Transfusion Medicine

The Laboratory Division is primarily responsible for processing blood to produce the following blood components:

·       Packed red blood cells, fresh frozen plasma for clinical and industrial use, platelets, platelet-rich plasma (PRP), and platelet gel.

·       Performs diagnostic testing to detect viral infections such as HBV, HCV, and HIV. Testing for viral markers is conducted using conventional immunoenzymatic assays and nucleic acid amplification techniques.

·       The Viral Molecular Biology Laboratory carries out quantitative HCV RNA and HBV DNA tests and HCV RNA genotyping. A pharmacogenetics service is also operational, focusing on genotyping oncology patients undergoing chemotherapy.

·       Conducts HLA antigen typing using molecular biology methods for diagnostic purposes in genetic disorders and, primarily, for the enrollment of bone marrow donors in the international donor registry.

·       Determines ABO and RH blood groups and other subgroups, detects and identifies irregular antibodies and autoantibodies, and tests for cryoglobulins to ensure transfusion compatibility and for diagnostic applications.

·       Cord Blood Bank - Puglia Region: Umbilical cord blood offers a valuable therapeutic option as a source of hematopoietic stem cells. These stem cells can be used even with partial compatibility, reducing the risks of rejection and transmission of latent viral infections. The bank operates within the framework of the Italian Cord Blood Network (ITCBN), which links nearly 300 birthing centers nationwide to 19 cord blood banks. Our facility collaborates with 14 birthing centers and ranks among the leaders in terms of collected and stored units. Cord blood units listed in the IBMDR (Italian Bone Marrow Donor Registry) are requested globally.

Report Retrieval:

Laboratory and Transfusion Center reports are available online and can also be collected in person three business days after receiving an SMS notification. Reports are distributed on weekdays from 8:00 AM to 2:00 PM at the Public Relations Office (URP) located on the Ground Floor, North Wing, of the Outpatient Facility.

• Phlebotomy Therapy in Polycythemic Patients: This procedure is used to lower hematocrit levels, thereby improving tissue oxygenation by reducing blood viscosity. In patients with Hemochromatosis, phlebotomy therapy reduces ferritin deposits in tissues, slowing the progression of organ damage. Additionally, therapeutic apheresis is performed in patients who benefit from plasma exchange therapy, such as those with autoimmune diseases, hyperviscosity syndromes, or acute toxic states.

  ·       Blood Transfusions for Thalassemic Patients: Patients with genetic disorders that result in a reduction or complete absence of normal hemoglobin production require regular transfusion support. The frequency of these transfusions varies depending on the specific genetic mutation. These patients are managed through the Thalassemia Day Hospital.

  ·       Apheresis for Donation: In addition to the donation of red blood cells and blood components via apheresis, it is now possible to donate stem cells through this method. Stem cell donation is available for donors found compatible with specific patients via IBMDR (Italian Bone Marrow Donor Registry) matching. This includes unrelated donors, who may undergo hematopoietic growth factor treatments prior to donation.

The CoreLab is a centralized, high-throughput automated system organized into specialized workstations. It enables the rapid processing of first-line tests on whole blood, plasma, and urine samples, supporting areas such as Biochemistry, Immunochemistry, Pharmacology, Hematology, Coagulation, and Virology. The system ensures centralization and full automation of pre-analytical, analytical, and post-analytical processes.

Protein Serology: Includes serum protein electrophoresis, serum and urine immunofixation, isoenzyme analysis (e.g., Lactate Dehydrogenase, Creatine Phosphokinase, Alkaline Phosphatase), and quantification of immunoglobulins and specific proteins through nephelometry.

Autoimmunity: Autoantibody testing includes

·       Anti-Nuclear Antibodies (ANA)

·       Anti-Mitochondrial Antibodies (AMA)

·       Anti-Smooth Muscle Antibodies (ASMA)

·       Anti-Gastric Parietal Cell Antibodies (APCA)

·       Anti-Double-Stranded DNA Antibodies tested on Crithidia Luciliae by indirect immunofluorescence

·       Extractable Nuclear Antigen (ENA) antibodies via ELISA

·       Anti-Thyroid Antibodies using enzymatic immunofluorescence

Allergy Testing: PRIST and RAST tests are conducted for allergens such as food, animal dander, parasites (Anisakis), grasses, inhalants, antibiotics (Penicillin G, Penicillin V, Ampicillin, Amoxicillin, Cefaclor, Succinylcholine), and occupational allergens (Latex, MDI Isothiocyanate, Formaldehyde/Formalin, TDI Isothiocyanate). The laboratory also measures antibodies against Desmoglein 1, Desmoglein 3, BP180, and BP230 for the differential diagnosis and therapeutic monitoring of autoimmune blistering skin diseases (pemphigus and pemphigoid), using indirect immunoenzymatic techniques (ELISA).

Toxicology: The lab provides therapeutic drug monitoring for immunosuppressants, antiepileptics, anticancer agents, and lithium. It also performs first-line screening for drugs of abuse in urine and chromatographic analyses (HPLC) for conditions such as hypertension and adrenal tumors (Catecholamines, Metanephrines, Vanillylmandelic Acid, Homovanillic Acid), carcinoid syndrome (5-HIAA), and bone metabolism (Pyridinoline and Hydroxyproline). Additional services include monitoring chronic alcohol consumption (CDT), microscopic examination of biological fluids and cerebrospinal fluid, chemical and microscopic stool analysis, fecal occult blood testing, and medico-legal toxicological investigations.

Pharmacogenetic Studies: Conducted in collaboration with the Ospedale Riuniti di Foggia.