Transfusion Medicine

The Department of Transfusion Medicine of Zhongshan Hospital Affiliated with Xiamen University was established in February 2006. After twenty years of development, it has become a department integrating clinical, laboratory, and management functions, with comprehensive development in medical care, education, and research. It undertakes the provision of clinical blood-use support and technical guidance for the entire hospital and serves as an important support platform for the treatment of critically ill and severely ill patients, surgical procedures, obstetric emergencies, oncology, and intensive care. The department currently covers more than 600 square meters and includes a comprehensive blood group laboratory, crossmatching room, dedicated blood storage area, thromboelastography room, and transfusion therapy room. It is equipped with specialized devices and systems, including fully automated blood group testing and crossmatching systems, an irregular antibody screening system, thromboelastography and hemostasis/coagulation analysis systems, intelligent refrigerated blood-component storage equipment, and a full-process blood-use management and traceability information system. These facilities enable the complete informatization and automation of transfusion compatibility testing, blood storage, blood-use review, quality control, and traceability. Since its establishment, the department has strictly controlled transfusion quality and safety. The rate of rational blood use has consistently exceeded 90%, while the rate of adverse transfusion reactions has been approximately 0.1%, effectively ensuring blood-use safety throughout the hospital. Every year, the department participates in the external quality assessment of transfusion compatibility organized by the National Clinical Laboratory Center under the Ministry of Health and the Fujian Provincial Clinical Laboratory Center, achieving excellent full scores each time.

Scope of Services The department’s services cover all blood-use scenarios throughout the hospital. Its routine services are comprehensive and its specialized technologies are mature. It provides daily clinical blood-use support for more than 30 departments throughout the hospital, completes more than 20,000 transfusion compatibility tests annually, and supports at least 15,000 units of clinical blood use annually. The qualification rates of transfusion application forms and clinical blood use both exceed 90%; the rates of repeat blood group testing of recipient specimens, internal quality control, and participation in external quality assessment programs are all 100%. The incidence of adverse transfusion reactions is lower than the provincial average, and the safety and quality of blood use are stable and reliable. The department’s main services are as follows:

(1) Routine laboratory testing for transfusion compatibility Routine testing covers all standard items, with standardized procedures and accurate, efficient results. Tests include ABO/RhD blood group serology, red blood cell antibody screening, platelet antibody testing, saline/antihuman globulin/polybrene-mediated crossmatching, thromboelastography (TEG), and other examinations. The annual volume of routine blood group testing exceeds 50,000 cases, with a 100% accuracy rate for blood group identification; the positive rate of antibody screening is 0.8%; more than 20,000 crossmatching tests are performed annually, with a 100% compatibility rate; and an average of more than 7,000 thromboelastography tests are performed each year to guide intraoperative and critical-care coagulation management and effectively reduce inappropriate blood use.

(2) Laboratory testing for difficult transfusion compatibility cases Focusing on high-risk and complex cases, the department performs laboratory diagnosis of hemolytic disease of the newborn caused by alloimmunization; compatibility testing for transfusion in patients undergoing allogeneic bone marrow or hematopoietic stem cell transplantation; transfusion compatibility testing for patients with autoimmune hemolytic anemia; difficult antibody identification and crossmatching; serologic and molecular biological typing of rare and difficult blood groups; platelet matching tests for patients with platelet transfusion refractoriness; and transfusion management of the coagulation system. These services address the clinical challenges of “difficult crossmatching and risky blood use.” More than 100 difficult cases are managed annually, with a 100% success rate for difficult crossmatching and an effectiveness rate of 95% for difficult transfusions.

(3) Transfusion therapy Centered on blood separation and exchange technologies, the department performs specialized therapies including platelet-rich plasma (PRP) collection, partial and whole blood exchange, and lymphoplasmapheresis. More than 100 therapeutic blood-component apheresis/exchange procedures are completed annually, with a clinical effectiveness rate of over 90%. PRP is known as a “perfect tissue repair” technology. It uses autologous material, causes no rejection, and carries a low risk of infection. It is applicable to osteoarticular injuries, tendon and ligament repair, wound healing, hair-loss regeneration, and other conditions. The platelet concentration after a single collection reaches 3–5 times that of whole blood. Partial and whole blood exchange and lymphoplasmapheresis are known as “the nemesis of immune diseases,” simultaneously removing pathogenic antibodies and abnormal blood cells. They are applicable to severe autoimmune diseases, hemolytic crises, sepsis, and multiple organ dysfunction, providing an adjunctive treatment option for severe immune diseases.

(4) Personalized transfusion Relying on a comprehensive compatibility testing laboratory and mature treatment technologies, the department provides safe and effective personalized transfusion plans according to disease type, disease stage, and the patient’s immune status, among other factors. Services cover surgery, obstetrics, oncology, critical care, hematology, transplantation, and other specialties. Patient blood management (PBM) is implemented through blood-use review, preoperative blood-use assessment, intraoperative autologous blood recovery, individualized guidance based on coagulation function, and targeted corrective actions for inappropriate blood use. These measures steadily improve the hospital-wide level of rational blood use, effectively reduce the use of allogeneic blood, decrease patients’ transfusion risks and medical consumption, and guide and support clinical diagnosis and treatment.

Expert Team The department has a professional team of transfusion medicine specialists with a well-balanced structure, solid technical expertise, and extensive experience. The overall professional hierarchy is well established, and all staff members are certified to practice. There are currently 9 staff members, of whom more than 70% hold senior or intermediate professional titles, including several master’s degree holders and key personnel. The academic leader has long been engaged in clinical transfusion medicine and management, with extensive expertise in difficult crossmatching, transfusion in special populations, massive transfusion resuscitation, and transfusion quality control. The leader has rich experience in managing difficult cases and departments and has a strong professional reputation in regional transfusion medicine. All members of the department routinely participate in special training programs and academic exchanges at the provincial and municipal levels. They are proficient in the diagnosis and treatment technologies required for various complex and special transfusion scenarios and are skilled in addressing clinical challenges including difficult blood groups, positive irregular antibodies, difficult crossmatching, rare blood groups, transfusion in pregnant women, parturients, and newborns, and personalized blood use in patients requiring repeated transfusions.