Institute of Hemostasis and Transfusion Medicine

“Hemostasis” means arrest of bleeding, “transfusion” stands for blood transfer. According to its name, the main areas of the Institute of Hemostasis and Transfusion Medicine include the examination and treatment of patients suffering from bleeding (“hemophiliacs”) and blood clotting disorders (thromboses). The Institute is also responsible for collecting, producing, storing and providing blood units. Patients requiring transfusions involve accident victims with high blood loss, patients undergoing extensive surgery, hemophiliacs, patients with tumors, children and adults with leukemia or lymph node cancer, premature-born babies and, sometimes, even unborn babies.

To supply the University Medical Center and its patients with blood and blood products, the Institute operates a Blood Donation Center and a Transfusion Center, which warrant maximum safety standards for voluntary donors and patients. To this effect, the Institute’s staff applies state-of-the-art methods of gene technology for infection diagnostics and for compatibility testing between donor and recipient. In addition, the blood products produced are subjected to extensive quality control examinations. Along with new treatment procedures which have reduced the transfusion "trigger", it is particularly due to the progress in modern medicine, such as high-dosage chemotherapy for cancer, that an increasing demand for blood and special blood products has result

Patient care

As a central facility of the Düsseldorf University Medical Center, the Institute of Hemostasis and Transfusion Medicine is involved in interdisciplinary patient care. This includes the production and preparation of red blood cell concentrates, platelet concentrates, and fresh frozen plasma. Every year, up to 60,000 stored units of blood components are provided for the treatment of patients requiring transfusions.

Furthermore, comprehensive laboratory analyses are performed at the Institute for purposes of indication, control, monitoring and consultation in hemotherapy. This particularly pertains critically ill patients with immunohematological problems due to autoantibodies or alloantibodies. A challenging diagnostic and, simultaneously, preparative input is required for the hemotherapeutic care of patients with a risk pregnancy, for example in cases of an immunological incompatibility between mother and fetus. Should an immunological reduction in platelets (fetal immunothrombocytopenia) or anemia (erythroblastosis) occur, immunogenetically compatible preparations are provided for hemotherapy of the unborn child (intrauterine transfusions).

The diagnostics and therapy of hemophiliacs or patients with thromboses are another area of activity and a major focus of the Institute. Patients with an increased risk of bleeding or thromboembolic diseases are examined and treated at the Hemostasis and Thrombosis Outpatient Clinic of the Institute. For diagnosis of platelet and coagulation disorders, the Institute offers a wide repertoire of different methods including molecular, molecular-genetic and flow-cytometric techniques.

Within a European network, the Institute has been operating for many years as one of the reference centres for diagnostics in hemostasis. Furthermore, the Institute has been selected as a Center of Competence for a national “Thrombosis Network”. In the case of critically ill hemophiliacs with acquired inhibitors against coagulation factors, the Institute’s staff successfully applies an innovative treatment procedure to eliminate the inhibitor (immunotolerance induction). Special consultations are available at the Institute for hemophiliacs and thrombosis-prone individuals. To those patients who need anticoagulation therapy with coumarins, the Institute’s staff provides training for monitoring of anticoagulation (self-determination of INR testing with "CoaguChek" system).

Research and teaching

The current research activities of the Institute cover innovative techniques (multicomponent apheresis) and the risk minimization in hemotherapy. Another focus is on the early recognition of hemostatic disorders as a cause of deep vein thromboses and arterial circulatory disturbances which may trigger off a stroke or a heart attack. The applied molecular-genetic and molecular-epidemiological methods enable the team of researchers to identify and quantify the risk of thrombosis in patients and to provide effective individual prevention strategies. This relates to the “pill and thrombosis” problem as well as the risk of thrombosis during pregnancy and the puerperium.

The Institute’s scientists are experimentally analyzing the molecular mechanisms which result in bleeding disorders or in thrombus formation. These projects are being supported by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) and the Volkswagen Foundation within the Program Project 612 ("Molecular Analysis of Cardiovascular Functions and Dysfunctions") or individual grants. The aim of this research, performed by the Institute in cooperation with the Düsseldorf Biological Medical Research Center (BMRC) and national and international working groups, is to establish new specific therapeutic strategies, including gene therapeutic approaches.

The Institute’s teaching activities cover lectures and practical courses in diagnostics of hemostasis and thrombosis, blood group serology, and the principles of hemotherapy and thrombosis prevention. The Institute is officially authorized to train residents, consultants and other medical professionals in "Transfusion medicine" and "Hemotherapy". Very recently, an intense training program in "Clinical Hemostasis" has been established and is now offered to MD students and MD residents.

Curriculum vitae Univ.-Prof. Dr. med. Rüdiger E. Scharf 

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