Blood Bank (ASCP MLT BOARD EXAM)

Irradiation of Blood Cells

disables t-lymphocytes present in donated blood due to t-lymphs causing reaction when tranfused, or graft vs host disease

Leukocyte-reduced blood

filtered to remove WBCs that contain antibodies that can cause fevers, or hemolytic reaction during transfusions

Purpose of Weak D testing

-Possess the D antigen

-tested on: Rh- cord with Rh-Moms or Rh- mom with positive fetal blood screen

Gel Blood Typing what does 0, 1+, 2+, 3+, 4+ look like?

Purpose of Elution Testing

-testing for antibody present that is not detected in the plasma

-elution will elute the antibody from Red cells into the supernatant

-elution is performed when DAT is positive with

-performed on cord specimen when the DAt is positive and if doctor requests

What would you do for nonspecific antibodies?

Cross match donor cells with the patient, and make sure the donor cells do not have the nonspecific antibody

What antibodies are more likely to be detected at Immediate spin/Room temperature?

Lea, Leb

M,N

P1,

A,

I,H,IH

What antibodies are more likely to be detected at 37C?

Weak Rh(D,C,E,c,e)

Kell

M

A

What antibodies are more likely to be detected at Anti-Human globulin phase?

Rh(D,C,E,C,e)

Kell

Duffy

Kidd

S,s

-Rh- Moms (older woman) who have for Rhogam before

(Cord cells with heavy

Antigen typing for pos and neg control meaning?

Positive: select reagent red cells that are heterozygous for the antigen thats being tested

Negative: select reagent red cells that are known to lack the antigen being tested (homozygous)

-they do not express Rh antigens on RBCs

-mild compensated anemia, reticulocytosis, stomatocytosis, low hemoglobin, and hematocrit, increase in hemologbin F, decreased serum haptoglobin, and rare cases increased bilirubin

What is partial D?

-Expression of D is weakened due to one or more D epitopes missing.

-individuals are at risk for making an anti-D specific for the epitope they are lacking

-normal other Rh antigen expression

Weiner into Fisher-Race Nomenclature: "R"

Presence of D

Weiner into Fisher-Race Nomenclature: r

Absence of D

Weiner into Fisher-Race Nomenclature: 1 or '

C

Weiner into Fisher-Race Nomenclature: 2 or ''

E

Weiner into Fisher-Race Nomenclature: 0

c + e

Weiner into Fisher-Race Nomenclature: Z or y

C + E

e is most common in

whites

what race is almost always D+

asians

What percentage of population is Rh+?

85%

what are the two most common genes(weiner) + antigens (fisher-race)

R1 = CDe

r = cde

R0

cDe

R1

CDe

R2

cDE

Rz

CDE

r

cde

r'

Cde

r''

cdE

ry

CdE

Le System

Lewis antigens arent produced by the red cell. Theyre absorbed onto it from the plasma

-if Le gene inherited, person has Lea absorbed onto RBCs - Le(a+b-)

-if Le and Se genes inherited, person has Leb absorbed onto RBCs - Le(a-b+)

Naturally occuring antibody

ABO, Lewis, P1, MN, Lua

Clinically significant antibody

ABO, Rh, Kell, Duffy, Kidd, SsU

Warm antibodies

Rh, Kell, Duffy, Kidd

Cold antibodies

M, N, P1

Usually only react in AHG

Kell, Duffy, Kidd

Can react in any phase of testing

Lewis

Antibodies detection enhanced by enzyme treatment of test cells

Rh, Lewis, Kidd

Antibodies Not detected with enzyme treatment of test cells

M, N, Duffy

Antibodies enhanced by acidification

M

Antibodies show dosage

Rh other than D, MNS, Duffy, Kidd

Antibodies bind complement

I, Kidd, Lewis

Antibodies cause in vitro hemolysis

ABO, Lewis, Kidd, Vell, some P1

Antibodies Labile in vivo and in vitro

Kidd

Antibodies that commonly cause of anamnestic response delayed transfusion reaction

Kidds are delayed

Antibodies associated with paroxysmal nocturnal hemoglobinuria

Anti-P

Blood Donor Criteria

-at least 16 with parent permission

-110 pounds

-whole blood can be donated once every 8 weeks

-blood pressure less than or equal 180/100

-50-100 pulse without cardiac abnormalities

-Hg > 12 (females), >13 (males)

-Hct: >36 females, >39 males

-temp < 37.5

What Lewis antigen(s) would be detected when phenotyping the red cells of an adult who has the Le, Se, and H genes?

Leb

-Le and Se genes produce Leb antigen on RBCs

What type of antibody is suspected if you have a strong reaction at immediate spin and w+ to negative reaction at AHG?

Suspect cold antibody (IgM)

Mix field reactions occur commonly when?

When patient is recently transfused with O neg, and they are another blood group type.

Can someone who has taken Tegison for severe psoriasis donate blood?

No, they are permenantly deferred as this can cause birth defects if transfused to pregnant woman

What medications will defer someone from donating blood? And time period?

Proscar + Avodart(used to treat enlarged prostates) = 1-6 month

Propecia (treat baldness) = 1 month

Accutane (treat severe acne) = 1 month

Soriatane + Tegison (treat severe psoriasis) = 3 year from last dose

Glycine-HCL/EDTA treatment of RBCs can destroy which antigen, allowing for confirmation of a suspected antibody and detecting additional antibodies?

Bg, and Kell

What antibodies are enhanced by enzyme treatment of red cells?

Rh, Lewis, Kidd

What enzymes are most sensitive to enzyme treatment?

Duffy, Fya, Fyb antigens

What drug can be used to decrease iron levels in patients with iron overload?

Desferrioxamine: iron chelating agent to reduce iron overload in patients who rely on transfusion to maintain hemoglobin levels and prevent anemia

What D varient has the best likelihood to receive D-pos RBCs without any adverse effects?

C in trans to RHD

-Individuals possess complete D antigen structures. The trans (opposite) interfers with expression of D-antigen. This is a weakened expression, but D antigen is still present. They can still receive the units without Rh-mediated transfusion rxn.

Acute intravascular hemolysis as result of a blood transfusion is most often associated with what?

Transfusion of ABO incompatible red blood cells being transfused to a recipient with naturally occuring ABO alloantibodies (

Dithiothreitol (DTT)

Can denature Luthern antigens (Lub, etc)

What type of Whole Blood can you give to a patient who is AB+?

Only AB+

Bombay phenotype

Two hh genes (or two inactive alleles of H or FUT1) are inherited at the H locus. These individuals cannot produce alpha-2-L-fucsyltransferase to product H,A, or B antigens. Consequently they produce anti-H, anti-A, and anti-B antibodies.

-Bombay red cells can appear group O. But their serum reacts with antibody screening cells and all normal group O cells due to presence of anti-H