Dr. Mrigender Virk completed his residency in Anatomic & Clinical Pathology at Georgetown University before joining Stanford for his Transfusion Medicine Fellowship. After completion of the fellowship, Dr. Virk joined the Department of Pathology as a Clinical Assistant Professor for Transfusion Medicine.
- Anatomic and Clinical Pathology
- Transfusion Medicine
Clinical Assistant Professor, Pathology
Associate Director, Transfusion Medicine Fellowship Program, Stanford University Medical Center (2018 - Present)
Board Certification, American Board of Pathology, Transfusion Medicine & Blood Banking (2018)
Fellowship, Stanford University, Transfusion Medicine & Blood Banking (2018)
Board Certification, American Board of Pathology, Anatomic & Clinical Pathology (2017)
Residency, Georgetown University, Anatomic & Clinical Pathology (2017)
Graduate and Fellowship Programs
Transfusion Medicine (Fellowship Program)
Non-HLA Antibody-Mediated Rejection of Lung Transplant Masquerading Transfusion-Related Acute Lung Injury
WILEY. 2019: 199A
View details for Web of Science ID 000502826600470
Detection of Anti-ABO Antibodies by Flow-Based Assays Predicts Clinical Hemolysis in HSCT Patients
WILEY. 2019: 90A
View details for Web of Science ID 000502826600201
- A FLOW CYTOMETRY BASED ABO-BLOOD GROUP ANTIBODY ASSAY (FABO-AB) FOR PREDICTING HEMOLYSIS IN ABO-MISMATCHED BONE MARROW TRANSPLANTATION (BMT) ELSEVIER SCIENCE INC. 2019: 40
Blood Donation During Pregnancy Due to Anti-Ku Hemolytic Disease of the Fetus and Newborn.
BACKGROUND: Management of pregnancy in patients with Kell-null phenotype can be challenging. The immune systems of these patients form an antibody that is universally reactive against the Kell Blood Group System and can cause hemolytic disease of the fetus and newborn.METHODS: A 29-year-old woman, pregnant for the first time, developed anti-D and anti-Ku. The mother had to have labor induced when her fetus showed signs of severe anemia, but no compatible blood was available for transfusion. The induction was delayed so that a unit of blood could be collected from the mother.RESULTS: Due to delayed cord clamping at delivery, the newborn did not have anemia and did not require a transfusion. The remaining blood was frozen for future needs.CONCLUSION: Blood donation by a pregnant woman for potential transfusion to a newborn with anemia is safe for the mother and fetus, and is possibly the only option in hemolytic disease of the newborn due to a rare antibody.
View details for PubMedID 31089725
International assessment of massive transfusion protocol contents and indications for activation
2019; 59 (5): 1637–43
Massive transfusion protocols (MTPs) provide blood products rapidly and in fixed amounts. MTPs are commonly used in trauma but may also be used in other clinical settings, although evidence to support fixed-ratio resuscitation in nontraumatic hemorrhage is lacking. The goals of this study were to describe the types and contents of available MTPs and the clinical indications for MTP activation.A survey was distributed to 353 transfusion medicine specialists to assess the types and contents of available MTPs. Survey participants were invited to provide the clinical indications for consecutive adult and pediatric MTP activations for at least 6 months during 2015 to 2017.There were 125 completed surveys (35% response rate) including three from children's specialty hospitals. Most hospitals that treated adult patients (90/122, 74%) utilized only one MTP for all adult bleeding emergencies, while one hospital had no MTP. Of the 31 hospitals that provided more than one adult MTP, 20 provided MTPs specific for obstetric bleeding cases. Of these, 50% (10/20) included at least one pool of cryoprecipitate or fibrinogen concentrate in the first MTP round, compared with 14% (13/90) of the hospitals with one MTP (p = 0.0012). Fifty-seven hospitals provided the clinical indication for 4176 adult and 155 pediatric MTP activations. Although trauma was the single most common indication, the majority of adult (58%) and pediatric (65%) activations were for nontrauma indications.The majority of hospitals use a single MTP to manage massive hemorrhage. The majority of MTP activations were for nontrauma indications.
View details for DOI 10.1111/trf.15149
View details for Web of Science ID 000467578600005
View details for PubMedID 30720872
ABO Antibody Detection with Biolayer Interferometry
WILEY. 2018: 145A
View details for Web of Science ID 000444475900335
Severe Underestimation of Serum Na following IVIG Treatment.
2018; 49 (4): 372–76
Current chemistry analyzers measure ion concentration using ion- selective electrodes; however, may differ in the specific technology at the bedside versus the central laboratory. Instruments utilized for point-of-care testing (POCT) at the bedside use direct ion-selective electrodes, whereas central-laboratory analyzers use indirect ion-selective electrodes. Under most circumstances, these instruments will deliver the same result; however, various substances can cause interferences in one or the other. An 18-year-old Hispanic woman with a history of immune thrombocytopenic purpura (ITP) presented at Children's National Medical Center (CNMC) with a severe headache and required intravenous immunoglobulin (IVIG) therapy. Because a discrepancy developed between her point-of-care and central-laboratory sodium values, another instrument was used to retest the central-laboratory plasma specimens. The results were more in agreement with those from the point-of-care instrument and revealed a unique interference in sodium measurement related to IVIG use.
View details for DOI 10.1093/labmed/lmy025
View details for PubMedID 29897485
Rh Immunoprophylaxis for Women With a Serologic Weak D Phenotype.
2015; 46 (3): 190–94
It is standard practice for pregnant RhD-negative women who have not already formed anti-D to receive antepartum Rh immunoprophylaxis and, if they deliver an RhD-positive neonate, to receive postpartum Rh immunoprophylaxis. An estimated 0.6% to 1.0% of white women have red blood cells that express a serologic weak D phenotype. Of these women, approximately 80% will have a weak D type 1, 2, or 3 that could be managed safely as RhD-positive. Surveys of laboratory practice reveal a lack of standards for interpreting the RhD type for women with a serologic weak D and for determining their need for Rh immunoprophylaxis. RhD genotyping is recommended to determine the molecular basis of serologic weak D phenotypes in pregnant women as a basis for determining their candidacy for Rh immunoprophylaxis.
View details for DOI 10.1309/LMUNUP4FJTUX2GCD
View details for PubMedID 26199257