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Essentials of Blood Banking
SR Mehdi
CHAPTER 1:
Immunohaematology
Antigen
Antibody
Production
Immunoglobulin structure
Immunoglobulin classes
IgA
IgG
IgM
Complete and incomplete antibodies
Monoclonal and polyclonal antibodies
Identification and estimation of immunoglobulin
Antigen antibody ratio
Complement
Sensitisation
Agglutination
Grades of agglutination
Factors influencing agglutination
Charge on cells
Albumin or enzymes
Effect of Coomb's serum
Haemolysis
CHAPTER 2:
ABO blood group system
Inheritance of Abo blood groups
Genotypes and Phenotypes
Antigens of Abo groups
ABO antibodies
Antibodies in infants
ABO subgroups
Subgroups of A
A1
A2
Subgroups of AB
Bombay blood group (Oh phenotype)
Antisera used in Abo grouping
Antisera A
Antisera B
Antisera AB
ABO grouping
Slide method
Procedure
Interpretation of results
Tube method
Washing of red cells
Preparation of 5% red cell suspension
Procedure
Cell grouping (forward grouping) (Table 2.4)
Serum grouping (reverse grouping) (Table 2.4)
ABO gel grouping
Reagents
Additional reagents required
Further materials required
Sample required
Preparation of blood samples
Procedure
Result
Positive
Negative
Interpretation of results
Precautions
ABO subgrouping
Procedure
ABO discrepancies
Group I discrepancy
Group II discrepancy
Group III discrepancy
Group IV discrepancy
Resolution of ABO discrepancies
Type I
Type II
Type III
Type IV
CHAPTER 3:
Rh blood group system
Nomenclature
Rh-Hr terminology
DCE terminology
Numerical terminology
Inheritance
Biochemical structure of rh antigens
Clinical significance
Types of Rh antigens
The D weak or Du phenotype
DU transfusion policy
Rh null syndrome
Rh antibodies
Rh grouping reagents
Tests for Rh grouping
Techniques
Slide test
Procedure
Tube test
Controls
False positive
False negative
Test for Du
Procedure
CHAPTER 4:
Other blood group systems
Lewis blood group system
Lewis antigens
Lewis antibodies
Anti-Lea
Anti-Leb
Detection of lewis antigens
MNS blood group system
MNS antigens
Antibodies of MNS system
Anti-M
Anti-N
Anti-S and Anti-s
P blood group system
Antigens
Antibodies
Anti-P1
Anti-P
Anti-PP1Pk
Ii blood group system
Antigens
Antibodies
Anti-i
Anti-I
Kell blood group system
Antigens
Antibodies
Kidd blood group system
Antigens
Antibodies
Duffy blood group system
Antigens
Antibodies
Lutheran blood group system
Antigens
Antibodies
Anti-Lua
Anti-Lub
CHAPTER 5:
Antihuman globulin (Coombs’) test
Principle of antiglobulin test
AHG (Coombs’) reagents
Polyspecific-1
Polyspecific-2
Monospecific anti-IgG
Monospecific (Heavy chains)
Anticomplement antibodies
Monoclonal antibodies
Role of anticomplement antibodies
AHG control cells
Preparation of positive control
Gel card technique for Coombs’ test
Additional reagents required
Materials required
Samples
Procedure
Clinical significance of Coombs’ test
Direct antiglobulin test (DAT)
Principle
Indirect antiglobulin test (IAT)
Principle
Procedure of DAT/DCT
Interpretation
Procedure of IAT/ICT
Interpretation
Factors affecting AHG test
Ratio of serum to cell
Temperature
Incubation time
Reaction medium
Albumin IAT technique
Procedure
One stage method
Two stage method
Enzyme IAT technique
Procedure
Sources of error
False positive
False negative
CHAPTER 6:
Detection and identification of antibodies
Screening cells
Primary panel
Secondary panel
Detection of antibodies
Identification of alloantibodies
Procedure
Saline phase
Enzyme phase
IAT
Evaluation of panel results
Record the result
CHAPTER 7:
Cross-matching (compatibility testing)
Cross-matching
Major cross-match
Minor cross-match
Sample collection for cross-matching
Procedure of cross-matching for whole blood transfusion
Saline technique
Interpretation
Albumin and AHG technique
Single tube cross-match
Procedure
Saline phase
Albumin phase
AHG/ IAT phase
Interpretation
Cross-matching in emergencies
Procedure
Low ionic strength salt (LISS)
Procedure (rapid 15 minutes test)
Interpretation
Procedure for issuing blood unit
CHAPTER 8:
Transfusion reactions and complications
Types of transfusion reactions
Haemolytic transfusion reactions (HTR)
Events in haemolytic transfusion reaction
Role of transfusionist in HTR
Investigation of a case of transfusion reaction
Interpretation of the results
Nonimmunological causes of haemolysis
Non-haemolytic transfusion reactions
Leucocyte incompatibility
Febrile reactions
Noncardiac pulmonary reactions
Reactions due to plasma proteins
Platelet incompatibility
Febrile reactions
Post-transfusion purpura
Anaphylactic reactions
Allergic reactions
Transfusion-related acute lung injury (TRALI)
Transfusion reactions based on time factor
Immediate effects
Delayed effects
CHAPTER 9:
Screening for diseases transmitted through blood
Tests for hepatitis B
Rapid tests
Reagent
Procedure
Test for anti-HCV antibody
Screening tests for HIV1 and HIV2
ELISA
Test for syphilis
Malaria
CHAPTER 10:
Blood donor and collection of blood
The blood donor
Types of Donors
Registration of donor
Consent of donor
Selection of donor
Medical history
Medication
Pregnancy
Surgery
Immunisation
Hepatitis B vaccination
Infectious diseases
Tattooing
Malaria
Physical examination
Age
Body weight
Volume
Pulse and blood pressure
Systemic examination
Screening of donor blood
Haemoglobin
Blood grouping
Tests for agents of transfusion transmitted diseases
Frequency of donation
Collection of blood
Bleeding room
Materials required for phlebotomy
Volume of blood
Phlebotomy
Site of venepuncture
Instructions to donor after donation of blood
Complications of blood donation (donor reactions)
Management of donor reactions
CHAPTER 11:
Storage and preservation of blood and its components
Biochemical changes in the stored blood
RBC
WBC
Platelets
Coagulation factors
Electrolytes
Preservative solutions
Acid citrate dextrose (ACD)
Citrate phosphate dextrose (CPD)
Citrate phosphate dextrose-adenine (CPDA-1)
Additive solutions
CPD-SAGM
CPD-Adsol
Long-term storage of red cells
Glycerolisation
High glycerol solution
Low glycerol solution
Thawing and deglycerolisation
Procedure for deglycerolisation
Indications for long-term storage of rbc in frozen state
Storage of plasma
Storage of platelets
CHAPTER 12:
Haemolytic disease of the newborn
Aetiopathogenesis
ABO HDN
Rh HDN
Rh HDN due to blood transfusion
Investigations on newborn
Antenatal management of Rh (D) negative mother
Amniocentesis
Rh immune globulin
CHAPTER 13:
Autoimmune haemolytic anaemia
Warm autoimmune haemolytic anaemia
Idiopathic
Secondary
Cold autoimmune haemolytic anaemia (cold agglutinin syndrome)
Idiopathic
Secondary
Paroxysmal cold haemoglobinuria (PCH)
Drug-induced AIHA
Transfusion in AIHA
Xylene elution technique
Procedure
Cold acid elution technique
Materials
Procedure
Note
CHAPTER 14:
Blood components
Preparation of Rbc concentrate
Centrifugation method
Leucocytes depleted red cell concentrate
Leucocyte depletion by centrifugation
Upright Spin
Inverted spin
Preparation of fresh frozen plasma (FFP)
Procedure
Preparation of platelet concentrate (PC)
Procedure
Platelet concentrate (PC)
Note
Cryoprecipitate
Preparation of cryoprecipitate
CHAPTER 15:
Transfusion therapy
Criteria for whole blood (WB) transfusion
Criteria for RBC concentrate transfusion in adults
Non-surgical cases
Surgical cases
Dosage and administration
Criteria for FFP transfusion
Transfusion of cryoprecipitate
Indications for Transfusion of Cryoprecipitate
Dosage
Transfusion of platelet concentrate
Criteria for platelet transfusion
Factors affecting response to platelet transfusion
Platelet increment
Requirement of platelets
Platelet refractoriness
Transfusion of fresh blood
Massive transfusion
Autologous blood transfusion
Options for autologous transfusion
Predeposit
Normovolumic haemodilution
Intraoperative salvage
Steps of intraoperative blood salvage (Figure 15.2)
Postoperative salvage
Single unit transfusion
Apheresis/hemapheresis
Frequency of donation
Therapeutic apheresis
Indications for therapeutic apheresis
Hospital transfusion committee
CHAPTER 16:
Neonatal and pediatric transfusion
Blood grouping of newborns or cord blood
ABO grouping
Rh grouping
Anti-human globulin (AHG) test (Coombs’)
Cross-matching in neonates
Procedure
Components transfusion in neonates
Red cells concentrate
Criteria for rbc concentrate transfusion in neonates
Criteria for FFP transfusion in neonates
Platelet transfusion
Transfusion of platelets in NAIT and NITP
Transfusion in preterm neonates
Exchange blood transfusion
Cross-matching for exchange transfusion
Complications of exchange transfusion
Intrauterine transfusion
Cytomegalovirus infection
CHAPTER 17:
Obstetrical transfusion practice
Criteria for obstetric transfusion
Anaemia in pregnancy
Antenatal care
Transfusion therapy in obstetrics
Transfusion in DIC
Massive transfusion
Further Reading
INDEX
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