BLOOD BANK SECTION Flashcards
• Immunohematology - branch of immunology deals with
immunologic principles with studying different blood groups
• Blood bank - area in clinical laboratory where blood
products
such as whole blood and blood components
collected from donor are prepared and stored for
transfusion.
Early History
• Pope Innocent VIII (1492) - drank blood from three young
boys in hopes of youth and vitality
ended up being dead
along with the boys.
Animal-to-Animal Transfusion
Jean Baptiste Denis
- Performed the first animal-to-animal transfusion by
bloodletting 16-year-old boy with 9 ounces of lamb’s
blood in exchange of the boy’s 3 ounces of blood
- His second patient was Anton Mauroy receiving calf’s
blood
in which he suffered transfusion reaction but
became well.
• Richard Lower
Transfused sheep’s blood to Arthur Coga
a clergy
student
Human-to-Human Transfusion
• Philip Syng Physick
- Conducted first human-to-human transfusion in 1795
but was not documented.
• John Henry Leacock
Performed and published animal experiments proving
donor and recipient must be the same species.
• James Blundell
In 1825
he successfully transfused a woman suffering
from postpartum pregnancy with the woman’s
husband’s blood.
• Emil Ponflick
-
Observed RBC lysis in blood of a woman transfused
with sheep’s blood. Also observed incompatible
transfusion reactions such as hemorrhage and
congestion of kidneys
lungs
• Leonard Landois
- Observed that human RBCs will lyse if mixed with sera
of other animals. Set the stage for studying
immunologic basis of blood compatibility.
• Braxton Hicks
Suggested the use of anticoagulant as clotting was the
primary obstacle of transfusion
Discovery of Blood Groups and Landsteiner Laws
•
Karl Landsteiner - discovered ABO blood group in
- He explained serious reactions from incompatible
transfusions.
• Landsteiner observed that blood mixed with other
specimen of human blood sometimes resulted to
agglutination
which is the clumping of cells.
• Landsteiner identified three blood groups
called A
and C (renamed as O from German word one meaning
without
• Alfred von Descatello and Adriano Sturli - discovered
blood group AB in 1902
• Landsteiner and Alex Weiner - discovered Rh blood
group in 1940
• Landsteiner Laws
a. Antigen of RBC determines the blood group
b. Corresponding antibody is never found in the
individual’s sera
c. Opposite antibody is found in the individual’s sera
Inheritance of ABO and Rh Blood Groups
Definition of Terms
• Genes - unit of heredity
molecular level of DNA sequence
responsible for expression of a specific trait
Allele - one or two alternate forms of a gene
• Genotype - set of genes possessed by an individual
• Phenotype - physical traits which expression is based on
inherited genes along with environmental factors.
• There are 4 possible phenotypes on ABO Blood Group
blood type A
B
• In a genotype
one is from the father and one is from the
mother
• Three alleles are used in ABO inheritance pattern: A
B
Allele A and B are dominant
can be heterozygous
(e.g.
AO) or homozygous (e.g.
- Allele A and B can be codominant
as type AB has
both A and B alleles.
Allele O is recessive
which is only expressed in
homozygous O (genotype 0O)
• Rh Blood Typing
Detects presence of D antigens on surface of RBCs
-
Genotype
AA (homozygous A)
AO (heterozygous A)
BB (homozygous B)
BO (heterozygous B)
AB
0
Phenotype
Blood Type A
Blood Type A
Blood Type B
Blood Type B
Blood Type AB
Blood Type O
Categorizes into Rh+ and Rh-
-
Sample is whole blood and reagent is Anti-D which is
colorless
Reaction
with Anti-D
+
Indication
Sample Problem
D antigen is
presents
D antigen is
absent
The mother’s blood type is A while the father is AB. What
are the possible blood types of their offspings?
Analysis: Mother’s genotype can be AO or AA
father’s
Testing compatibility of donor and recipient blood. Has
genotype is AB.
A
A
Case 1
Case 2
AA
AO
AB
BO
A
AA
AA
B
AB
AB
Type
Rh+
Rh-
• Crossmatching
two parts:
Major Crossmatch
RSDC (Recepient’s serum + donor’s cells)
Detects if recipient has antibodies that may destroy cells from the donor
b.
Minor Crossmatch
DSRC (Donor’s serum + recipient’s cells)
• Detects if donor has antibodies that may
destroy cells of the recipient.
Genotype
3 AA
3 AB
1 AO
1 BO
Phenotype
A
AB
Phenotype
Summary
Number
4
B
AB
3
Percentage
3/8 or
0.375
1/8 or 15.5
4/8 or 50%
There are 8 possible genotypes of the offsprings
Routine Tests in Blood Banking
• ABO Blood Typing: Four Major Blood Types
Blood Type
ANTIGEN in
RBCs
A
А
B
AB
Both A and B
No antigens
ANTIBODY
in Plasma
Anti-B
Anti-A
No antibodies
Both anti-A
and anti-B
- Direct/Forward/Cell Typing: most common
Determines antigens present on the surface of
patient’s RBCs
Uses whole blood and reagents are commercially
prepared antisera
Blood
ANTISERA reagent
Type
Anti-A
Anti-B
(BLUE)
(YELLOW)
A
-
AB
+
+
2
Indirect/Reverse/Serum Typing
Determines antibodies in the plasma or serum of a
patient’s specimen
Uses Red Cell Suspension (RCS) as reagent
Blood
RCS reagent
A Cell
B Cell
Type
Suspension
Suspension
А
+
B
+
AB
+
+
