Introduction to Immunohematology

What are the two main parts of immunohematology?

- Donor services and production

- Transfusion services

Who established the model for the national volunteer blood donor program in 1937?

Charles Richard Drew

What is the general process of donation services in immunohematology?

- Donor Hx and physical exam

- Preparation of the collection site

- Collect whole blood

- Centrifuge whole blood

- Separate plasma from red cells

- Separate platelets

What is the main method of platelet separation from a single donor's whole blood?

Apheresis

Who was responsible for introducing anticoagulants to blood banking, and for establishing the first USA blood bank at Cook County Hospital?

Dr. Bernard Fantus

What are the 4 main responsibilities of transfusion services in immunohematology?

- Determine patient ABO, Rh blood group

- Detect other unexpected red blood group antibodies

- Crossmatch to find compatible blood components

- Properly handle and store blood components

______ is who publishes the Technical Manual and the Standards for Blood Banks and Transfusion Services.

AABB

The FDA publishes the ______ for immunohematology.

Code of Federal Regulations

The main antigen on RBCs determines the ______.

ABO blood group

A blood type patients have the ______ antigen on their RBCs.

A

B blood type patients have the ______ antigen on their RBCs.

B

O blood type patients have ______ antigen on their RBCs.

neither A or B

AB blood type patients have ______ antigen on their RBCs.

both A and B

What are some other antigens on RBCs?

- Rh system

- Kell

- Kidd

- Duffy

- Lewis

- Lutheran

- MNSs

The immune system interacts with blood group ______ when exposed to those which are foreign.

antigens

______ discovered the ABO blood group system in 1900.

Karl Landsteiner

Landsteiner's Law states that if an agglutinogen is present in a patient's RBCs, the corresponding agglutinin must be ______ in the plasma, and vice versa.

absent

ABO antibodies are also called ...

isoagglutinins or naturally occurring antibodies

Do we expect to see ABO antibodies in a healthy individual?

Yes

ABO antibodies are generally class ______.

IgM

Rh blood group was discovered by ______ in 1937 in a maternal sample.

Levine and Stetson

Levine and Stetson observed unexplained ______ of the sample to ABO matched red cells.

agglutination

In 1940, Landsteiner and Wiener discovered ______ antibody that showed similar results to those observed by Levine and Stetson in 1937.

anti-Rhesus

People with Rh positive blood type have ______ antigen on their RBCs.

D

People with Rh positive blood type ______ (do/do not) have antibodies in their plasma.

do not

People with Rh negative blood type have ______ antigen on their RBCs.

no D

People with Rh negative blood type ______ (do/do not) have antibodies in their plasma.

do not

(possible anti-D if stimulated by transfusion or pregnancy)

85% of the general population has Rh ______ blood type.

positive

Agglutination is the visible clumping of ______ caused by interaction by a specific antibody.

particulate antigens (RBCs)

In the lab, we can use known antibodies to determine the presence or absence of ______ on RBCs.

antigens

(presence = agglutination; absence = no agglutination)

We can also use known RBCs to determine the presence or absence of ______ in the plasma or serum.

antibodies

(presence = agglutination; absence = no agglutination)

What are some basic reagents used in blood banking?

Anti-A/B/D

A1, B

Crossmatching determines compatibility of ...

ABO and Rh

Type specific crossmatching occurs when a component and the patient's blood types are ______.

identical

(ex. A+ patient receives A+ RBCs)

ABO compatible is when the component and patient's blood types are not ______, but are compatible.

identical

(ex. A+ patient receives O+ RBCs)

When transfusing red cells, a ______ must be performed in addition to determining type compatibility.

crossmatch

A crossmatch consists of testing patient ______ and donor ______.

serum, RBCs

Which blood type is the universal red blood cell donor? Why?

O since they do not have A or B antigen to react with recipient plasma antibodies

Which blood type is the universal plasma donor? Why?

AB blood type because it has neither anti-A or anti-B antibodies present