Transfusion medicine
Transfusion medicine (or transfusiology) is a medical branch that refers to transfusion of blood and blood components and hemovigilance. The activity is performed by laboratory technicians – transfusionists under the supervision of a doctor specialist – transfusiologist.
Hemovigilance covers all activities in the chain of transfusion medicine from the blood donor to the recipient. These procedures allow identification and prevention of the occurrence or recurrence of side effects associated with the transfusion of blood components in order to increase the safety and the efficiency during blood transfusion (WHO). In this regard is the rational use of blood components (timely transfusion only where it is really necessary), because blood is a limited resource of human origin, but also a transplant of a foreign tissue whose use is associated with a series of side-effects in the recipient.
Blood transfusion is the process of receiving blood in circulation through a vein. It is usually applied if the patient is bleeding, has anemia and coagulation disorders. In accordance with modern medical practice, only component therapy is transfused (erythrocyte concentrate, plasma, thrombocytes and coagulation factors) obtained from a unit of the entire blood.
Immunohematology is a branch of hematology and it examines the antigen-antibody reactions and the related phenomena – determination of blood groups, detection of antibodies (indirect antiglobulin test (EAT) or Coombs test and direct antiglobulin test (DAT), identification of antibodies and tests of compatibility (interactions). These tests are routinely performed in each patient before receiving transfusion or before a surgery in order to prevent serious post-transfusion reactions. Some of these tests are also performed during pregnancy in the mother and the newborn.
Hemostasis is a process that enables to stop bleeding from the damaged blood vessels in the organism. Blood vessels, coagulation factors in plasma, thrombocytes and erythrocytes participate in the very process. Coagulation tests (prothrombin time – PT/INR, partial thromboplastin time-APTT, thrombin time-TT) are used for diagnosis of disorders of the hemostasis. These tests are a routine analysis before and after the surgery in order to diagnose disorders in hemostasis, in order to stop bleeding by giving appropriate medications or blood components. The APTT test is used for control of heparin therapy, and INR (international normalized ratio) for guiding oral anticoagulant therapy (according to a pattern).
Phlebology is a medical specialty for diagnosis and treatment of diseases of the venous system. In the human body there is a superficial and a deep venous system, and the strategies for therapy in diseases of these systems are different. Deep vein thrombosis and their most serious complication is pulmonary thromboembolism which can be a life-threatening condition. Today these are one of the most common diseases in the world with an incidence of 80 per a population of 100.000. The vascular examination – Doppler ultrasound of deep and superficial veins is a non-invasive method when the doctor uses a probe and easily passes along the skin of the extremities following the flow of the venous circulation. A screen visualizes changes in venous blood vessels, their functionality, as well as presence of blood clots in deep and superficial veins.