Immunohematology/Blood Banking
- a branch of immunology which deals with the
uses of immunologic principles to study and
identify the different blood groups
- reflects the importance of the blood bank and the
MT profession in ensuring the safety and welfare
of patients that require blood transfusion
Blood Bank
- a separate area in a clinical laboratory hospital
where blood is collected from donors
- performs ABO and Rh typing (2 major blood
groups)
- separates blood components for future use or
transfusion
- prepares blood and blood components for
transfusion
- blood that is transfused into a recipient must be
tested first to ensure compatibility with the
patient’s blood
• To reduce risk of transfusion reactions
• To ensure that blood/blood components
are safe
- blood bags are procured with monetary value to
pay for the tests made on the blood to make sure
it is safe
ABO Blood Group System
- Discovered by Karl Landsteiner (1900s) and
received the Nobel prize (1930)
- He categorized the blood groups A, B, and O
• Based on the presence of agglutinating
antibodies in the serum/plasma of
individuals who do not possess
the corresponding ABO antigen
- AB – 4th major ABO blood type
• Discovered by Alfred Von Decastello and
Adriano Sturli
Antigen (Ags) - proteins found on RBC surface
Antibodies (Abs - found in serum/plasma
- naturally-occurring antibody
- formed prior to exposure to antigens
ABO Blood Typing
- a test to determine the blood type of an
individual
- Cell Typing (Direct or Forward Typing)
• To determine antigens in the RBC surface of an
individual by using commercially prepared antisera of
known specificity
• Antisera – reagent
-contains antibodies
Blue angel - Anti-A
Yellow bird - Anti-B
+ = presence of antigen on RBC surface
-/0 = absence of antigen on RBC surface
- Serum Typing (Backward, Reverse or Indirect
Typing)
• to determine antibodies in the serum/plasma of an
individual by using RBCs of known specificity
• Known A or B cells - reagent
- pooled
+ = presence of antibody in serum
-/0 = absence of antibody in serum
Rh Blood Group System
- Discovered by Karl Landsteiner and Alexander
Wiener (1940)
• They injected rabbits with Rhesus macaque
monkey RBCs and Rh antibodies were produced
- Rh antibodies - not naturally occurring
- exogenous
- can’t be performed on babies. Only on 4 months
above
☺Rh antibodies + human RBCs = AGGLUTINATION
Rh POSITIVE
☺Rh antibodies + human RBCs = NO AGGLUTINATION
Rh NEGATIVE
Rh negative status – must be confirmed through
performance of antiglobulin test
- 5 important Rh antigens: D, C, E, c
• D antigen - most important and
immunogenic antigen
- Rh Typing - based on the presence and absence of
the D antigen on the RBC surface
using commercially prepared anti-D
antisera
• + = presence of D antigen on RBC surface
• -/0 = absence of D antigen on RBC surface
ABO and RHESUS BLOOD GROUPING
Compatibility Test
- a series of test designed to ensure the safety of
transferring blood
- must be performed before transfusion of blood
components containing RBC
- Blood Typing and crossmatching must be done to
prevent harmful transfusion reactions between
recipient blood and donor blood
- 2 PARTS:
 • Major Crossmatch
- PS-DR (Patient Serum – Donor RBC)
- Patient serum is mixed with donor RBC
- detects if there are antibodies in patient serum
that can destroy transfused RBCs from donor

• Minor Crossmatch
- PR-DS (Patient RBC – Donor Serum)
- Patient RBCs are mixed with donor serum
- detects if there are antibodies in the donor
serum that can destroy patient RBCs
- already obsolete
*COMPONENT SPECIFIC ANG TRANSFUSION*
BLOOD COMPONENTS AND THEIR INDICATIONS
1.) Whole Blood
- rarely transfused wholly
- would only cause more damage if given
whole: cardiac overload
-Effect: volume replacement and restoration of
oxygen-carrying capacity
-Indications: acute blood loss
-Irradiated Whole Blood - avoidance TA-GVHD
*TA-GVHD – Transfusion Associated – Graft
Vs. Host Disease (rej

2.) Packed Red Blood Cell (PRBC)

-Effect: restoring oxygen-carrying capacity
-Indication: anemic conditions with hypoxia

3.) Washed PRBC

-Indication: Allergic response to plasma
Proteins
-plasma proteins removed to avoid allergic reactions
-Blood bag – machine – empty blood bag

4.) Leukocyte-Reduced PRBC

-Indication: febrile transfusion reactions
- WBC are removed using Leukocyte Reducing Filter

5.) Frozen PRBC

-Indication: unusual blood types
- lasts for 10 years

6.) Irradiated PRBC

-Indication: avoidance TA-GVHD (rejection)
- exposes to radiation to damage or kill all t-cells

7.) Fresh Frozen Plasma (FFP)

-Effect: replacement of plasma factors
-Indication: severe bleeding in unknown factor
deficiency (kulang sa coagulation factors)

8.) Platelet Concentrate

-Indications: - thrombocytopenia
- Platelet dysfunction
- should always be agitated to prevent clumping

9.) Cryoprecipitate
-Indications: Fibrinogen deficiency
- Fibrinogen – largest component found in
cryoprecipitate