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Transfusion Therapy: Clinical Principles and Practice.

Transfusion Therapy: Clinical Principles and Practice. Paul D. Mintz, ed., Bethesda, MD: AABB Press, 1999, 481 pp., $119.00. ISBN 1-56395-099-5

There is no question that practitioners of clinical transfusion medicine will find Transfusion Therapy: Clinical Principles and Practices, by Paul D. Mintz, a useful reference because this book fills a niche between the more encyclopedic textbooks and the assortment of handbooks that have been published on clinical transfusion practice. What is particularly valuable about this book is that its content is applicable to scientists beyond those interested in transfusion medicine. For example, the clinical chemist will find that this book contains useful information about physiologic processes, including adaptation to anemia, and useful information about tests such as the measurement of clotting factors. Of particular interest, this book includes a critical review of the hemostatic management of patients undergoing invasive bedside procedures.

The book is divided into 21 chapters, written by 27 distinguished authors and coauthors. The topics covered provide a comprehensive overview of transfusion medicine, including discussions of transfusion practice in clinical conditions such as chronic anemia, congenital hemolytic anemia, autoimmune hemolytic anemia, congenital coagulopathies, acquired disorders of hemostasis, surgery, and trauma. The book also includes discussions of specialized blood products such as leukocyte-reduced blood products, cytomegalovirus-reduced risk blood products, granulocyte transfusions, platelets and platelet pheresis, immunoglobulins, and fibrin sealants.

In addition, there are chapters devoted to transplantation topics, including solid-organ transplantation and hematopoietic stem cell transplantation, mononuclear cell transfusion, transfusion-associated graft-vs-host disease, and stem cell growth factors. The book is rounded out by chapters on neonatal and intrauterine transfusion, transfusion reactions, quality assessment and improvement, and alternatives to allogeneic transfusion in patients with surgical anemia.

The clinical chemist may find the chapters that address the treatment of congenital coagulopathy and acquired hemostatic disorders particularly interesting. The chapter entitled "Use of Blood Components Before Invasive Bedside Procedures: A Critical Appraisal" offers an analysis of common laboratory tests as predictors of bleeding. In this outstanding chapter, the validity of the following three assumptions is critically analyzed:

* Abnormal results of commonly used laboratory tests of hemostasis, such as prothrombin time (PT) and activated partial prothrombo-plastin time (aPTT), have predictive value in identifying patients at risk for bleeding complications during invasive procedures.

* Blood components administered before procedures are able to correct hemostatic abnormalities.

* Correction of hemostatic abnormalities by preprocedure blood components reduces the risk of bleeding at the time of the procedure.

In summary, this book is an excellent source of practical information for those actively involved in the field of clinical transfusion medicine as well as clinical chemists who have an interest in the interaction between the clinical laboratory (especially coagulation testing) and the patient who requires transfusion support.

Ira A. Shulman

University of Southern California

Health Sciences Campus

1200 North State St.

P.O. Box 778

Los Angeles, CA 90033
COPYRIGHT 1999 American Association for Clinical Chemistry, Inc.
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Copyright 1999 Gale, Cengage Learning. All rights reserved.

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Author:Shulman, Ira A.
Publication:Clinical Chemistry
Date:Nov 1, 1999
Words:470
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