Transfusion FAQs

Red cell transfusion

Expect a single unit RBC transfusion to bring up the haemoglobin by 10g/L in an average sized patient (70kg)
In a smaller patient expect a greater increment- caution as this can lead to a significant haemoglobin rise-in extreme cases this can cause ischaemic events such as stroke from acute hyperviscosity
Unless actively bleeding, even in a patient who is very anaemic, it is almost always safer to start with 1 or 2 units and review both repeat bloods and patient fluid balance before further transfusion. Transfusion associated cardiac overload (TACO) remains the major cause of death from transfusion as per the SHOT report 2017 (see ref)
Red cell transfusions can be;
- Emergency/‘Flying squad’ - O negative*, available immediately. (*O positive often given to male trauma patients as low risk and consequence of developing an anti-D antibody compared to female (risk of haemolytic disease of foetus and neonate from any antibody that develops))
- Group specific – ABO and Rh group matched (takes around 20 minutes)
- Cross matched – transfusion tested in lab to show no reaction (due to antibodies) when donor blood added to recipient plasma (takes around 45 minutes)
Red cells are prescribed on a transfusion chart and delivered over 90 minutes per unit for routine transfusion. This can be quicker if the patient is actively bleeding and slower if the patient is at risk of TACO

FFP

Evidence shows that FFP will not ‘correct’ a PT of 18-19 seconds or less, so giving FFP for at this level of PT or below gives no benefit to haemostasis and risks TACO. FFP should also never be given to a non-bleeding patient if there is no procedure planned, even in DIC (see refs NICE, BSH and Mild PT abnormalities)
The recommended adult dose of FFP is 12-15ml/kg. Therefore a 70kg adult would need between 900-1000ml of FFP. FFP comes as 'units' which are standardised to around 270ml. Therefore the dose for a 'standard' 70kg adult is four units of FFP.
This will be appropriate for patients of a similar size, but not appropriate for a 40kg patient =TACO risk. Use the ml/kg formula if any concern that the FFP dose may be inappropriate.

Platelets

Aspirin will start inhibiting platelets in less than one hour after ingestion (3-4 hours if enteric coated) and affect platelet function for 2 hours (or 4/5 if enteric coated)-platelet transfusion in this time unlikely to give any benefit. The effect is more short-lived than clopidogrel and many procedures (e.g PCI/CABG) are performed while still on aspirin (See ref BSH)
Clopidogrel will start inhibiting platelets 4-8 hours after ingestion and affect platelet function for 12 hours-platelet transfusion in this time unlikely to give any benefit. The effect of platelet inhibition will continue for around 1 week
See ‘Transfusion Thresholds’ module for advice on platelet transfusion threshold
Usually platelets are prescribed as 1 adult dose/’pool’ of platelets over 30 minutes

Cryoprecipitate

Cryoprecipitate is used to replace fibrinogen in a bleeding/at risk patient, usually if fibrinogen is less than 1.5g/L
In blood it is measured either as derived (calculated from other clotting tests) or by the Clauss method which measures more accurately
Cryoprecipitate is given at a dose of 5-10ml/kg depending on the clinical scenario (most common dosing is 2 ‘pools’ of 5 units, therefore 10 units- each unit being around 43ml (see ref))
Fibrinogen concentrate can also be used but is off-license and use must be discussed with haematology

General

Irradiated products have specific indications (see module)-most oncology patients will not need them.

References

RBC
- SHOT report summary 2017; https://www.shotuk.org/wp-content/uploads/myimages/SHOT-REPORT-SUMMARY-2017_FINAL2-.pd
FFP
- BSH FFP guidance; https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2141.2004.04972.x
- NICE ‘Do not do’ guidance; https://www.nice.org.uk/donotdo/do-not-offer-fresh-frozen-plasma-transfusions-to-correct-abnormal-coagulation-in-patients-who-are-not-bleeding-unless-they-are-having-invasive-procedures-or-surgery-with-a-risk-of-clinically-significant-bleeding-or-need-reversal-of-a-vitamin-k-antagonist
- Mild PT abnormalities; https://www.ncbi.nlm.nih.gov/pubmed/16934060
- Paediatrics; https://link.springer.com/article/10.1186/s40560-014-0064-1
Platelets
- BSH; https://b-s-h.org.uk/guidelines/guidelines/peri-operative-management-of-anticoagulation-and-antiplatelet-therapy/
Cryoprecipitate
- JPAC; https://www.transfusionguidelines.org/transfusion-handbook/3-providing-safe-blood/3-3-blood-products

Tranfusion threshholds

Guidance has been produced around transfusion thresholds as unnecessary transfusion is associated with morbidity and mortality

Haemoglobin

Indication	Target Haemoglobin
Critically ill patients	70-90g/L (up to 100g/L if acute sepsis with hypoxia))
Traumatic brain injury	70-90g/L (over 90g/L if evidence of cerebral ischaemia)
Subarachnoid haemorrhage	80-100g/L
Acute ischaemic stroke in neuro ICU	>90g/L
Acute coronary syndrome	80-90g/L

(Adapted from Retter et al- see Guideline (Red cell transfusion))

Platelet transfusion in bleeding

These are general thresholds and each case should be assessed individually

In minor bleeding keep platelet count over 30x10⁹/L
In major bleeding keep platelet count over 50x10⁹/9
In severe trauma keep platelet count over 100x10⁹/L
Do not use platelet transfusions in idiopathic thrombocytopenic purpura unless severe or life/limb-threatening bleeding or peri-operatively in an emergency situation (discuss with haematology)
Note, in the presence of a normal platelet count, platelet effectiveness may still be decreased by both medications (e.g anti-platelets, non-steroidal anti-inflammatory drugs) and systemic illness (e.g renal failure)

**Recommended platelet thresholds for procedures as per BCSH guidance**
Procedure	Threshold
Lumbar Puncture	>40x10⁹/L*
Central venous line insertion with US guidance**	>20x10⁹/L
Epidural catheter insertion/removal	>80x10⁹/L
Major Surgery	>50x10⁹/L
Neurosurgery or ophthalmic surgery	>100x10⁹/L
Percutaneous liver biopsy	>50x10⁹/L

* Some centres advocate the use of a threshold of over 70x10⁹/L due to the potentially significant consequences of a bleed into the dural space.

** Some centres advise this threshold only in the hands of an experienced operator under US guidance. For less experienced operators, a higher threshold may be according to local practice.

Links: Review (BCSH platelet transfusion) Guideline (Red cell transfusion) NICE transfusion guideline

Irradiated/CMV neg blood

Quick tip; If a patient who usually needs irradiated/CMV negative blood products needs blood in an emergency, don't delay transfusion to get them the blood with these characteristics. Give them non-irradiated/non-CMV-negative as delaying transfusion is more likely to kill them than receiving a non-irradiated blood product for example

Irradiated products are used when there is a risk that due to weak recipient T cell immunity, a normal transfusion, which contains some donor T cells, could lead to engraftment of those donor T cells into the recipients marrow causing transfusion-associated graft versus host disease (TaGvHD). This is very rare but almost uniformly fatal.

Blood products which need irradiating are; red blood cell products, platelet products and granulocytes.

Those who need irradiated products are;

Condition-specific
- Patients with Hodgkin lymphoma (lifelong)
- Patients with T cell immunodeficiency (e.g Di-George syndrome) if there is a qualitative or quantitative T lymphocyte defect - note this is new guidance in BSH 2020 Irradiated component guidelines-read this for guidelines for further information (see link below)
Chemotherapy-specific
- Patients who have had bendamustine chemotherapy (lifelong)
- Patients who have had purine analogue chemotherapy-fludarabine/cladribine/deoxycoformicin/clofarabine (lifelong)
- Patients who have had 'Campath' therapy (alemtuzumab) or anti-thymocyte globulin (lifelong)
  - The caveats to this are;
  - Patients who have received Alemtuzumab to treat MS/vasculitis with current (2020) regimes. In this case irradiated products are not required.
  - Patients who have received ATG as part of solid organ transplant conditioning. In this case irradiated products are not required.
Receiving products with matched/closely matched HLA antigens to self
- Patients who are receiving blood from a first/second-degree relative
- Patients receiving a granulocyte transfusion
- Patients receiving any Human Leucocyte Antigen (HLA) – selected components
Transplant-related
- Patients receiving allogeneic haematopoietic stem cell transplants from the start of conditioning therapy until all of the following conditions are met;
  - Graft-versus-Host Disease (GvHD) prophylaxis is completed and no GvHD remains (if GvHD becomes chronic then irradiated products should continue indefinitely)
  - Until lymphocytes over 1x10⁹/l
  - At least 6 months has passed post transplant
- Allogeneic HSC donors if having transfusion 1 week before stem cell harvest
- Patients undergoing an autologous HSC graft, for seven days up to and during the stem cell harvest and from the start of conditioning chemo-radiotherapy until three months after (six months if the patient received total body irradiation)
Cellular therapy related
- All patients receiving autologous CAR-T therapy for seven days up to and during the stem cell harvest and from the start of conditioning chemo-radiotherapy until three months after (new for 2020 guidelines).
All Intrauterine transfusions (IUT) of red cells and platelets must be irradiated and for 6 months after expected date of delivery.
Neonatal exchange transfusions (ET) if recipient has had IUT or if receiving from first/second degree relative. If there is time, irradiation is desirable for any ET, but should not delay transfusion.

Patients with HIV/AIDS are not thought to need irradiated products

TaGvHD is yet to be fully understood and not all cases occur in immunodeficient recipients, but that risk is higher if the recipient lacks T cell immunity or cannot identify donor T cells as foreign.

TaGvHD is incredibly rare. Leukodepletion of all routine blood products (except granulocytes) has reduced the risk of TaGvHD hugely. It can still occur however, therefore whenever there is time to give irradiated products to patients with the indications above, you should. However, if a patient needs transfusion as an emergency and there isn't time to wait for an irradiated unit of blood, then don't. The chance of TaGvHD is relatively small compared to the risk of death from delayed transfusion-consistently the 2nd commonest cause of death associated with transfusion.

CMV negative products

Over 50% of the adult population have been exposed to Cytomegalovirus (CMV) and will have immunity (CMV IgG). In certain immunocompromised patients CMV can be reactivated. Rarely CMV can be transmitted in blood products if a donor is acutely infected. However, current literature shows that leucodepletion (performed on all blood products except granuloctyes) is as effective as making products 'CMV negative'. Therefore only when there is risk of a foetal/neonatal CMV infection should CMV-negative products be used;

Intra-uterine tranfusions
Neonates up to 28 days post expected date of delivery
Transfusions during pregnancy, not including labour or delivery (leucocyte deplete blood can be used if no CMV negative products are available)

Guideline (Irradiated products) Guideline (HEV negative products) Guideline (CMV negative products)

The contents of these pages were created with great care. For the accuracy, completeness and timeliness of content, we can not take any responsibility. As a service provider we are responsible according §7 1 TMG for own contents on these pages under the general laws. According to §8 to 10 TMG we are not obligated as a service provider to monitor transmitted or stored information, or to investigate circumstances that indicate illegal activity. Obligations to remove or block the use of information under the general laws remain unaffected. However, a relevant liability is only possible from the date of knowledge of a specific infringement. Upon notification of such violations, we will remove the content immediately.

Privacy Policy of Buku Haematology

This Application collects some Personal Data from its Users.

This document can be printed for reference by using the print command in the settings of any browser.

Owner and Data Controller

Buku Haematology - Newcastle - United Kingdom

Owner contact email: bukuhaem@gmail.com

Types of Data collected

Buku Haematology (The Owner) records no personally identifiable data. The following usage data are collected by default by the host of our App, AppYourself GmbH. This data is then managed as per their privacy policy below.

System Version
Smartphone model
Hardware ID (https://help.pushwoosh.com/hc/en-us/articles/360000365023-What-is-a-HWID-)
Opening of each module together with the time of the action
Date of register

Data will only be shared by AppYourself in accordance with their Privacy Policy.

Buku Haematology (owned by Buku Tech Ltd) retain none of this data. We can see our user traffic, country of access and modules accessed. Unique identifiers are generated for each user by the AppYourself system to show the number of times the App is accessed and which modules are viewed by individuals. No further information about the individual is given.

AppYourself privacy policy

We (Buku Haematology) have removed those elements that we have chosen not to include in the App (such as Facebook integration for example). Please contact privacy@appyourself.net if you have any questions about personal data storage.

Among the types of Personal Data that this Application collects, by itself or through third parties, there are: Cookies; Usage Data; various types of Data; unique device identifiers for advertising (Google Advertiser ID or IDFA, for example); Storage permission; geographic position.

Complete details on each type of Personal Data collected are provided in the dedicated sections of this privacy policy or by specific explanation texts displayed prior to the Data collection.

Personal Data may be freely provided by the User, or, in case of Usage Data, collected automatically when using this Application.

Unless specified otherwise, all Data requested by this Application is mandatory and failure to provide this Data may make it impossible for this Application to provide its services. In cases where this Application specifically states that some Data is not mandatory, Users are free not to communicate this Data without consequences to the availability or the functioning of the Service.

Any use of Cookies – or of other tracking tools – by this Application or by the owners of third-party services used by this Application serves the purpose of providing the Service required by the User, in addition to any other purposes described in the present document and in the Cookie Policy, if available.

Mode and place of processing the Data

Methods of processing

In some cases, the Data may be accessible to certain types of persons in charge, involved with the operation of this Application (administration, sales, marketing, legal, system administration) or external parties (such as third-party technical service providers, mail carriers, hosting providers, IT companies, communications agencies) appointed, if necessary, as Data Processors by the Owner. The updated list of these parties may be requested from the Owner at any time.

Legal basis of processing

The Owner may process Personal Data relating to Users if one of the following applies:

Users have given their consent for one or more specific purposes. Note: Under some legislations the Owner may be allowed to process Personal Data until the User objects to such processing (“opt-out”), without having to rely on consent or any other of the following legal bases. This, however, does not apply, whenever the processing of Personal Data is subject to European data protection law;
provision of Data is necessary for the performance of an agreement with the User and/or for any pre-contractual obligations thereof;
processing is necessary for compliance with a legal obligation to which the Owner is subject;
processing is related to a task that is carried out in the public interest or in the exercise of official authority vested in the Owner;
processing is necessary for the purposes of the legitimate interests pursued by the Owner or by a third party.

In any case, the Owner will gladly help to clarify the specific legal basis that applies to the processing, and in particular whether the provision of Personal Data is a statutory or contractual requirement, or a requirement necessary to enter into a contract.

Retention time

Personal Data shall be processed and stored for as long as required by the purpose they have been collected for.

The Owner records no personal data, and therefore usage data is the only data retained, and this is retained by AppYourself.

Once the retention period expires, Personal Data shall be deleted. Therefore, the right to access, the right to erasure, the right to rectification and the right to data portability cannot be enforced after expiration of the retention period.

The purposes of processing

The Data concerning the User is collected for the following purposes: Analytics, Hosting and backend infrastructure, Data transfer outside the EU, Device permissions for Personal Data access, Displaying content from external platforms, Infrastructure monitoring, Registration and authentication, and Location-based interactions.

For specific information about the Personal Data used for each purpose, the User may refer to the section “Detailed information on the processing of Personal Data”.

Detailed information on the processing of Personal Data

Key facts about data control by AppYourself;

The servers used by AppYourself are located in Europe (and thus protected by GDPR) and the US.
The data is hosted on AWS infrastructure, but AWS does not store any user-related data. User-related data is stored by AppYourself in Google Firebase. The storage is located in USA.
Although the Google Firebase server (based in the US) is not secured by GDPR they operate under the EU-US privacy shield. For more information about cloud-sided encryption see; https://firebase.google.com/support/privacy#data_encryption. Google Firebase is also compliant with ISO27001. For more information see; https://firebase.google.com/support/privacy#firebase_is_certified_under_major_privacy_and_security_standards
User data is stored for up to 90 days after App subscription is terminated. Furthermore, users have the right to delete their profile at any time. By doing so, their account is irretrievably deleted.
In case of a data breach by AppYourself, this can be reported via https://iapp.org/resources/article/how-to-notify-your-dpa-of-a-data-breach/

Personal Data is collected for the following purposes and using the following services:

Analytics

The services contained in this section enable the Owner to monitor and analyze web traffic and can be used to keep track of User behavior.

Google Analytics for Firebase (Google LLC)

Google Analytics for Firebase or Firebase Analytics is an analytics service provided by Google LLC.

In order to understand Google's use of Data, consult Google's partner policy.

Firebase Analytics may share Data with other tools provided by Firebase, such as Crash Reporting, Authentication, Remote Config or Notifications. The User may check this privacy policy to find a detailed explanation about the other tools used by the Owner.

This Application uses identifiers for mobile devices and technologies similar to cookies to run the Firebase Analytics service.

Users may opt-out of certain Firebase features through applicable device settings, such as the device advertising settings for mobile phones or by following the instructions in other Firebase related sections of this privacy policy, if available.

Personal Data processed: Cookies; unique device identifiers for advertising (Google Advertiser ID or IDFA, for example); Usage Data.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

Data transfer outside the EU

Any data collected by AppYourself is transferred in keeping with these statements.

The Google Firebase services used to store and transfer data provide HTTPS encryption during information transit. Data encryption is also provided for cloud data storage. See https://firebase.google.com/support/privacy#data_encryption for more information.

Data transfer from the EU and/or Switzerland to the U.S based on Privacy Shield (this Application)

If this is the legal basis, the transfer of Personal Data from the EU or Switzerland to the US is carried out according to the EU - U.S. and Swiss - U.S. Privacy Shield.

In particular, Personal Data is transferred to services that self-certify under the Privacy Shield framework and therefore guarantee an adequate level of protection of such transferred Data. All services are listed within the relevant section of this document and those that adhere to Privacy Shield can be singled out by checking their privacy policy and possibly also by specifically checking for Privacy Shield adherence in the official Privacy Shield List. Privacy Shield also specifically guarantees rights to Users which can be found in its most current form on the website run by the US Department of Commerce.

Personal Data may be transferred from within the EU or Switzerland to the U.S. to services that are not, or not anymore, part of Privacy Shield, only based on other valid legal grounds. Users can ask the Owner to learn about such legal grounds.

Personal Data processed: various types of Data.

Data transfer to countries that guarantee European standards (this Application)

If this is the legal basis, the transfer of Personal Data from the EU to third countries is carried out according to an adequacy decision of the European Commission.

The European Commission adopts adequacy decisions for specific countries whenever it considers that country to possess and provide Personal Data protection standards comparable to those set forth by EU data protection legislation. Users can find an updated list of all adequacy decisions issued on the European Commission's website.

Personal Data processed: various types of Data.

Device permissions for Personal Data access

This Application requests certain permissions from Users that allow it to access the User's device Data as described below.

Device permissions for Personal Data access (this Application)

This Application requests certain permissions from Users that allow it to access the User's device Data as summarized here and described within this document.

Personal Data processed: Storage permission.

Hosting and backend infrastructure

This type of service has the purpose of hosting Data and files that enable this Application to run and be distributed as well as to provide a ready-made infrastructure to run specific features or parts of this Application. Some of these services work through geographically distributed servers, making it difficult to determine the actual location where the Personal Data are stored.

Firebase Cloud Functions (Google LLC)

Firebase Cloud Functions is a hosting and backend service provided by Google LLC.

Personal Data processed: Usage Data; various types of Data as specified in the privacy policy of the service.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

Firebase Cloud Firestore (Google LLC)

Firebase Cloud Firestore is a hosting and backend service provided by Google LLC.

Personal Data processed: Usage Data; various types of Data as specified in the privacy policy of the service.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

Firebase Realtime Database (Google LLC)

Firebase Realtime Database is a hosting and backend service provided by Google LLC.

Personal Data processed: Usage Data; various types of Data as specified in the privacy policy of the service.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

Firebase Cloud Storage (Google LLC)

Firebase Cloud Storage is a hosting service provided by Google LLC.

Personal Data processed: Usage Data; various types of Data as specified in the privacy policy of the service.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

Interoute (Interoute Communications Limited.)

Interoute is a hosting service provided by Interoute Communications Limited.

Personal Data processed: various types of Data as specified in the privacy policy of the service.

Place of processing: United Kingdom – Privacy Policy.

Infrastructure monitoring

This type of service allows this Application to monitor the use and behavior of its components so its performance, operation, maintenance and troubleshooting can be improved.

Which Personal Data are processed depends on the characteristics and mode of implementation of these services, whose function is to filter the activities of this Application.

Sentry (Functional Software, Inc. )

Sentry is a monitoring service provided by Functional Software, Inc. .

Personal Data processed: various types of Data as specified in the privacy policy of the service.

Place of processing: United States – Privacy Policy.

Managing contacts and sending messages

This type of service makes it possible to manage a database of email contacts, phone contacts or any other contact information to communicate with the User.

These services may also collect data concerning the date and time when the message was viewed by the User, as well as when the User interacted with it, such as by clicking on links included in the message.

Firebase Cloud Messaging (Google Inc.)

Firebase Cloud Messaging is a message sending service provided by Google, Inc. Firebase Cloud Messaging allows the Owner to send messages and notifications to Users across platforms such as Android, iOS, and the web. Messages can be sent to single devices, groups of devices, or specific topics or User segments.

Personal Data processed: various types of Data as specified in the privacy policy of the service.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

Further information about Personal Data

Push notifications

This Application may send push notifications to the User.

Unique device identification

This Application may track Users by storing a unique identifier of their device, for analytics purposes or for storing Users' preferences.

The rights of Users

Users may exercise certain rights regarding their Data processed by AppYourself.

In particular, Users have the right to do the following:

Withdraw their consent at any time. Users have the right to withdraw consent where they have previously given their consent to the processing of their Personal Data.
Object to processing of their Data. Users have the right to object to the processing of their Data if the processing is carried out on a legal basis other than consent. Further details are provided in the dedicated section below.
Access their Data. Users have the right to learn if Data is being processed by the Owner, obtain disclosure regarding certain aspects of the processing and obtain a copy of the Data undergoing processing.
Verify and seek rectification. Users have the right to verify the accuracy of their Data and ask for it to be updated or corrected.
Restrict the processing of their Data. Users have the right, under certain circumstances, to restrict the processing of their Data. In this case, the Owner will not process their Data for any purpose other than storing it.
Have their Personal Data deleted or otherwise removed. Users have the right, under certain circumstances, to obtain the erasure of their Data from the Owner.
Receive their Data and have it transferred to another controller. Users have the right to receive their Data in a structured, commonly used and machine readable format and, if technically feasible, to have it transmitted to another controller without any hindrance. This provision is applicable provided that the Data is processed by automated means and that the processing is based on the User's consent, on a contract which the User is part of or on pre-contractual obligations thereof.
Lodge a complaint. Users have the right to bring a claim before their competent data protection authority.

Cookie Policy

This Application uses Cookies and other Identifiers. To learn more, the User may consult the Cookie Policy.

Additional information about Data collection and processing

Legal action

The User's Personal Data may be used for legal purposes by the Owner in Court or in the stages leading to possible legal action arising from improper use of this Application or the related Services.

The User declares to be aware that the Owner may be required to reveal personal data upon request of public authorities.

Additional information about User's Personal Data

In addition to the information contained in this privacy policy, this Application may provide the User with additional and contextual information concerning particular Services or the collection and processing of Personal Data upon request.

System logs and maintenance

For operation and maintenance purposes, this Application and any third-party services may collect files that record interaction with this Application (System logs) use other Personal Data (such as the IP Address) for this purpose.

Information not contained in this policy

More details concerning the collection or processing of Personal Data may be requested from the Owner at any time. Please see the contact information at the beginning of this document.

How “Do Not Track” requests are handled

This Application does not support “Do Not Track” requests.

To determine whether any of the third-party services it uses honor the “Do Not Track” requests, please read their privacy policies.

Changes to this privacy policy

The Owner reserves the right to make changes to this privacy policy at any time by notifying its Users on this page and possibly within this Application and/or - as far as technically and legally feasible - sending a notice to Users via any contact information available to the Owner. It is strongly recommended to check this page often, referring to the date of the last modification listed at the bottom.

Should the changes affect processing activities performed on the basis of the User’s consent, the Owner shall collect new consent from the User, where required.

Definitions and legal references

Personal Data (or Data)

Any information that directly, indirectly, or in connection with other information — including a personal identification number — allows for the identification or identifiability of a natural person.

Usage Data

Information collected automatically through this Application (or third-party services employed in this Application), which can include: the IP addresses or domain names of the computers utilized by the Users who use this Application, the URI addresses (Uniform Resource Identifier), the time of the request, the method utilized to submit the request to the server, the size of the file received in response, the numerical code indicating the status of the server's answer (successful outcome, error, etc.), the country of origin, the features of the browser and the operating system utilized by the User, the various time details per visit (e.g., the time spent on each page within the Application) and the details about the path followed within the Application with special reference to the sequence of pages visited, and other parameters about the device operating system and/or the User's IT environment.

User

The individual using this Application who, unless otherwise specified, coincides with the Data Subject.

Data Subject

The natural person to whom the Personal Data refers.

Data Processor (or Data Supervisor)

The natural or legal person, public authority, agency or other body which processes Personal Data on behalf of the Controller, as described in this privacy policy.

Data Controller (or Owner)

The natural or legal person, public authority, agency or other body which, alone or jointly with others, determines the purposes and means of the processing of Personal Data, including the security measures concerning the operation and use of this Application. The Data Controller, unless otherwise specified, is the Owner of this Application.

This Application

The means by which the Personal Data of the User is collected and processed.

Service

The service provided by this Application as described in the relative terms (if available) and on this site/application.

European Union (or EU)

Unless otherwise specified, all references made within this document to the European Union include all current member states to the European Union and the European Economic Area.

Cookies

Small sets of data stored in the User's device.

Legal information

This privacy statement has been prepared based on provisions of multiple legislations, including Art. 13/14 of Regulation (EU) 2016/679 (General Data Protection Regulation).

This privacy policy relates solely to this Application, if not stated otherwise within this document.

Latest update: May 17, 2018

Cookie Policy of Buku Haematology

Cookies and other Identifiers consist of portions of code placed on the User’s device that assist the Owner in providing the Service according to the purposes described.

Some of the purposes for which Identifiers are used may also require the User's consent. Whenever consent is given, it can be freely withdrawn at any time following the instructions provided in this document.

Activities strictly necessary for the operation of this Application and delivery of the Service

This Application uses Cookies or other Identifiers to carry out activities that are strictly necessary for the operation or delivery of the Service and, therefore, do not require Users to consent. Users can disable such Identifiers by modifying their browser or device settings as described in more detail within this document, but this may affect core operational functions or result in the unavailability of the Service.

Other activities

Experience enhancement

This Application uses Cookies or other Identifiers to provide a personalized user experience by improving the quality of preference management options, and by enabling interaction with external networks and platforms.

Measurement

This Application uses Cookies or other Identifiers to measure traffic and analyze User behavior with the goal of improving the Service.

Analytics

The services contained in this section enable the Owner to monitor and analyze web traffic and can be used to keep track of User behavior.

Google Analytics for Firebase (Google LLC)

Google Analytics for Firebase or Firebase Analytics is an analytics service provided by Google LLC.

In order to understand Google's use of Data, consult Google's partner policy.

This Application uses identifiers for mobile devices and technologies similar to cookies to run the Firebase Analytics service.

Personal Data processed: Cookies, unique device identifiers for advertising (Google Advertiser ID or IDFA, for example) and Usage Data.

Place of processing: United States – Privacy Policy. Privacy Shield participant.

How to provide or withdraw consent

Users can provide or withdraw consent to the use of Cookies and other Identifiers by setting their preferences within the cookie notice or by updating such preferences via the relevant consent-preferences widget accordingly, if available.

Additionally, Users can manage preferences regarding Identifiers directly from within their own device settings and prevent – for example – the storing of third-party Identifiers. It is also possible, via relevant browser or device features, to delete previously stored Identifiers, including those used to remember the User’s initial consent. Users can, for example, find information about how to manage Identifiers in the most commonly used browsers at the following addresses: Google Chrome, Mozilla Firefox, Apple Safari and Microsoft Internet Explorer.

With regard to any Identifiers stored by third parties, Users can manage their preferences and withdraw their consent by clicking the related opt-out link (where provided), by using the means indicated in the third party's privacy policy, or by contacting the third party.

Notwithstanding the above, Users are hereby informed that they may follow the instructions provided by YourOnlineChoices (EU), the Network Advertising Initiative (US) and the Digital Advertising Alliance (US), DAAC (Canada), DDAI (Japan) or other similar services. Such initiatives allow Users to select their tracking preferences for most of the advertising tools. The Owner thus recommends that Users make use of these resources in addition to the information provided in this document.

Owner and Data Controller

Buku Haematology - Newcastle - United Kingdom

Owner contact email: bukuhaem@gmail.com

Since the storing of third-party Cookies and other Identifiers through the services used within this Application cannot be technically controlled by the Owner, any specific references to Identifiers stored by third parties are to be considered indicative. In order to obtain complete information, the User is kindly requested to consult the privacy policies of the respective third-party services listed in this document.

Given the objective complexity surrounding technologies related to Cookies and other Identifiers, Users are encouraged to contact the Owner should they wish to receive any further information on the use of such Identifiers by this Application.

Definitions and legal references

Personal Data (or Data)

Usage Data

User

The individual using this Application who, unless otherwise specified, coincides with the Data Subject.

Data Subject

The natural person to whom the Personal Data refers.

Data Processor (or Data Supervisor)

The natural or legal person, public authority, agency or other body which processes Personal Data on behalf of the Controller, as described in this privacy policy.

Data Controller (or Owner)

This Application

The means by which the Personal Data of the User is collected and processed.

Service

The service provided by this Application as described in the relative terms (if available) and on this site/application.

European Union (or EU)

Unless otherwise specified, all references made within this document to the European Union include all current member states to the European Union and the European Economic Area.

Cookie

Cookies are Identifiers consisting of small sets of data stored in the User's browser.

Identifier

Any technology - including Cookies - that allows for the storing of information, or the accessing of already-stored information, on the User’s device.

Legal information

This privacy statement has been prepared based on provisions of multiple legislations, including Art. 13/14 of Regulation (EU) 2016/679 (General Data Protection Regulation).

This privacy policy relates solely to this Application, if not stated otherwise within this document.

Buku Medicine

Transfusion FAQs

Tranfusion threshholds

Irradiated/CMV neg blood