The document outlines the key aspects of transfusion pathology, including blood groups, the ABO and Rh blood typing systems, blood products used for transfusion, common indications for transfusion, testing procedures, and potential dangers of transfusion such as hemolytic and non-hemolytic reactions, circulatory overload, and infections. It provides details on the antigens, genes, prevalence, and antibody responses for different blood types in the ABO system and describes the Rh system antigens and antibody acquisition.

1. Transfusion pathology Kristine Krafts, M.D. September 24, 2007

3. intro Rh ABO products other groups indications testing dangers

10. Type A intro Rh ABO products other groups indications testing dangers What are the antigens? Type B Type AB Type O

12. H antigen A antigen B antigen intro Rh ABO products other groups indications testing dangers

14. O None OO AB A and B AB B BO BB AO AA Genotype B A A Blood type Antigens intro Rh ABO products other groups indications testing dangers

15. How common is each blood type? 42% O 6% AB 12% B 40% A Percent of population Blood type intro Rh ABO products other groups indications testing dangers

17. Type A intro Rh ABO products other groups indications testing dangers So what? Type B Type AB Type O

18. anti-A anti-B none anti-A anti-B Antibodies O None OO AB A and B AB B BO BB AO AA Genotype B A A Blood type Antigens intro Rh ABO products other groups indications testing dangers

19. Compatible blood types * type O = universal d O nor! O O AB B A Recipient blood type AB, A, B, or O B or O A or O * Donor blood type intro Rh ABO products other groups indications testing dangers

20. O AB A B

23. Rh - none dd Rh + Dd DD Genotype D Rh + D Blood type Antigens intro Rh ABO products other groups indications testing dangers

31. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS

32. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS

33. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS

34. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets BLOOD PRODUCTS Fresh Frozen Plasma

35. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma VIII Cryoprecipitate BLOOD PRODUCTS IX Albumin IgG

37. Whole Blood Use: massive hemorrhage RBC WBC platelets plasma Contents: INDICATIONS

38. Whole Blood Red Cells Use: low hemoglobin RBC a few WBC a few platelets a little plasma Contents: INDICATIONS

39. Whole Blood Red Cells Granulocytes Use: sepsis in neutropenic patients neutrophils Contents: INDICATIONS

40. Whole Blood Red Cells Granulocytes Platelet-rich plasma INDICATIONS

41. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Use: bleeding due to thrombocytopenia platelets Contents: INDICATIONS

42. 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

43. 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

44. Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryoprecipitate INDICATIONS A bunch of other stuff Use: rarely used

47. patient red cells (type A) FORWARD TYPE anti-A antibodies AHG Forward typing is done using both anti-A and anti-B antibodies!

48. 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!

49. patient serum AHG donor red cells CROSSMATCH

50. patient serum AHG reagent RBC number 1 patient serum AHG reagent RBC number 2 ANTIBODY SCREEN no agglutination (negative test) agglutination (positive test)

60. What’s the risk of getting an infection? One in 50,000 Hepatitis C One in a million Bacterial infection One in 100,000 HTLV One in 100,000 Hepatitis B One in 2 million HIV One in a million Other infections Risk Bug intro Rh ABO products other groups indications testing dangers

61. What’s the risk of other complications? One in 100 (severe: one in 20,000) Allergic reaction One in 4,000 (fatal: one in 4 million) Delayed hemolysis One in 3,000 Circulatory overload One in 200 Febrile reaction One in 20,000 (fatal: one in 600,000) Acute hemolysis Risk Complication intro Rh ABO products other groups indications testing dangers