ImmunoHaematology at Durban Institute of Technology

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Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Briefly discuss rh antibodies. 

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Describe Haemolytic disease of the Foetus and Newborn under Antenatal and Postnatal treatment options. 

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Discuss two procedures that are useful in collecting samples during pregnancy and to determine the severity of the HDFN. 
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Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Name the laboratory tests done on new donors to prevent the transfusion of transmittible diseases to the recipient. 

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Name and explain five transfusion transmitted diseases that can be possible found in blood donations. 

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Briefly explain the selection of blood products for the transfusion. 

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Discuss the importance, and all the processes involved in selection of blood including compatibility testing. Mention the steps ensuring safe patient blood transfusion. 
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Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

What type of blood units can be selected for the following patient:
Group O, Weak D female 

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

What type of blood units can be selected for the following patient:
Group A, Weak D male

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

What type of blood units can be selected for the following patient:
Group B, rh positive baby

Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Discuss the following auto-immune diseases,
Cold Haemagglutinin Disease. 
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Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

Discuss weak D under the following:
a) Donor
b) Recipient/patient
c) Pregnant women 

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Exemplary flashcards for ImmunoHaematology at the Durban Institute of Technology on StudySmarter:

ImmunoHaematology

Briefly discuss rh antibodies. 
  • Rh system has five common Rh antibodies namely: Anti-D, Anti-C, Anti-E, Anti-c and Anti-e.
  • They are IgG and IgM antibodies.
  • IgG Rh antibodies  react well by enzyme technique as well as at 37 degrees Celsius by the Antiglobulin method (AHG)
  • They are red cell immune antibodies, meaning they can be produced or stimulated as a result of exposure to foreign red blood cells. 
  • All antibodies  reacted at 37 degrees Celsius are clinically significant antibodies.
  • These IgG antibodies are able to cause haemolytic transfusion reaction and Haemolytic disease of the foetus and newborn.
  • They do not activate complement but can cause extravascular red cell destruction
  • Weak reacting antibodies namely , Anti-E and Anti-c can cause delayed haemolytic transfusion reactions.
  • IgG antibodies react mostly in a cold environment by enzyme technique therefore cannot cause haemolytic transfusion reaction in transfusion.


ImmunoHaematology

Describe Haemolytic disease of the Foetus and Newborn under Antenatal and Postnatal treatment options. 
ANTENATAL -FOETUS 

PLASMAPHERESIS
Reduce level of IgG antibodies crossing the placenta to sensitize foetal red cells.

INTRA-UTERINE TRANSFUSION
To correct foetal anaemia 
Blood to be used : washed red cells, irradiated, leucodepleted,  Group  O Rh-negative low titre, freshly bled blood and antigen negative for antibodies that the mother has.

PREMATURE INDUCTION OF LABOUR
Performed at 36 weeks gestation and above.

POSTNATAL - NEWBORN 

EXCHANGE TRANSFUSION
Correct anaemia, remove bilirubin and sensitized cells from circulation, remove mother`s circulating antibodies from the baby`s circulation.  

RED CELL TRANSFUSION  
Treat anaemia,  fresh leucodepleted red cells.

ALBUMIN
Albusol to bind bilirubin for excretion and to lower bilirubin level.

POLYGHAM
Treat HDN ,to prevent exchange of transfusion.

PHOTOTHERAPY (Ultraviolet light)
breakdown of bilirubin. Supplementary treatment for exchange of transfusion in severe cases.

ImmunoHaematology

Discuss two procedures that are useful in collecting samples during pregnancy and to determine the severity of the HDFN. 
AMNIONCENTESIS
  • Procedure that is invasive (can induce labour or increased maternal antibody ) so it is applied/used between 15 to 18 weeks of pregnancy  (second trimester) , to rule out certain defects.
  • The procedure is advised when maternal antibody titre is 64 and above.
  • The amniotic fluid is collected by inserting the needle through the uterine wall into the uterine cavity of a pregnant mother. 
  • The sample is analysed for the presence of bilirubin in the foetus.
  • To check/assess anaemia in babies with Rh diseases.
  • To check /find out if foetal lungs are mature enough for the baby to be delivered. 

CORDONCENTESIS
  • Is an invasive procedure,  but safest. 
  • It  can be performed after 17 weeks of pregnancy.
  • The procedure is recommended  for diagnosis when amniocentesis procedure has failed, ultrasound and results of the tests cannot be concluded.
  • The foetal blood sample is collected directly from the umbilical cord or foetus by inserting a thin needle guided through the abdomen and uterine walls to the umbilical cord.
  • The sample is used to test the foetal red blood cell counts, foetal oxygen level, ABO and Rh
  • To determine foetal anaemia
  • To check bilirubin level, to look for the signs of red cell destruction in the cases of HDFN.





ImmunoHaematology

Name the laboratory tests done on new donors to prevent the transfusion of transmittible diseases to the recipient. 
  • Check Hb
  • Full blood count
  • Blood Grouping
  • ABO Titre
  • Irregular antibody screening
  • VDRL, HBsAg, anti-HIV 1 + 2 , p24 Ag, anti-HCV (Tests for infectious diseases )
  • Total protein
  • Serum albumin
  • LFT ( Liver Function Tests )
  • Screening of hyperimmune antibodies e.g anti-rabies, anti-D, anti- hepatitis B , anti-varicella zoster.  



ImmunoHaematology

Name and explain five transfusion transmitted diseases that can be possible found in blood donations. 
Hepatitis B Virus (HBV)  
  • The transfusion of HBsAg positive blood may result in a severe infection , even death in the recipient. 
  • Other viral markers HBcAg, HBeAg, anti-HBc and anti-HBe must be tested for the possible presence of HBV.
  • Therefore, all blood donations found positive for HBV must be destroyed and the donors be counseled. 
  • The donor must be requested not to donate blood in future and 
  • be removed from the donor panel.  

Hepatitis C Virus (HCV)
  • The donation that shows the presence of hepatitis C Virus may cause post transfusion hepatitis in the recipient and this can cause long-term complications such as hepatoma and liver diseases.
  • Therefore, all donations that are anti-HCV positive must be discarded/destroyed. 

Human Immunodeficiency Virus ( HIV-1 and HIV-2)
  • The donors who carry p24 antigen of anti- HIV1 and HIV2 are not allowed to donate  and their blood donations must be discarded.
  • The donors must be counselled and deferred permanently  as a blood donor. 

Syphilis
  • Any donor with a sexually transmitted infection such as syphilis may be a high risk for other diseases. 
  • Besides, syphilis can be transmitted by blood transfusion.
  • Therefore, all blood donations that are found syphilis positive must be discarded or destroyed. 

Cytomegalovirus (CMV)
  • This is a virus that is transmitted in the white blood cells but cannot survive on storage. 
  • The risk of transmission in blood donation is minimal over 48 hours.
  • Most of the units released are in the form of buffy coats to reduce the number of white cells
  • Blood screening for the presence of  anti- CMV is highly recommended for newborn babies and immunocompromised people.
  • To prevent the transmission of CMV , children/newborn babies  in ICU must be transfused with fresh filtered , irradiated blood .
  • Unfortunately, CMV is not part of the routine screening tests and the irradiation of blood can only be done as per Doctor`s requests.  



ImmunoHaematology

Briefly explain the selection of blood products for the transfusion. 
  • Homologous group blood must be selected for transfusion (group to group)
  • Example, Group B patient must receive Group B blood.
  • If ABO specific blood is unavailable (e.g Group B) , Group O unit -universal donor must be Selected provided that the anti-A and Anti- B are low titre.
  • Group AB – Universal recipient ( donor plasma should have low titre Abs, so as not to be harmful to recipient`s Ags).
  • When an irregular antibody is detected in the patient`s serum, random donor unit must must be selected for crossmatching  patient`s serum.
  • Make sure that donor unit selected and crossmatched will not expire before use.
  • Packed red cell units should be selected if the patient does not require volume, only Increased oxygen -carrying capacity.
  • Whole blood should be reserved for when patient needs volume expansion e.g surgery or Major trauma. 


ImmunoHaematology

Discuss the importance, and all the processes involved in selection of blood including compatibility testing. Mention the steps ensuring safe patient blood transfusion. 
  • The importance of compatibility testing is to make sure that blood to be transfused will survive normally in the recipient/patient.
  • This involved major crossmatching of blood unit by mixing the patient`s serum with the donor`s cells, to establish that there is no reaction between them and that the cells will survive normally in the recipient. 
  • The crossmatching of blood is the last stage in the process before the donor unit is released.

Steps ensuring safe patient blood transfusion:
  • A crossmatch laboratory request form must contain full patient and doctor`s details which include:
  • Surname, first name, age /date of birth, sex hospital patient identification number, hospital ward.
  • Diagnosis and other specified clinical information.
  • Previous transfusion history, number and type of blood /blood component, including transfusion accessories.
  • Any other special requirements. 
  • Date and time the product is required. 
  • Prescribing doctor`s name, signature and contact details.
  • In order to prevent patient misidentification, it is essential that the bedside check of the patient`s details is carried out with the utmost care. 
  • The person performing procedure must be a doctor, or on a specific instruction, a registered nurse /sister.

Steps for compatibility process:
  • Review patient`s past blood bank history and records if applicable. 
  • ABO grouping and Rh typing. 
  • Antibody screening of the recipient`s serum Crossmatch.                                              



ImmunoHaematology

What type of blood units can be selected for the following patient:
Group O, Weak D female 

Group O, Rh negative, low titre.

ImmunoHaematology

What type of blood units can be selected for the following patient:
Group A, Weak D male
Group A, Rh positive 
or 
Group O, Rh negative ,low titre.

ImmunoHaematology

What type of blood units can be selected for the following patient:
Group B, rh positive baby
Group B, Rh positive, 
or 
Group O , negative low titre, 
fresh filtered blood/leucodepleted      

ImmunoHaematology

Discuss the following auto-immune diseases,
Cold Haemagglutinin Disease. 
  • This is a disease resulted from patients who had an exposure to cold.
  • Once the temperature decreases from the body, auto-antibodies in the cold regions complex with red cell antigens.
  • When the cells return to parts of the body where the temperature is normal, the antigen-antibody reactions dissociate.
  • Some reactions may bind complement before complete dissociation occurs so the bound complement will cause haemolysis.
  • CHD can be idiopathic, associated with lymphoreticular malignancy and symptomatic of several infections such as influenza , acute mycoplasma pneumonia and infectious mononucleosis.        



ImmunoHaematology

Discuss weak D under the following:
a) Donor
b) Recipient/patient
c) Pregnant women 

Donor
Weak D donor is treated and labelled Rh-positive donors, this is to prevent the blood being transfused into Rh-negative recipients, who may be stimulated to produce ant-D.

Recipient/patient
Weak D female patients are treated as Rh negative, this is to prevent them from being transfused with Rh-positive blood which may stimulate them to produce anti-D, which may complicate future pregnancies. Weak D male patients may be transfused with Rh-positive blood.

Pregnant women 
The pregnant weak D women carrying Rh-positive foetuses should not develop anti-D even if there is a transplacental bleed because she has the entire D antigen (complete D protein), but fewer antigens per red cell.
Prophylaxis (anti-D immunoglobulin) offered to Rh-negative mothers who carry Rh-positive babies must not be given to weak D mothers.




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