Transfusion Pathology

1. Transfusion pathology Kristine Krafts, M.D. September 24, 2007

3. intro Rh ABO products other groups indications testing dangers

10. Type A intro Rh ABO products other groups indications testing dangers What are the antigens? Type B Type AB Type O

12. H antigen A antigen B antigen intro Rh ABO products other groups indications testing dangers

14. O None OO AB A and B AB B BO BB AO AA Genotype B A A Blood type Antigens intro Rh ABO products other groups indications testing dangers

15. How common is each blood type? 42% O 6% AB 12% B 40% A Percent of population Blood type intro Rh ABO products other groups indications testing dangers

17. Type A intro Rh ABO products other groups indications testing dangers So what? Type B Type AB Type O

18. anti-A anti-B none anti-A anti-B Antibodies O None OO AB A and B AB B BO BB AO AA Genotype B A A Blood type Antigens intro Rh ABO products other groups indications testing dangers

19. Compatible blood types * type O = universal d O nor! O O AB B A Recipient blood type AB, A, B, or O B or O A or O * Donor blood type intro Rh ABO products other groups indications testing dangers

20. O AB A B

23. Rh - none dd Rh + Dd DD Genotype D Rh + D Blood type Antigens intro Rh ABO products other groups indications testing dangers

31. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS

32. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS

33. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS

34. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets BLOOD PRODUCTS Fresh Frozen Plasma

35. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma VIII Cryoprecipitate BLOOD PRODUCTS IX Albumin IgG

37. Whole Blood Use: massive hemorrhage RBC WBC platelets plasma Contents: INDICATIONS

38. Whole Blood Red Cells Use: low hemoglobin RBC a few WBC a few platelets a little plasma Contents: INDICATIONS

39. Whole Blood Red Cells Granulocytes Use: sepsis in neutropenic patients neutrophils Contents: INDICATIONS

40. Whole Blood Red Cells Granulocytes Platelet-rich plasma INDICATIONS

41. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Use: bleeding due to thrombocytopenia platelets Contents: INDICATIONS

42. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Use: bleeding due to multiple factor deficiencies (e.g., DIC) Plasma (including ALL coagulation factors) Contents: INDICATIONS

43. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate Uses: low fibrinogen, vW disease, hemophilia A fibrinogen von Willebrand factor VIII Contents: INDICATIONS

44. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate INDICATIONS A bunch of other stuff Use: rarely used

47. patient red cells (type A) FORWARD TYPE anti-A antibodies AHG Forward typing is done using both anti-A and anti-B antibodies!

48. patient serum (with anti-B Ab) AHG reagent red cells (type B) REVERSE TYPE Reverse typing is done using both type A and type B reagent cells!

49. patient serum AHG donor red cells CROSSMATCH

50. patient serum AHG reagent RBC number 1 patient serum AHG reagent RBC number 2 ANTIBODY SCREEN no agglutination (negative test) agglutination (positive test)

60. What’s the risk of getting an infection? One in 50,000 Hepatitis C One in a million Bacterial infection One in 100,000 HTLV One in 100,000 Hepatitis B One in 2 million HIV One in a million Other infections Risk Bug intro Rh ABO products other groups indications testing dangers

61. What’s the risk of other complications? One in 100 (severe: one in 20,000) Allergic reaction One in 4,000 (fatal: one in 4 million) Delayed hemolysis One in 3,000 Circulatory overload One in 200 Febrile reaction One in 20,000 (fatal: one in 600,000) Acute hemolysis Risk Complication intro Rh ABO products other groups indications testing dangers