The Vanderbilt University Transfusion Medicine Program (VTMP) is dedicated to optimizing the use of blood products, apheresis and cellular therapeutics for patient care and advancement of the field through outstanding clinical service and through basic and translational research. We will lead our institution in transfusion medicine-related education and development of best practices while nurturing the next generation of Transfusion Medicine leaders.
The blood bank houses three automated testing platforms and the standard equipment to perform a wide breadth of serologic testing. Combined, annual red cell, platelet and plasma product throughput is ~7000 units each month. Our staff performs over 10,000 additional tests/month that include compatibility testing, specialized serological testing, product preparation, and medical support.
The Diagnostic Management Team (DMT) for Transfusion Medicine is composed of attending physicians, resident physicians, specialists in blood banking (SBBs), and medical technologists. The DMT meets on a daily basis to evaluate each abnormal blood bank test and all suspected transfusion reactions. A report is generated that integrates relevant blood bank and other laboratory testing results to the overall clinical status. The report provides input on clinical management, including advice on appropriate transfusion therapy. Additionally, the DMT in Transfusion Medicine serves as an educational and quality assessment/quality control function by reviewing any laboratory operational issues and procedure variances.
Vanderbilt Pathology Laboratory Services (VPLS), an outreach program established in 1987 by the Department of Pathology (now Pathology, Microbiology, and Immunology or PMI), markets Vanderbilt University Hospital (VUH) Diagnostic Laboratory testing and Pathology consult services to outside institutions. VPLS also services laboratory testing for Vanderbilt Medical Center (VMC) related off-site practices. VPLS is “owned” by the PMI Department and currently operates via a “buy and sell” business relationship with VUH. That is, VUH provides laboratory testing to the Department at a negotiated price, which VPLS sells to other institutions.
VMC benefits from this outreach program through an increase in laboratory test volumes, which allows a lowered fixed unit cost per test, an increase in the revenue base, and a more efficient utilization of resources within the laboratories. The added esoteric testing volume, in many cases, makes performing the testing in-house affordable and, therefore, available in a timely manner to Vanderbilt patients. The Hospital also gains a higher degree of visibility in the community and across the region. Today VPLS has clients in 48 states and 10 foreign countries, with VPLS workload comprising about 9% of the total VUH laboratory volume.
The PMI Department benefits from VPLS academically and financially. The ability to perform high-end esoteric testing in the diagnostic laboratories has allowed the department to expand its professional expertise and enhance its teaching and research capabilities. Additional revenues allow the Department to support new and ongoing programs. VMC and VUH also benefit financially via the internal revenue taxation program and purchase of testing from the Hospital, respectfully.
Type and Screen
Cold Agglutinin Screen
Cold Agglutinin Titer
The Transfusion Medicine section is also responsible for peripheral blood stem cell collections and photopheresis procedures. Both allogeneic and autologous stem cell collections are performed at VUMC, including National Marrow Donor Program (NMDP) collections. Approximately 30 stem cell collections are performed each month and 50 photopheresis procedures.
Suggested Infusion Rate of Blood Components in Nonemergency situations Suggested Infusion Rate Component Adult Pediatric Red Blood Cells 150-300 mL/hour 2-5 mL/kg/hour Fresh Frozen Plasma 200-300 mL/hour 60-120 mL/hour Platelets 200-300 mL/hour 60-120 mL/hour Cryoprecipitate As rapidly as tolerated As rapidly as tolerated Granulocytes 75-100 mL/hour 65-100 mL/hour Transfusion must be completed within 4 hours of spiking the unit
Massive Transfusion Protocol