2015 NORTHWEST TRANSFUSION SYMPOSIUM Final Program Tacoma, Washington 9/12/2015
Table of Contents Learning Objectives...2 Accreditation...3 Disclosure Policy...3 Committee Members...4 Speaker Schedule...5 Presentation Summaries...6 Morning Sessions: General Focus...6 Afternoon Sessions: Health Care Provider Focus...7 Afternoon Sessions: Technical/Laboratory Focus...8 General Information...9 Registration...9 Meeting Location...9 Directions...9 Parking...9 Hotels... 10 September 12, 2015 Page 1
Learning Objectives Morning Sessions: General Focus This activity is designed for physicians, nurses, laboratorians, and blood bankers. Upon completion of this course, participants will be able to: 1. Describe the situation and response in a mass casualty incident. 2. Discuss key learnings and future considerations for managing a mass casualty incident. 3. Illustrate the need for a communication plan (internal and external) to facilitate an effective response. 4. Explain the capabilities of pathogen-inactivation systems for platelets. 5. Recognize the benefits from implementing pathogen-reduced platelets. 6. Design a protocol to facilitate the implementation of pathogen-reduced platelets in a hospital transfusion service. 7. Describe the issues related to RBC storage. 8. Evaluate relevant studies on the age of blood. 9. Discuss relevant clinical implication. 10. Describe clinical use of type A plasma for emergency transfusion. 11. Describe clinical consideration for ABO mismatched platelet transfusion. 12. Describe clinical use of liquid plasma for emergency transfusion. Afternoon Sessions: Health Care Provider Focus This activity is designed for physicians, nurses, laboratorians, and blood bankers. Upon completion of this course, participants will be able to: 1. Describe several technology tools that can be used to achieve personalized medicine. 2. Discuss how technology tools can be used to provide transfusion care to populations with complex requirement. 3. Evaluate the implementation of personalized transfusion technology solutions. 4. Describe the clinical issues in massive transfusion. 5. Interpret the clinical impact of relevant studies on the management of massive transfusion. 6. Design a massive transfusion protocol. 7. List three problems with adult stem cell transplant using HPC, cord blood that need to be overcome. 8. Describe three different approaches to speeding cord blood transplant recovery and improving survival of the transplant. 9. Discuss two biologic mechanisms that encourage biologic acceptance of the stem cell transplant. 10. Describe the mechanisms of different anticoagulation agents. 11. Describe the reversal options for different anticoagulation agents. 12. Design protocols for anticoagulation reversal. 13. Describe the concept of relevant communicable diseases for which the FDA requires infectious disease testing. 14. Explain the fate of a unit of blood with a confirmed false positive test for an infectious disease agent. 15. Discuss the differences in infectious disease testing required by changing seasons and different parts of the country. 16. Cite current literature in support of transfusion indications. 17. List one point from AABB s choosing wisely statement. 18. Develop a differential for the bleeding patient. Afternoon Sessions: Technical/Laboratory Focus This activity is designed for physicians, nurses, laboratorians, and blood bankers. Upon completion of this course, participants will be able to: 1. Describe the importance of patient identification in the process of blood administration and how to avoid potentially fatal mistakes. 2. Explain the basic concepts of the transfusion of blood components consistent with safe transfusion practices and patient blood management concepts. 3. Guide others in the recognition, treatment, and reporting of suspected transfusion reactions. 4. Discuss antibody identification and potential pitfalls using a case illustration. 5. Identify decision steps during an antibody identification example. Page 2 University of Washington, Tacoma: William W. Philip Hall
6. Describe tools, reagents and methods used in an antibody identification example. 7. Compare type of cell sources in bone marrow transplantation. 8. Describe relevant laboratory work-up and consideration for ABO mismatched bone marrow transplantation. 9. Describe relevant clinical impact of ABO mismatched bone marrow transplantation. 10. Describe red cell genotyping techniques. 11. Provide examples of how RBC genotyping can enhance transfusion testing. 12. List clinical situations where RBC genotyping can be useful. 13. Describe different types of transfusion reactions. 14. Explain laboratory work-up for transfusion reaction. 15. Describe management and prevention for different types of transfusion reactions. 16. Describe the needs for patient blood management. 17. Describe the key element for patient blood management. 18. Implement one of few key elements for patient blood management. Accreditation CONTINUING MEDICAL EDUCATION CREDIT INFORMATION Accreditation This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Surgeons and Bloodworks. The American College of Surgeons is accredited by the ACCME to provide continuing medical education for physicians. AMA PRA Category 1 Credits The American College of Surgeons designates this live activity for a maximum of 5.50 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Co-Provided by ASCLS-WA Three contact hours per module will be awarded for P.A.C.E. credit. ASCLS WA is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E. Program. Disclosure Policy In compliance with the ACCME Accreditation Criteria, the American College of Surgeons, as the accredited provider of this activity, must ensure that anyone in a position to control the content of the educational activity has disclosed all relevant financial relationships with any commercial interest. All reported conflicts are managed by a designated official to ensure a bias-free presentation. Please see the insert to this program for the complete disclosure list. September 12, 2015 Page 3
Committee Members 2015 Northwest Transfusion Symposium Committee YanYun Wu, MD, PhD Bloodworks Northwest, Chief Medical Officer Jackie Degler, MT(ASCP) Bloodworks Northwest, Program Manager Linda Barnes Bloodworks Northwest, Chief Operating & Information Officer Melanie Jorgenson, RN, BSN Bloodworks Northwest, Chief Transfusion Safety Officer Staff Support Cecile Maass Bloodworks Northwest Page 4 University of Washington, Tacoma: William W. Philip Hall
Speaker Schedule Morning Sessions: General Focus 8:00am - 9:00am Continental Breakfast and Registration Moderator: YanYun Wu, MD, PhD 9:00am - 9:05am Welcome Remarks James P. AuBuchon, MD, FCAP, FRCP(Edin) 9:05am - 9:40am 9:40am -10:25am 10:25am - 10:35am 10:35am - 11:20am Mass Casualty Incident: Readiness and Response in the Mt. Pilchuck Marysville High School Shooting Implementing Pathogen Inactivation Technologies: In Search of Safer Platelet Transfusions Break RBC Storage: Old Blood Versus New Blood, What's New Joanne C. Roberts, MD James P. AuBuchon, MD, FCAP, FRCP(Edin) James C. Zimring, MD, PhD 11:20am - 11:50am Blood Product Consideration: Has Anything Changed? YanYun Wu, MD, PhD 12:00pm - 1:00pm Lunch: Round Table Discussions/Networking No CME Afternoon Sessions: Health Care Provider Focus 1:00pm - 1:30pm Personalized Transfusion Medicine Using Technology Solutions Moderator: Rebecca Haley, MD Meghan Delaney, DO, MPH 1:30pm - 2:00pm Updates on the Management of Massive Transfusion Thomas Deloughery, MD MACP FAWM 2:00pm - 2:30pm Engineering of Cord Blood Transplantation Rebecca Haley, MD 2:30pm - 2:40pm Break 2:40pm - 3:10pm Challenges in Anticoagulation Reversal Thomas Deloughery, MD MACP FAWM 3:10pm - 3:40 pm Updates on Transfusion Transmitted Diseases Rebecca Haley, MD 3:40pm - 4:10pm Critical Literature Review in Transfusion Medicine Theresa Nester, MD Afternoon Sessions: Technical/Laboratory Focus Moderator: Linda Barnes 1:00pm - 1:30pm Basics in Blood Administration Melanie Jorgenson, RN, BSN 1:30pm - 2:00pm RBC Serology: Case Illustration Allison Reid, MT(ASCP) SBB 2:00pm - 2:30pm 2:30pm - 2:40pm ABO Still Matters in Bone Marrow Transplantation, a Transfusion Perspective Break YanYun Wu, MD, PhD 2:40pm - 3:10pm Integrating RBC genomics in a Transfusion Work-Up Meghan Delaney, DO, MPH 3:10pm - 3:40 pm Work-Up for Transfusion Reactions Katie Wilkinson, MD 3:40pm - 4:10pm Patient Blood Management Program Kirsten Alcorn, MD September 12, 2015 Page 5
Presentation Summaries MORNING SESSIONS: GENERAL FOCUS Mass Casualty Incident: Readiness and Response in the Mt. Pilchuck Marysville High School Shooting Joanne C. Roberts, MD Review of the Response to the Mt. Pilchuck High School Shooting including key learnings, communication planning, and coordination considerations for future readiness. Upon completion of this course, participants will be able to: 1. Describe the situation and response in a mass casualty incident. 2. Discuss key learnings and future considerations for managing a mass casualty incident. 3. Illustrate the need for a communication plan (internal and external) to facilitate an effective response. Implementing Pathogen Inactivation Technologies: In Search of Safer Platelet Transfusions James P. AuBuchon, MD, FCAP, FRCP(Edin) Pathogen inactivation technologies have the potential to radically alter our approach to providing safe transfusions, but their practical application to create pathogen-reduced blood components raises a variety of questions and poses considerable challenges. Although the treatments result in reduced platelet recovery, the probability of significant bleeding after transfusion parallels untreated platelets. Explaining this to clinicians may require detailed interactions. The value of directly attacking the residual risk of bacterial contamination as well as that of current and future viral and other pathogens threats are highly coveted, of course, but dealing with the economics of the implementation will require multifaceted approaches. Upon completion of this course, participants will be able to: 1. Explain the capabilities of pathogen-inactivation systems for platelets. 2. Recognize the benefits from implementing pathogen-reduced platelets. 3. Design a protocol to facilitate the implementation of pathogen-reduced platelets in a hospital transfusion service. RBC Storage: Old Blood versus New Blood, What's New James C. Zimring, MD, PhD This session includes a description of issues related to RBC storage, clinical relevance and studies regarding the aging of blood. Upon completion of this course, participants will be able to: 1. Describe the issues related to RBC storage. 2. Evaluate relevant studies on the age of blood. 3. Discuss relevant clinical implication. Blood Product Consideration: Has Anything Changed? YanYun Wu, MD, PhD This session will discuss blood product considerations and substitutions available for transfusion. Upon completion of this course, participants will be able to: 1. Describe clinical use of type A plasma for emergency transfusion. 2. Describe clinical consideration for ABO mismatched platelet transfusion. 3. Describe clinical use of liquid plasma for emergency transfusion. Page 6 University of Washington, Tacoma: William W. Philip Hall
AFTERNOON SESSIONS: HEALTH CARE PROVIDER FOCUS Personalized Transfusion Medicine Using Technology Solutions Meghan Delaney, DO, MPH The electronic record and computerized physician order entry allow for improvements to transfusion care. Several examples of how technology solutions can provide safety measures and specific transfusion protocols will be described. Upon completion of this course, participants will be able to: 1. Describe several technology tools that can be used to achieve personalized medicine. 2. Discuss how technology tools can be used to provide transfusion care to populations with complex requirements. 3. Evaluate the implementation of personalized transfusion technology solutions. Updates on the Management of Massive Transfusion Thomas Deloughery, MD MACP FAWM This session will include a description of a massive transfusion protocol and the clinical issues and management involved. Upon completion of this course, participants will be able to: 1. Describe the clinical issues in massive transfusion. 2. Interpret the clinical impact of relevant studies on the management of massive transfusion. 3. Design a massive transfusion protocol. Engineering of Cord Blood Transplantation Rebecca Haley, MD In this session the advantages and difficulties of stem cell transplantation for malignant and non-malignant will be presented with engineered cord blood stem cell transplants providing some hopeful new approaches. Three approaches now in clinical trials will be described. Upon completion of this course, participants will be able to: 1. List three problems with adult stem cell transplant using HPC, Cord Blood that need to be overcome. 2. Describe three different approaches to speeding cord blood transplant recovery and improving survival of the transplant. 3. Discuss two biologic mechanisms that encourage biologic acceptance of the stem cell transplant. Challenges in Anticoagulation Reversal Thomas Deloughery, MD MACP FAWM This session will include a discussion of the mechanisms involved in anticoagulation and options for anticoagulation reversal. Upon completion of this course, participants will be able to: 1. Describe the mechanisms of different anticoagulation agents. 2. Describe the reversal options for different anticoagulation agents. 3. Design protocols for anticoagulation reversal. Updates on Transfusion Transmitted Diseases Rebecca Haley, MD This session will include a discussion of infectious disease testing FDA requirements for blood donors including confirmation testing and follow-up. Upon completion of this course, participants will be able to: 1. Describe the concept of relevant communicable diseases for which the FDA requires infectious disease testing. 2. Explain the fate of a unit of blood with a confirmed false positive test for an infectious disease agent. 3. Discuss the differences in infectious disease testing required by changing seasons and different parts of the country. Critical Literature Review in Transfusion Medicine Theresa Nester, MD Using case-based scenarios, a select review of the literature will be done to support current transfusion indications. Upon completion of this course, participants will be able to: 1. Cite current literature in support of transfusion indications. 2. List one point from AABB s choosing wisely statement. 3. Develop a differential for the bleeding patient. September 12, 2015 Page 7
AFTERNOON SESSIONS: TECHNICAL/LABORATORY FOCUS Basics in Blood Administration Melanie Jorgenson, RN, BSN This session will cover the practice of administering blood components. This session will also cover patient identification, pre-transfusion sample collection, patient assessment, administration of blood components, monitoring, evaluation, suspected transfusion reactions recognition, response, and reporting. Upon completion of this course, participants will be able to: 1. Describe the importance of patient identification in the process of blood administration and how to avoid potentially fatal mistakes. 2. Explain the basic concepts of the transfusion of blood components consistent with safe transfusion practices and patient blood management concepts. 3. Guide others in the recognition, treatment, and reporting of suspected transfusion reactions. RBC Serology: Case Illustration Allison Reid, MT(ASCP)SBB This session will introduce an interesting antibody case and follow the process and decision steps thru to completion. Upon completion of this course, participants will be able to: 1. Discuss antibody identification and potential pitfalls using a case illustration. 2. Identify decision steps during an antibody identification example. 3. Describe tools, reagents and methods used in an antibody identification example. ABO Still Matters in Bone Marrow Transplantation, a Transfusion Perspective YanYun Wu, MD, PhD This session includes a discussion of a bone marrow transplantation and types of cell sources. It will include laboratory testing considerations involved with an ABO mismatched transplantation and the clinical significance. Upon completion of this course, participants will be able to: 1. Compare type of cell sources in bone marrow transplantation. 2. Describe relevant laboratory work-up and consideration for ABO mismatched bone marrow transplantation. 3. Describe relevant clinical impact of ABO mismatched bone marrow transplantation. Integrating RBC genomics in a Transfusion Work-Up Meghan Delaney, DO, MPH In this section, the technique and uses of red blood cell genotyping will be described. Case examples will be used to show how red cell genotyping can improve transfusion medical care. Upon completion of this course, participants will be able to: 1. Describe red cell genotyping techniques. 2. Provide examples of how RBC genotyping can enhance transfusion testing. 3. List clinical situations where RBC genotyping can be useful. Work-Up for Transfusion Reactions Katie Wilkinson, MD This session includes a discussion of the different types of transfusion reactions, the laboratory testing involved, and the management and prevention for the different types of reactions. Upon completion of this course, participants will be able to: 1. Describe different types of transfusion reactions. 2. Explain laboratory work-up for transfusion reaction. 3. Describe management and prevention for different types of transfusion reactions. Patient Blood Management Program Kirsten Alcorn, MD This session will discuss a patient blood management program and the elements involved. Upon completion of this course, participants will be able to: 1. Describe the needs for patient blood management. 2. Describe the key element for patient blood management. 3. Implement one of few key elements for patient blood management. Page 8 University of Washington, Tacoma: William W. Philip Hall
General Information REGISTRATION Register early as space is limited: Online registration: http://nwtransfusionsymposium.brownpapertickets.com Online registration closes three days prior to event On-site registration, if space is available and additional fees apply Registration Fees: $150 Physician $75 Non-physician or physician trainee $45 student (show student ID on-site) Additional $20 for on-site registration, if space is available Continental breakfast and lunch included in price Full-day registration only MEETING LOCATION The 2015 Northwest Transfusion Symposium will take place at the University of Washington Tacoma, William W. Philip Hall. Address: University of Washington Tacoma William W. Philip Hall 1918 Pacific Avenue Tacoma, WA 98402-3100 DIRECTIONS From Interstate 5 take the I-705/Tacoma City Center exit (exit 133). From I-705 take the South 21st Street exit. Turn left at the traffic light onto 21st Street. Go through the light at Pacific Avenue and the campus will be on your right. PARKING Parking information can be found at: http://www.tacoma.uw.edu/events-conference-services/parking-and-directions. September 12, 2015 Page 9
HOTELS The following hotels are located close to the University of Washington Tacoma campus: Holiday Inn Express & Suites 2102 South C Street Tacoma, WA 98402 (253) 272-2434 Courtyard Marriott 1515 Commerce Street Tacoma, WA 98402 (206) 591-9100 Hotel Murano 1320 Broadway Tacoma, WA 98402 (253) 238-8000 Page 10 University of Washington, Tacoma: William W. Philip Hall