Immunohematology Review Flashcards

Flashcards covering Immunohematology review topics such as blood donation criteria, donor deferrals, blood components, blood testing, transfusion reactions, HDFN, and RhIG.

Criteria for Whole Blood Donors - Age

≥ 16 or as allowed by state law

Criteria for Whole Blood Donors - HGB/HCT (Male)

HGB ≥ 12.5g/dL or HCT ≥ 38%

Criteria for Whole Blood Donors - HGB/HCT (Female)

HGB ≥ 11.0 g/dL or HCT ≥ 33%

Criteria for Whole Blood Donors - Temperature

≤ 37.5°C (99.5°F)

Criteria for Whole Blood Donors - Venipuncture Site

No infectious skin disease or scars indicative of drug use

Aspirin Deferral Time

2 days (if donor is sole source of platelets)

Measles, Mumps, Polio, Typhoid, Yellow Fever vaccines Deferral Time

2 weeks

Rubella, Chicken Pox (varicella-zoster) Vaccine Deferral Time

4 weeks

Whole Blood Donation Deferral Time

8 weeks

Syphilis, Gonorrhea Deferral Time

12 months

Mucous membrane exposure to blood Deferral Time

12 months

Recipient of blood, blood components, plasma-derived clotting factor concentrates, or transplant Deferral Time

12 months

Malaria or travel to an area endemic for malaria Deferral Time

3 years

Parenteral drug use Deferral Time

Permanent

Family history of Creutzfeldt-Jakob disease Deferral Time

Permanent

Tested positive for HBsAg Deferral Time

Permanent

History of babesiosis or Chagas’ disease Deferral Time

Permanent

Volume of blood routinely collected during whole blood collection

450 mL ± 10% or 500 mL ± 10%, depending on collection bag.

Maximum volume of blood collected during whole blood collection

10.5 mL of blood per kg of donor’s weight, including samples for testing

Anticoagulant volume for 450-mL collection

63 mL

Anticoagulant volume for 500-mL collection

70 mL

Apheresis

Automated blood collection system that allows removal of 1 or more components from blood & return of remainder to donor.

Donor Testing Required by AABB

ABO Rh (including weak D), Antibody screen, Syphilis testing, Hepatitis testing, HIV testing, Other infectious disease testing

ACD-A

Acid citrate-dextrose; RBC Shelf Life 21 days; used for apheresis

CPD

Citrate-phosphate-dextrose ; RBC Shelf Life 21 days; Higher pH preserves 2,3-DPG better for better O2 delivery

CP2D

Citrate-phosphate-double-dextrose; RBC Shelf Life 21 days. Contains 100% more glucose than CPD.

CPDA-1

Citrate-phosphate-dextrose with adenine; RBC Shelf Life 35 days; Adenine increases ADP, which increases synthesis of ATP; Contains more glucose to sustain cells during longer storage.

Purpose of Additive Solutions

Extend shelf life of RBCs to 42 days

Blood Components—RBCs Storage Temperature

1° –6°C

Blood Components—RBCs Shelf Life

35 days in CPDA-1 or 42 days with additive solution

Open System

Seal on unit is broken to attach external transfer bag; components stored at 1° –6°C must be used within 24 hr after system opened; components stored at 20° –24°C within 4 hr.

Closed System

Sterility maintained through use of attached satellite bags or sterile connecting device. No exposure to air. No change to expiration date.

Washed RBCs Storage Temperature

1° –6°C

Washed RBCs Shelf Life

24 hr after washing (open or closed)

RBCs Leukocytes Reduced Storage Temperature

1° –6°C

RBCs Leukocytes Reduced Shelf Life

Same as RBCs

RBCs Irradiated Storage Temperature

1° –6°C

RBCs Irradiated Shelf Life

Original outdate or 28 days from irradiation, whichever comes 1st

Fresh Frozen Plasma (FFP) Storage

Frozen: ≤ –18°C. After thawing: 1° –6°C

Fresh Frozen Plasma (FFP) Shelf Life

Frozen: 12 mo. After thawing: 24 hr

Cryoprecipitate Storage

Frozen: ≤ –18°C. After thawing: RT

Cryoprecipitate Shelf Life

Frozen: 12 mo. After thawing: single units 6 hr, pools 4 hr

Platelets Storage Temperature

20° –24°C

Platelets Shelf Life

5 days from collection, with agitation

Apheresis Platelets Storage Temperature

20° –24°C

Apheresis Platelets Shelf Life

5 days with agitation

Leukocyte Reduced Platelets Storage Temperature

20° –24°C

Leukocyte Reduced Platelets Shelf Life

Open system—4 hr. Apheresis—5 days

Prestorage Pooled Platelets Storage Temperature

20° –24°C

Prestorage Pooled Platelets Shelf Life

5 days from collection

Purpose of Leukoreduction

To ↓WBCs to ↓ febrile nonhemolytic transfusion reactions, transmission of CMV, & HLA alloimmunization

RBC Storage Lesion - Increased

Lactic acid, Plasma K+, Plasma hemoglobin, Microaggregates

RBC Storage Lesion - Decreased

Shift to left of O2dissociation curve (↑ HGB/O2 affinity, ↓ O2 ATP delivery to tissues), 2,3-DPG, pH, Glucose, Viable cells

IgG Structure

Monomer

IgM Structure

Pentamer

IgG Type of Ab

Immune

IgM Type of Ab

Naturally occurring

IgG Optimum Temperature of Reactivity

37°C

IgM Optimum Temperature of Reactivity

25°C or lower

ABO Group O Antibodies

Anti-A, Anti-B

ABO Group A Antibodies

Anti-B

ABO Group B Antibodies

Anti-A

Break the Rh Code: r before h

“big” e.g., rh’ = C

Break the Rh Code: h before r

“little” e.g., hr’ = c

Break the Rh Code: R

presence of D e.g., Rh1 = DCe

Break the Rh Code: r

absence of D e.g., rh’ = dCe

I antigen

adult cells have much I Antigen

i antigen

cord cells have much i Antigen

Polyspecific (broad spectrum) Antiglobulin Serum

Detects IgG & C3d; Used for direct DAT

Monospecific Anti-IgG Antiglobulin Serum

Detects IgG; Used for routine compatibility tests & ab ID. Detects clinically significant abs. Helpful in investigation of immune hemolytic anemia.

Monospecific Anti-C3d Antiglobulin Serum

Detects Complement IgG ; Helpful in investigation of immune hemolytic anemia.

Anti-A1

Only found in subgroups of A. Agglutinates A1 & A1B cells, but not A2 or O.

Anti-I

Agglutinates all adult cells, except i adult. Doesn’t agglutinate cord cells.

Anti-i

Agglutinates cord cells more strongly than adult cells.

Anti-H

Most common in A1 & A1B. Agglutinates O cells most strongly, followed by A2 & B; then A1 & A1B.

Anti-IH

Most common in A1 & A1B. Agglutinates cells that possess both I & H. Agglutinates adult O cells most strongly. Weaker rxn with A1 cells. Doesn’t agglutinate cord cells.

Most common cause of tf-related deaths in U.S.

Transfusion-related acute lung injury (TRALI)

ABO HDFN

Mothers at risk Usually group O; First child affected?; Yes; Frequency; Common; Severity; Mild

Rh HDFN

Mothers at risk; Rh neg; First child affected?; Not usually; Frequency; Uncommon; Severity; Can be severe

Rh Immune Globulin (RhIG)

Anti-D derived from pools of human plasma; Prevent immunization to D