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The promise and pitfalls of a blood test. From cell-free DNA to blood typing conundrums, we look at new developments in the field. Plus, a CAP course in transfusion medicine helps you in the blood bank. This is the Path News Network Daily Edition from the College of American Pathologists. I'm Elizabeth McMahon. It's Thursday, April 30th. Cell-free DNA... Those DNA fragments circulating in your bloodstream are valuable biomarkers that are revolutionizing oncology and prenatal medicine. But CFDNA also has growing relevance in the laboratory, especially in organ transplant monitoring and transfusion safety. A new CAP article highlights the insights and approaches CFDNA is providing in these fields and beyond, all in an easy blood sample. Co-author Dr. Gagan Mathur, Medical Director of Transfusion Medicine at UC Irvine, says an exciting application of CFDNA is non-invasively monitoring complications after organ transplants, including organ rejection.
- Dr. Gagan Mathur
The cell-free DNA again comes in here where we can detect these DNA fragments shared by the transplanted organ into the recipient's body. So now when we can measure those, so then we can find that there are this transplanted organ. Is it injured, inflamed, or is it under stress? So with cell-free DNA testing, we can proactively identify this in a timely manner. And by measuring the increase or decrease in the level of the cell-free DNA, we can know how the clinical situation is evolving.
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Though CFDNA tests are showing exciting clinical applications, Dr. Mathur says they are limited to high-complexity labs with molecular capabilities. Standardization in testing and reporting will be critical as the tests expand and evolve. Dr. Pearl Audon, a pathology resident and co-author at UC Irvine, says there are exciting potential future applications for CFDNA testing, including testing blood donors for a wider range of infectious diseases and emerging pathogens.
- Dr. Pearl Audon
I think I'm most excited to see how cell-free DNA detection can be used for out. blood donor screening, especially because there are already technologies developed to detect cell-free DNA within blood for different infections, so viral, fungal, bacterial infections. But it would be great to be able to do that with blood products that we get.
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To read the full article, click on the Pathologist to Pathologist link under Member Resources on the CAP homepage. Every once in a while, though not often, a patient reports their blood type only to get a hospital draw that says something different. In fact, sometimes blood types and their positive or negative RHD factor can differ among labs and even within labs depending on testing methods, reagent types, and other issues. A new course in the CAP's CPIP, or Clinical Pathology Improvement Program, will explore discrepancies in serologic RHD testing I mean, and review which RHD variants can place patients at risk during pregnancy or transfusion. Dr. Kerry O'Brien, Medical Director of the Blood Bank at Beth Israel Deaconess Medical Center in Boston, is the author of the CPIP course. She says that while serologic RHD discrepancies aren't very common, pathologists covering blood banks will encounter them.
- Dr. Kerry O'Brien
We usually will see patients when they come in for their new OB appointment, And that's where, that's the... typical case that we see here. And it's important in this population to capture these discrepancies and resolve them so that these patients will know for the future what, you know, what variant they may have. Because if they choose, you know, if they go to a different hospital system, you know, the next year or in five, 10 years from now, they may still be having serologic discrepancies.
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The course will review which variants allow patients to be safely transfused with RHD positive red blood cells without risk of an immune response. Dr. O'Brien says it's essential that physicians know the right steps, including offering molecular blood testing for a patient's health and treatment down the road.
- Dr. Kerry O'Brien
I think it's important for people in the community when they see patients like this to not just treat them as negative and you know, move on, I think it's important to do the molecular testing or at least to offer it to the patient because you're giving that patient more of a say in their diagnosis, right? If you give the patient a molecular result, then they have that information. They can take it with them.
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Learn about the CPIP course and the CME credits available under the Clinical Pathology Program section on the CAP's education page. Blood safety and stewardship grabbed top headlines in April's CAP Today. A Q&A with CAP Checklists Committee member Dr. Karen Roush helps break down some of the new revisions and additions to the CAP Transfusion Medicine Accreditation Checklist. The changes, made to safeguard patients, donors, and the blood bank inventory, encompass specimen labeling, type verification, stewardship of Group O RHD-negative red blood cells, and transfusionist training, among others. Dr. Roush, Vice Chair of Pathology at Methodist Health System in Dallas, covers several new requirements in the Q&A, including those that help preserve RHD-negative red blood cells for patients who really need them, you and those that strengthen ABO group and RHD type verification. Find the article at the CAP Today homepage. And finally, a tip of the hat to the CAP's media team. The American Society of Association Executives recognized the team's 2025 campaign focused on seasonal infectious diseases and laboratory readiness with its Gold Circle Award. The campaign connected reporters, with pathologists as infectious disease stories unfolded, from measles outbreaks to back-to-school illness risks and emerging public health threats.
- Hailey Hernandez
And then it doesn't really have an effect on us. So are we still concerned if it comes to a really condensed area that this could be a disaster?
- Dr. Ben Bradley
I mean, I think there is always a threat of these outbreaks occurring.
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Outlets including CNN, NBC, Fox. And NPR participated in the briefings, resulting in more than 70 TV and radio segments from coverage of measles alone. That does it for today's Daily Edition. Be sure to check the show notes for more information on today's stories. Got a story you'd like us to cover on the Daily Edition? Write to us at stories at cap.org. We're back at 5 a.m. Eastern for another episode of the Daily Edition. I'm Elizabeth McMahon. Have a great day.