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Immunohematology

ABO discrepancies

TermDefinition
Group 1 discrepancy Weak or missing ag due to immunocompromised status
Group 2 discrepancy Missing antigens due to disease or rare subgroup
Group 3 discrepancy Unexpected antigens due to disease or extra proteins
Group 4 discrepancy Unexpected antibodies due to infection or alloantibodies
Group 1 missing ab resolve Determine diagnosis, incubate at room temperature 15 minutes, incubate at 4 to enhance cold ab
Group 2 missing ag resolve Room temperature incubation to enhance weak rxn, pretreat with enzymes, check for acquired B
Group 3 unexpected ag resolve Wash to resolve forward testing, saline replacement, wash to remove whartons jelly
Group 4 unexpected ab resolve DAT at cold temp for cold alloantibodies, Dolichos biflorus to detect A2 our other A subgroup, ab screen/panel to detect alloantibodies
Forward typing discrepancies Missing ag due to subgroup/disease, extra ag due to disease or protein, mixed field die to transfusions or transplant
Reverse typing discrepancies Missing ab in newborns or elderly, extra ab due to anti-A1 alloantibodies, passive immunity
Caucasian ABO frequencies A 41%, B 10%, O 45%, AB 4%
Black ABO frequencies A 27%, B 20%, O 49%, AB 4%
Asian ABO frequencies A 28%, B 26%, O 40%, AB 6%
Enzymes enhance Rh, Kidd, Lewis, P
Enzymes destroy Kell, Duffy, MNS (Lutheran)
Cold antibodies Lewis, P, MN, Lu-a
Warm antibodies Rh, Kell, Duffy, Kidd, SsU, Lu-b
Labile in vivo and in vitro Kidd
Expression lost during pregnancy Lewis
Resistant to P. vivax Fy (a-b-) cells
R1 DCe, common
R0 Dce, common in blacks, otherwise rare
R2 DcE, 20% or less in all pops
RZ DCE, extremely rare
r dce, rare in Asians, otherwise common
r' rCe, rare
r" dcE, extremely rare
rY dCE, extremely rare
Hydatid cyst fluid Has anti-P activity
Donath-Landsteiner test For paroxysmal cold hemogloburia. Detects anti-P IgG
Hematocrit increase per unit RBC 3%
Hemoglobin increase per unit RBC 1g/dL
Whole blood indications Symptomatic anemia with large volume deficit
RBC indications Symptomatic anemia
Plasma indications Deficiency of labels and stable plasma coagulation factors
Cryoprecipitate pooled indications Hypifibrinogenemia, factor Xlll deficiency
Factor Vlll indications Hemophilia A
Basic evaluation of transfusion rxn Clerical error check, hemolysis check, DAT, retype
Increase in platelets per unit 20,000-40,000
Factor IX Hemophilia B
RhIgG dose calculation Fetal cell % x 50 \ 30 plus one vial
Refractive mixed field agglutination Anti-Sda
Warm autoimmune hemolytic anemia Often associated with anti-e
Neutralize Lea Use saliva containing secretions of Lea
Complement dependant antibodies detection Serum stored at 4C for less than 48 hours
HTLA High titer low avidity antibodies
NAT testing for HIV, HCV
Vaccines with no deferral period Recombinant vaccines
Acceptable time limit for whole blood collection 20 minutes
Placid/clopidogrel Destroys platelets
Waiting period between autologous donations 3days
Cryoprecipitate expiration post thaw, post pooling 4 hours
RBCs retained after leukoreduction 85%
Techniques for weak D testing 37C incubation +IAT
Wiener Rh theory Single-locus theory, multiple alleles determine surface Rh antigens
Weak D is missed by gel testing, because ithe ABD card lacks a 37C and AHG phase
U antigen Part of the MNS group, no dosage, not affected by enzymes, IgG class warm significant antibody
Poorly expressed at birth Lewis, Lutheran, I, ABO
strong expression at birth Rh, Kell, Duffy, Kidd, MNS
Clinically significant antigens in generally non-significant groups Lub, SsU
McLeod phenotype Lacks Kell group. Associated with CGD
Created by: Enebergall
 

 



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