My name is Nour AlMozain and I serve as a hematopathology, transfusion medicine, and apheresis consultant in the Laboratory and Blood Bank departments at King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia. It is one of the largest academic hospitals in Saudi Arabia and the Middle East. I supervise a large donor center that collects around 70-100 whole blood and apheresis platelets per day. I oversee the blood component manufacturing process, ensuring that blood products meet the quality of national and international standards. I also lead the inventory management process, always ensuring that blood requisitions meet patient blood management recommendations and local hospital policy guidelines. In addition, I review and report transfusion reactions and help the blood bank scientists in dealing with pre-transfusion testing. Our department provides a wide range of therapeutic apheresis procedures performed by our apheresis nurses, including: therapeutic plasma exchange, red cell exchange, and stem cell collection. My role is to provide consultations for these patients and help the primary teams tailor the appropriate management plan.
KSUMC has a sizeable medical oncology center. We provide a range of services, such as blood transfusion, therapeutic apheresis, and stem cell transplantation for hematology-oncology patients and patients with hemoglobinopathies. It also has a busy cardiac center, huge surgical and obstetric, and gynecological departments, which requires the transfusion service to always be well prepared and “on our toes”. Besides clinical service, I provide teaching and training to interns in the allied medical sciences, as well as residents and fellows rotating from different specialties such as hematology, anesthesia, etc.
To be certified for his job, I joined the King Saud University Hematopathology & Blood Transfusion Residency Program after finishing medical school in 2012. This program lasts for five years and focuses on training in different aspects of diagnostic hematology and blood transfusion. Training included reviewing and reporting peripheral blood smears, bone marrow aspirates, and trephine biopsies; interpretation of hemoglobin electrophoresis, and coagulation testing. The transfusion part covers donor selection, component processing, simple top-up transfusion, red cell exchange, therapeutic plasma exchange, and stem cell transplantation.
In September 2017, I became a qualified hematopathologist and transfusion medicine specialist. Around one year later, fate and circumstances arranged for me to work full-time in transfusion medicine and apheresis. In all honesty, I was initially frustrated, as the bulk of my training focused on diagnostic hematology. However, I still shadow some diagnostic hematology services and teach to keep my first passion alive.
In Saudi Arabia, the King Saud University Hematopathology & Blood Transfusion Medicine Residency Program was the only recognized national training for diagnostic hematology. The Saudi Commission for Health Specialties has recently approved another program that will be accepting candidates starting next year, in 2022. Other equivalent international credentials could be obtained in many different ways. For example, in the UK it is equal to the FRCPath in Hematology. However, FRCPath covers the clinical aspect of hematology as well. In the US, the equivalent credential can be obtained by AP/CP residency, with fellowships in hematopathology and/or transfusion medicine. It appears that Canada offers the most similar program under the Royal College of Physicians and Surgeons of Canada in Hematological Pathology.
Finally, I would like to take the chance to advocate for both the laboratory profession and transfusion medicine. What is unique about these specialties is that they are the center of clinical services, academia and basic science, research, and patient advocacy. The added benefits for transfusion medicine and apheresis provide an opportunity to bond with patients and be actively involved in patient management.