratory Contact Information: 617-636-6450
Contact Information:
Medical Director:
Ray Comenzo, MD
Phone: 617-636-5842
Email: rcomenzo@tuftsmedicalcenter.org
Associate Medical Director:
Jensyn Cone Sullivan, MD
Phone: 617-636-2547
Email: jconesullivan@tuftsmedicalcenter.org
Manager and Contact Information:
Teresa Gorey
Phone: 617-636-6455
Email: tgorey@tuftsmedicalcenter.org
Supervisor and Contact Information:
Nuong Phan
Phone: 617-636-6450
Email: nphan@tuftsmedicalcenter.org
Quality Assurance Supervisor and Contact Information:
Judy Forbes
Phone: 617-636-4378
Email: jforbes@tuftsmedicalcenter.org
Cell Therapy Processing
Location: Proger 8
Summary of Services Provided:
The Cell Therapy Processing Laboratory prepares hematopoietic progenitor and mononuclear cells for the Tufts Medical Center patient; product sources include bone marrow, peripheral blood and cord blood. Orders from Tufts Medical Center physicians are required for the collection, processing, storage and infusion of cellular products.
Hours of Operation: Monday through Friday from 8 a.m. to 4:30 p.m.
Laboratory Contact Information: 617-636-6450
Medical Director:
Ray Comenzo, MD
Phone: 617-636-5842
Email: rcomenzo@tuftsmedicalcenter.org
Associate Medical Director:
Jensyn Cone Sullivan, MD
Phone: 617-636-2547
Email: jconesullivan@tuftsmedicalcenter.org
Manager and Contact Information:
Teresa Gorey
Phone: 617-636-6455
Email: tgorey@tuftsmedicalcenter.org
Supervisor and Contact Information:
Nuong Phan
Phone: 617-636-6450
Email: nphan@tuftsmedicalcenter.org
Quality Assurance Supervisor and Contact Information:
Judy Forbes
Phone: 617-636-4378
Email: jforbes@tuftsmedicalcenter.org
Neely Cell Therapy and Collection Center
Location: South 8
Summary of Services Provided:
The Neely Cell Therapy and Collection Center provides services to patients requiring therapeutic apheresis, photopheresis, red blood cell exchange and therapeutic phlebotomy. These services require prior evaluation by a Blood Bank physician. New patient consults are conducted in the Neely Center during regular business hours and or by contacting the Blood Bank resident on-call (p1270).
Additional services include hematopoietic progenitor cell collection by apheresis for autologous and allogenic hematopoietic transplantation, mononuclear cell peripheral blood collection for CAR-T manufacture as well as, outpatient transfusions and infusions.
Hours of Operation: Monday through Friday from 8 a.m. to 4:30 p.m.
Laboratory Contact Information: 617-636-6453
Medical Director:
Ray Comenzo, MD
Phone: 617-636-5842
Email: rcomenzo@tuftsmedicalcenter.org
Associate Medical Director:
Jensyn Cone Sullivan, MD
Phone: 617-636-2547
Email: jconesullivan@tuftsmedicalcenter.org
Manager and Contact Information:
Teresa Gorey
Phone: 617-636-6455
Email: tgorey@tuftsmedicalcenter.org
Supervisor and Contact Information:
Mark Diethelm, RN
Phone: 617-636-6453
Email: mdiethelm@tuftsmedicalcenter.org
Quality Assurance Supervisor and Contact Information:
Judy Forbes
Phone: 617-636-4378
Email: jforbes@tuftsmedicalcenter.org
