Transfusion medicine (or transfusiology) is the branch of medicine that encompasses all aspects of the transfusion of blood and blood components including aspects related to hemovigilance. It includes issues of blood donation, immunohematology and other laboratory testing for transfusion-transmitted diseases, management and monitoring of clinical transfusion practices, patient blood management, therapeutic apheresis, stem cell collections, cellular therapy, and coagulation. Laboratory management and understanding of state and federal regulations related to blood products are also a large part of the field.
In most countries, Immunohematology and Transfusion Medicine specialists provide expert opinion on massive transfusions, difficult/incompatible transfusions and rational use of specialised blood product therapy like irradiated blood/ leukodepleted/washed blood products.
The blood donor center is the facility that collects blood components from screened blood donors, either whole blood or separate components such as plasma or platelets only via apheresis. These blood components are then transported to a central location for processing such as fractionation, testing and redistribution. The testing includes determining blood type and testing for infectious diseases. Whole blood is fractionated into red blood cells, platelets and plasma whilst plasma can be further refined into separate components such as albumin, clotting factor concentrates and immunoglobulin.
The blood bank is the section of the clinical laboratory where laboratory scientists store and distribute blood components. Both areas are typically overseen by a specialist in transfusion medicine. Transfusion medicine was earlier a branch of clinical pathology, however the field has now expanded into a clinical, hospital-based specialty. The practice of transfusion medicine involves both laboratory and clinical aspects of transfusion as communication between blood bank and patients, treating specialists and other medical staff is vital in situations such as massive transfusions or transfusion reactions.
To ensure the safety of blood components, regimented procedures and quality assurance systems must be in place covering all aspects of the transfusion chain, from donation to transfusion outcomes. Within hospitals, transfusion committees are established to ensure safe hospital transfusion practice such as compliance with standards and guidelines, reviewing transfusion reactions and management of blood supply. These multidisciplinary committees are composed of transfusion medicine specialists, transfusion nurses, laboratory scientists, clinicians and staff from hospital management and the quality team.