MLSP FINALS IMMUNOLOGY, SEROLOGY, AND BLOOD BANKING

Immunology

- study of immune system (prevents the establishment of infection in the body)

- Study of molecules, cells, tissue, organs, andsystems whose function is to recognize and dispose harmful substances or foreign substances

- Study of desirable and undesirable consequences (autoimmune disorders such as genetics and other factors) of the immune system

- one of the sections in clinical laboratory

SEROLOGY

- study of Antigen-antibody reactions

- Study of non-cellular component of the blood called SERUM

- Samples used in Serological Test:

o Serum (most commonly used)

o CSF

o Urine

o Stool

ANTIGEN

- Also known as Foreign Substances

- Stimulate the immune system

- Substances that induce or elicit an immune response

- Substances that induce or elicit the production of antibodies

- It causes sickness

ANTIBODIES

• Also known as Immunoglobulins

- One of the major substances produced by the immune system that will block harmful antigen

- antibodies are proteins in terms of chemical composition

- it attaches to the antigen or to the cell that is infected by an antigen

- antibodies belong to specific immunity

- Functions:

o Cell toxicity

o Neutralization

o Opsonization (immune process which uses opsonins to tag foreign pathogens for elimination by phagocytes)

AGGLUTINATION

• Whole blood

• Antigen involved are particulate

PRECIPATION

• Serum and other body fluids

• Antigen involved are soluble antigens

Venereal Disease Research Laboratory (VDRL)

test

• Only use for screening for syphilis, uses

  heated serum (above 37 °C)

• Principle: flocculation

Ezyme Linked Immunosorbent Assay (ELISA)

• also known as Enzyme Immunoassay

• Measures enzymatic reactions

• Uses enzymes as labels

• Enzyme labels:

Highly stable

Extreme specificity

Cannot be altered by inhibitors

• more specific and more prone to contamination positive

result: color change

Rapid Plasma Reagin (RPR)

• Only use for screening for syphilis, uses unheated serum

• Principle: flocculation (white clumping)

Fluorescent Immunoassay

• uses fluorescent compounds known as fluorophores or fluorochrome as labels

• Positive Reaction: emission of light

• Requires microscopy

Radioimmunoassay

• uses radioactive substances as label

• Positive Reaction: emission of light

• Requires microscopy

IMMUNITY

- the condition of being resistant to infection

- the recognition of foreign substances and subsequent production of antibodies to these substances.

- can be classified as either innate or acquired.

NATURAL IMMUNITY

• Innate/non-adaptive/non-specific

• ability of an individual to resist infections by means of normally present body functions.

• present at birth

• WBCs, cytokines, anti-inflammatory

• agents, complement systems

ACQUIRED IMMUNITY

• adaptive/specific

• a reaction resulting from invasion o foreign substances

• antibodies (important player)

ACTIVE

 the body is involved in producing antibodies

• Natural Active

• Artificial Active

PASSIVE

the body is being provided with antibody

• Natural Passive

• Artificial Passive

BLOOD BANKING

- Refers to the collection, processing, typing and storage of whole blood and other blood products

- Also known as Immunohematology

- Study of immunologic principles applied in blood group specific antigens and antibodies

- It also deals with mechanism of blood typing and crossmatching, detection and measurement of antibody titers, screening of donors for blood donation, bleeding techniques, proper labeling, storing and disposal of blood emphasis on quality assurance

 Forward or Direct Typing

• Detection of antigens on patients RBC using known commercial anti-sera (antibodies)

• Uses dermal puncture

Reverse or Back typing

Detection of antibodies in serum of patient with known commercial RBCs (Substitute: Type O and NSS solution)

Allogenic Donation 

 Involves donation of blood for the use of general public

Directed Donation 

 Involves donation of blood use of specific patient

Autologous Donation

Donate blood for your own use in the future

Apheresis Donation 

donate specific component of blood

REGISTRATION

- Get the vital information from the donor

• Name

• Address

• Telephone number

• Date and Time of Collection

• Gender and Birthdate

• Age

▪ Minimum age: 17 years old

▪ In the Philippines: 18 years old

▪ If below 18 years old, you need consent from the guardians or parent

HEALTH OR MEDICAL HISTORY

- Interview sheet or questionnaire must be given

- Questionnaire are designed to ensure safety for the donor and recipient

- Questions might ensure safety of the donor, like:

• Are you feeling healthy today?

• Do you have a positive result for Hepatitis B Virus?

PHYSICAL EXAMINATION

- Weight

• Minimum weight requirement is 50kg/110lbs

• There should be 10.5mL/kg to be donated

• Maximum amount of blood for blood bag is 525mL

• Anticoagulant present is 63mL

- Temperature

• Required temperature is not >37°C or 99.5°F

- Blood Pressure

• Systole: not <180mmHg

• Diastole: not <100mmHg

- Pulse Rate

• Use the index finger or the middle finger or both

• Count in 1 full minute

• Normal Value: 50-100 or 60-100bpm

- Hemoglobin and Hematocrit

• Standard method: cyanmethemoglobin

• Screening Test: Copper Sulfate Solution

• Accept: If the blood SINK within 15 secs: >12.5g/dL

• Defer: If the blood FLOAT within 15 secs.: <12.5g/dL

SIX STEPS IN DONOR SCREENING AND COLLECTION

1. registration

2. health or medical history

3. physical examination

4. phlebotomy

5. post-donation

6. serological testing of donor’s blood

Whole Blood

blood collected before separation into components

Components

parts of whole blood that are separated

 Closed System

 a sterile system of blood collection

Open System

when the collection is exposed to air, decreasing expiration date

Whole Blood (Fresh Whole Blood Cells)

• Stored: 1-6°C

• Transport: 1-10°C (place inside the ice box)

Red Blood Cells

• Stored: 1-6°C

• Transport: 1-10°C (place inside the ice box)

Platelets

• Stored: 20-24°C (room temperature w/

  constant agitation)

Fresh Frozen Plasma

• Stored: 1-6°C

• Transfused within 24 hours

Cryoprecipitate

• Stored: -18°C for 1 year

Plasma and Liquid Plasma

• Stored: -18°C

APHERESIS

- Separate the blood component

- 2 Methods:

• Intermittent: 1 vein

• Continuous: 2 veins

- Anticoagulant: Heparin

- Advantages:

• Large volume of blood

• Removal of unwanted substances

Platelet apheresis

• collection of platelets by apheresis while returning the RBCs, WBCs, and component plasma

• coagulation disorders

Leukapheresis

• removal of PMNs, basophils, eosinophils for transfusion into patients whose PMNs are ineffective or where traditional therapy has failed

• autoimmune disorders and cancers

Plasmapheresis

• collection of blood plasmas by apheresis while returning the RBCs, WBCs, and platelets

• passive immunity treatment