Bloodbanking Must know (PART 1)

Pope Innocent VII

He was the first recipient of the first blood transfusion in history

James Blundell

He performed the first successful blood transfusion to a patient

Dr. Charles Drew

He was appointed as the director of the first American Red Cross blood bank at the Presbyterian Hospital.

• Von Descatello

• Sturli

They discovered the fourth blood group (AB)

• Karl Landsteiner

• Alex Wiener

They discovered the Rh blood group

500 mL +/-10% of blood

The current whole blood collection volume per unit:

1 part AC:7 parts blood

Anticoagulant to blood ratio in blood collection

10.5 mL/kg donor’s weight

Maximum allowable amount of blood to be extracted

525 mL

A maximum volume of ____ can be collected from a 110-pound donor.

8-15 mins

Donation average length of time

10-12 pints

Total blood volume of most adults

24 hrs

1 pint of blood can be replenished within:

8 weeks

Whole blood can be donated every:

Phospholipid

Main membrane content of the RBC

2 pairs of globin chains; 4 heme groups

Hemoglobin structure

Gas transport

Function of hemoglobin

Embden-Meyerhof Pathway

Pathway in which anaerobic glycolysis provides 90% ATP

HMP/PPP

Pathway which provides 10% ATP and reduce glutathione

Leubering-Rapoport

Pathway which permits 2,3-DPG accumulation and off-loads oxygen to tissue

Methemoglobin Reductase Pathway

Pathway that maintains heme iron of the hemoglobin in ferrous state

75%

FDA requires an average 24-hr post transfusion RBC survival of more than:

1-6 degC

Whole blood storage temperature

1-10 degC

Shipping/transport temp of whole blood

Phosphate

Source of 2,3-DPG

35 days

Shelf life of CPD-A1

72 hrs

Additive solutions must be added to RBC within the first __ hours of storage

42 days

Additive solutions support red cell survival up to how many days?

Adsol (Baxter healthcare)

AS-1

Nutricel (Pall corporation)

AS-3

Optisol (Terumo)

AS-5

100 mL

How much additive solution is used for a 450 mL blood bag?

3 days

Rejuvenation solutions can be used up to __ days after expiration of red cells.

Inosine

Rejuvenated RBCs are washed in order to remove:

3 years

Frozen rejuvenated RBCs have a shelf life of __ years using AS-1

10 years

Frozen rejuvenated RBCs have a shelf life of __ years using CPD and CPDA-1

Glycerol

What is the cryoprotective agent added to RBCs when freezing then?

Rejuvesol

It is the only FDA-approved rejuvenation solution in the USA

4+

One solid agglutinate, clear supernatant

3+

Several large agglutinates, clear supernatant

2+

Medium-sized agglutinates, clear background

1+

Small agglutinates, turbid background

Centrifugation

It is the simplest and most common technique to enhance agglutination

Prozone

Antibody excess

Serum dilution

Remedy for prozone phenomenon

Postzone

Antigen excess

Increase serum to cell ratiom

Remedy for postzone phenomenon

6.5-7.5

The ideal pH for most red blood cell agglutination reactions is:

22% Albumin

Protein media that causes agglutination by adjusting zeta potential between red cells.

Polyethylene glycol (PEG)

Protein media that reduces false-positive reactions and is more effective than albumin

LISS

Decreases ionic strength of a reaction medium and reduces zeta potential; increase rate of antibody uptake during sensitization

• Rh

• Kidd

• P1

• Lewis

• I

Enzymes that ENHANCE antibody reactivity to antigens

• Fya

• Fyb

• M N S

Enzymes that DESTROY reactivity to red cell antigens

DTT and 2-ME

Thiol-reducing agents that break the disulfide bonds of the J chain of the IgM molecule

ZZAP

Thiol reagent + proteolytic enzyme that causes dissociation of the IgG molecules from surface of sensitized RBCS and alters their surface antigens

ABO (ISBT 001)

Most important blood group

• Causes the most severe HTR

2-4 years of age

Full expression of ABO antigens occur between

Acetic anhydride

Resolution for Acquired B phenomenon uses monoclonal anti-B ckone and treatment of RBCs using:

Rh (ISBT 004)

Which blood group is the primary cause of HDFN?

Washing step

It is considered the most important step in the AHG phase.

Lewis (ISBT 007)

It is the only blood group that is NOT INTRINSIC to red blood cells.

Leb

Which lewis antigen serves as the receptor for Helicobacter pylori?

Le (a+b)

Lewis non secretor

MNS (ISBT 002)

Which blood group is found in Glycophorin A?

Ss

Which antigens are found in Glycophorin B?

Anti-Tja

Which antibody is associated with increased incidence of spontaneous abortions in early pregnancy?

Individuality

In the I blood group system, the “I” stands for:

Autoanti-I

Which antibody is associated with Cold Agglutinin Syndrome and Mycoplasma pneumonia infection?

CGD

The McLeod phenotype is associated with what disease?

Anti-K

Other than ABO, which antibody is commonly encountered in blood bank?

Lutheran and Sda

Which blood groups are associated with mixed-field agglutination?

• ABO

• Rh

• Kell

• Kidd

• Duffy

• SsU

• Lub

Clinically significant antibodies

• ABO

• Lewis

• P

• MN

• Lua

Naturally occurring antibodies

• Rh

• Kell

• Duffy

• Kidd

Warm antibodies

• M

• N

• P

Cold antibodies

Lewis

Which antibody can react in ANY phase?

• Duffy

• MNS

• Lutheran

• Rh

• Kidd

Which antibodies show dosage?

Anti-i

Which antibody is associated with infectious mononucleosis?

Anti-P

Which antibody is associated with PNH

17

Minimum donation age

110 lbs

Minimum weight requirement for donation

≥12.5 g/dL

Minimum hemoglobin for donation

≥11 g/dL

Minimum hemoglobin for autologous transfusion

≥33%

Minimum hematocrit for autologous transfusion

2 days

Deferral period for Aspirin

6 months

Deferral period for Avodart

3 years

Deferral period for Malaria or from an area endemic for Malaria

No deferral

Deferral period for Toxoid vaccine, treated and inactive TB patient, and recombinant growth hormone

40-60 mmHg

Tourniquet/Sphygmomanometer pressure for WB collection

16G

Needle gauge for blood donation

18G

Needle gauge for blood transfusion

<10 minutes

Time of blood collection

20-24 degC

Storage temperature for platelets

24 hrs

Collected WB units stored at 1-6 degC should be submitted within:

6-8 hrs

Collected WB units storer at 20-24 degC should be submitted within:

Platelet preparation

Whole blood submitted within 6-8 hours after collection can be used for:

Yellow

Color label for A

Pink

Color label for B

White

Color label for AB

Blue

Color label for O

6-8 hrs

Separation of blood components should be done within: