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Transfusion pathology www.freelivedoctor.com
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
intro Rh ABO products other groups indications testing dangers www.freelivedoctor.com
Transfusion Pathology Outline ,[object Object],[object Object],www.freelivedoctor.com
[object Object],intro Rh ABO products other groups indications testing dangers www.freelivedoctor.com
[object Object],[object Object],intro Rh ABO products other groups indications testing dangers www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],Red Cell Antigens intro Rh ABO products other groups indications testing dangers www.freelivedoctor.com
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
What are the antigens? ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com ,[object Object],[object Object],[object Object],[object Object],[object Object],intro Rh ABO products other groups indications testing dangers
What are the antigens? Type A Type B Type AB Type O www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
How do you make the antigens? ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
H antigen A antigen B antigen www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
What are the genes? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*  almost! www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
www.freelivedoctor.com Genotype Antigens Blood type AA A A AO BB B B BO AB A and B AB OO None O intro Rh ABO products other groups indications testing dangers
How common is each blood type? www.freelivedoctor.com Blood type Percent of population A 40% B 12% AB 6% O 42% intro Rh ABO products other groups indications testing dangers
So What? ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
So what? Type  A Type  B Type AB Type O www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
www.freelivedoctor.com Genotype Antigens Blood type Antibodies AA A A anti-B AO BB B B anti-A BO AB A and B AB none OO None O anti-A  anti-B intro Rh ABO products other groups indications testing dangers
Compatible blood types *   type  O  = universal d O nor! www.freelivedoctor.com Recipient blood type Donor blood type A A or O * B B or O AB AB, A, B, or O O O intro Rh ABO products other groups indications testing dangers
O AB www.freelivedoctor.com B
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
What are the antigens? ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
www.freelivedoctor.com Genotype Antigens Blood type DD D Rh + Dd D Rh + dd none Rh - intro Rh ABO products other groups indications testing dangers
What are the antibodies? ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Don’t tell me there are more systems. ,[object Object],[object Object],[object Object],*   Not quite: a sh*tload is defined as more than 42. www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
What do you mean, products? ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
What are the products? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets BLOOD PRODUCTS Fresh Frozen Plasma www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma VIII Cryoprecipitate BLOOD PRODUCTS IX Albumin IgG www.freelivedoctor.com
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Whole Blood Use: massive hemorrhage RBC WBC platelets plasma Contents:  INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Use: low hemoglobin RBC a few WBC a few platelets a little plasma Contents:  INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Use: sepsis in neutropenic patients neutrophils Contents:  INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-rich plasma INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Use: bleeding due to thrombocytopenia platelets Contents:  INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Use: bleeding due to multiple factor deficiencies (e.g., DIC) Plasma  (including ALL  coagulation factors) Contents:  INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate Uses: low fibrinogen, vW disease, hemophilia A fibrinogen von Willebrand factor VIII Contents:  INDICATIONS www.freelivedoctor.com
Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate INDICATIONS A bunch of other stuff Use: rarely used www.freelivedoctor.com
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
patient  red cells (type A) FORWARD  TYPE anti-A antibodies AHG Forward typing is done using both anti-A and anti-B antibodies! www.freelivedoctor.com
patient serum (with anti-B Ab) AHG reagent  red cells (type B) REVERSE  TYPE Reverse typing is done using both type A and type B reagent cells! www.freelivedoctor.com
patient serum AHG donor red cells CROSSMATCH www.freelivedoctor.com
patient   serum AHG reagent  RBC number  1 patient serum AHG reagent   RBC number 2 ANTIBODY  SCREEN no agglutination (negative test ) agglutination (positive test) www.freelivedoctor.com
Transfusion Pathology Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
What can go wrong? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Acute Hemolytic Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
www.freelivedoctor.com
Delayed Hemolytic Transfusion Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Non-Hemolytic Transfusion Reactions ,[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Circulatory Overload ,[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Iron Overload ,[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
Infections ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
What’s the risk of getting an infection? www.freelivedoctor.com Bug Risk Hepatitis C One in 50,000 Hepatitis B One in 100,000 HTLV One in 100,000 Bacterial infection One in a million Other infections One in a million HIV One in 2 million intro Rh ABO products other groups indications testing dangers
What’s the risk of other complications? www.freelivedoctor.com Complication Risk Allergic reaction One in 100 (severe: one in 20,000) Febrile reaction One in 200 Circulatory overload One in 3,000 Delayed hemolysis One in 4,000 (fatal: one in 4 million) Acute hemolysis One in 20,000  (fatal: one in 600,000) intro Rh ABO products other groups indications testing dangers

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Transfusion pathology

  • 2.
  • 3. intro Rh ABO products other groups indications testing dangers www.freelivedoctor.com
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. What are the antigens? Type A Type B Type AB Type O www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
  • 11.
  • 12. H antigen A antigen B antigen www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
  • 13.
  • 14. www.freelivedoctor.com Genotype Antigens Blood type AA A A AO BB B B BO AB A and B AB OO None O intro Rh ABO products other groups indications testing dangers
  • 15. How common is each blood type? www.freelivedoctor.com Blood type Percent of population A 40% B 12% AB 6% O 42% intro Rh ABO products other groups indications testing dangers
  • 16.
  • 17. So what? Type A Type B Type AB Type O www.freelivedoctor.com intro Rh ABO products other groups indications testing dangers
  • 18. www.freelivedoctor.com Genotype Antigens Blood type Antibodies AA A A anti-B AO BB B B anti-A BO AB A and B AB none OO None O anti-A anti-B intro Rh ABO products other groups indications testing dangers
  • 19. Compatible blood types * type O = universal d O nor! www.freelivedoctor.com Recipient blood type Donor blood type A A or O * B B or O AB AB, A, B, or O O O intro Rh ABO products other groups indications testing dangers
  • 21.
  • 22.
  • 23. www.freelivedoctor.com Genotype Antigens Blood type DD D Rh + Dd D Rh + dd none Rh - intro Rh ABO products other groups indications testing dangers
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS www.freelivedoctor.com
  • 31. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS www.freelivedoctor.com
  • 32. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS www.freelivedoctor.com
  • 33. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets BLOOD PRODUCTS Fresh Frozen Plasma www.freelivedoctor.com
  • 34. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma VIII Cryoprecipitate BLOOD PRODUCTS IX Albumin IgG www.freelivedoctor.com
  • 35.
  • 36. Whole Blood Use: massive hemorrhage RBC WBC platelets plasma Contents: INDICATIONS www.freelivedoctor.com
  • 37. Whole Blood Red Cells Use: low hemoglobin RBC a few WBC a few platelets a little plasma Contents: INDICATIONS www.freelivedoctor.com
  • 38. Whole Blood Red Cells Granulocytes Use: sepsis in neutropenic patients neutrophils Contents: INDICATIONS www.freelivedoctor.com
  • 39. Whole Blood Red Cells Granulocytes Platelet-rich plasma INDICATIONS www.freelivedoctor.com
  • 40. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Use: bleeding due to thrombocytopenia platelets Contents: INDICATIONS www.freelivedoctor.com
  • 41. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Use: bleeding due to multiple factor deficiencies (e.g., DIC) Plasma (including ALL coagulation factors) Contents: INDICATIONS www.freelivedoctor.com
  • 42. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate Uses: low fibrinogen, vW disease, hemophilia A fibrinogen von Willebrand factor VIII Contents: INDICATIONS www.freelivedoctor.com
  • 43. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate INDICATIONS A bunch of other stuff Use: rarely used www.freelivedoctor.com
  • 44.
  • 45. patient red cells (type A) FORWARD TYPE anti-A antibodies AHG Forward typing is done using both anti-A and anti-B antibodies! www.freelivedoctor.com
  • 46. patient serum (with anti-B Ab) AHG reagent red cells (type B) REVERSE TYPE Reverse typing is done using both type A and type B reagent cells! www.freelivedoctor.com
  • 47. patient serum AHG donor red cells CROSSMATCH www.freelivedoctor.com
  • 48. patient serum AHG reagent RBC number 1 patient serum AHG reagent RBC number 2 ANTIBODY SCREEN no agglutination (negative test ) agglutination (positive test) www.freelivedoctor.com
  • 49.
  • 50.
  • 51.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58. What’s the risk of getting an infection? www.freelivedoctor.com Bug Risk Hepatitis C One in 50,000 Hepatitis B One in 100,000 HTLV One in 100,000 Bacterial infection One in a million Other infections One in a million HIV One in 2 million intro Rh ABO products other groups indications testing dangers
  • 59. What’s the risk of other complications? www.freelivedoctor.com Complication Risk Allergic reaction One in 100 (severe: one in 20,000) Febrile reaction One in 200 Circulatory overload One in 3,000 Delayed hemolysis One in 4,000 (fatal: one in 4 million) Acute hemolysis One in 20,000 (fatal: one in 600,000) intro Rh ABO products other groups indications testing dangers