Background Blood and plasma volume calculations are a daily part of practice for many Transfusion Medicine and Apheresis practitioners. Though many formulas exist, each facility may have their own modifications to consider. ChatGPT (Generative Pre-trained Transformer) provides a new and exciting pathway for those with no programming experience to create personalized programs to meet the demands of daily practice. Additionally, this pathway creates computer programs that provide accurate and reproducible outputs. Herein, we aimed to create a step-by-step process for clinicians to create customized computer programs for use in everyday practice. Methods We created a process of inputs to ChatGPT-40, which generated computer programming code. This code was copied and pasted into Notepad (and saved as a Python file) and Google Colaboratory to verify functionality. We validated the durability of our process by repeating it over a 5-day timeframe and by recruiting volunteers to reproduce our outputs using the suggested process. Results Computer code generated by ChatGPT-40 in response to our common language inputs was accurate and durable over time. The code was fully functional in both Python and Colaboratory. Volunteers reproduced our process and outputs with minimal assistance. Conclusion We analyzed the practical application of ChatGPT-40 and artificial intelligence (AI) to perform daily calculations encountered in Transfusion Medicine. Our results provide a proof of concept that people with no programming experience can create customizable solutions for their own facilities. Our future work will expand to the creation of comprehensive and customizable websites designed for each individual user.

Intravenous immune globulin (IVIG) is a common treatment given after plasma exchange procedures to either prevent secondary hypogammaglobulinemia or as an adjunctive treatment for organ transplant rejection. However, side-effects are relatively common with this medication during and after infusion. This case-report describes our alternative to IVIG infusions post-plasma exchange. We hypothesize that in patients unable to tolerate IVIG, using thawed plasma as a replacement fluid provides a suitable increase in the patients post procedure immunoglobulin G (IgG) levels for patients with secondary hypogammaglobulinemia that are unable to tolerate IVIG infusions.

This manuscript describes a novel approach for treating patients with long-term sequelae from hemoglobin Evans (Hb Evans). After instituting conservative therapies for approximately 2 years, our patient's symptoms continually worsened. Therefore, we performed red blood cell exchange (RBCx) to reduce his Hb Evans percentage and his co-existing elevation of methemoglobin. Our assumptions of clinical benefit were based on our collective experience performing RBCx for patients with sickle cell disease. After the first exchange, pre- and post-laboratory results supported our approach and the patient experienced marked improvement in his clinical signs and symptoms. This report provides preliminary proof of principle for the use of RBCx to treat Hb Evans and other non-Hb S hemoglobinopathies.

Background aimsThis white paper was developed to provide leukapheresis guidance for the collection of mononuclear cells from adult and pediatric patients who are destined for immune effector cell (IEC) therapies for commercial and research applications. Currently, there is considerable variability in leukapheresis processes and limited published information regarding best practices relevant to new cellular therapies, especially IECs. Herein the authors address critical leukapheresis questions in five domains to help guide consistent collection processes and ensure high-quality products. The first four domains are onboarding, pre-collection, collection and post-collection, with protocol feasibility, preparation, care and follow-up of the patient/donor at each step, respectively, and technical considerations during collection. The fifth domain of quality assurance focuses on ensuring product potency, purity, safety and auditing.MethodsThe American Society for Apheresis (ASFA) Clinical Applications Committee (IEC Therapy Subcommittee) was charged by the society's board of directors with working collaboratively with other ASFA committees and organizations, including the Foundation for the Accreditation of Cellular Therapy, Association for the Advancement of Blood and Biotherapies, American Society for Transplantation and Cellular Therapy, National Marrow Donor Program and International Society for Cell & Gene Therapy, to develop guidelines regarding leukapheresis collection of cells destined for the manufacture of IEC therapies. After a review of the literature and discussion with members of the involved committees and various institutions, a draft guidance was created and circulated for comment and revision.ResultsCritical aspects of apheresis that could affect the quality and quantity of the leukapheresis product were identified. These areas were then discussed and reviewed. After consensus, the best practice guidelines were proposed and accepted.ConclusionsIn the current era of rapid growth of IEC therapies, it is important to address critical leukapheresis steps to provide high-quality products and more consistent practices and to eliminate redundant efforts.

Sickle cell disease is a lifelong disorder which may be managed by chronic red cell transfusion including exchange transfusion. Chronic indwelling vascular catheters including ports offer convenient and reliable access for red cell exchange but confer risk of complications including infection and thrombosis. Detection of these complications is essential for preserving vascular access and relies on both clinical and laboratory observation. Here we describe a case of asymptomatic port infection detected by manual screening of a peripheral blood smear.

Eighteen pediatric oncology or bone marrow transplant (BMT) survivors who had liver iron content of >12 mg/g dry weight also underwent Cardiac MR (CMR) to quantify cardiac iron content. Despite high transfused packed red blood cell volumes (mean 383 ml/kg) patients all had cardiac T2* relaxation times in normal ranges (T2* relaxation time mean 35.1 msec ± 7.1 [normal >20 msec]).

TransfusionVolume 61, Issue 4 p. 1010-1011 TRANSFUSION MEDICINE ILLUSTRATED Platelet-rich aggregates in MNC collection circuit Nisar Amin, Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorJoseph H. Cho, orcid.org/0000-0002-6250-1797 Medical Sciences Institute, Versiti, Milwaukee, Wisconsin, USASearch for more papers by this authorPhillip McMullen, Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorImran Uraizee, Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorGeoffrey Wool, orcid.org/0000-0002-3335-2905 Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorLeon Su, Corresponding Author lsu@phoenixchildrens.com orcid.org/0000-0002-0318-6096 Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital, Phoenix, Arizona, USA Correspondence Leon Su, Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ, USA. Email: lsu@phoenixchildrens.comSearch for more papers by this author Nisar Amin, Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorJoseph H. Cho, orcid.org/0000-0002-6250-1797 Medical Sciences Institute, Versiti, Milwaukee, Wisconsin, USASearch for more papers by this authorPhillip McMullen, Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorImran Uraizee, Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorGeoffrey Wool, orcid.org/0000-0002-3335-2905 Department of Pathology, University of Chicago, Chicago, Illinois, USASearch for more papers by this authorLeon Su, Corresponding Author lsu@phoenixchildrens.com orcid.org/0000-0002-0318-6096 Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital, Phoenix, Arizona, USA Correspondence Leon Su, Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ, USA. Email: lsu@phoenixchildrens.comSearch for more papers by this author First published: 04 March 2021 https://doi.org/10.1111/trf.16288Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume61, Issue4April 2021Pages 1010-1011 RelatedInformation

Sickle cell patients receiving chronic RBC exchange require a form of long‐term central venous access if peripheral access is inadequate. In adults, dual lumen (DL) ports have been utilized but associated with greater procedure complications and duration when compared to other forms of access. In the pediatric sickle cell population, the use of DL ports for RBC exchange has not been well described. In this retrospective cohort study, RBC exchange procedures utilizing DL ports in the pediatric vs adult sickle cell population were compared.

BACKGROUNDAfter hematopoietic stem cell transplantation (HSCT) autoimmune hemolytic anemia (AIHA) is a known and fairly common complication. It is often refractory to conventional therapies including corticosteroids, intravenous immunoglobulin, splenectomy, and the more recently described use of monoclonal antibodies. The high morbidity associated with these severe persistent cases elucidates the gaps in alternative therapies available for treatment. STUDY DESIGN AND METHODSWe described the successful use of abatacept for severe refractory AIHA after HSCT in three patients. RESULTSThree pediatric patients with refractory AIHA after allogeneic stem cell transplantation were observed to be unresponsive to multitude immunosuppressive therapies, resulting in persistent transfusion dependency. Treatment with abatacept, a fusion protein that inhibits T-cell activation by binding to CD80/CD86 on antigen-presenting cells (APCs), thus blocking the required CD28 interaction between APCs and T cells, resulted in the resolution of hemolysis. CONCLUSIONAbatacept may provide significant clinical benefit in the management of AIHA after HSCT.

Even though hepatic veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic cell transplantation (HCT), there is paucity of research on the management of associated multiorgan dysfunction. To help provide standardized care for the management of these patients, the HCT Subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators and the Supportive Care Committee of the Pediatric Blood and Marrow Transplant Consortium, collaborated to develop evidence-based consensus guidelines. After conducting an extensive literature search, in part 2 of this series we discuss the management of fluids and electrolytes, renal dysfunction; ascites, pleural effusion, and transfusion and coagulopathy issues in patients with VOD. We consider the available evidence using the GRADE criteria.

Defibrotide is being used with increasing frequency in the prevention and treatment of sinusoidal obstructive syndrome (SOS). The mechanism of action of defibrotide includes fibrinolytic, anti-thrombotic, anti-ischemic, and anti-inflammatory properties. At Phoenix Children's Hospital our practice is to optimize hemostasis during defibrotide therapy in order to prevent possible life-threatening bleeding. Coagulopathy is historically identified by routine coagulation testing (RCT), which includes elevated international normalized ratio (INR), prothrombin time (PT) and activated partial thromboplastin time (aPTT).