Blood Groups and Transfusion

Question 1

What is present on the surface of red blood cells to determine ABO blood grouping?

Answer 1

Sugar (glycoprotein)

Question 2

What is present on the surface of red blood cells to determine Rhesus blood grouping?

Answer 2

Protein

Question 3

What is the role of ABO antibodies?

Answer 3

These are IgM antibodies that an individual has to antigens on the surface of red blood cells that are non-self i.e. if an individual is Group A, they will have IgM antibodies for B-type antigens on RBCs.
These antibodies are also known as cold-acting as they can bind to antigens at room temperature

Question 4

What antibodies will someone with Group A blood have?

Answer 4

Anti-B IgM antibodies

Question 5

What antibodies will someone with Group AB blood have?

Answer 5

No IgM antibodies

Question 6

What antibodies will someone with Group B blood have?

Answer 6

Anti-A IgM antibodies

Question 7

What antibodies will someone with Group O blood have?

Answer 7

IgM antibodies to both a and b types

Question 8

What genotype would give rise to the group A blood phenotype?

Answer 8

AA/AO

Question 9

What genotype would give rise to the group B blood phenotype?

Answer 9

BB/BO

Question 10

What genotype would give rise to the group AB blood phenotype?

Answer 10

AB (codominance)

Question 11

What genotype would give rise to the group O blood phenotype?

Answer 11

OO

Question 12

What are the three inherited antigens that are important in Rhesus blood grouping?

Answer 12

C/c, D/d (d represents no rhesus factor), E/e and these are inherited as a triplet

Question 13

What is haemolytic disease of the newborn (HDN)?

Answer 13

If a mother is Rhesus negative (d) carries a child that is Rhesus positive (D) then on the first pregnancy they will develop antibodies to Rhesus factor in an immune response, but complications don’t occur. However, if a second pregnancy occurs with a child that is Rhesus positive, the mother’s immune system will illicit an immediate immune attack on the foetal red blood cells which can lead to still-birth or severe brain damage in the foetus.

Question 14

What are alloantibodies?

Answer 14

A type of antibody produced by an individual in response to antigens that are not present on their own cells ordinarily

Question 15

What are autoantibodies?

Answer 15

Antibodies which react with antigens that are present on a person’s own cells

Question 16

What happens when antibodies bind to antigens on structures?

Answer 16

They perform an agglutination function whereby the red blood cells with non-self antigens are pooled together which makes it easier for the complex to be engulfed by macrophages

Question 17

What are the four main types of blood transfusion possible?

Answer 17

Red cells, platelets, fresh frozen plasma and clotting factors.

Question 18

What is meant by ‘whole blood transfusion’?

Answer 18

This is where the blood is collected directly from a donor into an anticoagulant and administered to a patient

Question 19

What is a ‘red cell transfusion’

Answer 19

This is where blood is taken from a donor and most of the plasma is removed

Question 20

What is a ‘red cell in additive solution’ transfusion?

Answer 20

This is a blood unit where most of the plasma, white cells and platelets are removed

Question 21

What is a ‘leukocyte-depleted red cell’ transfusion?

Answer 21

This is a blood unit where almost 100% of all of the white cells in a simple are removed

Question 22

What form of blood transfusion would be given to a leukaemia patient

Answer 22

Leukocyte-depleted red cell transplant

Question 23

If an individual is Rhesus positive (D) what kind of blood can they receive?

Answer 23

Rhesus positive or negative blood, as they do not facilitate an immune reaction

Question 24

If an individual is Rhesus negative (d) what kind of blood can they receive?

Answer 24

Rhesus negative only, they will stimulate an immune reaction to Rhesus positive blood

Question 25

What are the disadvantanges of red blood cell transfusion?

Answer 25

Infection transmission, allo immunisation risk (could compromise future transfusion effectiveness), incompatibility, iron-overload and danger of circulatory overload

Question 26

When may platelets be administered to a patient?

Answer 26

If they have a disorder of platelet function, bone marrow failure or bypass surgery

Question 27

What are the three forms of plasma that can be collected from a donor?

Answer 27

Fresh frozen plasma (whole), cryoprecipitate and albumin

Question 28

When would fresh frozen plasma be administered to a patient?

Answer 28

This form of plasma still retains functional clotting factors and therefore can be administered in those with bleeding disorders such as haemophilia

Question 29

When would cryoprecipitate (plasma) be administered to a patient?

Answer 29

This form of plasma is high in certain clotting factors but low in others, and is most commonly used in the treatment of low fibrinogen levels

Question 30

When would albumin (plasma) be administered to a patient?

Answer 30

This form of plasma has been heat-sterilised and fractionated so are blood group antigens are destroyed and therefore it can be used solely to replace plasma albumin to maintain oncotic pressure

Question 31

Why does plasma transfusion have to be matched to blood groups?

Answer 31

Plasma contains clotting factors and antibodies, and therefore if an individual is blood group A but they are given the plasma of someone who is blood group O, the plasma will contain antibodies to their blood group and lead to rejection.

Question 32

What kind of fresh frozen plasma can be given to someone who is Rhesus positive?

Answer 32

Plasma is unaffected by Rhesus factor so it doesn’t matter

Question 33

What kind of fresh frozen plasma can be given to someone with blood group A?

Answer 33

Plasma from A or AB donor

Question 34

What kind of fresh frozen plasma can be given to someone with blood group B?

Answer 34

Plasma from B or AB donor

Question 35

What kind of fresh frozen plasma can be given to someone with blood group AB?

Answer 35

Plasma from AB donor

Question 36

What kind of fresh frozen plasma can be given to someone with blood group O?

Answer 36

Plasma from A, B, AB or O donor (any)

Question 37

What is a major indicator to stop transfusion?

Answer 37

Rapid temperature spike >40 degrees as this is indicative of intravascular haemolysis

Question 38

What are the signs and symptoms of a transfusion reaction?

Answer 38

Symptoms: restlessness, flushing, anxiety, abdominal pain, nausea, vomiting

Signs: fever, hypotension, haemoglobinuria, oozing from venipuncture site

Question 39

How is an acute transfusion reaction treated?

Answer 39

Stop transfusion promptly! Administer IV saline to control hypotension, administer frusemide (loop diuretic) to maintain renal perfusion if there is low urinary output and treat any resultant disseminated intravascular coagulation