Overview
The UAB Hospital’s Transfusion Services (aka “Blood Bank”) is the largest of the clinical laboratories with 40+ employees working under Connie Langley, MT (ASCP), laboratory supervisor. They staff the main laboratory in the Spain-Wallace building, the satellite laboratory next to the North Pavilion 7th floor operating rooms, and the Highlands Hospital Blood Bank a mile away. In addition, we are fortunate to have a transfusion safety officer (TSO), Ashton Kornbrust, BSN, RN, OCN, a previously Oncology nurse. Ashton now serves as the main liaison between the Blood Bank and the clinical providers of both hospitals to ensure safe transfusion practices. Our “team” works closely with clinical colleagues from many departments regarding many clinical questions such as appropriateness of transfusions and the need for specialized products such as phenotype-matched PRBCs, crossmatched platelets, coagulation factors, etc. As the only level 1 adult trauma center in central Alabama, UAB treats more than 4,000 trauma victims each year, often with life-threatening hemorrhage. A massive transfusion protocol (MTP) has been in place for almost 10 years to ensure emergent release of whole blood, PRBCs, plasma and/or platelets for exsanguinating patients. Dr. Kerby, division director of acute care surgery, in a story in al.com in May of 2017, granted the improved survival of massively injured patients to the availability of a MTP: 'They walked out alive': As Birmingham area gun violence soars, so do survival rates. Other patients who depend on our blood products routinely are those with sickle cell anemia, cancer, or undergoing major surgery such as cardiovascular or solid organ transplants.
Our Faculty
Katayoun Fomani, MD
Associate Professor, Laboratory Medicine
Jose Lima, MD
Assistant Professor, Laboratory Medicine
Medical Director, Therapeutic Apheresis
Marisa Marques, MD
Professor, Division Director, Laboratory Medicine
Medical Director, Apheresis Collection Facility
Rance C. Siniard, MD
Assistant Professor, Laboratory Medicine
Nirupama Singh, MD
Assistant Professor, Laboratory Medicine
Elizabeth Staley, MD, PhD
Assistant Professor, Laboratory Medicine
Residency/Fellowship Training
Two residents rotate in our service for 4 consecutive months and alternate primary coverage of Blood Bank or Apheresis. Each resident works with a separate Attending from Monday to Friday, while the BB/Transfusion Medicine fellow oversees the training of both residents and work alongside them. On weekdays, all trainees (including rotating medical students), Attendings and the TSO get together for Morning Report when night calls and all ongoing patients’ needs are discussed as a group. At this meeting, the residents also learn how to maintain a proper blood inventory, how to evaluate and manage patients with abnormal bleeding or presumed transfusion reactions, how to deal with risk management issues, etc. Every week, residents and fellow also attend rotation-specific lectures by UAB faculty or outside guests. In addition, they are welcome to attend multidisciplinary conferences to complement their training in our department. Our fellows are encouraged to pursue unique training opportunities that match with their future career interests, such as additional training in cell therapy or Hematopathology.
Our Testing
The 60,000+ tests performed in the Transfusion Services are mainly intended to prepare patients to be transfused (blood type and antibody screen). Other tests aid in the investigation of hemolysis, as well as hemolytic disease of the fetus and newborn. We also evaluate for the possibility of a hemolytic transfusion reaction. We utilize automated and manual methodology depending on the circumstances of the patient and the physician order. For pre-operative patients, we have a UAB-specific maximum surgical blood order schedule (MSBOS) to guide appropriateness of orders. The MSBOS is an example of collaboration between Pathology, Anesthesiology and Surgery that ensures proper laboratory utilization.
The Transfusion Services also stores and dispenses blood products - PRBCs, plasma, apheresis platelets and cryoprecipitate as well as blood derivatives such as Rh immunoglobulin and coagulation factors, for inpatients and outpatients. Annually, approximately 36,000 units of PRBCs, 12,000+ units of plasma, around 8,500 units of platelets, and more than 2,000 cryoprecipitate units are transfused to our patients. While critically ill patients in the 8 adult intensive care units receive approximately one third of the total units of PRBCs per year, other patients who depend on such transfusions include those with cancer (especially leukemia) and sickle cell anemia. In order to optimize the utilization of PRBCs, UAB has had a patient blood management (PBM) for the past 12 years, and restrictive transfusions are the standard of care with individualized decisions in every case.
Contact Us
Marisa B. Marques, MD
Professor and Division Director, Laboratory Medicine
Director, Blood Bank/Transfusion Medicine Fellowship
The University of Alabama at Birmingham
619 19th Street South, P230K
Birmingham, AL 35233
mmarques@uabmc.edu
Blood Bank/Transfusion Medicine Fellowship information:
Program Coordinator
Telephone: (205) 975-3450 Fax: (205) 975-PATH
E-mail: path-fellowships@uabmc.edu
Website: https://www.uab.edu/medicine/pathology/education/fellowship-program