Fundamentals of Immunohematology Lecture Notes

Vocabulary flashcards covering the fundamentals of immunohematology, including historical milestones, blood preservation, component storage, genetics, and immunology as presented in the lecture notes.

Pope Innocent VII (1492)

The first account of blood transfusion where blood was directly transferred from three donors via a tube to the patient; all four individuals died due to a lack of knowledge regarding antigens and antibodies.

Braxton Hicks (1869)

Introduced the use of sodium phosphate as a blood preservative, which acts as a base to regulate pH levels.

Karl Landsteiner (1901)

Known as the father of immunohematology, he discovered the ABO blood group system, the first system identified.

Edward Lindemann (1913)

Performed the first blood transfusion using syringes and a cannula, improving upon the earlier tube method.

Albert Hustin (1914)

Introduced sodium citrate as a blood preservative; citrate is an acid that helps regulate pH levels.

Richard Lewisohn (1915)

Determined the minimum amount of sodium citrate required for anticoagulation to prevent clotting without negatively affecting blood cell counts.

Francis Rous and James Turner (1916)

Introduced citrate-dextrose as a blood preservative; dextrose (glucose) serves as a nutrient for the cells.

John Gibson (1957)

Introduced citrate-phosphate dextrose ($CPD$), which replaced $ACD$ as a blood preservative to maintain blood pH between $7.35$ and $7.45$.

AABB Donation Interval

The American Association of Blood Banks requires an interval of every $8\text{ weeks}$ ($2\text{ months}$) between donations.

DOH Donation Standard

The Philippine Department of Health standard for blood donation is every $3\text{ months}$, corresponding to the $90-120\text{ day}$ lifespan of red blood cells ($RBCs$).

Buffy coat

The middle layer of anticoagulated blood after centrifugation that contains white blood cells ($WBCs$) and platelets.

Cryoprecipitate

A blood component derived by thawing Fresh Frozen Plasma ($FFP$) and isolating the insoluble precipitates resuspended in plasma.

Deformability

The flexibility of the red cell membrane maintained by $ATP$; a decrease in $ATP$ leads to increased calcium and rigid cells like spherocytes or bite cells.

Spectrin

A membrane skeleton protein that maintains red cell membrane integrity and shape; its phosphorylation is dependent on $ATP$ levels.

2,3-diphosphoglycerate ($2,3-DPG$)

The component responsible for the red cell's affinity to oxygen ($O_2$); levels are directly proportional to oxygen content.

RBC Survival Rate

According to the FDA, at least $\text{75}\%$ of transfused red cells must be viable $24\text{ hours}$ post-transfusion.

Storage lesion

Biochemical changes in a blood unit during storage, including increased lactic acid and plasma potassium, and decreased glucose, $ATP$, and pH.

Citrate-Phosphate-Dextrose-Adenine ($CPDA-1$)

A blood preservative with a storage life of $35\text{ days}$ because adenine provides a base for $ATP$ formation.

Additive Solutions ($AS$)

Products like Adsol ($AS-1$) or Optisol ($AS-5$) that reduce the hematocrit of packed red cells and extend shelf life to $42\text{ days}$.

Mannitol

A component in additive solutions (like $AS-1$) that prevents hemolysis during prolonged red cell storage.

Glycerol

The most used cryoprotective agent for freezing red blood cells, allow for a storage life of up to $10\text{ years}$.

Rejuvenation

The process of restoring $2,3-DPG$ and $ATP$ levels in expired red cells using a solution of phosphate, adenine, and inosine, extending shelf life by $3\text{ days}$.

Blood Pharming

The culturing of red blood cells from hematopoietic stem cells ($HSCs$) to increase blood supply.

HBOCs and PFCs

Red blood cell substitutes; Hemoglobin-based oxygen carriers and Perfluorocarbons are gases or solutions designed to deliver oxygen to tissues.

Platelet Storage Conditions

Stored at $20^{\circ}C - 24^{\circ}C$ with constant agitation for a shelf life of only $5\text{ days}$.

Platelet Swirling

A physical viability check performed by shaking a blood bag to inspect for visible clumps, which indicates a lack of proper agitation.

Pan Genera Detection ($PGD$)

A rapid kit used to detect if bacteria in a platelet sample are gram-positive or gram-negative.

Platelet Apheresis

A procedure where a machine removes platelets from a single donor and returns the other components to the body; $1\text{ unit}$ is equivalent to $4-6\text{ units}$ of pooled concentrate.

Codominance

A non-Mendelian inheritance pattern where both alleles are equally expressed, such as the A and B alleles in the ABO blood group system.

HLA Typing

The determination of Human Leukocyte Antigens, critical for preventing graft rejection in organ transplants.

Innate Immunity

Non-specific defense present at birth consisting of physical barriers, phagocytes, $NK$ cells, opsonins, and complement.

Active Artificial Immunity

Immunity acquired through vaccination, where the body is stimulated to produce its own antibodies.

Passive Artificial Immunity

Immunity acquired through the transfusion of blood products containing pre-formed antibodies from a donor.

Opsonins

Substances that label or tag antigens to present them to phagocytes for destruction.

Complement System

A series of proteins that function in cell lysis, opsonization, and inflammation via classical, alternative, or lectin pathways.

Cardinal Signs of Inflammation

Rubor (redness), Tumor (swelling), Calor (heat), Dolor (pain), and Functio Laesa (loss of function).

IgM

The largest immunoglobulin (pentamer) responsible for the primary immune response; it is a cold agglutinin and the most efficient at fixing complement.

IgG

A small immunoglobulin responsible for the secondary immune response; it is a warm agglutinin that reacts at $37^{\circ}C$.

Antisera

Laboratory-manufactured suspensions of antibodies used to detect specific antigens on red blood cells.

Affinity

The binding strength of a single antigen-antibody reaction ($1\text{ Fab}:\text{1 Ag}$).

Avidity

The total binding capacity of an antibody with multiple antigens.

Immunogenicity

The ability of an antigen to elicit an immune response; proteins are highly immunogenic, and the Rh group is the most immunogenic blood group.

Duffy Blood Group System

A system where individuals lacking $Fy^a$ or $Fy^b$ antigens are resistant to malaria caused by Plasmodium vivax.

Prozone

A state of antibody excess in an antigen-antibody reaction which can result in false-negative or weak agglutination.

Zeta Potential

The electrical charge around red cells that keeps them apart; reduced by Low Ionic Strength Solution ($LISS$) to enhance agglutination.

Polyethylene Glycol ($PEG$)

The most preferred additive for the enhancement of antigen-antibody reactions, stronger than albumin or $LISS$.

Enzymatic Effect on BGS

Enzymes like papain decrease reactions for Duffy ($Fy^a$, $Fy^b$) and $MNS$ systems but increase reactions for Rh, Kidd, and Lewis systems.

Direct Antiglobulin Test ($DAT$)

A Coombs test used to detect if red blood cells have been coated with antibodies or complement in the body.