Our blood bank is on four floors in house 10 of the LKI (a historic, heritage-protected building).
We have many different departments here, all responsible for specific things and have a department head.
On the ground floor, there is a part of the component separation - namely, the platelet production laboratory of the blood bank. This is where the apheresis and pool products are pathogen-inactivated, labelled and then sent electronically to the immunohaematology lab (and, of course, have to be physically taken there).
Floors one to three belong entirely to the blood bank.
On the first floor is the donor ambulance. This is where the voluntary donors come to donate blood, but mainly platelets.
The outpatient therapy area is separated from the donors by the staircase, where patients are treated with apheresis procedures if they are mobile enough to come themselves. If this is not the case (such as with Gullian-Barré syndrome), we drive the apheresis machine to the patient on the ward.
The most common therapy we perform on-site is photopheresis.
The donor and therapy outpatient departments have the most real contact with either donors or patients, which is the exception in our profession.
The last separate area on the first floor is the component separation - this is a clean room. The whole blood is centrifuged and then separated into erythrocytes, plasma and buffy coat. Five buffy coats are used to make a pooled platelet concentrate.
All the laboratory facilities are located on the second and third floors.
On the second floor is the infectious serology unit, where the donated blood is tested. Actually, not directly the finished blood units, but blood samples from the donors taken as part of the donation.
Next to it is the immunohematology lab, where the reception and processing of the orders and blood product distribution occur. Our supply area covers the entire Tyrol. Routine samples are processed here: blood grouping, antibody screening, and patient compatibility testing. We always have between 100 and 300 reserved blood units on the stand. These units have been prepared for operations - they have already been crossmatched with the patient's serum and tested for compatibility. They can be sent to the operating theatre by pneumatic tube within minutes if necessary.
The cold storage for the red blood cell concentrates is also located here. There is also the blood group laboratory, where the results are validated, discrepancies are clarified, and manual testing is carried out, e.g. for infants. In addition, the donor samples are immunohaematologically tested here. For first-time donors, the blood group is determined from two separate tubes. In the case of rhesus-negative donors, additional tests are also carried out to completely rule out the possibility that a donor does express the rhesus antigen weakly. However, he is rhesus negative in routine examinations.
A cross-check with the previous donation is always made - in the case of discrepancies, these must be clarified before a product can be released.
In the special and pregnancy laboratory, all abnormal samples are investigated, and special tests are carried out that are not routinely done on everyone. These include antibody differentiation, elutions and crossmatches for platelets (MASPAT). And as the lab name suggests, samples from antenatal care are tested here.
On the third floor is the office of our institute director, a seminar room, the quality management office and the IT department.
And here, you will also find our last laboratory: the HLA/immunogenetics laboratory and the biologists who work for it. What happens in the HLA lab? This is where patients and potential donors (kidney, bone marrow, liver) are HLA-typed before transplants. After the transplantation, the HLA antibodies are checked and identified (similar to red serology with erythrocytes) - this should contribute to the timely detection of humoral rejection.
Furthermore, all other molecular tests are carried out here: genetic blood group determination, fetal rhesus diagnostics, and much more.
And now, it should become clear that a transfusion physician also has much to do.
My own work focuses mainly on immunogenetics - i.e. the HLA laboratory.
Last update on 12.08.2023.