Blood Bank Final Lect

What is a Forward Type?

Identifying unknown antigens on RBCs

What type of sample is used for a Forward Type?

RBCs

What is the RBC percent when testing a Forward Type?

4%

What is the frozen state temperature for FFP?

-18 degrees

What happens to ATP levels in blood products over time?

Decrease

What happens to pH levels in blood products over time?

Decrease

What happens to glucose levels in blood products over time?

Decrease

What happens to 2,3 DPG levels in blood products over time?

Decrease

What happens to oxygen affinity in blood products over time?

Decrease

What percentage of RBC biochemical structure is protein?

52%

What percentage of RBC biochemical structure is lipid?

40%

What percentage of RBC biochemical structure is carbohydrate?

8%

What is the expiration period for CPDA-1 anticoagulant?

35 days

What is the expiration period for CP2D anticoagulant?

21 days

What is the expiration period for AS-1 anticoagulant?

42 days

What is the expiration period for AS-3 anticoagulant?

42 days

What is the expiration period for AS-5 anticoagulant?

42 days

What does DTT destroy?

IgM pentamer, Cold Antibodies

What does ZZAP destroy?

WARM and creates K null cells

What does Papain enhance?

Kidd, Rh, ABO, Ii, Lewis, P

What does Ficin enhance?

Kidd, Rh, ABO, Ii, Lewis, P

What is AET used for?

Remove auto antibody to antigen type the patient red cells

What is EGA used for?

Remove auto antibody to antigen type the patient red cells

What is Chloroquine used for?

Remove auto antibody to antigen type the patient red cells

What is the reactivity of an antigen that is Amorph or Silent Allele?

Undetectable

What is the most common Amorph allele?

d (haplotype)

What is the definition of phenotype?

Serologically observed traits

What are examples of ABO phenotypes?

A, B, O, AB

What is the definition of genotype?

Molecular tested traits

What are examples of ABO genotypes?

AA, AO, BB, BO, OO, AB

What is an immunogen?

Antigen

What is an immunoglobulin?

Antibody

How is an immunoglobulin produced?

Immune response to unknown antigen

Which antibodies have the strongest immunogenicity?

D > K > c > E > C > e

What antibody is created first in an immune response?

IgM

What antibody is created later in an immune response?

IgG

How many alleles are tested in paternity molecular tests?

12 alleles + Amelogenin

What is a Reverse Type?

Identifying antibodies in plasma or serum

What type of sample is used for a Reverse Type?

Plasma or Serum

What is the minimum age for a valid Reverse Type?

4-6 years

What causes ABO discrepancy in reverse type due to old age or cancer?

Hypogammablobinemia

How can we fix a non-agglutinating reverse type?

Incubate at Room temp or refrigerate for 15 mins, add more plasma

What is Indirect Antiglobulin Testing (IAT)?

Test using patient plasma and known antigen screen cells

Is IAT performed in-vivo or in-vitro?

In-vitro

Does IAT have an incubation phase?

Yes, at 37 degrees

How can you shorten the incubation phase of IAT?

Use potentiator, LISS or Peg

What antibodies could be missed during the IAT?

Low Frequency Antibodies

What are examples of low frequency antibodies?

Wra, Lua

How do you perform Direct Antiglobulin Testing (DAT)?

Use patient RBCs, wash 4x, add AHG

Is DAT performed in-vivo or in-vitro?

In-vivo bound antibodies

Does DAT have an incubation phase?

No, because reaction happens in body

What type of antibodies are ABO antibodies?

Naturally Occurring IgM type antibodies

What are the ABO immunodominant sugars?

GALNac, Gal, Fuc

What ABO type does the Bombay phenotype resemble?

O phenotype

What type of blood is needed for a compatible transfusion of a Bombay?

Bombay blood

What is the scientific name for A1 lectin?

Dolichus biflorus

What is the scientific name for H lectin?

Ulex europeus

What lectin reacts strongest with blood types?

Ulex Europeaus: O > A2 > B > A2B > A1 > A1B

What is the scientific name for B Lectin?

Bandeiraea simplicifolia (Griffonia simplicifolia)

How do acquired B individuals react with B Lectin?

They test negative with this reagent.

What causes acquired B blood type?

Bacterial contamination breaking sugar bonds of A sugar.

How can you fix the acquired B issue?

Acidify anti-B reagent or use acyl anhydride on patient's RBCs.

What is the anti-B reactivity in ABO testing for acquired B?

Weak or 1-2+ anti-B reactivity.

How do Ael reactions behave with anti-A reagent?

Normally test negative but weakly reactive with Anti-A,B reagent.

What does A2 reaction indicate?

Forward type A and back type O with weak reactive A1 cell reaction.

How do you test for A2 reactions?

Use A1 lectin and A2 cells; A1 lectin won't react with A2 individual.

What is A3 reaction characterized by?

Mixed field reactivity with Anti-A and anti-A,B reagent (ex. 2+ mf).

What antibodies can cause Hemolytic Disease of the Newborn (HDN)?

IgG antibodies like Rh, Kidd, Kell, Duffy, Ss, Lub.

What virus is transmitted from WBCs?

Cytomegalovirus; important to give CMV negative to babies.

How do we prevent CMV transmission at donation?

By using leukoreduced units.

What antigens are present in utero and newborn cells?

K, Rh, later Duffy; Lewis is absent.

Is Lewis an antigen present in utero?

No, it is not a true RBC antigen.

What is the procedure to perform a weak D test?

Incubate at 37 for 15 mins, wash 4x, add 2 drops IgG, add check cells.

For whom should a weak D test be performed?

Women of childbearing age, babies, unknown blood types.

What are the potential child phenotypes from R1r mom and rr dad?

Child can be R1r or rr.

Given antigen reactivity, what is the Weiner phenotype?

D: 2+, C: 2+, E:0, c: 2+, e:2+; phenotype is R1r.

What is a secretor?

When soluble antigens can be found in plasma or tissues.

What percentage of the population are secretors?

80%, must have secretor gene (SeSe or Sese).

What RBC antigen determines secretor status?

Le(a=b+).

What is a non-secretor?

When soluble antigens cannot be found in plasma or tissues.

What percentage of the population are non-secretors?

20%, lack secretor gene (Sese).

What RBC antigen is absent in non-secretors?

Le(a=b=).

What Lewis phenotype would a pregnant female have?

Le(a=b=).

Does the Lewis phenotype cause HDN?

No, because Lewis is IgM and doesn’t cause HDN.

What is different about DMNSs group antigens?

They are of immunoglobulin class.

What is the commonality of DMNSs antigens?

They are destroyed by enzymes.

What antibodies can be created if the antigen is absent in Rh Fisher/Race phenotype?

Dce/Dce: make C and E antibodies; dcE/dcE: make D, C, and e.

Is the Big K antigen high or low frequency?

Low frequency; most common antibody found.

Is blood with Big K antigen easy or difficult to find?

Easy, must antigen type units for crossmatching compatibility.

What percentage of the population is negative for Big K antigen?

91%.

Is K antigen affected by common enzymes?

Not affected by enzymes like ficin, papain.

What enzyme can create K null phenotype?

ZZAP.

What type of antibody is associated with Duffy group?

IgG; must antigen type units for crossmatching compatibility.

Can Duffy group cause HTR and HDN?

Yes.

In which race is the Duffy null phenotype more common?

Blacks, Africans.

What are Duffy null phenotype individuals resistant to?

Malaria, Plasmodium vivax.

Is Duffy antibody naturally occurring?

No, must be sensitized with antigen to create response.

What type of antibody is associated with Kidd group?

IgG; must antigen type units for crossmatching compatibility.

What is the null phenotype resistant to?

Malaria, Plasmodium vivax

Is the null phenotype naturally occurring?

No, must be sensitized with antigen to create antibody response