BB1.28.24 Flashcards
Donor req:Min age…Min weight lbs/kg…Min temp C/F
Min age >= 16Weight min 110lbs/50kgTemp <=37.5/99.5F
Donor req:Blood pressure mmHg SystolicDiastolicPulse
90-180 Systolic50-100 DiastolicPulse 50-100
Donor hgb/hct M/F…allogenic donor…
allogenic 12.5g/dL/38% HCTFemales: >=12.5 hmg/>=38% hctMales:>=13.0 hmg/>=39% hct
1 yr defferal: due to/examples
exposure to hep, HIV, malaria-Hep B Immunoglobulin-After stopped treatment syphilllis/gonn-Transfusion-Tattoo-Living with/sex with person positive HBsAG/HBV NAAT/symptoms HCV-Mucous/skin penetration ->72hrs in jail
Interval between whole blood donations
2 mths(8 weeks)
How long deferral for…-Hep B Immunoglobulin-Transfusion-Tattoo-Living with/sex with person positive HBsAG/HBV NAAT/symptoms HCV-Mucous/skin penetration ->72hrs in jail
1yr
Indenfinite/permanent defferal
-Viral hep after age 11-Pos HBsAg/HBV NAAT-Repeat reactive anti-HBc/anti-HTLV-Infection HCT/HTLV/HIV or T.cruzi-drug use-Family history CJD/vCJD-Babesiosis-Human growth hormone
3 yr deferral for:
exposure to malaria-asymptomatic during visit to endemic area-previously diagnosed w/malaria
Defferal for how long? -Viral hep after age 11-Pos HBsAg/HBV NAAT-Repeat reactive anti-HBc/anti-HTLV-Infection HCT/HTLV/HIV or T.cruzi-drug use-Family history CJD/vCJD-Babesiosis
Indefinit/permanent
75 year old male with acute hepatitis 20 yrs ago (age 55) after surgery would be permantly deffered because
He got it after 11yrs of age
38 yr old male got rabies vaccine after a dog bite 3 mths ago would be deffered for
12mths after bitten
19yr old first time donor got human growth hormone 12 yrs ago would be defered
permaently
24yr old donor with pos test for hepC would be defered
permanently
Good for?ACD/CPD/CPD2IrradiatedCPDA-1Additives/Adsol
ACD/CPD/CPD2: 21daysIrradiated: 28daysCPDA-1: 35 daysAdditives/Adsol: 42 days
Autologous donationsAge limit?Hct/Hgb:Time needed to collect before surgery:
Age limit? NoneHct/Hgb: >=33%/11g/dLTime needed to collect before surgery: >72hrs
Rejuvenating Sln restores these two
2,3 DPGATP
Cytapheresis: PLTS, Grans, Leuko need to be spaced…days apartand no more than … in any … days
need to be spaced 2 days apartand no more than 2 in any 7 days period
After donate 2 units wait…must not decrease hct/hmg by…
for every 2 units 4mths (each unit 2mths,)hmg below 30%/10g/dL
1 unit packed RBCs raises hgb and hct by
Hmg 1g/dLHct 3%
Storing RBCs in fridge decreases plasma…
pH and sodium
Storing RBcs in fridge increases plasmsa…
NH4, K+
Washing cells prevents…Removes__ and __ Washed cells expire ___ after seal broken
allergic response to plasma proteins and anaphlyatic shock in IgA def PTsremoves anti-HPA-1a and complementexpires 24hrs after seal broken
Leukoreduced number of leukocytes/unit
<5x10*6 leuko/unit
Leukoreduced % red cell retained…Final WBC count…Prevents…
85% red cells<5x10*6 WBCprevents febrile NH, HLA alloimm, CMVdue to presence of cytokies from WBCs or alloimm from HLA/leu ag
Frozen/deglycerolized cells% glycerol…Expires, stored at…thawed at, then stored at/for… after deglycerolizing
40% glycerolExpires 10yrsstored at <=-65CThawed at 37, deglycerolizedThen stored at 1-6C for 24hrs
FFP:stored/expires…freeze w/in…thaw at..Store at… For up to…
stored <=-18C for 1yr or <=-65C for 7yrsfreeze w/in 8hrs of separation from cellsthaw at 30-37C up to 24hrsstore 1-6C
FFP is used for and has
coagulation defFactor 11
Cryo is made from…w/in…hrsthen thawed…which forms a…. …. …..it is separated, refrozen w/in….
FFP frozen w/in 8hrs then thawed 1-6C which forms a cold insoluble portion separated, refrozen w/in 1hr
Cryo is stored at…for…After thawing, store at…Transfuse w/in…-after thawing:-pooling open:-pooling closed:
<=-18C for 1yrRT after thawingTransfuse w/in 6hrs thaw4hrs pooling in open6hrs pooling in closed
PLTs/ApheresisLight spin removes…Heavy spin…Used for….pH needed…
Light spin removes red cellsHeavy spin spins down PLTs/WBCsUsed for thrombocytopenia and PLT dysfunctionph >=6.2
1 unit PLT raises PLT….1 apheresis raises PLT…
5-10,0000/uL20-60,000/uL
Granulocyte apheresis used for…can transmit/induce/cause….if not irridatedstore…for…w/out…
neutropenic patients w/gram neg sepsiscan transmit CMV, induce HLA imm, and cause GVHDstore 20-24C for 24hrs without agitation*ABO compatible
Irradiated prevents…
GVHDinactivates T cells due to donor lymps
Dolichos biflorus agglutinates…
A1
Ulex europaeus agglutinates
H
Bombay phenotype, type as…
Oh, hh lack Htype as O*Anti-H Ulex eurpaeus will not agglutinate Bombay but will O cells
Greatest amount of H to least…H gene codes for the enzyme…
O>A2>B>A2B>A1>A1B>OhL-fucosyltransferaseA1 has 5x more antigen than A2 this less H
R..r…
Dd
0 or nothing about C/E
ce
1 or ‘
C
2 or “
E
z or y
CE
R0 gene…ag?
Dce
R1 gene..ag?
DCe
R2 gene…ag?
DcE
Rz gene…ag?
DCE
r gene…ag?
ce
r’ gene…ag?
Ce
r” gene..ag?
cE
ry
CE
plasma ag absorb on RBCsDon’t cause HDFN, not on fetal cells
Lewis
Absent/weak on cordmostly adultsigM cold ab
I, anti-I
on infants
i
IgG autoab: Donath-Landsteiner biphasic/PCH
anti-P
Anti-P1typeneutralized by
IgM coldP1 sub hydatid cyst fluid
M/N, S/s are ….alleles
codominant
Anti-M/N type
IgMAnti-M can be IgG and cause HDFN
Anti-M/Ndosage?enzymes?HDFN?
Has dosagedoesn’t react/destroyed by enzymesDoes’t cause HDFNexcept with anti-M IgG
Anti-S/s type
IgG
Anti-U typeformed by…who lack…
IgGBlacks lack S,s,U
Jka/b type (kidd)enzymes?dosage?associated with?
IgGreact stronger w/enzymesshows dosageassociated with delayed transfussion rxn
Fya/btypeenzymes?dosage?
IgGnegative/destroyed by enzymesweak examples may show dosage
Fya-b-%/race
68% Blacks
increase ab uptake, allows decreased incubation
LISSlow ionic strength saline
Bromein, ficin, papain, tyrpsinremoves..promotes..
removes neg surface changepromotes cell agglutination
Ezymes increase reactivity of these 5 ab
ABO/RhKiddLewisIP1
Enzymes decrease/destroy these 3 systemsvariable in…
Fya, FybM,N,SLua/bvariable in s
shows dosage in 4 systems
M,N,S,sRhKiddDuffy (weak example of ab may show)
3 Absent ag on cord cells
ILewisSda
Anti-I, H, P1M,NLea/Lebtemp, media, class
4-22CSalineIgM
Rh ab temp, media, class*exception
37C, Liss/Albumin, IgG*IgM cold ag/reacting at higher thermal range
IgG reacting at 37, AHG
Anti…RhKellDuffyKidd*some M
IgM reacting at 4-22, saline
Anti…I, H, P1M,NLea,Leb
Cold Hemmaglutinin Disease and Paroxysmal cold hemoglobinuria both have what protein coating their RBCs
complement
Drug induced HA (DIHA) and Warm AutoAb (WAIHA) both can have what proteins coating their red cells?
IgG and/or complement
Mixed type AIHA has what proteins coating red cell?
IgG and complement
Type of protein covering cells in HDN and trans rxn
IgG
Universal donor forRBC and plamsa
RBC: OnegPlasma: AB
Universal recipient RBC and plasma
RBC: ABPlasma: O
Transfusion related,Acute respiratory insuff/pulmonary edemaHypotensionAb to donor plasma to neutrophils/HLA ag
Trans related acute lung injuryTRALI
Transfusion associated,Pulmonary edema w/hypertensionPTs >70/infants
Transfusion associated circulatory overloadTACO
Allergic rxn mildab type, symptoms
IgEMild-urticarial hives/itching
Allergic rx severe called, type, cells preferred
classic anaphylaxisIgA def PTwashed cells
2F rise w/in 1 hr
febrile rxn
Condition where transfused Immunocompetent lymph attach recipientand HLA ag are different
TA-GVHDtransfusion associatedgraft vs host disease
Conditon where there’s shaking, hypotension and occurs with PLTs
Transfusion related sepsis
Critical titer for most ab at AHG
16
Critical titer for anti-K at AHG
8
Used to establish severity of HDFN
ultra sound and color Doppler ultrasonography
Purpose of exchange transfusion
reduces bilirubin and removes maternal ab
Antepartum Rh imm glob given…wks to…
28weeks to Dneg women
Postpartum Rh immglob given …hrs to women who deliver..
w/in 72hrs to Dneg women who deliver Rhpos infant
Test used to determine how much Rh Imm Glob to useIs positive when…
Kleihauer-Betkefetal cells resist acid elution, appear pink
self/non self2 classestransplantssusceptibility of diseases, paretange testingchromosome 6
HLA human leukocyte antigens, glycoproteins on cells
Class I genes
HLA-A,B,Cfor the antigens A,B,C
Class II genes
HLA-DP, DQ, DR
Serological/viral tests required by AABB
syphillis/RPRanti-HIV/RNA HIVanti-HTLV 1/2anti-HCVHBsAg, HBV DNAT.cruziBabesia RNA/DNAWNV/Zika RNA
Order of Hepatitis B ag/ab
1.)HBsAg early acute2.)HBeAg3.)anti-HBc early recovery, window 4.)anti-HBe5.)anti-HBs recovery
Screen for HIVviral markers for HIV
screen: ELISAviral: anti-HIV 1/2anti-HTLV 1/2a distant relative of the human immunodeficiency virus (HIV)
3 bacteria contaminants of blood products
Y.e. (Yersinia enterocolitica)C.f.(Citrobacter freundii)P.p.(Pseudomonas putida)
3 parasites transmitted by blood transfusion
BabesiaMalaria/PlasmodiumTrypanosoma
What is…a group of 9 plasma proteins, causes hemolysis of red cells, actived by IgG/IgM
complement
Enzyme A gene codes for…immunodominant sugar…
alpha-3-N-acetylgalacN-acetyl-D-galactosamine
Enzyme B gene codes for…immunodominant sugar…
alpha-3-D-galacD-galactose
Frequency of ABO greatest to least
O>A>B>AB
O antigen on cell..ab in serum..geno type…
Hanti-A,B,A1BOO
Aantigen on cell, ab in serum, genotype
A, anti-BAO, AA
B antigen on cell, ab in serum, genotype
B, anti-ABO, BB
AB antigen on cell, ab in serum, genotype
AB, no abAB, cis-AB
O can results from what genotype and why
OOO is a amorph/autorecessivehave to get from both parents to show*chromosome 9
What antigen is…a variant, tested at 37/AHG, can be neg/weak
Weak D/Du
f and Cw is part of what blood grp
Rh
U is part of what blood grp
MNSs
Tja is part of what blood grp
P system, PP1PK
Which antibody…mostly IgM, netraulized by Lewis subs, doesn’t cause HDFM
anti-Lea
How many people have D on their cells?
85%
which ab/ag…IgG, caused by transfusion, is the 2nd most potent antigen(next to D)
Kell
How many people have K antigen
9%
Cellano antigen can produce
anti-k
How many have k on cells?
99%as opposed to K, 9%
Little versions of antigens are more prevalant on cells than the big versions
C 68, c 80E 29, e 98K 9, k 99S 55, s 89
Fy a-b- resistant to two kinds of malarial species
P. vivax, P.Knowlesi
How many what are the names of the antigens does Kidd blood grp have
Jka, Jkb, Jk3
Which antigen…is poorly developed on cord cells, pos in adults, reacts strong at 4C/RT, not seen in whites, cold agg strongly attracted to, binds complement
I
Cold agg disease to which antigen and is a and is caused by which organism
anti-Icold ab (IgM)M.pneumoniae
Infectious mono caused by which antibody
anti-i
AB frequency
4%
PT red cells direct commbs pos, bacterial contaminant reagents, penicillin/cephalothin,methydopa, quinidine and complement fixation cause DAT to be…
positive
inadequate washing of cells cause false…DAT
negative
Which tests help diagnose HDN, HTR, AHA
DAT
Which enzyme…has phosphate buffered saline and glycineenhances speed/sensitivitydecreases electropos cations
LISS
Type of HDFNincreased spherocytesDAT weak/negdelayed jaundice1st prego
ABO
Type HDFNincreased retics DAT posbilirubinnot 1st prego
Rh
Pulse for donor
50-100
Blood pressure for donor
90-180/50-100
Color label O
BlueO likes A, blue
Color label B
PinkB becomes pink
Color label AB
Black, grey, white
Donor label A
Yellowswitches with B
Deferral for MMR, typhoid oral, yellow fever
2 weeks
Deferral German measles, chicken pox
4 weeks
Deferral West Nile
28 days
Cells that present foreign material to lymphs, initiating immune responseLarge, specialized cells in the immune system that recognize, engulf and destroy infecting or damaged cells.
Macrophages
Cells involved in intracellular, cellular immunity
Tcells
Which cells recognize/interact with antigen and make cytokines that activate other cells such as Bcells/T cytotoxic
T helper
Cells involved in extracellular, humoral immuniity
Bcells
Response with lag phase of 7-14 days before ab is deteced, IgM to IgG
Primary
Made by T helper cells that are signals between cells, regulate intensity of a rxn, initiate inflammation, cause fever, and stimulate BM to make more cells
Cytokines
response with 1-2 days before sig amt ab made, IgG, 1000x more ab then slow decline
Secondary
strength of binding between single ab and epitope of agThe strength of the interaction between the antigen-binding site (paratope) on an antibody and the epitope on an antigen
affinity
overall strength between epitopes and absRepresents the overall strength of the antibody-antigen interaction and is influenced by three factors – the binding affinity, valency, and the structural arrangement of the antibody and antigen in question.
avidity
Testing with in vivo sensitization of red cells, happens in PT, cells must be washed
DAT
Testing with in vitro sensitization, 2 steps, serum incubated, washed
IAT
3 potentiators that decrease zeta potential
LISS, BSA/albumin, proteolytic enzymes
1 potentiator that increases concentration of ab
PEG
Commb check cells, screening cells and panel cells are type…
O
Cells that are IgG sensitized cells, used to confirm addition of AHG
Commbs check cells
Plants lectin is made from seeds of..that agglutinate A1 cells
Dolichos biflorus
lectin is used to demonstrate the presence and strength of expression of the H and A2 antigen…
Ulex europaeus
Kind of gel used in Gel technique for BB that traps agglutinated red cells
dextran acrylamide gel
In gel, no rxn is…positive rxn is…
no: solid button on bottomrxn: agg cells on top
In microplate/solid phase, …is coated on bottom of well, serum is added wit indicator cells.what is pos..what is neg…
pos: bottom coated with cells/coveredneg: button
Blood group system where antigen isn’t directly produced by the gene; gene makes something that put ag on red cell; ag is in fluid and gene transfers carb on that red cell
ABO
ABO/H are on these 6 things
red cells, lymphs, PLTsepis, endothelial, organs
ABO from most frequency to least
O>A>B>AB
Need … on red cells to express A or B ag
H
A gene makes
N-acetly galac(galactosaminyl transferase)
B gene makes
D-galac(galactosyl transferase)
Which ABO has most H substance…Which has the least…
Most: OLeast: A1B
A2 has more or less H than A1
A2>A1A1 has 5x more A antigen than A2
Order of ABO from most to least amt H
O>A2>B>A2B>A1>A1B
80% of group A have subtype20% have subtype
A1: 80%A2:20%
Subtype of A which MF rxn with antiA, anti A,B, seen in 1:1000
A3
Subtype A mistaken for O, weak rxn
Ax
In ABO, A and B are
codominantwhen inherited both are expressed
O gene is…Must inherit … to express
recessiveinherit 2 O’s from each parent, HH,Hh
System naturall occuring, usually IgM, non RBC stimulated, stimulated by bacteria when born
ABO
In reverse typing extra rxns could be caused by 3 things
rouleauxA subgrpcold allo/auto
In reverse typing, missing/weak rxn could be caused by
newborn, elderlyHPC transplant
In forward rxn, extra rxn could be caused by
Roleux, polyaggAcquired B, B(A)
In forward rxn, missing/weak rxn could be caused this
ABO subgroup
In forward rxn, MF could be due to these 3
transfusionHPC transplantsubgrop A, A3
Most immunogenic…2nd most immunogenic…3rd most immunogenic..
ABORh/DKell
Nomenclature that Rh ag is inherited as a gene complex coding for 3 closely related linked set of alleles
Fisher Race
Nomenclature where theres one gene for expression of all Rh ag on cells, accounts for lack of d ag
Weiner Rh-Hr
Numeric terminology with ISBT# not based on genetics; computerized data entry
Rosenfeld
Weiner:R^0 to fisher
Dce
R^1 to fisher
DCe
R^2 to fisher
DcE
R^Z to fisher
DCE
r to fisher
dce
r’ to fisher
dCe
r’’ to fisher
dcE
r^y to fisher
dCE
Rh antibodies:Ig..temp…shows…can cause….
IgG37Cshows dosagecan cause HDFN
Second most immunogenic to D
Kell
KellIg…temp…enzymes?HTR/HDN?
IgG37Fnot affected by enzymescan cause HTR,HDN
cellano is…is…frequency…%
khigh, 99.8%
Kell is…frequencythus common to see…
lowcommon to see antibodies if been exposed
Kpa, Jsa are …frequencyKpb, Jsb are…frequency
Kpa/Jsa: low Kpb/Jsb: high
Kx neg is called…seen in…because it’s.. …
Mcleod phenotypemales (xlinked)
Duffy:Ig..temp..HTR/HDN?
IgG37FHTR/HDN
Duffy…enzymes?dosage?
destroyed by enzymesdosage
Fya+b+ seen in …% of…Fya-b- seen in…% of …
49% whites68% blacks
Fya-b- resistance to these two malarial species
vivax, knowlesi
Antibody that is IgG, 37C, binds complement, and seen in severve delayed transfusion rxn
Kidd
Oral temp not exceedC, F
37.5C99.5F
Min hmg allogenic donorMin hct allogenic donor
12.5 g/dL for allogenic38%
Donor age
> 16
Donor pulse
50-100
donor weight lb,kg
> = 110>=50kg
BP
90-180/50-100
Pregnant woman deffered
6weeks postpartum/after birth
defereal Hep b vaccine
21 days
possible exposure to hepatitis/HIV/malaria defferalblood trans, tatto, sex with someone with hepatitis
12mths/1yr
Possible exposure to malaria, history of malaria defereal
3yrs after stoopped treatment
Pos TB skin, meets all other criteria, deferal
no
Viral hep after age 11, defereal
perm
incarcerated deferal >72hs
1 yr
deferal symptom free after immunozied oral polio, mumbs
2 weeks
Babesisois CJDT.cruzi all defered
poermanent
Donor blood must be tested for these 5
sysphillisantiHIV, antiHTLVantiHCVHBV stuff
Optional, not req testing these two…although second question says its required
antiHBcantiHAV
Color coding for blood labelsABOAB
A=yellowB=pinkO=blueAB=black/grey/white
Only marker of HBV in window period
antiHBc IgM
chronic carrier Hep B is when PT serum is positive for… forr at least…
HBsAg6mths min
Majority of most transfusion associated Hepatitis is from
HCV
3 markers req for viral testing HIV1 marker not req
3 req:antiHIV 1, 2anti HTLV I/II1 not req: HIV1 p24ag
BB fridege temp…transport of blood temp..PLTs/RT…
BB fridge 1-6Ctransport blood 1-10CPLT/RT 20-24C
Deferral for visitor/immigrant from endemic area for malaria
3yrs
Deferral for travel to endemic area for malaria
1 yr
Deferral after treatment of syphilis and gonnorhea
12mths after cessation of treatment
All donor blood tested for…
-ABO, Rh (not full pheno)-ab screen-serological syphilis/RPR-serological T.cruzi-HepB, C-HIV, HTL-WN,Zika
3 req viral hepatitis markers
HBsAgantiHBcanti-HCV
Early acute, viremic phase of Hepatitis what marker
HBsAg
Shortest to longest expiration date of 3 main types of anticoagulant/additives
-ACD/CPD/CPD-2: 21 days-CPDA-1: 35 days, longer with extra adenine -Additives/ADSOL: 42 days
All RBCs: leuko reduced, aphresis stored at
1-6C
Frozen RBCs 40% glycerol stored at…for…
-65C for 10yrs-Less glycerol needs colder -once deglycerolized 24hrs
FFP and Cryo stored at…for…
<=-18C for 1yr
Platelets: closed, open pooled, leuko reduced stored at…with…Unless open, good for…
20-24C with constant agitation5 daysOpened 4hrs
NH4, K… During storage of plasma
Increase
pH, Na, 2-3 DPG… During storage of plasma in fridge
Decrease
Autologous reqs:Hct/Hmg…No…Age?Collect at least…hrs B4 surgery/trans
> =33%/11g/dLNo bacteremiaNo age req >72hrs B4
Only testing req for autologous
ABO/Rh
WBC separated by reversible filtration/centrifugation
Leukapheresis
Withdrawal of Blood, keep plasma, return RBC
Plasmapheresis
How long after donating a unit of whole blood does it take for PLTs to replenish enough to do plateletpheresis?
72hrs
How long after plasmapheresis does it take for plasma to replenish for being able to donate whole blood?
48hrs
If you donate plasmapheresis more than once every 2 months, what to you check at 4mth intervals?
TP
Codes for things; Made of DNA; hereditary info on a chromosome
Gene
Genes that occupy a specific locus/site on a chromosome
Allelles
Group of genes, inherited together from a single parent
Haplotype
Occur in different forms, genetic variation
Polymorphic
Gene with no directly observable product, doesn’t code for any functional protein…Example of an amorph gene…
AmorphO Gene, doesn’t code for an enzyme, just has H
2 diff alleles of a particular gene
Heterozygous
2 identical genes at a locus;2 identical alleles on both homologous chromosomes
Homozygous
Term where both alleles are expressed at the same time..
Codominant
Most blood group genes are…Ie.AB has both alleles expressed at the same time, one allele one B allelle
Codominant
Organism with cells with more than one distinct genotype
Chimerism
Term where variant expresses more strongly
Dominant
Term that’s overruled by dominant, needs two…alleles
Recessive
Genes carried on a sex chromosome
Sex linked
Gene inheritance of most blood group systems.Inheritance that refers to two alleles of an autosomal gene where each allele contributes to the phenotype.
Autosomal codominant“Autosomal” means that the gene in question is located on one of the numbered, or non-sex, chromosomes.
Antibodies made after exposed to foreign antigens simulated by transfusion or pregnancy
Alloantibodies
the immune response occurring on the first exposure to an antigen, with specific antibodies appearing in the blood after a multiple day latent period
primary response
Days to till primary response occurs
7-14
Same foreign ag, rapid increase in abthe immune response occurring on second and subsequent exposures to an antigen, with a stronger response to a lesser amount of antigen, and a shorter lag time compared to the primary immune response
secondary response,Anamnestic
Type off immunity passed thru placenta to fetus from Mom
Naturally acquired passive immunity
H Gene codes for enzyme
L-fucosyltransferase
Kell, Duffy, Kidd:red cell stimulated?Ig..Which one enhanced by enzmes?
red cell stimulatedIgGKidd enhanced by enzymes
M/N:Ig..optimal temp…enzymes…dosage…pH…
IgMbut optimal 37Cdestroyed by enzymesdosageph6.5
Nf caused by
formadehyde
S,s,U:Ig..temp…ezymes..dosage…
IgG37Cdestroyed by enzymesdosage
U present if…or…presentU neg means, S/s…seen in…U is ficin…
S,sU neg means S/s negseen in blacksU is ficin resistant as compared to S/s
Luteran antibody that can be present without red cell stimulation, is both IgM/G but best at RTAlso MF rxns and can cause mild HDFN
anti Lua
Luteran that is high frequency, rare antibody; IgG, MF
anti Lub
Lewis:Ig..temp…ezymes…
IgMRTenzymes increase
Antigens that are made by tissue cells that are secreted into BFs then adsorbed onto red cell membranej
Lewis
Three genes Lewis is affected by
H, Le, Se
Le sese H, what is in secretion
Lea
Le Se H, what is in secretion
Lea, Leb, H
lele sese H, what in secretion
none
lele Se H, secretion
H
Le sese hh, secretions
Lea
Le Se hh, secretions
Lea
lele sese hh, secretions
none
lele Se hh, secretions
none
Sese Hh AO what soluble antigens in saliva
A, H
MF reaction with anti A, neg rxn with antiA1 lectin which subgroup
A3
Bombay type as…are…they don’t have these 3 antigens and will produce these 3 antibodies
type as O, Ohno A,B,H so will make anti-A,B,H
Frequency of ABO most to least for Whites/USO..A…B..AB..
O: 46A: 41B: 9AB: 4
Forward type: antiA 3+, antiB 3+Reverse type: A1 2+, B 0
A2B perosn with A1not as strong with antiseraA2 make A1 antibodies
Genotype needed to have O phenotype
OO
Heterozygous Group A is..Heterozygous Group B is…What would phenotype of offspring be…
Hetero A: AOHetero B: BOUse Punnett square to get:A,B, AB, O
Group O mom and Group AB dad, probability of making A baby?
Use punnett,AO,AO, BO,BO50%
Rh antibodies:Ig..temp…acquired from…or…can cause…
IgG37Cacquired from transfusion/pregnancycan cause HDFN
amorph Rh antigen
d
antibodies formed by R1R1
Fisher: DCe/DCeantibodies to c, E
Most immunogenic Rh antigen
D
Variant of D antigen that is inherited, common in blacks and is considered Rhpos
Weak D
Weak D alternate name…Initial testing appears…or … ….temp…Phase..
Dunegative, weakly reactiveTest at 37, AHG
Most common Rh neg genotype
cde/cde
Name of phenotype in absense of Rh antigen
Rh null
IgM, best in saline, best at 4C all are indicative of what kind of ab
naturally occuring
antiA/B, antiM/N, antiLea, antiP1 are all
naturally occuring
IgG, in AHG, cross the placenta all are characteristics of what kind of ab
immune ab
% range of people that get immunized to blood group antigens
1-4%
U is part of what system
MNSs
Cw and f are part of what system
Rh
Tja is part of what system
P
Anti N will react most strongly with what genotype
NNdue to dosage
Antigen in plasma and adsorbed onto red cells
Lea
Paroxymal cold hemoglobinuria ass with
anti P
Lele Sese Hh AB, what solube antigens in saliva
Lea, Leb, H, A, B
antibody in Le a-b-, IgM, netraulized by lewis substance
anti Lea
True or False, Lea causes HDFN
false
3 systems destroyed by enzymes
MNSFya/bLua/b
5 systems enhanced by enyzmes
Kidd, RhLewis, I, P1
anti-Lua:temp…medium…rxn…HDN?
RTsalineMFno HDN
% lack K ag
91%
of ten units, how many will be incompatible/ not antigen neg for K?
1/10% incompatible, 90% compantibility since 90% don’t have K antigen
cellano antigen stimulates this ab
anti k
anti Fya:enzymes
destroyed, prevents detection of
Most common of duffy antibodies
anti Fya
Antigen poorley developed on cord cells, on adult cells
I
cold autoantibody in cold hemagglutin disease and mycoplasma pneumoniae
anti I
cold, IgM ab to infectious mononulceosis and lymphoproliferative disease
anti i
P1, Ig…P, Ig…
P1, IgMP, IgG
Which antigen can be neutralized by hydatid cyst liquid to reveal underlying ab
P1
P1:Ig…enzymes..
IgM, coldenyzmes enhance
Donath-Landsteiner ab, biphasic…
autoanti P
PCH, Paroxysmal cold Hmguria seen with kids w/viral infection, adults with syphilis…
autoanti P
null p phenotype…two namesrare but very…causes….
anti=PP1Pk, Tjavery hemolytic, causes miscarrages
LISS:2 positive2 negatives
sensitive, fasterbut enhances cold auto and can miss k,E
BSA/albuminpositivenegative
doesn’t enhance warm autobut needs longer incubation
PEGpositivenegative
eliminates reactivity of Duffy,MNS agbut enhances cold/warm auto
If have multiple ab can use… to eliminate/enhance
enzymes
If <3 mths since last transfusion,…will be inaccurate due to donor cells inside circulation (RBCs live 120days/3mths)
phenotype
Cause of all cells on panel are positive with the same rxn strength
high frequency ag
Cause of panel cells all reacting with diff reactivities…rememdy…
cold allo, prewarm
Pos AC, do a…can use …cells to help id cold abcan use…/… to help ensure absence of underlying ab
DATcan use cord cells to id cold abelution/adsorption
Pos DAT, … or … coated in….Need to…or else with be negativePos ass w/immune mediated…
IgG, complement in vivowashhemolysis
Auto/allo ab, drug induced ab, passenger lymphs, non-ab immunoglobulin all can cause… ….
pos DAT
Used to remove ab from sensitized cell…Type…
elutioncold acid eluate
Autoimmune, drug induced and alloimune are all types of… …
extravascularhemolytic anemia
Type of crossmatch where use donor serum with PT blood to test for compatibility
minor xmatch
Type of crossmatch where you use POT serum with donor blood to test for compatibility, two names
major, serological
These 4 govern xmatch
AABB, FDACAP, Joint
Computer xmatch does the final ….check after two diff blood types are done/on file/ab screen neg
ABO check
Incompatible xmatch due to three…most common reason…
low freq agpos DAT in donor(most common)at IS: ABO issue
Term when products totally exchange PTs blood in 24hrs, about 10-12units
massive transfusion
HIV has window period of …to… days before ag detected
22-25days
HTLV:1 related to…2 related to…
1: T cell leukemia2: hairy cell leukemia
2 things increased in blood at 1-6C
plasma hmg, K
5 things decreased in blood at 1-6C
viable cellspHATP, 2-3 DPGplasma Na
CPD means…shelf life
citrate phosphate dextrose, 21 days
CPDA means..shelf life
citrate phosphate dextrose plus adenine, 35 days
AS means…shelf life
additive sln, 42 days
Light spin removes…Hard spin removes…and…PLTs left to rest 1hr before agitating RT up to 5 days
light removes RBCshard removes plasma, PLTS
To be fresh (FFP) need to freeze within…hrs, stored at…for…
8hrs, -18C, 1 yr
Cryo is made from…It’s frozen then thawed at…white precipitate forms, then spun at heavy spin and….
made from FFPthawed at 1-6expressed off and refrozen
Blood product used to reduce adverse trans rxn; filtered to reduce leukocytes, reduces CMV<5,000/unit
leukoreduced
Product where red cells are collected, fluid given back, sometimes with saline
Apheresis RBC
In apheresis RBC, you can get …allogenic or autologous units per donorThis can be done every…mths
2 units/donorevery 4mths
Product used for rare blood types; add glycerol and frozen; removed with saline washes
frozen RBC
Product where DNA in Tcells is broken down to not further divide; prevent GVHD
Irradiated RBC
Product to raise PLTS, control bleeding, cancer w/chemocells live 3 days thus require many transfusions
PLTS
Product with coag factors to coag def, mass transfusion issues, anticoagulant therapy issues, surgery
FFP
Product with concentrated coag factors used for surgery
cryo
Cryo has these three factors
vWF, fibrinogen, F8
Product given to neutropenic, lack response to antibiotics
granulocytes
Storage of blood products should be monitored every……thermometer
4hrsNIST
When administering product:check patient first…then every…must be transfused w/in…
check for 15minthen every 30mintransfuse w/in 4hrs
Rxn where ab+ag activate complement, coagulation, mono/phago, cytokines and cause shock/renal issues
HTRhemolytic transfusion rxn
Acute hemolytic trans rxn where ag/ab complex initiate coag/fibrinolytic systems;all clotting factors and PLTs get used up and there’s uncontrolled bleeding
DIC
Rapid onset, usually ABO caused is termed
acute
Blood exposed to temps <0->50C, improper thawing of frozen, small needle, saline not used, and bacteria all can cause
nonimmune red cell destruction
Rxn where there’s no hemolysis; caused by ab to HLA/granulocytes/PLT ag
immuno mediated nonhemolytic
Rxn with urticarial or anaphylactic; IgA def
allergic trans rxn
Rxn with pulmonary edema/lung injury; usually female who have been pregnant more than once; HLA ab
TRALI
Disease where fetal cells destroyed for maternal IgG
HDFN
HDFN:see increased…Most common in first prego is….2nd most common ab…
increased indirect biliMost common ABO HDN(sperocytes)second most common is anti c
RhIg: has reduced Rh HDFN-protects…mL of fetal WB with…microg dose-given to…moms who have…babies-given at…wks..before or …hrs after delivery of D+ baby
protects 30mL fetal WBwith 300microg dosegiven to D- mom with D+ babiesgiven 28wks before, within 72hrs after
Screen for fetal maternal hemorrage…Confirmation for fetal maternal hemorrage…
fetal rossetteKleihauer Betke
Kleihauer Betke calculation
vol fetal in maternal=%cells x 50 =fetal blood /30
Two conditions with decreased PLTs, HA, renal dsy, CNS issues
HUS, TTP
Conditions needing transfussion support
sickle cellthallasemiaImmune HA
antibody that is IgG, needs AHG to agg sensitized cells
incomplete
antibody that is IgM, can agg w/out AHG
complete
Reagent made in lab animals/not humans, detects IgG and complement, is either poly or mono specific
AHG
Reagent blood cells used to do QC on AHG reagent…What rxn do you get…
Group O check cellsAdd AHG to to check cells Get weak pos rxn(2+)
Adding check cells to negative AHG tubes doesn’t mean that…
patient serum was added
3 things check cells with AHG confirm
AHG was addedCells were washedThere was no antiglobulin serum thus didn’t react with red cells being used
Cause of false pos AHG
bacterial contamination of reagents
3 causes of false neg
didn’t wash rbcab eluted due to delayed washingprozone, too much ab
time frame in mins and temp for IAT
15-60min, 37C
Reagent that is:-made of buffered saline/glycine-enhances speed/sensitivity-decreases electropos cations on rbc
LISS
LISS is used in AHG testing to…
shorten incubation period
Reagant that increases sensitivity of IAT by removing net charge and increasing ab uptake
albumin
most warm auto in caused by …antigen
e
Minor xmatch eliminated due to …being done
donor ab screen
To do compatibility testing, fresh serum less than…needs to be used to preserve…
less than 48hrscomplement
e antigen, most people have, about %compatible units about…E antigen, less people have, more will be compatible
98% have e so only 2% compatible
after anti D, most likely ab in Rh hemolytic disease of newborn
anti-c
3 things part of prenatal work out, 1 not
ABO,Rh, ab screenDAT not done
After pos ab screen in mom and pos DAT in babie, what is done
titrate maternal ab
Critical titer for most ab is…A titer of 8 with postpartum ab screen on RhIg candidate w/anti D due to….
titer >168, antepartum admin of RhIg
Optimal pH for ab to bind
6.5-7.5
rbc suspension
2-5%
In titration, first 3 tubes neg, later tubes pos due to
prozone
Most common reason for MF agg
transfused, two pops
microscopic clumps, cloud backgroud
weak pos
solid button, clear background
4+
large clumps, clear background
3+
many medium sized agg, clear background, no free rbc
2+
many small clumps barely visible, turbid background, many free rbc
1+
With HTR, do this immediately
DAT on post trans
Two symptoms in HTR
hemoglobinuria, hypotension
Febrile rxn…F rise in temp within ..hr of trans
2F, 1hr
Hives/itching in
urticarial
