By Lynn McCain
 

In decades past, people often lived lifelong within a narrow geographic region and received healthcare from one institution. Today, our population is highly mobile. Individuals may receive healthcare from locations across the United States and globally. This causes significant safety issues for patients who need blood transfusions, especially those who are unable to relay their medical history. To reduce patient risk, the Alloantibody Exchange created a nationwide blood transfusion database freely accessible by any participating health system. Recently, Michigan Medicine joined this exchange to provide enhanced patient care and safety.

Before the Alloantibody Exchange, no system provided national blood transfusion record-sharing. “Gathering crucial transfusion history can be impossible from, say, an unconscious trauma patient needing lifesaving transfusion. The Alloantibody Exchange fills in that history,” explains Dr. Jensyn Cone Sullivan, Clinical Assistant Professor of Pathology and Director of Michigan Medicine’s Blood Bank. She continued, “A pediatric patient of Michigan Medicine’s was recently worked-up by a California Blood Bank. Important transfusion information was identified there. Thanks to the Exchange, that data is readily available to our Blood Bank.”

Patients may make antibodies against transfused blood antigens. These antibodies may hemolyze future transfused blood. Donor blood with antigens targeted by these antibodies should, in general, never be transfused to that patient again. Over time, these antibodies fade but with blood exposure can rapidly reform, increasing the risk of potentially deadly hemolytic transfusion reactions to future transfusions.

The Alloantibody Exchange is a 501(c)3 nonprofit organization founded and led by Dr. Ronald “George” Hauser. The Exchange is a cloud-based database automatedly gathering transfusion history from Blood Banks’ software, with the goal of data-sharing among Blood Banks nationally. “The Exchange provides patients’ history at all hospital systems in the Exchange, supporting provision of the safest blood possible,” said Cone Sullivan. “Michigan Medicine is the first Michigan Blood Bank with data live. Indeed, we beat Ohio State to the Exchange.”

“Nearly everyone we talk to about the Alloantibody Exchange agrees this is a good idea,” said Hauser. “Right now, people call each other to get this information, and it is hard to have a secure phone conversation with somebody because you don’t really know who is on the other end of the line. It is also very slow. You don’t know who to call, so you pick up the phone, start dialing numbers, and hope you find the right person. Having a place where you could go to look up a patient can save a tremendous amount of time, increases patient safety, and reduce the risk of releasing information inappropriately.”

“Benefits of the Exchange significantly impact the safety of transfusion, particularly to patients with multiple historic blood transfusions or blood exposures, like those with sickle cell disease, thalassemia, blood cancers, historic solid-organ transplant, or historic or current pregnancy,” added Cone Sullivan.

Currently, the Alloantibody Exchange has enrolled Blood Banks from California to Maine, Alabama to Michigan, and several states in between. “As we move forward, we want to fill in the map. Jensyn is running the Michigan-based outreach program, and we are reaching out to institutions in other states,” said Hauser. “This Exchange enables healthcare systems to provide state-of-the-art care for patients and make transfusions safer for patients. That means safer surgeries, safer cancer treatments, and safer care for anyone who requires blood transfusions. It also streamlines the workflow for laboratories and Blood Banks and saves money.”

Cone Sullivan added, “Phone-relayed information is susceptible to transcription errors. In transfusion, mis-capitalizing a letter (e.g. thinking a patient has an anti-C antibody, when they have an anti-c) could lead to incompatible transfusion and death. By accurately relaying data, the Exchange will guard patient safety.”

The Alloantibody Exchange needs your help. “Spread the word. If you are a surgeon using blood in your practice, check with your Blood Bank to see if they are using this. If you are an oncologist and have patients receiving blood transfusions with chemotherapy or radiation therapy, you would want your Blood Bank to use this safety measure. You can also sign our petition for inclusion,” said Hauser.

To learn more about the Alloantibody Exchange and how you can support this effort, visit their website Alloantibody Exchange.