Blood Banking and Transfusion Disorders

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Synthesis of Antibodies:

• Blood group antibodies are synthesized in Peyer's patches.

Blood group O:

• Antigens: none.

• Antibodies: anti-A-IgM; anti-B-IgM.

Blood group A:

• Antigens: A

• Antibodies: anti-B-IgM.

Blood group B:

• Antigens: B

• Antibodies: anti-A-IgM.

Blood group AB:

• Antigens: A and B

• Antibodies: none.

Blood transfusion screening:

• Syphilis, Hepatitis B/C, HIV 1/2, and HTLV-1.

Transfusion reactions: allergic reactions:

• IgE mediated.

• Findings: urticaria, fever, tachycardia, wheezing.

Transfusion Reactions: Febrile Reaction:

• Recipient has HLA directed against foreign HLA.

• Type II hypersensitivity reaction.

• Fever, chills, headache, flushing.

Treatment:

• Antipyretics.

Transfusion Reactions: Acute Hemolytic Transfusion Reaction:

• Intravascular: ABO incompatibility; type II hypersensitivity.

• Extravascular: donor RBCs coated with antibodies; jaundice.

Findings:

• Fever, back pain, hypotension, DIC, oliguria.

Hemolytic Disease of Newborn:

• Maternal IgGs coat infant RBCs.

Hemolytic disease of newborn: ABO HDN:

• Mom = type O; baby = type A or B.

• Jaundice develops 24 hours after birth.

• Anemia.

• + Coombs' test on baby blood.

Hemolytic disease of newborn: Rh HDN:

• Mom is RH negative; baby is Rh positive.

• Mom exposed to fetal blood, develops anti-D-IgG antibodies.

• First pregnancy plays no role.

• During second pregnancy, anti-D-IgG enters placenta coats baby RBCs.

Treatment:

• At 28th week of pregnancy, give mom anti-D globulin (it covers and eliminates "Rh+" baby blood before mom's body officially mounts an attack against it), which lasts ~3 months.

Findings:

• Jaundice, kernicterus, positive direct/indirect Coombs' test.

• Use blue fluorescent light on newborn skin.

Additional Reading:

Basic Pathology

1. Cell Injury
2. Inflammation and Repair
3. Immunopathology
4. Water, Electrolyte, Acid-Base, Hemodynamic Disorders
5. Genetic and Developmental Disorders
6. Environmental Pathology
7. Nutritional Disorders
8. Neoplasia
9. Vascular Disorders
10. Heart Disorders
11. Red Blood Cell Disorders
12. White Blood Cell Disorders
13. Lymphoid Tissue Disorders
14. Hemostasis Disorders
15. Blood Banking and Transfusion Disorders
16. Upper and Lower Respiratory Disorders
17. Gastrointestinal Disorders
18. Hepatobiliary and Pancreatic Disorders
19. Kidney Disorders
20. Lower Urinary Tract and Male Reproductive Disorders
21. Female Reproductive and Breast Disorders
22. Endocrine Disorders
23. Musculoskeletal Disorders
24. Skin Disorders
25. Nervous System Disorders
26. Notes on Tissue Regeneration
27. A Table of Bleeding Disorders
28. FAQ on Structure and Function of Red Blood Cells
29. FAQ on Components of Blood
30. Notes on Hemostatic Mechanisms
31. What is Fever?
32. What is Edema?
33. FAQ on Blood Pressure
34. FAQ on principles of fluid and flow dynamics of Blood
35. Causes of Thrombocytopenia
36. Squamous cell carcinoma of head and neck mucosa
37. Four tumors which never metastasize to the brain
38. What is caustic injury?
39. What causes Peripheral Edema?

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