UVOD V TRANSFUZIJSKO MEDICINO - Shrani.si · 10 Kratka zgodovina transfuzije Jean-BaptisteDenis...
Transcript of UVOD V TRANSFUZIJSKO MEDICINO - Shrani.si · 10 Kratka zgodovina transfuzije Jean-BaptisteDenis...
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VsebinaVsebina
Kratka zgodovina transfuzije1
Transfuzijska medicina v Sloveniji2
3 Organizacija transfuzijske dejavnosti
4 Transfuzija kod veda, znanost
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Prihodnost transfuzije
Mednarodna združenja
K-skladna transfuzija
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Kri je edini tekoči organVsebuje številne vrste celicBrez krvi ni življenjaOskrbuje vsako človeško celico:
– Hranivo– Kisik– Energija– Toplota– Izmenjava snovi
Ima sposobnost hemostazeVsebuje informacije o drugih organihAli je že na razpolago umetna kri?
To drži, kajti:
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Huang Di Nei Jing - Yellow Emperor’s Classic
of Medicine, China, Warring States period,
475-221 B. C.
“The flow of blood . . never stops . . . . . it is moving eternally . . . . in a closed circle . “
Chi Poh, Court doctor
Huang Di (2698 - 2589 B.C.)
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1492:First reported historical attempt at a blood transfusion:
the Pope Innocent VIII sank into a coma, at the suggestion of a Jewish physician, the blood of three boys was infused into his veins. They were ten years old, and had been promised a ducat each. All three died.
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1667 Jean-Baptiste Denis, a physician to Louis XIV : the first transfusion from a sheep to a madman. The patient died, Denis accused of murder,Blood transfusion banned by for 150 years.
1666 Richard Lower:
direct transfusion dog-dog: “The dog came back from the dead, as though the life force had filled it up again."
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Kratka zgodovina transfuzije
Jean-Baptiste Denis1640 - 1704
Transfuzijaprepovedana
Pariška medicinska fakulteta
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transfuzija živalske krvi človeku 1667
James Blundell*1770-1878
Transfuzija krvi s človeka na človeka
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Karl Landsteiner1868-1943
Odkrije ABO in (skupaj z Levinom)Rh sistem
PREPOVED VELJA 130 LET!
Prvo uspešno ABO –skladno transfuzijo -V bolnišnici Mt. Sinaiizvede Dr. Reuben
Ottenberg
19071818
*Sklicuje se na Leacockovo delo na Karibih
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Dr.James Blundell, a British obstetrician:the first successful transfusion human-patient for the treatment of postpartum hemorrhage. He used the patient's husband as a donor, extracted 4 ounces of blood from his arm to transfuse into his wife.
1825 – 1830: he performed 10 transfusions, 5 beneficial and published
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Uvod dr. James Blundell, 1825Uvod dr. James Blundell, 1825--18301830
performed 10 transfusions, 5 beneficial and published
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MILESTONES OF TM IN 20th cent.
1900 : Landsteiner AB0 blood groups1909: Ottenberg - crossmatch1914: Albert Hustin, BE, non-direct transfusion with Na-citrate1916: Royal Army Medical Corps: cooled stored blood 1925: blood transfusion institute, Alexander Bogdanov - Moscow1940: Landsteiner, Wiener - Rh blood groups 1945: Coombs et al. - antiglobulin test (Moreschi 1908)1964: Terasaki - microcytotoxicity test, HLA typing1990s: - molecular typing2000s: - cellular therapies
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1901: Institute of Pathology and Anatomy, Vienna.Prof. Dr. Anton Weichselbaum. Assist. Dr. Karel Landsteiner
Tabelle 1. betrettend das Blut sechs anscheinend gesunder Manner
Sera/RBCs Blood group
Dr. Stork - + + + + - CDr. Plečnik - - + + - - BDr. Sturli - + - - + - ADr. Erdheim - + - - + - Alab. Carič - - + + - - BDr. Landst. - + + + + - C
Odkritje krvnih skupin ABOOdkritje krvnih skupin ABO
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Predtransfuzijske preiskave
1909: v bolnišnici Mount SinaiHospital, New York - izvede dr. Reuben Ottenberg prvo uspešno ABO – skladno transfuzijonavzkrižni preiskus
1882-1959
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PretransfusionPretransfusion TestingTesting
● 1939/40: RhD kompatibilnost
● 1946 → antiglobulinski (Coombsov test)
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Slovenska transfuzijska medicina
1926: prva transfuzija krvi v Mariboru, dr. A.Ramšak1945: Oddelek za transfuzijo krvi v Centralni vojni bolnici -organizacija krvodajalstva, odvzemanje in konzerviranje krvi, 1946: Zavod za transfuzijo krvi MF v Ljubljani1956: Zavod RS za transfuzijo krvi1949 – 1959: transfuzijski oddelki v CE, MB, Izoli, MS, Ptuju, SG, NG, NM in Trbovljah
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5 Collection Issuing & crossmatching Processing Testing
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8,980
41,029
312
11,414
4,457
4,240
4,179
2,914
2,776
1,409
4,769
Trbovlje
Ptuj
Ljubljana
Organization of Blood transfusion service in Slovenia - 2004
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Blood Donors Structure in Slovenia
Sex:female male
Age:
Frequency of blood donation
4 x2 %
3 x7 %
2 x29 %
1 x62 %
per yearblood donors
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94,9351070 sessions
83 694 units33 951 units
1 394 units27 991 litres
blood donors (4.75% of population)(323 at the field collection sites)red blood cellsplatelets (recovered from whole blood)platelets (platelet apheresis)plasma (recovered from whole blood + collected by plasmapheresis)
Statistics for the Year 2004
Percentage of collected whole blood
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TRANSFUZIJSKA MEDICINA KOT MEDICINSKA VEDA
združuje klinične in temeljne medicinske vedePodročja:
biologija krvi, fiziologija, imunologija,imunohematologija in imunogenetika,celične terapijamedicinska biotehnologija, itd.
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TRANSFUZIJSKA MEDICINA KOT STROKA
1. preskrba s krvjo – krvodajalstvo, blood banking2. zdravljenje s krvjo in krvnimi pripravki - klinična TM3. transplantacija, histokompatibilnost4. zdravljenje z drugimi postopki – biotehnologija, celična TH5. laboratorijske preiskave, ki podpirajo TM6. spremljevalne aktivnosti:
nacionalni register krvodajalcev, bolnikov, dajalcev kostnega mozgabiobankarazvoj transfuzijske informacijske tehnologijeprenatalna zaščita
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TM KOT ZNANOST
Influence of 3D carriers on differentiation capabilities of chondrocytesL7-7598
The use of cultivated skin supplements for the treatment of chronic and acute woundsL7-7457
Development of tissue engineered bone for use in periodontology, traumatology and orthopaedic surgeryL4-6325
Isolation, characterisation and differentiation of human stem cell as a basis for cellular therapyL3-6011
Prion diseases and their diagnosticsL3-6006
The use of cultivated autologous chondrocytes for ttreatment of vesico-uretheral refluxL3-6265
Prion diseases and their diagnosticsL3-3435
Immunomodulation in solid malignant tumors refractory to standard treatmentL3-3368
Human Monocyte Derived Dendritic Cells - The Activators and Modulators of Specific Immune ResponsesL1-6295
The production of human recombinant metalloproteinase inhibitor TIMP-1 and development of specificimmunodiagnostic reagents for determination of the native TIMP-1 in biological samples.L1-3372
Pharmakogenetics of thiopurines- diagnostics and individualized therapyJ3-7406
Healing of poorly healing fractures of long bone with the use of platelet rich plasmaJ3-6290
Genetic background of chronic diseases in children and adolescentsJ3-6072
Genetic mechanisms of human diseasesJ3-4532
Molecular-genetic basis of chronic disorders in children and adolescentsJ3-3096
Chemical and biological monitoring of neonicotinoids and their impact assessment in the environmentJ1-6001
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TM V IZOBRAŽEVANJU
Dodiplomski programi:• Medicinska fakulteta
•Katedra za ginekologijo/porodništvo V letnik •Katedra za interno medicino VI letnik
• Visoka šola za zdravstvo - Program za VMS – 2.letnik• Fakulteta za farmacijo: Laboratorijska biomedicina, Visoki študij 3+2. Predmet: Hematologija s transfuzijsko medicino, 2.letnik
Podiplomski programi:• Medicinska fakulteta
•Smer Biomedicina, izbirni predmet: Transfuzijska medicina, transplantacija in celična terapija
• Fakulteta za farmacijo: Predmet Laboratorijska transfuzijska medicina in transplantacija, Magistrski študij (+2)
[1] Directive 2002/98/EC of the European Parliament and of the Council of 27 January 2003 setting standards of quality and safety for the collection, testing, processing, storage and distribution of human blood and blood components and amending Directive 2001/83/EC
[2] Directive 2004/23/EC Of The European Parliament and of the Council of 31 March 2004 on setting standards of quality and safety for the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells. Official Journal of the European Union 7.4.2004 L 102/48
Zakonodaja
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GENETICS: HUGO 2001
PRIHODNOST TM 2006
CLASSICAL TRANSFUSION
MEDICINEStem cell
engineering
Cellular therapies& engineering
Gene therapy Recombinant technologies
PROTEOMICS and microarray technology
Viral inactivation
Blood substitutes
European School of Transfusion Medicinewith Prof. Dr. Umberto Rossi
European Federation of Immunogenetics
Bristol School of Transfusion and Transplantation Sciences
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Mednarodne organizacije
European Commission: http://europa.eu.int/comm/health/
Council of Europe http://www.coe.int/
WHO: http://www.who.int/bloodsafety/en/
URL: http://www.ztm.si/e-Pošta:[email protected]
Telefon: +386 (0)1 5438100Faks: +386 (0)1 5438186
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