G R V r i & s r s i n h a a t si r e p p i v tahir99-VRG & vip.persianss.ir BASIC & APPLIED CONCEPTS of BLOOD BANKING and TRANSFUSION PRACTICES Third Edition tahir99-VRG & vip.persianss.ir YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK ACTIVATE THE COMPLETE LEARNING EXPERIENCE THAT COMES WITH YOUR BOOK BY REGISTERING AT http://evolve.elsevier.com/Blaney/bloodbank/ Evolve Resources for Basic & Applied Concepts of Blood Banking and Transfusion Practices offers the following features: • Case Studies • Laboratory Manual REGISTER TODAY! tahir99-VRG & vip.persianss.ir BASIC & APPLIED CONCEPTS of G and BLOOD BANKING R -V r i & s r s i n h TRANSFUSION PRACTICES a a i t rs e p ip v Kathy D Blaney, MS, BB(ASCP)SBB Third Edition Tissue Typing Laboratory Florida Hospital Orlando, Florida; LifeSouth Community Blood Centers Gainesville, Florida Paula R Howard, MS, MPH, MT(ASCP)SBB Community Blood Centers of Florida A Division of OneBlood, Inc Lauderhill, Florida tahir99-VRG & vip.persianss.ir 3251 Riverport Lane St Louis, Missouri 63043 BASIC & APPLIED CONCEPTS OF BLOOD BANKING AND TRANSFUSION PRACTICES Copyright © 2013 by Mosby, an imprint of Elsevier Inc Copyright © 2009, 2000 by Mosby, Inc., an affiliate of Elsevier Inc ISBN: 978-0-323-08663-9 All rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) G R V r i & s r s i n h a a t si r e p p i v Notices Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein International Standard Book Number: 978-0-323-08663-9 Publishing Director: Andrew Allen Content Manager: Ellen Wurm-Cutter Publishing Services Manager: Catherine Jackson Senior Project Manager: David Stein Design Direction: Maggie Reid Working together to grow libraries in developing countries Printed in the United States www.elsevier.com | www.bookaid.org | www.sabre.org Last digit is the print number:  9  8  7  6  5  4  3  2  tahir99-VRG & vip.persianss.ir This book is dedicated to my family, Tommy and Sean, for their support And to all the students and professionals I have worked with throughout my career in immunohematology KDB This third edition is dedicated in loving memorium to my parents, William and Olga Juda, who encouraged my individuality and desire for continuous learning and to my partner, Jack, for his perpetual belief and support of my professional goals And as always to all of my former CLS students who energized my personal joy of learning and inspired my desire for excellence in teaching PRH tahir99-VRG & vip.persianss.ir This page intentionally left blank tahir99-VRG & vip.persianss.ir Reviewers Charlotte Bates, MEd, MT(ASCP) Instructor Medical Laboratory Science Department Armstrong Atlantic State University Savannah, Georgia Dorothy A Bergeron, MS, CLS(NCA) Associate Professor and Program Director Clinical Laboratory Science Program Department of Medical Laboratory Science University of Massachusetts Dartmouth North Dartmouth, Massachusetts Kim Boyd, MS, MT(AMT) Assistant Professor Medical Laboratory Technology Program Amarillo College Amarillo, Texas Cara Calvo, MS, MT(ASCP)SH Program Director and Lecturer Medical Technology Program Department of Laboratory Medicine University of Washington Seattle, Washington Linda Collins, MS, MT(ASCP) Instructor Delaware Technical and Community College Georgetown, Delaware Max P Marschner, MBA, MT(ASCP)SBB, CHS Manager, Tissue Typing Lab Florida Hospital Medical Center Orlando, Florida Nicole S Pekarek, MAT, MT(ASCP) Instructor Clinical Laboratory Science Instructor Winston-Salem State University Winston-Salem, North Carolina Ellen F Romani, MHSA, MT(ASCP)DLM, BB Department Chair Medical Laboratory Technology Program Spartanburg Community College Spartanburg, South Carolina Judith A Seidel, MT(ASCP)SBB Clinical Instructor, Immunohematology Clinical Laboratory Science Program Indiana University Health Indianapolis, Indiana Melissa Volny, MT(ASCP)SBB, MBA Coordinator of Transfusion Services Centegra Health System McHenry, Illinois; Elgin Community College Elgin, Illinois Terry Kotrla, MS, MT(ASCP)BB Department Chair and Professor Medical Laboratory Technology Program Austin Community College Austin, Texas vii tahir99-VRG & vip.persianss.ir This page intentionally left blank tahir99-VRG & vip.persianss.ir Preface Basic & Applied Concepts of Blood Banking and Transfusion Practices was developed for students in 2- or 4-year medical laboratory science programs, laboratory professionals undergoing retraining, and other health care professionals who desire knowledge in routine blood banking practices Basic didactic concepts are introduced, and the practical application of these theories to modern transfusion and blood bank settings is emphasized The third edition includes updates to the ever-changing field of blood banking Donor criteria and testing have been updated to include the current donor restrictions, infectious disease testing methods, and current requirements for viral marker testing A new chapter was added to address automation for the transfusion service The section on molecular techniques applying to blood banking was expanded, accompanied by an expanded section on HLA The chapter on blood components and therapy includes a description of new products such as leukoreduced components and red cell apheresis This textbook provides important features to assist both the student and the instructor Each chapter features: • Chapter outlines listing the important elements in the chapter • Learning objectives for use by both the student and the instructor • Study questions for self-assessment • Key words with definitions on the same page • Chapter summaries, in varying formats, to provide a succinct overview of the chapter’s important points • Critical thinking exercises to illustrate the practical applications to the clinical environment • Illustrations and tables designed to reinforce and summarize the most important information found in the chapter The third edition’s presentation of topics was reorganized to improve the overall flow of the information We also included additional details on some topics more appropriate for the 4-year medical laboratory science programs The third edition also has an accompanying Evolve website where the ancillaries are highlighted For students, the ancillaries include additional case studies and access to the laboratory manual The instructor ancillaries include an image collection that features figures found in the text, an extensive collection of test bank questions as well as answers to the critical thinking exercises, and PowerPoint presentations for each chapter that include illustrations appearing in this text We are very appreciative of the editors at Elsevier for their patience and professionalism in the manuscript review and publication process for this third edition We are proud of the final product, which is user friendly to students and instructors Kathy D Blaney Paula R Howard ix tahir99-VRG & vip.persianss.ir 376 INDEX Black populations (Continued) MNS blood group in, 150t P1PK blood groups in, 145t Rh blood group system in, 112, 112t-113t Blocking phenomenon in D testing, 254 defined, 254 Blood, autologous, crossmatching, 202, 204 Blood banking reagents, 31-32 See also Reagents; specific reagents categories of, 31 quality control for, 32 regulation of manufacture for, 31-32 Blood banks See also Quality Control programs; Safety programs change to automated testing in, 209 molecular technology in, 69, 69t QA departments of, 348 Blood-borne diseases, in health history interview, 272 Blood collection bag labeling in, 276 bags for, 305, 305f special apheresis, 281 autologous donations, 279-280, 279t directed donations, 280 Blood collection and storage, 305-309 additive solutions, 307-308 anticoagulant-preservative solutions, 307, 307t rejuvenated solutions, 308-309 storage lesions, 306-307, 306f Blood components administration of, 324-325 apheresis granulocytes, 321 availability of, 304 checklist for receiving, 323t defined, 304 distribution and administration, 321-325 indications for, 325, 325t-326t labeling of, 321-323, 322f in liver transplant procedure, 333 plasma, 318-321, 319t, 321f platelets, 316-318, 316f, 318f preparation of, 309-321, 310f red blood cells, 311-316, 312f-315f storage of, 323 transfused during transplant surgery, 333, 333t transportation of, 323-324, 323f, 323t Blood donation, types of, 268 Blood donor educational materials, 268-269, 269f Blood donors See also Donor screening adverse reactions in, 277, 278t, 282 criteria for, 267-268, 282 identification of, 276 screening of, 268-276 universal, 90 The Blood Group Antigen Facts Book (Reid and Lomas-Francis), 67 Blood group collections, 143 Blood group genetics terminology, 60-67, 60f-67f, 63t-64t Blood group systems, 59, 150, 151t See also specific blood group systems assignment of antigens to, 78, 79t chromosomal assignment of genes for, 64, 64t composition of, 78 functional roles of, 127, 128t genetic pathways in, 60 physiologic functions related to red cell membranes of, 127, 128t polymorphic, 61-62 study of, 60, 127-128 Blood loss, iatrogenic, 332 Blood order schedule, 201, 204 Blood pressure diastolic, 275 in donor screening, 275, 276t Blood products See also Blood components autologous blood, 202, 204 bacterial contamination of, 236-237 checking, 198-199, 199t emergency release of, 200, 200t for infants, 202-204 issuing, 198-199, 199t leukocyte reduced, 19 in massive transfusion, 201 MSBOS for, 201 storage of, 199, 308t T/S protocols for, 201-202 tagging, 198, 199t urgent requirement for, 199-200, 200t, 204 Blood supply, maintaining adequate, 268 Blood Transfusion Therapy, a Physician’s Handbook (AABB), 324, 341 Blood transfusions, and HLA sensitivity, 22 See also Transfusion therapy.; Transfusions Blood unit records, retention of, 349, 349t-350t Blood warmer, 147 Bombay phenotype, 82, 100-101 Bovine serum albumin (BSA) in antibody screening, 161, 162t enhancement properties of, 49 preparation of, 48 Bradykinin defined, 229 in AHTR, 229 Bromelin enzyme, 48 C Calculated panel reactive antibody (CPRA), 22 Cancer, transfusion support in, 336-337, 338t, 342, 342t Capture-R® test procedure, 213-216, 213t, 217f Capture Ready-Screen, 215-216, 216f, 218f Capture technology, 213-214 See also solid phase red cell adherence assays Capture Workstation, 213-214, 215f Carbohydrates, defined, immunogenicity of, Carcinoma, and antibody detection, 162 Cardiac surgery, transfusion support for, 330-331, 342, 342t Cardiopulmonary bypass, transfusion support in, 333 Cartwright blood group system, 151t Cell separation techniques, 166 Cell-separator machine, 281, 282f Centers for Disease Control and Prevention (CDC), and Hemovigilance Model, 227 Centers for Medicare and Medicaid Services (CMS), 346 Centrifugation in agglutination, 17 of whole blood, 309 Chagas disease, 273, 273t, 299-300 Change control defined, 352 example plan, 352, 353f goal of, 352 Check cells, 46-47 Chemical hazards, classification of, 359 Chemiluminescence, 291 Chemokines action of, 134-135 defined, 134 Chemotactic, defined, 14 Chemotactic proteins, 13-14 Chemotherapeutic agents, 336-337 Chido/Rodgers blood group system, 151t Children See also Infants ABO titers in, 88, 88t transfusion therapy for, 331-332 Chimerisms artificially induced, 96 defined, 72 studies of, 72 Chromosomes defined, 60 location of, 60f Chronic granulomatous disease defined, 133 in McLeod syndrome, 133 Chronic hematologic problems, transfusion support for, 329 Chronic renal disease, transfusion support in, 337, 338t, 342, 342t Circulatory overload, transfusionassociated, 237 Cis, use of term, 65 Citrate toxicity, 237-238 Classical pathway, for activation of complement proteins, 13, 13f Clinical insignificance of anti-I, 143 defined, 143 Clinical laboratories, cost-effectiveness of, 212-213 Clinical Laboratory Improvement Amendments (1988), 353-354 Clinical significance defined, 88 determining, 127-128 of Duffy antibodies, 138, 138t of Kell antibodies, 138, 138t of Kidd antibodies, 138, 138t in transfusion medicine, 88-89 Clone, Closed system, 305 INDEX Coagulation, process of, 318 Coagulation factors in cardiac surgery, 330-331 in FFP, 318 sources of, 319t Code of Federal Regulations (CFR), 31, 267-268 for acceptable blood donors, 282 OSHA, 347 Codominant inheritance pattern, 62 Cold hemagglutinin disease auto-I associated with, 144 defined, 144 “Cold panel”, 175-176, 175f Collection tubes, for compatibility testing, 195-196 College of American Pathologists (CAP), 191 College of American Pathologists (CAP) Survey, 355-356 Colloids, as alternative to transfusion therapy, 341, 342t Colony-stimulating factors (CSFs), 336-337, 338t Colton blood group system, 151t Column agglutination, in antibody screening, 161, 162t Combs control cells, 46-47 Compatibility testing antibodies missed in, 194 comparison with previous records in, 196 defined, 188-189 for exchange transfusions, 260 history of, 189-190, 190f and life-threatening hemorrhage, 199-200 pretransfusion testing on recipient sample, 197-198 process of, 188, 189f, 203 repeat testing of donor blood in, 196, 197f sample collection tubes for, 195-196 selection of ABO donor units for, 198, 198t selection of antigen-negative donor units for recipients with antibodies, 198 selection of D antigen donor units for, 198 steps in, 194, 194t age of sample, 196 patient identification and sample labeling, 195, 195f recipient blood sample, 194-196 sample collection and appearance, 196 and tagging donor unit, 198, 199t use of term, 188 Competency assessment corrective actions taken, 354 defined, 353 performing, 354 periodic, 353-354 purpose of, 353 Complement activation and ABO blood group, 88-89 and red cell destruction, 45-46 Complement family, components of, 12 Complement pathway, in AHTR, 229 Complement proteins, biological effects mediated by, 14t Complement systems, 12-14, 13f comparison of classical and alternative, 13f defined, 12 Compound antigens defined, 117 examples of, 117 on Rh proteins, 118t Computer crossmatch, 189-190, 192-193 advantages of, 193 first use of, 193 requirements for, 193t Constant regions, Cord blood, 81 ABO antigens in, 80-81 ABO typing of, 255 Wharton’s jelly in, 94 Cord samples, group O, 175-176 Cordocentesis for direct intravascular transfusion to fetus, 252-253 in HDFN diagnosis, 252-253 Corrected count increment (CCI) calculation of, 316-317, 316f defined, 316 Cost blood group collection, 151t CPRA See Calculated panel reactive antibody Creutzfeldt-Jakob disease, in health history interview, 272, 273t Critical products, 354 Cromer blood group system, 151t Crossing over defined, 66-67 unequal, 67f Crossmatch, 31, 31t abbreviated, 192 antiglobulin, 192 compatible, 193, 203 compatible versus incompatible, 191t computer, 204 (see also Computer crossmatch) defined, 166 immediate-spin, 189-190, 192 in transfusion reaction investigation, 240 incompatible, 166, 203 indications for, 190 principles of, 190-191, 191t procedures, 190-191, 190f, 192f, 203 computer crossmatch, 192-193, 193t serologic crossmatch, 192, 192f purposes of, 191 serologic, 203 types of, 203-204 unexpected incompatibilities in, 194, 194t Crossmatch testing indications for, 198 limitations of, 193-194 Crossmatches, incompatible, 194, 194t with anti-A1, 89 occurrence of, 89 377 Crossmatching, 188 See also Compatibility testing during acute emergency, 200 of infants, 202-203 CRYO See Cryoprecipitated AHF Cryoprecipitate, 319-321 defined, 203 pretransfusion testing for, 203 Cryoprecipitated AHF (CRYO), 319-321, 325, 325t-326t calculating dose for, 321f clinical uses of, 320 components of, 320 plasma cryoprecipitate reduced, 320 pooled, 320, 321f quality control of, 320 storage of, 308t storage of pooled, 308t thawing of, 320 Cryoprotective, defined, 314 Crystalloids, as alternative to transfusion therapy, 341, 342t Current Good Manufacturing Practices (cGMP), 345-346 elements of, 348t of FDA, 304-305 Cytapheresis, 337t Cytokines, Cytomegalovirus (CMV) detection of, 299 transfusion-transmitted, 332 transmission of, 299 D D antigens concentration for, 114f discovery of, 108 immunogenicity of, 112 inheritance of, 112, 114f phenotyping of, 36-37, 36t, 37f discrepancies in, 37 reagents for, 36-37, 37f in Rh blood group, 11 sources of antigen and antibody for typing of, 31t weak D, 112-115, 114t, 115f, 116t genetic expression, 115 older terminology for, 114-115 partial D, 115-116 position effect on, 115, 116f required testing of, 117 significance of testing for, 116-117 test for, 114t, 115f, 116 “d”, notation of, 110 D testing, for HDFN, 254, 254t D typing, for donors units, 288 DARC gene, 135 DAT See Direct antiglobulin test Data handling, automation of, 211 See also Automated systems DDAVP, 338t Deacetylating, defined, 93 Deacetylating enzyme, 93 Decontamination, in blood bank safety program, 359 Deglycerolized process, 314, 315f Deglycerolized red blood cells, 314, 315f 378 INDEX Delayed hemolytic transfusion reaction (DHTR), 230 blood group antibodies associated with, 230-231 cause of, 230 compared with AHTRs, 231t management of, 231t pathophysiology of, 231 sign of, 230, 231t Delayed serologic transfusion reaction, 232-233 Deoxynucleotide triphosphates (dNTPs), 73 Dialysis patients, N-like antibody in, 150 Diastolic blood pressure defined, 275 in donor screening, 275 Diego blood group system, 151t 2,3-diphosphoglycerate (2,3-DPG), red cell, storage of, 306-307 Direct antiglobulin test (DAT) in antibody detection, 160-161, 165 defined, 41 differential, 45, 46t, 215, 216f distinguished from IAT, 41-42, 44t indications for, 42 interpreting positive, 174, 174t positive, 42, 42t, 179t procedure, 42, 42f, 44t in Rh HDFN, 248 in risk of HDFN, 255 Direct exclusion, in relationship testing, 68-69 Directed donations, 280 crossmatching, 202 defined, 268 Disseminated intravascular coagulation (DIC) caused by hemorrhage, 329-330 transfusion support for, 340-341 Dithiothreitol (DTT) treatment, eliminating antigen reactivity by, 170, 170t Diversion pouch, 277, 278f DNA, in HLA typing SBT, 72 SSOP technique, 71-72, 71f SSP test method, 71, 71f STR testing, 72 DNA probe described, 71 in SSOP technique, 71-72 Document control, 349 See also Record keeping Documentation during acute emergency, 200 for administration of blood components, 324 of reagent use, 32 Dolichos biflorus lectin reagent, 85 Dombrock blood group system, 151t Dominant inheritance pattern, 62 Donath-Landsteiner antibody, 146-147 Donath-Landsteiner test, 147f Donation time, 277 Donor blood samples, routine typing of, 89 Donor blood testing, 286-287 categories of, 287 goal of, 287 immunohematologic ABO and D phenotype, 287-288 antibody screen, 288 for infectious disease for bacterial contamination of blood components, 300 Chagas disease, 299-300 cytomegalovirus, 299 human retroviruses, 295-297, 296f-298f recipient tracing (Look-back), 299 serologic tests for syphilis, 288-289 viral hepatitis, 292-295, 293f-294f, 293t viral marker testing, 289-292, 289f-290f, 290t West Nile virus, 298-299 required, 287, 287t sample for, 287 Donor centers, pediatric units prepared at, 203 Donor Disease Marker Testing, 301, 301t Donor History Questionnaire (DHQ), 267-268, 270, 271f-272f Donor records, retention of, 349, 349t-350t See also Record keeping Donor screening, 268-276 educational materials for, 268-269, 269f health history interview in, 270t, 271f-272f and informed consent, 276 physical examination in, 275-276, 276t registration, 268, 282 Donor testing importance of subgroup identification in, 86 and molecular testing, 69t Donor unit, in transfusion reaction investigation, 241 Donors, blood adverse reactions in, 277, 278t, 282 criteria for, 267-268, 282 identification of, 276 screening of, 268-276 universal, 90 Doppler ultrasound, HDFN detected with, 251 Dosage effect, 65, 65f Duffy blood group system, 134, 134t, 152t antibodies of, 135, 138t antigens of, 134, 135t biochemistry of, 134-135 characteristics of, 134, 135t discovery of, 134 Fya and Fyb, 134-135 common frequencies in, 134, 134t common phenotypes in, 134, 134t genetics of, 135 and malaria, 136 Dysfibrinogenemia, 320 E ECHO technology, 213-214, 214f EDTA See ethylenediaminetetraacetic acid Educational materials, for donor screening, 268-269, 269f Elderly, ABO antibody titers in, 88t Eluate, 178-180 nonreactive, 180 preparing, 180 Elution A antigen demonstrated with, 85-86 defined, 86 freeze-thaw method of, 178-180 methods of, 179t principle of, 179f process, 178-180 Emergency situations, release of blood products in, 199-200, 200t Engraftment evaluations, 72 See also Chimerism Enhancement media, 47 See also Antibody potentiators Environmental Protection Agency (EPA), 347-348 Enzyme immunoassay (EIA), 289 Enzyme-linked immunosorbent assay (ELISA), 289-291 competitive, 287, 289-291 indirect, 289 methodologies, 289, 289f principle of, 289, 290f sandwich, 287, 289-291 term and definitions, 289, 290t Enzymes See also Ficin enzymes; Papain enzymes bromelin, 19 deacetylating, 93 glycosyltransferase, 82 proteolytic, 47-48, 47t transferase, 82 Epitopes, defined, multiple, 11f Equipment, in QA programs, 355, 355f Errors, contributing to AHTR, 229-230, 230t Erythroblastosis fetalis, 246-247 See also Hemolytic disease of fetus and newborn Erythropoietin, 338t Erytype S technology, 217, 220f Ethylenediamine tetraacetic acid (EDTA) anticoagulant, for performing DAT, 174 Ethylenediaminetetraacetic acid (EDTA)glycine acid, 129-130 Ethylenediaminetetraacetic acid (EDTA) tube, 42 Exchange transfusions for HDFN, 259-260 purpose of, 260 in Rh HDFN, 248 selection of blood for, 260, 260t Expiration limits, for blood components, 307-308, 308t Eyewash device, 357 INDEX F Fab (fragment, antigen-binding), 4f, Facilities, in QA programs, 355, 355f Factor VIII deficiency, CRYO for, 320 Factor VIII:C deficiency, CRYO for, 320 False-negative results in antiglobulin tests, 43-44, 44t with IgG-sensitized red cells, 47 False-positive results in antibody screen, 159-160 in antiglobulin testing, 43-44, 44t defined, 36 negative reagent control for, 36 Fatalities, FDA reportable, in transfusion reaction investigation, 241 Father, alleged, in relationship testing, 68-69 Fc (fragment, crystallizable), 4f, 5, 6f Febrile nonhemolytic reaction, 233 Fetal screen (rosette test), 258 Fetomaternal hemorrhage (FMH) defined, 247 at delivery, 247 quantifying, 258, 258f-259f screening for, 257-258, 257f Fetus See Hemolytic disease of fetus and newborn Fibrinogen deficiency, CRYO for, 320 Ficin enzyme, 48 and antibody detection, 161, 162t and Duffy antigens, 134 Kell antigens treated with, 130 resistance of Lutheran antigens to, 138 Filter standard 170-µm, 312-313 for administration of blood components, 324 Fisher-Race genetic theory, 109f, 109t-110t, 110 Flow chart, for T/S testing decision making, 202, 202f Fluid replacement, postdonation, 277 Food, Drug and Cosmetic Service Act (1938), 346 Food and Drug Administration (FDA), U.S., 31, 191, 346 and CFR, 267-268 Code of Federal Regulations, 304-305 and computer crossmatching, 193 current good manufacturing practices of, 304-305 fatal transfusion reactions reported to, 227, 227t Good Manufacturing Practices, 360-361 policy enforcement of, 346 quality assurance programs of, 345-346 Forward grouping, 89 Fresh frozen plasma (FFP), 318-319 coagulation factors in, 318, 319t dose for, 319 indications for use of, 318 preparation of, 309-311, 310f storage of, 308t thawing of, 319-320 “Fresh red cells”, for newborns, 306-307, 332 Frozen plasma See also Fresh frozen plasma defined, 203 pretransfusion testing for, 203 L-fucosyltransferase, 140 FUT2 gene, 101 Fy allele, 136 G G antigens, 118 Gel cards, with ORTHO ProVue, 221-222 Gel electrophoresis, for amplicon assessment, 71 Gel technology, 50 in antibody screening, 161, 162t applications, 50 automated platforms for, 208 categories of gel cards for, 50 history of, 49 procedure, 49-50, 51f Gene frequencies, calculating, 68 Genes defined, 60-61 location of, 61, 62f silent, 63, 63t suppressor, 63, 63t Genetic interaction cis position in, 65, 65f trans position in, 65, 65f Genetic loci, 61, 62f Genetics See also Molecular genetics; Population genetics of ABO blood group system, 86-87, 87f, 87t blood group terminology in, 60-67, 60f-67f, 63t-64t Mendelian and ABO blood group system, 86-87, 90t principles of, 63-64, 63f terminology, 60-67 chromosomal assignment, 64, 64t crossing over, 66-67, 67f genes, alleles, and polymorphism, 61-62, 62f genetic interaction, 65, 65f heterozygosity and homozygosity, 64-65, 64f-65f inheritance patterns, 62 linkage and haplotypes, 65-66, 66f Mendelian principles, 63-64, 63f phenotype vs genotype, 61 Punnett square, 61, 62f silent genes, 63, 63t Genotype, use of term, 111-112 Genotypes, 61 determination of, 61 phenotype vs., 61, 61f in relationship testing, 68-69, 69t Genotyping, fetal, 253 Gerbich blood group system, 151t GLOB blood group system antibodies of, 144, 145t, 146-147 antigens of, 144-145, 145t, 146f biochemistry of, 145-146, 146f frequencies for, 144, 145t phenotypes of, 144, 145t 379 GLOB collections, antigens assigned to, 144 Globoside blood group system, 144-147 Gloves, as protective barrier, 358 Glucose, red cell, in storage, 306-307 Glycolipids, 10-11 Glycophorin, 148 Glycophorin A (GPA), 148 Glycophorin B (GPB), 148 Glycoproteins, 10-11 Duffy, 134-135 Kell, 129-132 Glycosyltransferase enzyme defined, 82 function of, 82 Gonorrhea, 274 Graft survival, transfusion support for, 333 Graft-versus-host disease (GVHD), 23 HPC transplantation for, 335 in immunocompromised patients, 23 risk in HPC transplantation, 23 transfusion-associated, 235-236, 236t, 242t, 315 Granulocyte concentrates defined, 203 pretransfusion testing for, 203 Granulocytes, apheresis, 321, 325, 325t-326t Group A2 patient, transfused with anti-A1, 96, 96b-97b, 96t-97t Group A red cells, with acquired B antigen, 92-93, 93t Group AB red cells, properties of, 90-91 Group B patient, transfused with group O RBCs, 96, 96b, 96t Group O RBCs, 83 in emergency situations, 200, 204 properties of, 90-91 H H antigens, 82, 82f biochemical structure of, 83f carbohydrate precursor for, 81f development of, 82, 83f as precursor of A and B antigens, 82 production of, 81 H blood group systems, and classic Bombay phenotype, 100-101 Hand washing, requirement for, 358 Haplotype defined, 19, 65-66, 66f inheritance as, 19-20 Haptens, contrasted with antigens, defined, Haptoglobin defined, 229 in AHTR, 229 in transfusion reaction investigation, 240 Hardy, G., 68 Hardy-Weinberg law, 68 Harvey, William, 189 Hazard Communication Standard, 359 HDFN See Hemolytic disease of fetus and newborn 380 INDEX Health history interview, in donor screening, 270t, 271f-272f conditions for deferrals in, 270, 270t, 273t infectious diseases in, 272-274, 273t medications in, 273, 273t-274t questions for protection of donor, 270-272 questions for protection of recipient, 272-275, 273t-274t vaccinations in, 273-274, 274t Heart and heart-lung transplants, transfusion support in, 333 Heavy chains, antibodies reacting with, 45 of antibody molecule, 3-4 Helicobacter pylori, Leb antigen and, 141 Hemagglutination, 10-11, 14, 15t Hemagglutination assays, 10-11 automated systems for, 215 indications for, 214 performed in microplates, 214-215 results with, 214-215, 215f Hematocrit in donor screening, 275 effect of unit RBCs on, 191 Hematologic status, in transfusion reaction investigation, 240 Hematopoietic progenitor cells (HPCs) defined, 69 diseases treated with, 22-23 sources of, 22-23, 334-335, 334f transplantation of, 332 Hematopoietic progenitor cell (HPC) transplantation, 22-23, 69, 69t ABO component selection in, 335, 336t autologous, 335 described, 95 mixed-field reaction in, 95-96 therapeutic uses for, 333-334, 334t transfusion support for, 333-335, 334t, 342, 342t Hemoglobin in donor screening, 275 effect of unit RBCs on, 191 Hemoglobin F, 331 Hemoglobinemia, 231 Hemoglobinuria, 231 Hemolysin, biphasic, 146-147 Hemolysis, 12 in crossmatch procedure, 190-191, 191t extravascular, 5, 45-46 as indicator of antigen-antibody reactions, 18 intravascular, 6-7, 45-46 mechanical, 196 of red cells, 12 Hemolysis causes of non–immunemediated, 231-232 Hemolytic anemias, immune, 340 Hemolytic disease of fetus and newborn (HDFN), 7, 108, 120 ABO, 249 alloantibodies causing, 249-250 classification of, 248 and D antigen, 36 Hemolytic disease of fetus and newborn (HDFN) (Continued) defined, 246-247 diagnosis of, 254, 254t etiology of, 247, 260-261 factors present in, 247-250, 261 and molecular testing, 69t pathogenesis of, 127 postpartum testing for, 253-255, 254t prediction of, 250-253, 250t with amniocentesis, 252, 253f antibody titration in, 250-251, 251f with cordocentesis, 252-253 maternal history in, 250 with ultrasound techniques, 251 prevention of, 120, 255-258, 256t antepartum RhIG administration, 256 postpartum RhIG administration, 256-258 Rh, 248-249 treatment of postpartum, 259-260 in utero, 258-259 Hemolytic transfusion reaction acute, 228-230, 230f, 230t-231t defined, 228 delayed, 230-231, 231t Hemolytic uremia syndrome (HUS), transfusion support in, 338-339, 342, 342t Hemophilia A, CRYO for, 320 Hemorrhage defined, 329 hypovolemia of, 330, 330f physiologic responses to, 329-330 Hemosiderosis, transfusion, 237 Hemostatic disorders, transfusion support for, 340-342, 342t Hemotherapy, defined, 304 Hemovigilance model, 227, 227t Hemovigilance reporting, in transfusion reaction investigation, 241, 241t Heparin, treatment for excess, 331 Hepatitis, 292 Hepatitis A virus (HAV), 292-293, 293t Hepatitis B surface antigen (HBsAg), 294-295 Hepatitis B virus (HBV), 293, 293t incidence of, 293f serologic and clinical patterns observed in, 294f window period for detection of, 293 Hepatitis C virus (HCV), 293 characteristics of, 293t NAT in screening of, 291 Hepatitis D virus (HDV), 293-294, 293t Hepatitis E virus (HEV), 293t, 294 Hepatitis G virus (HGV), 294 Hepatitis tests, 294 antibody to hepatitis B core, 295 antibody to hepatitis C virus, 295 hepatitis B surface antigen, 294-295 nucleic acid testing, 295 Heterozygosity explained, 64, 64f in serologic testing, 65, 65f Heterozygous, use of term, 64 High-titer, low-avidity (HTLA) reaction pattern, 170-171, 170t-171t Hinge region, of heavy chains, Histamine defined, 229 in AHTR, 229 History See Health history; Patient history Homozygosity explained, 64, 64f in serologic testing, 65, 65f Homozygous, use of term, 64 HPA-1a antigen, 23 Human erythrocyte antigen (HEA) bead chip technology, 73 Human immunodeficiency virus (HIV) in donor screening, 275 HIV-1 infection, 296 nucleic acid testing for RNA of, 297 serologic profile of, 297, 297f structure of virus particle of, 298f testing for antibody to, 296-297 Western blot banding of proteins and glycoproteins of, 298f HIV-2 infection, 296-297 incidence of, 296f NAT in screening of, 291 types and 2, 296-297 Human leukocyte antigen (HLA), 19-24 inheritance of, 19, 20f laboratory testing application of, 19, 19t linkage in, 66, 66f lymphocytotoxicity test for identification of, 20-21, 21f naming of, 20-21, 20t polymorphism of, 61-62 testing to identify, 21 Human leukocyte antigen (HLA) compatibility, and HPC transplants, 335 Human T-Lymphotropic virus type (HTLV-1), 297 Human T-Lymphotropic virus type (HTLV-2), 297 Hybridization defined, 71 in SSOP, 71-72 Hybridomas, 33, 34f Hydatid cyst fluid defined, 144 P1 antigen in, 144 Hydrogen bonding, 8-10, 10t Hydrophobic bonding, 8-10, 10t Hydrops fetalis defined, 247 and HDFN, 247 Hypogammaglobulinemia acquired, 88, 88t congenital, 88, 88t INDEX Hypothermia, response of newborn to, 332 Hypovolemia, symptoms of, 329-330, 330f I I blood group system, 142, 142t, 152t autoanti-I, 143 I antigens, 143, 143f biochemistry of, 143, 143f characteristics of, 143 structure of, 143f IAT See Indirect antiglobulin test Icterus defined, 239 in transfusion reaction, 239 ID-MTS Gel Test procedure, 220, 222-223, 222f Identification, patient for blood products, 199 in compatibility testing, 195, 195f Idiotope defined, and heavy chains, IgG antibodies, 12 characteristics of, 6f, 6t, in immune response, 8, 9f subclasses of, weak, 171, 172f IgG molecule basic structure of, 3, 4f and zeta potential, 16-17, 16f IgM antibodies characteristics of, 6-7, 6f, 6t in immune response, 8, 9f IgM molecules, and zeta potential, 16-17, 16f Ii Blood Group Collection 207, 143 Immediate-spin agglutination, 6, 15 Immediate-spin crossmatch, in massive transfusion, 201 Immediate-spin phases, 35 Immune complex, Immune response comparison of polyclonal and monoclonal, 33, 33f primary, 7-8, 9f secondary, 8, 9f Immunization, during pregnancy, 12 Immunogen, Immunogenicity of D antigen, 112 defined, 112 factors contributing to, 4t Immunoglobulin (Ig) defined, use of term, 3-4 variable region of, 5, 5f Immunoglobulin (Ig) class, 127-128 Immunoglobulin (Ig) molecule, Immunohematology, antigen-antibody reactions in vitro, 14-18 in vivo, 12-14 antigens of interest in, 59 automation in, 208-211 molecular genetics of, 60 Immunohematology reference laboratory, 170 Immunohematology testing, 29-31, 29f-30f examples of, 29, 30f routine procedures, 30-31, 31t sources of antibody for, 30, 30t sources of antigen for, 29-30, 30t Immunosuppression, and risk of GVHD, 335 In vitro, 14 In vivo, 12 Incubation time, in agglutination, 15 Independent assortment, law of, 63-64, 63f Independent segregation defined, 63 Mendel’s law of, 63-64 Indirect antiglobulin test (IAT) in antibody screen, 159 applications of, 43, 43t for D antigen, 112-114, 114t, 115f defined, 41 distinguished from DAT, 41-42, 44t procedure, 43, 43f, 44t SPRCAs for, 215, 216f Indirect exclusion, in relationship testing, 69 Infants See also Newborns crossmatching of, 202-204 iatrogenic blood loss in, 332 Infections, potential transfusiontransmitted, 273, 273t Infectious diseases, in health history interview, 272-274, 273t Infectious hepatitis, 292-293 See also Hepatitis Informed consent, in donor screening, 276 Infusion rate, for administration of blood components, 324 Inheritance patterns, 62 codominant, 62 dominant, 62 recessive, 62 International Council on Commonality in Blood Banking Automation, 321-322 International Society of Blood Transfusion (ISBT) and Hemovigilance Model, 227 blood group system numbers used by, 127-128 blood group system symbols of, 127-128 blood group systems defined by, 127 ISBT 128 labeling of, 321-322 on Rh blood system, 107-108 standardized numeric terminology of, 109t, 111 terminology of, 305 Working Party on Terminology for Red Cell Antigens of, 78 Intraoperative cell recovery instrument, 280, 280f Intrauterine transfusions for HDFN, 258-259 interpreting test results with, 255 Inventory requirements, 309 381 Investigation, transfusion reaction initiating, 238-241 instructions to medical staff, 238, 239f laboratory testing in, 240-241, 240t postreaction work-up, 239, 239f records and reporting of, 241 Ionic bonding, 8-10, 10t Ionic strength, in agglutination, 15t, 16 Irradiated blood products, in TA-GVHD, 235-236, 236t Irradiation, of RBCs, 315-316 ISBT See International Society of Blood Transfusion Ischemia defined, 229 in AHTR, 229 Isotype defined, distinguishing, J Jaundice, in HDFN, 247 JMH blood group system, 151t The Joint Commission, 191 K K0 phenotype, 130-131 Kappa chains, 3-5 KEL gene, 131 Kell blood group system, 129, 129t, 152t antibodies of, 131-132, 138t antigens of biochemistry of, 129-130 frequencies for, 127, 130t immunogenicity of, 130, 132 K0 or Kellnull phenotype, 130-131 terminology for, 129 treated with papain or ficin, 130 common frequencies in, 131t common phenotypes in, 131t discovery of, 129 genetics of, 131, 131t inheritance of, 63-64, 63f and Kx antigen, 132 phenotypes, 132, 133t Kellnull phenotype, 130-131 Kernicterus, in HDFN, 247, 248f Kidd blood group system, 63, 136, 136t, 152t antibodies of, 137-138, 138t antigens of biochemistry of, 136-137 characteristics of, 136 common frequencies in, 136, 137t common phenotypes in, 136, 137t genetics of, 137 Kidney transplant, transfusion support in, 333 Kinins defined, 229 in AHTR, 229 Kleihauer-Betke acid elution, 258, 258f Knops blood group system, 151t Kx antigen, and Kell blood group system, 132 Kx blood group system, 129, 131-133 Kx antigen, 132 and McLeod phenotype, 132 tahir99-VRG & vip.persianss.ir 382 INDEX L Label control programs, 356 Labeling and Circular of Information, 322-323 in compatibility testing, 195, 195f confirming correct, 196 ISBT, 321-322 requirements, 322f standardization of, 322 Labile factors, defined, 318 Laboratory information system (LIS) interface in automated testing, 211 defined, 211 Lambda chains, 3-5 Landsteiner, K., 79-80 Landsteiner’s rule, 79-80, 89 Lattice formation, 14, 15t Leb antigen, 141 Lecithin/sphingomyelin (L/S) ratio defined, 252 and lung maturity, 252 Lectins as alternatives to antisera for blood typing purposes, 49 commonly used in blood bank, 49t properties of, 28 Leishmaniasis, 273, 273t Leukapheresis, 281 Leukocyte reduction filter, 312-313, 312f for platelets, 318 prestorage, 309-311 Leukocyte removal filter, 233f Leukocytes, removal of, 312-313, 312f Lewis antigens, carbohydrate precursor for, 81f Lewis blood group system, 140, 140t, 152t antibodies of, 142 antigens of biochemistry of, 140-141, 141t characteristics of, 140 formation of, 141f inheritance of, 141, 141f, 141t-142t biochemistry of, 141t frequencies for, 140, 140t genetics of, 141, 142t phenotypes of, 140, 140t red cell phenotypes of, 141, 142t Light chains, antibodies reacting with, 45 of antibody molecule, 3-4 Liley graph defined, 252 in prediction of HDFN, 252, 253f Linkage, 65-66, 66f disequilibrium, 65-66 in HLA system, 66, 66f Linked, use of term, 66 Lipids defined, immunogenicity of, Liver transplant HLA antigens in, 21 transfusion therapy in, 342, 342t Look-back process, 299 Low-ionic-strength saline (LISS), 47-48, 47t in antibody screening, 161, 162t mechanism of action for, 47t in solid phase red cell adherence assays, 215-216, 217f Lung injury, transfusion-related acute, 234, 235t, 242t Lutheran blood group system, 63, 138, 138t, 152t antigens of, 139 biochemistry of, 139 characteristics of, 138-139 common frequencies in, 139t common phenotypes in, 139t genetics of, 139 LW antibody, 120 LW antigen, 108 LW blood group system characteristics of, 120t and Rh blood group system, 120 Lymphocytotoxicity assay, for identifying HLA, 20-21, 21f M Major histocompatibility complex (MHC) gene system, 19, 20f Malaria and donor deferral, 273, 273t and Duffy blood group system, 136 Massive transfusion, 342, 342t complications in, 331t defined, 330 trauma and, 329-330, 330f Material Safety Data Sheets (MSDS), 359 Maternal history, in prenatal testing, 250 Maximum Surgical Blood Order Schedule (MSBOS), 201 MBOS See Maximum Surgical Blood Order Schedule McLeod phenotype occurrence of, 132 red cell abnormalities associated with, 132, 133f McLeod syndrome, 133 Medical directors, blood bank, 270 Medications accepted for blood donation, 273t in donor screening, 273 requiring deferrals, 274t Meiosis crossing over during, 66-67, 67f defined, 60 Membrane attack complex defined, 12 formation of, 12 Memory B cells, defined, in immune response, 2, 9f Mendelian genetics and ABO blood group system, 86-87, 90t principles of, 63-64, 63f Microplate testing methods, 50 background of, 50 microtiter plate wells for, 51f positive and negative reactions in, 52f procedure, 50 Mitosis, 60 Mixed-field agglutination defined, 85 with A phenotype subgroups, 85-86 Mixed lymphocyte culture (MLC), 22 MN sialoglycoprotein (GPA), 148, 149f MNS blood group system, 148, 152t antibodies of, 148, 149t anti-M, 149-150, 149t anti-N, 150 anti-S, 150 anti-s, 150 anti-U, 150 antigens of M and N antigens, 147-148, 147t S and s antigens, 148, 148t U antigens, 148 biochemistry of, 148 genetics of, 148 haplotypes in, 65-66, 66f phenotype frequencies in, 150t Molecular genetics, 69-73 blood banking applications, 69, 69t of immunohematology, 60 polymerase chain reaction in, 70-72, 70f in red cell typing, 69t, 72-73 Mononuclear phagocyte system, 14 Multiple myeloma defined, 99 rouleaux associated with, 99 Mycoplasma pneumoniae infections, autoanti-I associated with, 144 N N-acetylgalactosamine, 82-83, 83f National Healthcare Safety Network (NHSN), and Hemovigilance Model, 227 NEO technology, 213-214, 214f Neonatal, defined, 247 Neonatal alloimmune thrombocytopenia (NAIT), 23 Neonates See also Newborns “fresh red cells” for, 306-307, 332 transfusion issues unique to, 332, 332t transfusion therapy for, 331-332, 342, 342t Neutralization antibody identification technique, 142 Neutralization techniques, with cold alloantibodies, 173, 173f, 173t Newborns See also Hemolytic disease of fetus and newborn ABO titers in, 88, 88t hemoglobin levels in, 332 red cells of, 80-81 response to hypothermia of, 332 Nomenclature, systems of Fisher-Rice: CDE, 109f, 110, 111t for Rh blood group systems, 109t, 110 ISBT, 109t, 111 Rosenfield numeric, 109t, 111 Wiener: Rh-Hr, 109f, 110-111, 110t-111t Non-red blood cell stimulated, use of term, 88 Nonsecretor classification as, 101 defined, 101 tahir99-VRG & vip.persianss.ir INDEX Normal saline, in administration of blood components, 324 Nucleic acid testing (NAT), 69 donor viral, 291 for HCV RNA, 295 procedure, 291 Null phenotypes and categorization of blood group systems, 118 defined, 118 in Rh blood groups, 119 O O red cells, 83 See also Group O RBCs Obligatory gene, in relationship testing, 68-69 Occupational Safety and Health Act (1970), 347 Occupational Safety and Health Administration (OSHA), 347 Oligosaccharide chain composition of, 82 defined, 82 type and type 2, 82f Oncology, transfusion support in, 336-337, 338t, 342, 342t One-stage enzyme technique, of antibody identification, 168 Open system, 305 Opsonin, 13-14 Opsonization, in AHTR, 229 Organ transplants, transfusion support for, 333, 333t See also Transplantation, ORTHO ProVue, 220, 220f components of, 221, 221f features of, 221 ID-MTS gel test with, 222 sample results with, 222, 222f software for, 221-222, 222f test types supported by, 221 P P value, 166 P1A1, 23 Pacific Islanders, Kidd blood group in, 136 Package inserts, percentages for antigen frequencies in, 67 See also Product inserts Panel-reactive antibody (PRA), 22 Papain enzyme, 48 and antibody detection, 161, 162t and Duffy antigens, 134 Kell antigens treated with, 130 resistance of Lutheran antigens to, 138 Parasitic infections and donor deferrals, 273t in health history interview, 273 Parenteral transmission, of hepatitis virus, 293 Paroxysmal cold hemoglobinuria (PCH) antoanti-P associated with, 146-147 defined, 146 Paternity index, 69 Paternity tests, 60 Patient history, in antibody detection, 161-162 See also Health history Patient identification for blood products, 199 in compatibility testing, 195, 195f Patient records, retention of, 349, 350t See also Record keeping Patient samples for compatibility testing age of, 196 collection and appearance, 196 comparison with previous records, 196 hemolyzed, 196 lipemic, 196 repeat testing of donor blood, 196 tubes for, 195-196 in transfusion reaction investigation, 240 recipient ABO and D phenotype of, 197 antibody detection test, 197 pretransfusion testing on, 197-198 Pattern matching for antibodies to high-frequency antigens, 169 in panel interpretation, 164t, 166, 166t PCH See Paroxysmal cold hemoglobinuria Pediatric units, preparation of, 203 Pedigree chart D antigen inheritance on, 112, 114f of Rh blood group inheritance, 112, 113f Perinatal, defined, 247 Personal injury, reporting, 360 Personal protective equipment, 357, 358f Personnel, blood bank employee education for, 360 laboratory attire for, 357 qualifications of competency assessment, 353-354 job description, 352-353 selection criteria, 352 training, 353 reporting personal injury to, 360 pH in agglutination, 15 of stored plasma, 306-307 Phases for antibodies to high-frequency antigens, 169 in panel interpretation, 164t, 165 Phenotypes, 61 ABO, 81, 81t Bombay, 82 calculating frequencies for, 67-68 determination of, 61 null, 63 in relationship testing, 68-69, 69t Rh blood group system, 111-112, 113t use of term, 111-112 vs genotype, 61, 61f Phenotyping routine ABO, 89, 90t technical considerations in ABO, 91-92, 91t 383 Phlebotomy arm preparation and venipuncture, 277, 282 bag labeling in, 276 identification of donor, 276 postdonation instructions and care, 277 therapeutic, 281 Photopheresis, 337t Phototherapy defined, 249 in HDFN, 249, 259 Plasma, 325, 325t-326t See also Fresh frozen plasma in immune response, platelet-rich (PRP), 309-311, 313f processing of, 309-311, 310f storage of, 308t “thawed”, 319 Plasma cells, Plasma components, 318-321, 319t, 321f cryoprecipitated antihemophilic factor, 319-321, 321f fresh frozen plasma, 318-319, 319t significant antibody present in, 288 Plasma cryoprecipitate reduced, 320 Plasma pH, in storage, 306-307 Plasma transfusions compatibility for, 90-91, 90t and D antigen, 203 Plasmapheresis, 281, 337t Plasmodium spp., and Duffy blood group, 136 Platelet antigens, 23 Platelet components apheresis platelets, 317-318, 318f indications for use of, 316-317, 316f leukocytes reduced, 318 pooled platelets, 317 prepared from whole blood, 317 significant antibody present in, 288 testing for bacterial contamination of, 300 Platelet concentrates defined, 203 pretransfusion testing for, 203 Platelet-rich plasma (PRP), preparation of, 309-311, 313f Platelet transfusions effectiveness of, 316-317, 316f and HLA antigens, 19 refractory response to, 316-317, 317t Plateletpheresis, 281, 317 Platelets, 325, 325t-326t antigens on, immunology of, 19-24 pooled, 325, 325t-326t random donor, 317 single-donor, 317 storage of, 308t Pneumonia, and antibody detection, 162 Polyagglutination ABO discrepancies caused by, 94 defined, 94 Polyethylene glycol (PEG), 47t, 48 as antibody potentiator, 119 in antibody screening, 161, 162t tahir99-VRG & vip.persianss.ir 384 INDEX Polymerase chain reactions (PCRs), 70, 70f components of, 70t and human leukocyte antigen typing procedures, 70-72, 71f Polymorphic, use of term, 61-62 Polymorphic genetic system, 19-20 Polymorphism, HLA, 61-62 Polypeptides, Rh blood group system, 108-110, 109f Population genetics, 67-69 blood group, 67 combined phenotype calculations, 67-68 gene frequencies, 68 relationship testing, 68-69, 69t Postpartum testing, in risk of HDFN, 253-255, 254t ABO testing, 255 D testing, 254, 254t Posttransfusion purpura (PTP), 23, 226, 238 Postzone, 17, 17f Potency, product defined, 31 FDA standard for, 31 Potentiators in antibody detection, 161, 162t defined, 119 polyethylene glycol, 119 P1PK blood group system, 152t anti-P1, 146 antibodies of, 144, 145t anti-PP1Pk, 147 autoanti-P, 146-147 antigens of, 144-145, 145t, 146f biochemistry of, 145-146, 146f frequencies for, 144, 145t P1 and P2 phenotypes, 144 P antigen, 144, 144t P1 antigen, 126, 144 phenotypes of, 144, 145t Practices, transfusion in anemias, 339-340, 339t cardiac surgery, 330-331, 342, 342t in chronic renal failure, 337, 338t in HUS, 338-339 neonatal and pediatric issues, 331-332 in oncology, 336-337, 338t therapeutic apheresis, 335-336 for transplantation, 332-335, 333t in TTP, 338-339 urgent and massive transfusion, 329-330, 330f, 342, 342t Pregnancy alloantibodies produced by, 12 and HLA sensitivity, 22 incompatibility testing during, 171 Pregnancy history, in antibody identification procedures, 161-162 Prenatal, defined, 247 Prenatal testing first trimester, 250 monitoring antibody increases, 251, 251f preparing antibody for, 251, 251f purpose of, 250, 250t Pretransfusion testing for autologous units, 202 for non-red blood cell products, 203-204 of recipient sample ABO and D phenotype, 197 antibody detection test, 197 crossmatch test, 198 Prewarming technique, 143 in autoantibody identification, 176, 176f indication for, 143 Problem solving, in error management, 354 Product inserts for D antigen typing, 36-37, 37f percentages for antigen frequencies on, 67 for reagents, 32 Product specifications, 354 Proficiency testing, 355-356 Proteins chemotactic, 13-14 complement, 12-14, 13f immunogenicity of, Proteolytic enzymes, 47-48, 47t in antibody detection, 168-169, 168t in antibody screening, 161, 162t properties of, 48 Prozone, in agglutination, 17, 17f PTP See Posttransfusion purpura Public Health Service (PHS) Act (1944), 346 Pulse, in donor screening, 275, 276t Punnett squares for ABO inheritance, 62f antigen inheritance on, 112, 114f application of, 87f defined, 61 of Rh blood group inheritance, 112, 113f Q Quality Assurance (QA) programs, 345-346, 348, 361 components of, 347t, 348-356 change control, 352 error management, 354 facilities and equipment, 355 label control, 356 personal qualifications, 352-354 proficiency testing, 355-356 standard operating procedures, 351 supplier qualification, 354 validation, 355 records and documents in, 348-350, 349t-351t computerized record guidelines, 350 document control, 349 manual record guidelines, 350, 351f record keeping, 349-350 Quality control program, for blood banking reagents, 32 Quality Control (QC) for blood components, 307-308, 308t defined, 348 Quality Essentials (AABB), 347, 347t R Rabbit erythrocyte stroma, 177, 177t Race and antibody identification, 132 and antigen frequencies, 67 Radiation safety, 359 Radioisotope labeling, for crossmatch testing, 191 Random-access in automation of testing, 211 defined, 211 Random donor platelets, 317 Rapid plasma reagin test, for syphilis, 288 Rare Donor Registry, 150 Rare donor units, 131 Reaction method, optimal in vitro, 127-128 Reaction phase, in IAT, 43 Reaction strength for antibodies to high-frequency antigens, 169 in panel interpretation, 164t, 165 Reaction temperature for antibodies to high-frequency antigens, 169 in panel interpretation, 164t, 165 Reactivity, antibody, with enzyme-treated reagent red cells, 127-128 Ready-ID test, 215-216, 216f, 218f Reagent control, low-protein, 37-38, 38t Reagent red cells, 38-40, 38t A1 and B red cells for ABO serum testing, 38-39, 38t antibody identification panel cells, 40 screening cells, 39, 39f summary of, 40f Reagents, blood banking, 31-32 See also Antibody reagents; Antiglobulin reagents; Antihuman globulin (AHG) reagents for ABO typing, 35, 36f categories of, 31 product inserts for, 32 quality control for, 32 regulation of manufacture of, 31-32 Recalls, in error management, 354 Receptors, 13-14 Recessive inheritance pattern, 62 Recipients, blood defined, 39 tested for antibodies, 39 universal, 90 Recombinant immunoblot assay (RIBA), 295 Record keeping, 349-350 for administration of blood components, 324 computerized guidelines for, 350 correcting manual record, 351f good vs bad, 350, 351t in transfusion reaction investigation, 241 manual guidelines for, 350 retention, 349, 349t tahir99-VRG & vip.persianss.ir INDEX Red blood cell components apheresis red blood cells, 313-314 deglycerolized red blood cells, 314, 315f frozen red blood cells, 314, 314f indications for use of, 311-312 irradiated red blood cells, 315-316 leukocyte reduced, 312-313, 312f-313f washed red blood cells, 315 Red Blood Cells Low Volume unit, 305 Red blood cells (RBCs), 325, 325t-326t antibodies to, 10, 11f, 12 antigens on, 3, 10-11, 11f IgG-sensitized, 46-47 irradiated, 308t, 325, 325t-326t of newborn, 80-81 preparation of, 309-311, 310f routine ABO phenotyping for, 89, 90t sensitized with IgG or complement, 41, 41f storage of, 308t Tn-polyagglutinable, 95-96 washed, 325, 325t-326t Red cell adherence assays, solid phase, 215-216, 216f See also Solid phase red cell adherence assays Red cell antigens, 10-11, 11f Red cell apheresis, 281 Red cell lysis, in AHTR, 229 Red cell membrane, blood group antigens on, 78, 78f Red cell stroma defined, 229 in hemolysis, 229 Red cell testing additional antibodies in, 96-99, 96b-97b, 96t-97t extra antigens in, 92-94, 93t-94t, 94b missing or weak antibodies in, 99-100, 100b, 100t missing or weakly expressed antigens in, 94-95, 95b, 95t mixed-field reactions, 95-96, 96b, 96t Red cell washing, 41 Refractoriness, 19 Regulator gene defined, 119 and inheritance of Rhnull phenotype, 119 Regulatory agencies, 346, 360-361 Rejuvenation solution, 308-309 Relationship testing, 60, 68-69, 69t Renal disease, transfusion support in, 337, 338t, 342, 342t Renal failure, caused by severe AHTR, 229, 230f Respiratory distress syndrome defined, 252 and fetal lung maturity, 252 Reticulocytosis defined, 133 in McLeod phenotype, 133f Retroviruses, human HIV, 296-297 human T-Lymphotropic virus Types and 2, 297 NAT for RNA of HIV-1, 297 Western blotting for, 297, 298f Reverse grouping, 89 Rh antigens, nomenclature for, 109t, 110 Rh blood group system, 107-108, 121 antibodies of, 117t, 121t general characteristics, 119 in HDFN, 120 transfusion reactions to, 119-120 antigens of, 117-118, 117t, 121t common, 108, 109t compound antigens, 117-118, 118t D antigen, 11, 112-117, 114f-116f, 114t G antigens, 118 biochemistry of, 108-110, 109f determining genotype from phenotype, 111-112, 112f, 112t discovery of, 108 frequency of haplotypes, 112, 112t genetics of, 108, 109f Fisher-Race theory, 109f, 109t-110t, 110 Wiener theory, 109f, 110-111, 110t-111t inheritance of, 112, 113f and LW blood group system, 120, 120t phenotypes and genotypes, 112, 113t terminology for, 109t, 110 converting Fisher-Race to Wiener terminology, 111, 111t Fisher-Race, 109t, 110, 111t ISBT, 109t, 111 Rosenfield numeric, 109t, 111 Wiener, 110-111, 110t-111t unusual phenotypes in, 118-119 D-deletion phenotype, 114f, 118-119 Rhmod phenotype, 119 Rhnull phenotype, 119 Rh hemolytic disease of fetus and newborn (HDFN), 248-249 compared with ABO HDFN, 249t incidence of, 248 Rh immune globulin (RhIG) administration of, 255, 256t antepartum, 256 postpartum, 256-258 calculating dosage of, 258, 259f defined, 117, 249 and FMH screening, 257-258, 257f indication for, 255 introduction of, 248 and quantifying fetomaternal hemorrhage, 258, 258f-259f routine postpartum administration of, 255 weak D testing on, 117 Rh-negative, use of term, 108 Rh-positive, use of term, 108 RHCE gene, 108, 109f Rhesus antibody, specificity of, 108 Rhmod phenotype, 119 Rhnull phenotype, 108-110, 119 RhoGAM, 117 Ribonucleic acid (RNA), viral, 291 Robotics, 208, 223 Root-cause analysis, 354 Rosenfield terminology system, 109t, 111 Rosette test, for detection of fetomaternal hemorrhage, 257-258, 257f 385 Rouleaux in ABO discrepancy, 98, 98b-99b, 98t Waldenström’s macroglobulinemia associated with, 99 RPR test See Rapid plasma reagin test Rule of three for antibodies to high-frequency antigens, 169 in pattern interpretation, 164t, 166 Rule out, use of term, 165 Ruling out, in panel interpretation, 164t, 165-166 S Safety measures, 226 Safety programs, blood bank, 346, 356-360 biohazardous wastes in, 359-360 biological safety cabinets, 358 chemical storage and hazards, 359 decontamination, 359 employee education, 360 gloves and hand washing, 358 laboratory attire, 357 and OSHA regulations, 356, 357t personal injury and reporting, 360 personal protective equipment, 357, 358f physical space, 357 radiation safety, 359 standard vs universal precautions in, 356 storage, 360 transportation, 360 warning signs, 358-359, 359f written requirements for, 356-357, 360-361 Safety regulations environmental protection agency, 347-348 OSHA, 347 Saline, physiologic, added to donor units, 232, 232f Saline replacement technique, 99f See also Low-ionic-normal-strength saline; Normal saline in ABO discrepancy, 99 goal of, 99 Sample diversion pouch, 277, 278f Sample handling, in automated testing, 211 Scianna blood group system, 151t Screening cell antigram, 159f Screening cells, in antibody detection tests, 39, 39f Sda blood group system, 151t Secretor classification as, 101 defined, 101 Secretor status, of ABO blood groups, 101, 101f Segment, from donor unit bag, 196, 197f Self-antigens, 166 Sensitization defined, 14 factors affecting, 15t in hemagglutination reaction, 14-15 tahir99-VRG & vip.persianss.ir 386 INDEX Sequence-based typing (SBT), 72 Sequence-specific oligonucleotide probes (SSOP) technique, 71-72, 71f Sequence-specific primers (SSPs) test method, 71, 71f Serotonin defined, 229 in AHTR, 229 Serum hepatitis, 293 Serum-to-cell ratio, 15 Sexual contact, and blood donor criteria, 269f Shock, in AHTR, 229 Short tandem repeats (STR) described, 72 testing, 72 Showers, safety, 357 Sialic acid, 148 Sickle cell disease and antibody detection, 162 transfusion support in, 339, 339t, 342, 342t Solid-phase red cell adherence assays, 52 background of, 52 procedure, 39, 52 Solid phase red cell adherence assays (SPRCAs) in antibody screening, 161, 162t automated instruments for, 213-214, 214f-215f automated platforms for, 208 automated systems for, 213-217, 216f Erytype S technology, 217, 220f hemagglutination assays, 214-215, 215f Solidscreen II technology, 216-217, 219f manufacture of, 213-214 reactions and interpretation of, 215-216, 217f Solid-phase testing, 10-11 Solidscreen II technology, 216-217, 219f Specificity, product defined, 31 FDA standard for, 31 Spectrophotometric analysis, of amniotic fluid, 252, 253f SPRCAs See Solid phase red cell adherence assays Ss sialoglycoprotein (GPB), 148, 149f SSOP technique See Sequence-specific oligonucleotide probes technique Standard blood order, 201 Standard operating procedures (SOPs), 360-361 defined, 349 elements of, 352f guidelines for, 351 laboratory, 32 Standard precautions defined, 356 guidelines for, 356, 356t introduction of, 356 Standards for Blood Banks and Transfusion Services (AABB), 28, 36, 39, 191, 267-268, 305, 347 STAT samples, with automated systems, 212 Statement of criteria for acceptable reagent performance, 32 Sterile-connecting devices, 312-313, 313f Storage, of blood and blood components, 360 Storage lesion, 306-307, 306f Sugar, immunodominant for A antigens, 83, 83f for B antigens, 83, 83f defined, 82 for H antigen, 82, 83f specificity defined by, 83 Sulfhydryl reagents, sensitivity of Kell antigens to, 129-130 Supernatant, 18 Suppressor genes, 63, 63t Surgery, preparing blood for, 201 Surrogate markers defined, 295 in hepatitis testing, 295 Syntenic, use of term, 135 Syphilis, 274 serologic tests for, 288 confirmatory testing for, 289 hemagglutination test for Treponema pallidum antibodies, 289 rapid plasma reagin test, 288 Syringes, for transfusions to infants, 203 Systemic lupus erythematosus (SLE), and antibody detection, 162 Systolic blood pressure defined, 275 in donor screening, 275 T T lymphocytes (T cells), defined, in immune response, TANGO optimo automated blood bank system, 216-217, 219f Technical Manual (AABB), 35, 67, 309-311, 324, 347 Technologists, cross-training of, 209 Temperature in agglutination, 15 in donor screening, 275, 276t for storage of blood components, 307-308, 308t Thalassemia defined, 237 iron overload in patients with, 237 Thalassemia, transfusion support for, 339-340 “Thawed” plasma, 319 Therapeutic apheresis, 281 conditions treated with, 336, 337t goal of, 335 indications for, 337t transfusion support for, 335-336 Therapeutic phlebotomy, 281 Therapeutic plasma exchange for HUS, 338 in TTP, 338 Thrombotic thrombocytopenic purpura (TTP), transfusion support in, 338-339, 342, 342t Throughput in automation of testing, 211 defined, 211 Titers ABO antibody, 88 defined, 88 Tn-polyagglutinable red cells defined, 96 mixed-field reactions in, 95-96 Tourniquet, in phlebotomy, 277 Trans, use of term, 65 Transferase enzymes defined, 82 function of, 82 Transfusion, massive, 330, 330f, 331t blood groups available in, 201 defined, 201, 204 Transfusion, passive defined, 201 and original ABO phenotype, 201 Transfusion history, in antibody identification procedures, 161-162 Transfusion reactions See also Investigation, transfusion acute, 227 acute hemolytic, 80 allergic, 234 anaphylactic, 234, 242t categories of, 228-238, 228f citrate toxicity associated with, 237-238 delayed, 193, 227 delayed hemolytic, 137 delayed serologic, 232-233 fatalities associated with, 227, 227t febrile nonhemolytic, 233, 233f, 233t, 242t hemolytic, 228-232, 230f, 230t-231t, 232f, 242t immune-mediated, 228, 242t initiating investigation of, 238-241, 239f non–immune-mediated, 228, 242t non–immune-mediated mechanisms of red cell destruction, 231-232, 232f, 242t non–life-threatening, 194 posttransfusion purpura, 226, 238 recognition of, 227-228 reporting, 325 suspected, 238 with antibodies to Rh blood group system, 119-120 Transfusion, adverse complications of, 226, 242, 242t Transfusion-associated circulatory overload (TACO), 237 Transfusion-associated graft-vs.-host disease (TA-GVHD), 235-236, 236t, 242t Transfusion-related acute lung injury (TRALI), 242t management of, 235t pathophysiology of, 234 prevention of, 235t symptoms of, 234, 235t Transfusion services MSBOS of, 201 T/S protocols of, 201-202, 202f tahir99-VRG & vip.persianss.ir INDEX Transfusion therapy, alternatives to, 336-337, 338t, 341-342 factor concentrates, 341, 341t volume expanders, 341, 342t Transfusions See also Practices, transfusion alloantibodies produced by, 12 detecting and identifying antibodies for, 12 history of, 189-190, 190f and HLA sensitivity, 22 and molecular testing, 69t Transmissible spongiform encephalopathies, in health history interview, 272, 273t Transplant, previous, and HLA sensitivity, 22 Transplant, solid-organ antibody detection and identification for, 21-22, 22f transfusion support in, 333, 333t Transplantation and molecular testing, 69t transfusion support in, 332-335, 333t Transportation within institution, 360 shipping, 360 Trypanosomiasis, American, 299-300 Tube agglutination tests, limitations of, 210 Tube testing, crossmatch procedures, 192 Two-stage enzyme technique, of antibody identification, 168 Type and screen (T/S) protocols, 201-202, 202f, 204 Typing procedures, HLA, 70-72, 71f sequence-based typing, 72 sequence-specific oligonucleotide probes, 71-72, 71f sequence-specific primers, 71, 71f short tandem repeats, 72 Typing procedures, red cell, 69t, 72-73 U Ulex europaeus: plant lectin, 85-86 Ultrasound, HDFN detected with, 251 Unexpected, use of term, 159 Universal donors for plasma transfusions, 91 for RBC transfusions, 90-91 Universal precautions defined, 356 mandate for, 356 Universal recipients group AB recipients, 90-91 for plasma transfusions, 91 V Vaccinations, in donor screening, 273-274, 274t Valency, Validation defined, 355 in QA programs, 355 Van der Waals forces, 8-10, 10t Variable regions, Vasoactive amines, 13-14 Vel blood group system, 151t Vendor assessment for automation systems checklist for, 211-212, 212t and laboratory requirements, 211-212 need for, 211 Venipuncture site, preparation of, 277 Viral marker testing, 272 chemiluminescence, 291 controls, 291-292 enzyme-linked immunosorbent assay, 289-291 nucleic acid testing, 291 sensitivity and specificity, 292 Volunteer donations, 268 von Willebrand’s disease CRYO for, 320 transfusion support for, 340 W Waldenström’s macroglobulinemia defined, 99 rouleaux associated with, 99 W.A.R.M reagent, 180 Warm autoimmune hemolytic anemia (WAIHA), 177, 182 387 Warning signs, in blood bank safety program, 358-359, 359f Washed red blood cells, 315, 325, 325t-326t Washing step, of antiglobulin test, 40-41 Waste management programs, 359-360 Wastes, biohazardous, 359-360 Weight, in donor screening, 275-276, 276t Weinberg, W., 68 West Nile virus (WNV), 291, 298-299 Western blotting, for human retroviruses, 297, 298f Wharton’s jelly in ABO discrepancy, 94 defined, 94 White cells, antigens on, White populations GLOB blood groups in, 145t Kell blood group system in, 131-132, 131t MNS blood, 150t P1PK blood groups in, 145t Rh blood group system in, 112, 112t-113t Whole blood, 311 defined, 304, 311 indications for use of, 311 preparation of, 311 separation of, 304 separation of components from, 309, 310f storage of, 308t Wiener genetic theory, 109f, 110, 110t-111t Working Party, ISBT, 78 X Xg blood group system, 64, 151t Z Zeta potential, in agglutination, 16-17, 16f Zone of equivalence, in agglutination, 17, 17f “ZZAP”, 180 tahir99-VRG & vip.persianss.ir This page intentionally left blank tahir99-VRG & vip.persianss.ir This page intentionally left blank tahir99-VRG & vip.persianss.ir This page intentionally left blank tahir99-VRG & vip.persianss.ir ... 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