Bloodbanking

1. The Role of Blood Banking in the Diagnosis and
Treatment of a Patient with β Thalassemia Major
Aysha Taylor & Shalandria Franklin-Jackson | MLT-1060-76879 | Immunohematology | Professor Gill | September 22, 2021
Abstract
Pathophysiology
Thalassemia is caused by mutations inside DNA of cells that make
hemoglobin. This mutation is genetically passed from parents to their
offspring. Abnormal hemoglobin causes a shortage of oxygen to the
tissues in the body. This can cause damage to the organs and
eventually death. Thalassemia is a genetic condition so anyone can
inherit it. People at higher risk are individuals from Mediterranean
countries, Asia, Africa, and the Middle East.
Acceptable Blood Banking Specimen
• Whole blood collected in
lavender top (EDTA) tube
must be:
 1-4 mL for each test (ABO/D
typing, antibody screening).
 Collected from the veins.
 Used as soon as possible or
stored at 2°C to 8°C.
Instrument Methodology
Individuals with Thalassemia will require
frequent blood transfusions. Blood
transfusions will require proper testing in
order to make sure the blood that the patient
is receiving is safe for them to receive.
 ABO/D typing
o A common test used for blood typing
is tube testing. It consists of using
agglutination of the patient’s red blood
cells and plasma.
Typical Blood Banking Results Diagnostics
• To ensure a safe blood transfusion, the patient must be ABO/D
compatible with the donor.
• Transfusion therapy increases the risk of allo-antibodies:
 Rhesus (Rh)
 Kell (K)
 Duffy (Fy)
 Kidd (Jk)
• On a study done on β thalassemia major patients who received
transfusions:
 5 were IAT positive
 5 were DAT positive
Interfering Factors/ QA Issues
• Recently transfused patients may have ABO/D typing
discrepancies.
 There may be extra RBC reactivity in the forward typing.
 Mixed field reactivity can occur if type O blood is given to a type A or type
B recipient.
o The forward results can be interpreted as type O, or the patient's blood
type.
o The reverse results are consistent with the patient's blood type.
Additional Testing
Blood Products Used for Treatment
Regular red cell transfusions are the
main choice of treatment for patients
with thalassemia major. Packed red
cells are washed and leukocyte
reduced. The red cells are also frozen
or cryopreserved within 7 days of
collection. They are then stored at -60
to -80 degrees Celsius.
References
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Hematology results show a microcytic hypochromic anemia:
• MCV: 70 ± 9.5 μm3
• Hemoglobin: 7.2 ± 1.5 g/dL
• Hematocrit: 21.5 ± 5.3 %
• Platelet count: lower than normal
• CBC: lower than normal
Thalassemia is a blood disorder that is genetically inherited which
causes individuals to have anemia. Blood banking is used to diagnose
this condition with methods such as complete blood count (CBC). This
method consists of using EDTA Whole Blood for testing. A complete
blood count test is done automatically using a hematology analyzer
that measures the quantity and characteristics of a red blood cell. The
results consist of lower-than-normal indices such as MCV, MCHC,
and H&H.