transfusion medicine
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The chapter will provide a global situation analysis, describe the key elements of knowledge economy in the healthcare and transfusion medicine field, and analyze the impact of the knowledge economy on the pace of development progress of national blood supply and transfusion structures. The authors will provide examples to illustrate the case of applying knowledge economy principles to advance the safety and availability of blood products in clinical healthcare and hence the economy of care. Recommendations on how to improve will be described.

Phosphate-buffered saline (PBS) and Alsever’s solution (AS) are frequently used as media in blood-related studies, while 0.9% normal saline (NS) is frequently used in transfusion medicine. Despite the frequent use, the effects of these solutions on the shape and volume of red blood cells (RBCs) have not been reported. We collected blood samples from five healthy adults and used three-dimensional refractive index tomography to investigate the changes in the morphology of RBCs caused by changes in osmolality and solutes at the single-cell level. After diluting 2 μL of RBCs 200-fold with each solution (PBS, AS, and 0.9% NS), 40 randomly selected RBCs were microscopically observed. RBC shape was measured considering sphericity, which is a dimensionless quantity ranging from 0 (flat) to 1 (spherical). RBCs in plasma or AS showed a biconcave shape with a small sphericity, whereas those in 0.9% NS or PBS showed a spherical shape with a large sphericity. Moreover, we confirmed that sodium chloride alone could not elicit the biconcave shape of RBCs, which could be maintained only in the presence of an osmotic pressure-maintaining substance, such as glucose or mannitol. Although 0.9% NS solution is one of the most commonly used fluids in hematology and transfusion medicine, RBCs in 0.9% NS or PBS are not biconcave. Therefore, as the debate on the use of NS continues, future clinical studies or applications should consider the effect of glucose or mannitol on the shape of RBCs.

Background: This review describes and evaluates the most relevant preanalytical errors and their impact on subsequent laboratory diagnostics. Quality management for laboratory processes remains extremely important, despite current advancements in information technologies and fully automated routine procedures. Methods: This review is focused on specific preanalytical requirements for the blood bank and transfusion laboratory. Conclusions are done based on literature review. Results: Human errors, or lack of procedures, continue to be the cause of many errors within laboratory processes. The medical laboratory needs an impetus and stipulation to improve processes, to help eliminate errors, and meet regulatory guidelines. Conclusions: General preanalytical rules exist for clinical and research laboratories but differences in laboratory specialty and provided services influence compliance