American Red Cross Laboratory Helps Diagnose Blood Disorders and Fight Transfusion-Related Complications for Hospitals and Patients around the World
Lab achieves perfect score on international proficiency assessment
ST. PAUL, Minn. (February 24, 2010) – Approximately one of every 10 patients admitted to a hospital will need a blood transfusion. Those on the receiving end of the gift of life and those battling blood disorders can find comfort in medical professionals and laboratories like the Neutrophil Reference Laboratory at the North Central Blood Services Region of the American Red Cross in St. Paul, Minnesota.
Here you will find an unassuming laboratory helping to determine the leading causes of transfusion-related complications and diagnose blood disorders for health institutions around the world. Its already solid reputation was enhanced recently by achieving a perfect score on a prestigious international proficiency assessment.
American Red Cross Neutrophil Reference Laboratory technicians screen blood samples for neutrophil antigens and antibodies to diagnose blood disorders such as alloimmune neonatal neutropenia and autoimmune neutropenia, as well as the leading cause of transfusion-related patient deaths, Transfusion Related Acute Lung Injury (TRALI). The lab is one of two in the American Red Cross system and one of approximately 20 around the world.
"The top priority of the American Red Cross is the safety of the blood supply," said David Mair, M.D., chief medical officer for the local Red Cross Blood Services Region. "The expertise our neutrophil lab provides to healthcare institutions is critical to saving patients' lives. While it is not yet known exactly what causes certain transfusion-related complications such as TRALI, our world-renowned lab is a key partner in the global effort to determine what is."
Neutrophils are white blood cells that provide the first line of defense against bacterial and fungal infections. Blood disorders such as alloimmune neonatal neutropenia and autoimmune neutropenia are conditions with too few neutrophils, compromising patients' immune systems. The Red Cross neutrophil lab helps ascertain what's destroying them.
In cases of TRALI, patients' neutrophils are confronted by antibodies directed against them in transfused blood products. This conflict activates the neutrophils, causing damage to the lung's blood vessels. The result is a leakage of fluids into the lung's air space making it extremely difficult, if not impossible, for a patient to breathe. Although rare, TRALI is the leading cause of transfusion-related patient deaths according to the Food and Drug Administration.
The Red Cross provides testing to partnering Red Cross hospitals and other institutions. The neutrophil lab receives approximately 1,000 samples from around the world each year. Since 2004, the lab has partnered in a National Institute for Health (NIH) Specialized Centers of Clinically Oriented Research grant project to determine the cause of TRALI. Over a five year period, the lab tested 2,000 additional samples including more than 500 samples in the final three months of 2009. Results of the study are expected to be available in early 2010 through the NIH.
The proficiency of the lab's highly trained and skilled technicians was reaffirmed last month by the 9th International Granulocyte Workshop Survey where the Red Cross neutrophil lab was one of two participating labs in the world to score 100 percent on both the Human Neutrophil Antigen (HNA) detection and HNA genotyping portions of the assessment. The other lab belongs to the Australian Red Cross.
Neutrophils are considered to be the most difficult blood cell to work with because they are highly sensitive and time bound. When the body alerts neutrophils to an infection, they activate and converge on the infection site. For testing to be accurate, neutrophils must remain inactive which requires lab technicians to handle them very carefully. Neutrophils also have a short lifespan – about 24 hours after collection – requiring lab technicians to work very quickly while ensuring integrity of the tests.
"This is the highest score we've ever achieved in both portions of the assessment since the workshop was established in 1989," said Randy Schuller, supervisor of the Neutrophil and Platelet Immunology Lab for the North Central Blood Services Region." Our lab's commitment to continual improvement to the point of perfection on behalf of the hospitals and patients we serve is outstanding. I'm very proud of our Red Cross team – they exude our lifesaving mission." The American Red Cross neutrophil lab also has the highest cumulative score of all participating laboratories since 2004.
The St. Paul-based Red Cross laboratory was first established in 1981 at the University of Minnesota by Laboratory Supervisor Mary E. Clay, MS MT (ASCP) and Red Cross Medical Director and blood banking pioneer Jeffrey McCullough, M.D. In 1985, the lab transitioned to the Red Cross.
Assessing labs' abilities to detect neutrophil antigens and antibodies is relatively new. In 1989 the International Granulocyte Immunology Workshop was established to assess performance and provide a forum to improve standards.
Twelve labs from the United States, Australia, Japan, Slovenia, Spain, The United Kingdom, Germany, Poland, The Netherlands, and Sweden participated in the most recent assessment. More than 40 percent of the participating laboratories were unable to achieve an acceptable grade of 70 percent, demonstrating the overall difficulty of the work and the assessment.
Schuller, who has worked in the lab since 2002, says he often finds that people are surprised to learn of the highly technical and international work going on at the local Red Cross. "People know us for blood donation and distribution. They know us for teaching lifesaving courses and providing disaster relief assistance. I also want them to know that the Red Cross is working 24 hours a day, seven days a week, to ensure that should they ever need a blood transfusion, the Red Cross will continue to have the safest possible blood supply available at their time of need," he added.
Call 1-877-447-6489 or visit redcrosslab.org for more information about the Red Cross' Neutrophil, Platelet and Red Cell Reference Laboratories.
About the American Red Cross
The North Central Blood Services Region of the American Red Cross is the largest blood supplier in Minnesota, serving 111 hospitals in the Twin Cities, greater Minnesota, western Wisconsin and eastern South Dakota. Governed by volunteers and supported by giving individuals and communities, the American Red Cross is also the single largest supplier of blood products to hospitals throughout the United States. While local hospital needs are always met first, the Red Cross also helps ensure no patient goes without blood no matter where or when they need it. In addition to providing nearly half of the nation's blood supply, the Red Cross provides relief to victims of disaster, trains millions in lifesaving skills, serves as a communication link between U.S. military members and their families, and assists victims of international disasters or conflicts.
Editor's note: A photo of the Neutrophil Reference Laboratory team is available.