Week 13 - Donor Selection

IMMUNOHEMATOLOGY
DONOR SELECTION/DONOR SCREENING (WEEK 13/FINALS)

2nd SEM, 2022
Donor Selection/Donor Screening restriction; donor-patient must be

● The selection of potential blood donors and evaluated by the blood bank medical
the subsequent collection and processing of director
those donor units are the first stages of the ● Donor’s consent
blood banking process that eventually lead to ● Additional information:
the transfusion of lifesaving blood products to ○ Name of patient for whom the blood is
a patient. intended
○ Race of the donor for unique
ADDED NOTES: phenotypes
➔ The importance is to assess donor to their ○ Cytomegalovirus status
respective recipient, helps pathologists, ■ Testing is only in US
interviewer and collects blood to the donor ■ But in PH is HIV
➔ *chicken* - deferred patient (not allowed to
donate) Medical History
➔ For safety of the recipient; subjected to further ● Essential to ensure protection of the donor and
testing against transmitted diseases benefit to the recipient
➔ Freely or voluntary donation ● The questionnaire was designed to be
self-administered by the donor but if preferred
DONOR SCREENING may be administered by a trained medical
1. Encompasses the medical history historian or physician
Requirements for the donor ● The interviewer should be familiar with the
◆ In a close setting, the interviewer and question.
patient lang dapat because mostly the
questions are confidential
2. Physical Examination
◆ includes blood pressure &
temperature, skin
3. Serologic Testing of the donor blood
◆ CMV, HIV, Syphilis, HBV/HCV
◆ malaria, rubella
◆ need maggawa ng thin smear, WBC,
EDTA and red top - thick and thin smear

thin smear - identification of specific parasite at check
if may parasite na iba, hematocrit,
Registration
● Must confirm donor’s identity and must link the
donor existing record.
● 1 unit - 10,000 private - 20,000
● Need for Identification card (ID)
● List of information used in the registration
process:
○ Name (First, Last, MI)
○ Date and time of donation
○ Address
○ Telephone
○ Gender
○ Age or Date of Birth
■ Allogeneic: 16-17 yrs old
■ Autologous: no age
restrictions
● Age or Date of Birth
○ Allogeneic Donation: between 16 and
17 years, depending on individual
state requirements. ●
○ Autologous Donation: There is no age The interview should be conducted in a
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ARAULLO, ASGARE, BAIS, BALATBAT, BANAWA, BRIONES, DE CASTRO, DE LEON, DELOS TRINOS, DURAN, GALANG, MENDOZA, MUZADA, OLBES, ORDONA, OSDON, PUNZALAN, RASING, SALVO, RODRIQUEZ, TOLENTINO, VENTURA
IMMUNOHEMATOLOGY
2nd SEM, 2022
secluded area.
ADDED NOTES:
➔ If the patient taking aspirin because it inhibits
enzyme Cyclooxygenase → Thromboxane
A2 (formation of clot) or Prostacyclin that
promotes platelet aggregation; if deficiency
there’s no healing in site of collection
➔ In FEMALE if they’re pregnant
➔ Interval should be 8 weeks or 2 months; in
PH is 3 months or wait until fully recover
➔ Some vaccines are deferred from donating
blood you are deferred from donating:
◆ deferred 2 weeks if: mumps, oral
polio, typhoid, yellow fever, rubeola
& animal serum products
◆ deferred 4 weeks: german measles
and chickenpox
◆ if the patient have smallpox, needed to
be fully recovered before donating it
takes 14-21 days or the scab has
fallen off
Full-Length Donor History Questionnaire

ADDED NOTES:
➔ Tattoo (half body: 6 months), ear & body
piercing
➔ No deferral: Rabies vaccine (Prophylactic
vaccine no deferral)
➔ 12 months: ERIG or Rabies Immune globulin
➔ Avodart (Prostate enlargement)
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IMMUNOHEMATOLOGY
2nd SEM, 2022
Medication deferral list
➔ 110 if pounds; 50 if kilogram
● Temperature: Orally should not exceed 99.5’F

or 37.5’C
● Pulse: 50 to 100 beats per minutes (PH
60-100)
● Blood Pressure: No greater than 180mmHg
Systolic
○ Diastolic: no greater than 100mmHg
(other countries)
○ 120/80mmHg in PH
● Hematocrit and Hemoglobin:
○ 38% Hct (12.5g/dL Hgb)
Copper Sulfate Mtd. (CuSo4)

● Principle: A drop of Whole blood when
dropped in a solution of CuSO4 (viscous),
which has a given specific gravity, will maintain
its density for approximately 15 seconds.
● Specific gravity of CuS04 is 1.053 which is
equivalent to 12.5 g/dL
ADDED NOTES:
➔ normal Hgb concentration dapat mag float
yung ating blood for 15 seconds, pag nag sink
low Hgb conc
ticlodine and plavix same as aspirin

The Physical Examination
● General appearance
● Weight: mandates a maximum of 10.5ml of
blood/kg
○ 110Ibs (50kg)
○ If donor is less than 110Ibs: depends
how much blood to donate
Types of Deferral
● Temporary Deferral
○ Prospective donor is unable to donate
blood for a limited period of time
○ Example: Donor has received a blood
transfusion; defer for 12 months from
the date of transfusion
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IMMUNOHEMATOLOGY
2nd SEM, 2022
○ Donor received vaccination for yellow ○ Hemoglobin/hematocrit – should not

fever; defer for 2 weeks from date of be less than 11g/dL and 33% mas
vaccination mababa keysa allo kailangan 12.5 sa
Hct 38%
● Indefinite Deferral ● Frequency – donations should not be more
○ Prospective donor is unable to donate frequent than every 3 days and the final
blood for someone else for an donation must be completed at least 3 days
unspecified period of time due to prior to the scheduled surgical procedure
current regulatory requirements. This
donor would not be able to donate Types of Autologous Donation
blood until the current requirement 1. Predeposit donations
change, these donors may be eligible ● Refers to the blood that is drawn some time
to donate autologous blood before the anticipated transfusion and stored.
○ Example: Donor states they have ● Usually liquid but occasionally frozen
lived in England for 1 year in 1989; 2. Intraoperative Autologous transfusion
defer indefinitely ● Occurs when blood is collected during the
■ unless ibaba yung criteria or surgical procedure and usually reinfused
regulatory requirement saka immediately
pa lang iaallow mag donate
3. Immediate preoperative hemodilution
● Permanent Deferral ● Takes place in the operating room when 1-3
○ Prospective donor will never be units of WB are collected and the patient’s
eligible to donate blood for someone volume is replaced with colloid or crystalloid.
else. These donors may be eligible to ● The blood is reinfused during the surgical
donate autologous blood. Some procedure
permanent deferrals may result from
the testing performed on a previous 4. Post-operative salvage
donation ● not recommended nowadays; An autologous
○ Example: Donor state that he or she donation in which a drainage tube is placed in
has hepatitis C the surgical site and postoperative bleeding is
salvaged, cleaned and reinfused.
● di na ginagawa dati
Autologous Donation BLOOD COMPONENT PREPARATION AND
● Donor who donates blood for his or her own COMPONENT THERAPY
use WHOLE BLOOD
● Donor referred as: Donor-patient ● Contains RBCs and Plasma, with a hematocrit
● Purpose: level of approximately 38%
○ Treat surgical blood loss ● Provides oxygen-carrying capacity and volume
○ Decreased risk of disease
expansion
transmission
○ Dec. transfusion reaction
○ And alloimmunization ADDED NOTES:
○ Greatest advantage for those very rare ➔ For anemic patients we transfuse whole blood
blood types para mabigyan ng Hgb is necessary for
○ Those with multiple antibodies transport of oxygen
● Phlebotomy process stimulates the BM to ➔ Patient have a severe bleeding giving whole
increase cell production
blood will serve as volume expander
● Disadvantage:
○ Higher cost because of added ➔ however the usage of whole blood nowadays
administrative processes are not advisable because platelet, WBC, and
○ Special labelling other clotting factors usually do not survive in
○ High percentage of wasted units a stored whole blood
● Criteria:
○ No age limit ● Platelets, WBC and clotting factors do not
○ No strict weight limit requirements
survive in stored whole blood
unlike Allogeneic: (110 or 50 kg)
● whole blood is rarely used for transfusion
today, except autologous donation.
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IMMUNOHEMATOLOGY
2nd SEM, 2022
● Storage: 1’C to 6’C causes we need to increase the Hgb and by

● Shelf-life: doing that we can increase the amount of hgb
○ ACD and CPD (21days) of the recipient to normalize the level
○ CPDA-1 (35days)
RBC ALIQUOTS
● Whole blood units can be irradiated to inhibit ● Product most often transfused during the
T-cell proliferation in the recipient neonatal period or in infants younger than 4
● Irradiation will decrease the shelf-life to 28 months of age
days ● Indication of transfusion:
● Minimum dose of Radiation: ○ Anemia caused by spontaneous
○ 25 Gy in the center of container fetomaternal or fetoplacental
hemorrhage
○ 15 Gy in other point of container
○ Twin-twin transfusion
● Cesium-137 and Cobalt-60 may used to ○ Obstetric accidents to y
irradiate whole blood ○ Internal hemorrhage
PACKED RED BLOOD CELLS ● Transfusion for neonates require only small
● Prepared from whole blood by centrifugation volume of RBCs (10 to 25 mL)
or sedimentation ● The aliquoted blood has an expiration time of
● May obtained directly by apheresis 24 hours, store at 1’C to 6’C
➔ we directly get the specific component ● Anticoagulant most often used for neonate
and then the rest of the blood products transfusion is CPDA-1
na di naman kailangan will be returned
to the donor IMPORTANT NOTES:
● Packed RBC may be prepared at any time ➔ A transfusion of 10 mL/kg in a unit with a
during the normal storage time hematocrit level of 80% should raise the
● Prepared shortly after donation to allow the hemoglobin by 3 g/dL
manufacture of: ➔ Concerns with additive solutions involve the
○ Platelets Concentrates constituents adenine and mannitol and their
○ Frozen plasma toxic effect on the renal system.
○ cryoprecipitate
○ Prepared w/in 8 hours RBC’S IRRADIATED
➔ after several hours kailangan ● Indication of Irradiated blood:
muna maggawa yung platelet ○ Patients who are
concentratesy box r, fresh immunocompromised
frozen plasma and
cryoprecipitate ➔ If we transfused regular blood:
◆ rejection, hemolytic transfusion
● Plasma removed from the whole blood unit will reaction, WBC attacking the recipient
vary depending on the blood
anticoagulant-preservatives solution used. ○ Receiving a bone marrow
○ CPDA-1 (200 to 250 mL of plasma, ○ Stem cell transplant
HCT 65% to 80%) ○ Fetus undergoing an intrauterine
○ ADSOL (50 mL, HCT less than 55% to transfusion
65%)
● RBC final Volume: 160 to 275 mL or 50 to ● Irradiation inhibits the proliferation of T-cells
80g of hemoglobin suspended in the residual and subsequent transfusion-associated
plasma or additive graft-versus-host disease
● Useful when patients is also at risk of ● RBC’s, platelets and granulocyte concentrates
circulatory overload contain viable T lymphocytes that can become
○ Example: Patient with anemia in engrafted when transfused if the host’s
addition to cardiac failure immune system is not capable of identifying or
➔ If anemic patient we transfuse pRBCs the defending against the foreign cells
specific component that is needed are the red ● Irradiation is generally performed using
blood cell; does not need plasma since we cesium-137 or cobalt-60.
only need the red part of the blood component ● The expiration date of irradiated RBCs is 28
➔ due to blood loss sometimes or there are other days from the time of irradiation or the original
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IMMUNOHEMATOLOGY
2nd SEM, 2022
outdate. should prevent reactions that

are caused by leukocyte
RBC’S LEUKOREDUCED antibodies in patient plasma.
● Leukoreduced red cell is a product in which
the absolute WBC count in the unit is reduced FROZEN, DEGLYCEROLIZED RBC’S
to less than 5 x 10^6 and contains at least ● Freezing RBCs with glycerol stored up to 10
85% of the original RBC mass years
● Two major categories: Prestorage and Post ○ For those patients with rare
storage phenotypes
○ For autologous use
○ Prestorage leukoreduction
○ For military used
■ Special filters procure at least
a 99.9% removal of ● The resulting deglycerolized product is free of
leukocytes by employing leukocytes, platelets and plasma due to the
multiple layers of polyester or washing process
cellulose acetate nonwoven ● Washed red cells can be used:
fibers that trap leukocytes and ○ Patient with Paroxysmal Nocturnal
hemoglobinuria
platelets but that allow RBC to
○ IgA deficiency with circulating anti-IgA
flow through.
● Cryoprotective agents: avoid deterioration
● Three methods in prestrorage leukoreduction: ○ Penetrating agent:
● First method: an in –line filter can be ■ small molecules that cross the
attached to the whole blood unit and filtered cell membrane into the
via gravity cytoplasm.
■ Osmotic force prevents water
○ RBCs and Plasma can be prepared
from migrating outward as
● Second method: Plasma is initially removed extracellular ice is formed,
from the whole blood unit, and then the preventing intracellular
packed cells are passed through an in-line dehydration.
reduction filter ■ Example: Glycerol
○ Random-random platelet cannot be
○ Nonpenetrating agent:
prepared
■ Hydroxyethyl starch (HES)
● Third method: A sterile docking device can ■ Large molecule do not enter
be used to attached a leukocyte reduction filter the cell but instead form a
to a unit of RBC, which allowed to flow via shell around it, preventing loss
gravity of water and subsequent
○ Post storage leukoreduction dehydration.
■ Leukocyte are removed in the ■ HES is dimethylsulfoxide:
used to freeze
blood bank prior to issuing
hematopoietic progenitor
blood or at the bedside before cells
transfusion. Whereas
centrifugation can procure
counts less than 5 x 10^8
which can prevent most febrile
hemolytic reactions to RBC
concentrates
■ Third generation filter -
reduce leukocyte to level of
5 x 10^6
■ Removing leukocytes by
centrifugation or filtration just
before transfusion of blood
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IMMUNOHEMATOLOGY
2nd SEM, 2022
● Contain sufficient plasma typically 40 to 70mL

PLATELET CONCENTRATES ● Shelf-life: 5 days
● Whole blood first then centrifuge that will form ● Apheresis method – Single donor platelets
whole pack red blood cells and the plasma
● Apheresis or Single-donor platelets contain at
portion wherein it contains platelet
concentrates; after 8 hours least 3 x 10^11 platelets
● Can be produced during the routine ● Stored at 22’C to 24’C with continuous
conversion of whole blood into concentrated agitation contain approximately 300mL of
RBCs or by apheresis Plasma
● Use of Platelet concentrate: ● Shelf-life of 5 days
○ Bleeding patient who are
thrombocytopenic (low plt) PLATELET ALIQUOTS
○ Cancer patients during radiation and ● For platelets transfusion for neonates: requires
chemotherapy small volume only
○ Thrombocytopenic preoperative ● Indicated for neonates whose counts fall below
patients 50,000ul and who are expecting bleeding.
● Prophylactic platelet transfusion: not ● Factors that may be associated with
recommended
thrombocytopenia include:
○ DIC
○ ITP ○ Immaturity of coagulation system
○ Platelet dysfunction
○ Increased platelet destruction
○ Dilution effect secondary to massive
transfusion
○ Intraventricular hemorrhage
PLATELET LEUKOREDUCED
● Help prevent febrile non hemolytic reactions
● Random-donor platelets can be leukoreduced
by using a leukoreduction filter designed for
platelets.
● Random-donor platelets must contain less
than 8.3 x 10^5
○ If leukoreduced it must have a
leukocyte count of less than 5 x 10^6
○ For single-donor or apheresis platelets
that have been leukoreduced must
contain less than 5 x 10^6
leukocytes
FROZEN PLASMA
● May be made into:
○ Fresh Frozen Plasma (FFP)
○ Plasma Frozen within 24 hours (PF24)
○ Plasma Cryoprecipitate-reduced
FRESH FROZEN PLASMA

● Must be frozen within 8 hours of collection if
the anticoagulant used was CPD, CP2D or
CPDA-1 and within 6 hours if the preservative
● Prepared from whole blood are generally was ACD.
referred as random-donor platelets ● FFP – stored at -18’C or Colder for 1 year
● Should contain at least 5.5 x 10^10 platelets ○ 65’C for 7 years
● Stored at 20’C to 24’C with continuous ● Contain the maximum levels of both stable
agitation and labile clotting factors
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IMMUNOHEMATOLOGY
2nd SEM, 2022
● Contains all stable proteins found in FFP, has deficiencies

normal levels of factor V and has only slightly
reduced levels of factor VIII CRYOPRECIPITATED ANTIHEMOPHILIC FACTOR
● Cold-precipitated concentration of Factor VIII,
the antihemophilic factor (AHF)
ADDED NOTES: ● Prepared from FFP thawed slowly between
➔ Normal = FV 1’C and 6’C
➔ Slightly reduced = FVIII ● Prepared from a single whole blood unit
collected into CPDA-1 or CPD and suspended
FFP & PF24 in approximately 15mL of Plasma.
● Thawed at temperature between 30’C and ● Product contain:
37’C ○ Factor VIII
● If water bath is used, the product must be ○ Fibrinogen
○ 80 units of AHF activity and 150mg of
placed in a protective lining or overwrap so
fibrinogen
that the ports of the unit are not contaminated ● Other significant factors found in
by contact with water. Cryoprecipitate:
● Stored at 1’C to 6’C for 24 hours ○ Factor XIII
● 150ml to 250 ml (400mg of fibrinogen) enough ○ Von Willebrand factors
to support Factor l deficiency ○ fibronectin
● Shelf-life of 12 months
CRYOPRECIPITATE-REDUCED PLASMA
● Thawed must be transfused within 6 hours
● Prepared from Fresh frozen Plasma after
● Stored at 22’C to 24’C
thawing and centrifugation to prepare
cryoprecipitate.
● The process removed factor VIII, XIII, vWF, PLASMA DERIVATIVES
cryoglobulin and fibronectin ● Prepared by further manufacture of pooled,
● Result: Cryo-poor plasma human source and recovered plasma
● Must be refrozen within 24 hours; stored at ● Process: Recombinant DNA technology or
-18’C or colder for 1 year Monoclonal Antibody purification
● This product still contains albumin, II,V, VII, IX, ● Most derivative plasma is also further tested
X, XI for hepatitis A and parvovirus
➔ should undergo different testing to
THAWED PLASMA
● Contains stable coagulation factors such as assure safe plasma derivatives to
fibrinogen and prothrombin but reduced deploy
amounts of factor V, VII, VIII and X
● Prepared from FFP and PF24 thawed at 30’C ACTIVATED FACTOR Vll (Vlla)
to 37’C and maintained at 1’C to 6’C for up to ● Produced by recombinant DNA technology
4 days and has been approved for use in patients
● Should be not be used to treat specific factor with:
deficiencies where other products with higher ○ hemophilia A who have circulating
factor levels are available and it should not be antibodies or inhibitors to factor VII
used purely as a volume expander. ○ Patients with congenital Factor VIII
deficiency
LIQUID PLASMA ○ Trauma, massive transfusion and liver
● Separated no later than 5 days after the transplantation
expiration date of whole blood
● Stored at 1’C to 6’C ● Most successful in controlling intracranial
● Can be transfused for up to 5 days after the bleeding in patients with major head trauma
whole blood’s expiration date and cerebral hematomas
● Levels of coagulation factors are poorly ● Disadvantage: have been associated with an
characterized and depend upon storage increased risk of spontaneous thrombosis and
conditions and cellular interactions overtime. thromboemboli
● Indication:
○ Include patients undergoing massive FACTOR VllI CONCENTRATES
transfusion with current coagulation
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IMMUNOHEMATOLOGY
2nd SEM, 2022
● Treat patient with Hemophilia A or classical

hemophilia FACTOR IX CONCENTRATE
● Almost completely replaced cryoprecipitate as ● For the treatment Factor IX deficiency or
a product of choice. Hemophilia B (Christmas Disease).
● Prepared from large volumes of pooled ● Have been used to treat patients with acquired
plasma, but most commonly prepared by inhibitors of factor VIII
recombinant DNA technology ○ Have factor VIII bypassing activity
● If produced from pooled plasma (must be ● Contains also factors II, VII & X in
treated by Pasteurization, solvent/detergent concentrated form
treatment or monoclonal purification to ● Vials containing 500 units of factor IX
inactivate or eliminate viral contamination
FACTOR IX CONCENTRATE & LIVER DISEASE
● Pasteurization – stabilizers such as albumin,
● It is contraindicated in patients with liver
sucrose or glycine are added to the factor VIII disease
concentrate to prevent denaturation of the ○ Have low levels of circulating
product. antithrombin III
● The product is heated to 60’C for 10 hours ○ Activation of clotting factors present in
● The stabilizers are removed, and the product some factor IX concentrates,
is lyophilized. ○ cause DIC
● This product is safe from HIV-1 and hepatitis
transmission BLOOD PRODUCTS & TREATMENT OF SPECIFIC
● Solvent/detergent treatment - ethyl ether CLOTTING FACTOR DEFICIENCIES
and tri(n-butyl) phosphate and the detergent
DEFICIENCY BLOOD PRODUCT
sodium cholate and Tween 80 are effective in INDICATED
disrupting the viral coat membrane, preventing
the transmission of lipid-enveloped virus like: Cryoprecipitate
HIV and Hepa B FIBRINOGEN
● Lyophilized after the removal of solvent and Stored plasma
detergent.
Fresh frozen plasma
● Monoclonal purification. Immunoaffinity
FACTOR V
chromatography is used to positively select out frozen plasma
the vWF:FVIII complex from the plasma pool.
Factor IX concentrate
PORCINE FACTOR Vlll FACTOR Vll
● Xenographic form of factor VIII is made from Stored plasma
porcine plasma and is beneficial for patients
with Hemophilia A who have developed Factor VIII concentrate
inhibitors or antibodies to human factor VIII. FACTOR Vlll
● Provides effective hemostatic control for Cryoprecipitate
patients with Intermediate FVIII inhibitor levels
Cryoprecipitate
RECOMBINANT FACTOR Vlll
● The first generation rFVIII products are Von Willebrand’s Fresh frozen plasma
synthesized by introducing human FVIII gene Disease
Frozen plasma
into BHK (baby hamster kidney) cells
● Released into culture medium and harvested, FACTOR IX Factor IX concentrate
isolated and purified using a combination of
Ion-exhange chromatography, gel filtration and FACTOR X Stored plasma
immunoaffinity chromatography
● Uses human albumin as stabilizer FACTOR XI Stored plasma
● Available in three dose
FACTOR XIIl Stored plasma
● For patient with untreated hemophilia A
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IMMUNOHEMATOLOGY
2nd SEM, 2022
HEPATITIS B IMMUNE GLOBULIN (HBIG)

ADDED NOTES: ● Contains Hepatitis B immune antibodies.
➔ HMWK, Pre K, Factor Xll - does not ● From plasma of donors with high titer of Ab to
included because have BLEEDING HBsAg
TENDENCIES ● Provides passive immunization for HBV.
➔ Factor Xl - have bleeding tendency ● For treatment after exposure to HBsAg.
● For the prevention of maternally transferred
2-ONCOTIC AGENTS HBV (perinatal exposure)
● Albumin: volume expansion
● Other colloids are available for blood volume VARICELLA-ZOSTER IMMUNE GLOBULIN (VZIG)
expansion ● Derived from patients had recent Herpes
○ Dextran Zoster infections
○ Gelatin ● Herpes Zoster infections result in severe fatal
○ Hydroxyethyl starch infection in immunocompromised individuals
○ Polyvinylpyrrolidone ● Passive administration of VZIG during 72
hours of exposure can prevent or attenuate
infection
ALBUMIN
● Albumin is prepared by ethanol fractionation of Rh IMMUNE GLOBULIN (RhIG)
pooled plasma ● Derived from Rh -ve individuals
● Available in 5% and 25% concentrations. ● Contains IgG antibodies to the D antigen on
● Have physiological sodium content red blood cells.
● No risk of hepatitis, sterilized during ● Given during pregnancy and post-natally to Rh
preparation negative mothers to prevent the development
● No coagulation factors or blood group Abs of anti-D and hemolytic disease of the
● Used for treatment of hypovolaemia and newborn (HDN) due to anti-D.
hypoalbuminaemia (result from abnormal ● Given prophylacticaly following abortion, or
synthesis, increased metabolism or loss) invasive maternal procedures (e.g.,
● It maintains capillary osmotic pressure amniocentesis).
● Carrier protein for drugs, hormones, enzymes
& metabolites TETANUS IMMUNE GLOBULIN (TIG)
● Prepared from individuals specifically
PLASMA PROTEIN FRACTION immunized for tetanus toxoid
● Partially purified albumin ● Available for individuals at risk following injury
● Contains ≈ 83% albumin & 17% globulin
3-IMMUNE GLOBULINS
● Contains immune IgG antibodies, prepared
from pools of plasma.
● For disease prophylaxis, hepatitis A, measles,
varicella and rubella.
● For the treatment of hypogammaglobulin-emia
and agammaglobulinemia (absence of
antibody or immunoglobulin)
IMMUNE SERUM GLOBULINS (ISG)

● Primarily IgG Ab
● Prevention of some viral diseases
● Hypogammaglobulinemia
● Congenital immune deficiency
● Given by IM injection (aggregates of IgG)
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2nd SEM, 2022
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IMMUNOHEMATOLOGY
2nd SEM, 2022
TRANSFUSION-TRANSMITTED DISEASE ● Incubation period 28 days and peak viremic

period occurs 2 weeks before the onset of the
DONOR TESTING elevation of liver enzymes or appearance of
● subject into different testings
jaundice.
Lab diagnosis:
● Virus shed in the feces during the incubation
period and declines to low levels by the onset
of symptoms
● Hav Antigen - sheds in feces of an
individual
○ IgM anti-HAV – required for diagnosis
of hepatitis A; marker of acute Hepa A;
TRANSFUSION ASSOCIATED HEPATITIS peak: 1st month thru ELISA
○ IgG anti-HAV – appears soon after
HEPATITIS IgM and persist for years after
● Generic term for the inflammation of the liver infection; produced thru: natural
● Symptoms: infection or immunization indicates
○ Jaundice, Dark urine, hepatomegaly, immunity against Hepa A virus can
Anorexia, Malaise, Fever, Nausea, detect thru ELISA
Abdominal pain, Vomiting
● Caused by: viruses, bacteria, noninfectious
agents (drug and alcohol), ionizing radiation
and autoimmune
● Transmission: transmitted through fecal-oral
route or parenterally (through contact with
blood and other body fluids).
● Belongs to Picornaviridae family
● Small, non-enveloped, single stranded
enterovirus RNA virus
○ DNA: HAPPPy
● Most common type of hepatitis
● Symptoms:
○ Appear abruptly and last fewer than 2
months up to 6 months
● Jaundice is more common among children ● Immune globulin can be used pre-exposure to
between 6 to 14 years. protect those traveling to high HAV-endemic
areas or postexposure to prevent infection in
HEPATITIS A those exposed within a family
● Symptoms usually resolve within 3 weeks and
are generally self-limiting HEPATITIS B
● IP: 28 days ● also known as “Serum Hepatitis”
● “Infectious Hepatitis” ● Dane particle: complete HBV that causes
infection
Epidemiology & Transmission: ● HBV is a partially double-stranded circular
● Transmission is primarily through fecal-oral DNA virus of the Hepadnaviridae family.
route - spread through water, food and person (HHAPPPy)
to person contact ● The individual may be completely
● Poor hygiene and sanitation asymptomatic or present with typical signs of
● Asymptomatic in children disease, including jaundice, dark urine,
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hepatomegaly, anorexia, malaise, fever, ◆ 1st marker to appear: Hepa B

nausea, abdominal pain, and vomiting. surface antigen (HBsAg) - serves as
indicator in active or chronic infection,
Epidemiology and Transmission: important marker during screening of
HBV is transmitted through exposure the blood donors
to bodily fluids containing the virus ◆ Hepatitis B envelope antigen
from an infected individual. (HbeAg) - present during periods of
Concentrations of the virus are at high active replication of the virus; indicates
levels in blood, serum, and wound high degree of infectivity and usually
exudates high during vertical transmission
Moderate levels in semen, vaginal ◆ Hepatitis B core antigens (HBcAg) -
fluids, and saliva seldom not detectable in serum
low levels in urine, feces, sweat, tears, because the viral envelope that masks
and breast milk. it; detected only through biopsy in an
infected liver and not considered as
Transmission: serological marker
● sexual, parenteral and perinatal
● Percutaneous transmission may occur through ➔ Hepatitis B Antibodies
needle stick (drug use, occupational hazard, ◆ Hepa B core IgM (Anti-HBc IgM) -
acupuncture, tattooing, or body piercing), first antibody to produce; it indicates
● hemodialysis, current or recent infection of hepa b
● human bite virus
● transfusion of unscreened blood or blood ◆ Anti-HBc IgG - lifelong marker of
products, or sharing razors. hepatitis b virus infection (persists for
● Permucosal transmission can occur through a lifetime of an individual infected)
sexual intercourse ◆ Anti-HBe - indicates the patient is
● vertically from mother to infant (transplacental recovering from hepatitis b virus
or through breast milk) infection and this serves as marker of
● through contact with infected household convalescence and in favorable for
objects (toothbrush or razor) prognosis
● An HBV vaccine was licensed in 1981 and ◆ Anti-HBs - appears during the
introduced in 1982. recovery period of acute hepatitis b
usually it persists for years and
provide protective immunity also can
be also present as the individual
introduced antibody through
immunization with hepatitis b vaccine
(either thru immunity or immunization)
ADDED NOTES:
➔ Serological markers:
______________________________________________________________________________________ 13
IMMUNOHEMATOLOGY
2nd SEM, 2022
● Recombinant immunoblot assays (RIBA),

licensed by the FDA, can be used for
confirmation of anti-HCV tests.
● Currently there is no HCV vaccine. Prevention
consists of worldwide screening of blood and
blood products.
● Antiviral therapies consist of IFN- or pegylated
IFN-2a or -2b monotherapy or in combination
with ribavirin
HEPATITIS D
● unclassified, single stranded RNA virus also
called as “incomplete virus”, can be
transmitted parenterally and usually occur in
the presence of Hepatitis B
● HDV is a defective, single-stranded RNA virus
that is found only in the patients with HBV
infection.
● It requires HBsAg in order to synthesize an
envelope protein.
● It was previously called the delta antigen.
● If HBV and HDV are contracted
concurrently/simultaneously, this co-infection
○ (if consequentially “superinfection” is
called)
● severe acute disease, with a higher risk of
fulminant hepatitis (2 to 20%) but a lesser risk
of developing chronic hepatitis.
● Individuals with chronic HBV who contract
HEPATITIS C HDV can develop a superinfection
● “Non-A - Non-b Hepatitis” ● highest risk of infection are IV drug users. This
● HCV is a member of the Flaviviridae virus infection can also be transmitted sexually.
family; Genus: Hepavirus Perinatal HDV transmission is rare
● It is a small, lipid-enveloped, single stranded ● HDV is detected by testing for IgM and/or IgG
RNA virus. HCV was discovered in 1989 and anti-HDV and/or HDAg and HDV RNA in the
was soon recognized as the primary cause of serum.
post-transfusion non-A, non-B hepatitis. ● tests for HDV are not required for blood
● most frequent cause of chronic hepatitis, donations. If a donor has HBV, the unit will not
cirrhosis be used for transfusion. As HDV cannot exist
● The incubation period of HCV is 2 to 26 without HBV, testing for HBV will eliminate any
weeks. infections with HDV.
● HCV-infected individuals, 75 to 85 % become
chronic carriers, with 20 % developing liver HEPATITIS E
cirrhosis ● called also as “water-borne hepatitis”
● most HCV cases are asymptomatic ● usually acute self-limiting hepatitis without
● Same transmission with Hepatitis B. progression to a chronic carrier state
○ EIA or CLIA ● HEV is a member of the Calciviridae family of
● Diagnosis of HCV is difficult. detection of HCV nonenveloped RNA viruses.
RNA or anti-HCV in serum, and/or a known ● HEV is spread through the fecal/oral route,
exposure to the virus. usually through contaminated drinking water in
______________________________________________________________________________________ 14
IMMUNOHEMATOLOGY
2nd SEM, 2022
developing countries. A carrier state does not ○ Interferon- treatment has been used
develop after the acute, usually self limiting, with conflicting results.
illness.
● Symptoms are the same as for any hepatitis.
Generally, these cases are short-lived HIV TYPES 1 AND 2
● HEV usually occurs in developing countries HIV 1 anf HIV 2
● Etiologic agent: AIDS Acquired
and is responsible for acute, sporadic cases of
Immunodeficiency Syn.
infection that can be short lived or prolonged.
● First diagnosed in 1981
● The fecal/oral route is the most common form
● HIV
of transmission.
○ Retrovirus
● Very rare person-to-person transmission has
○ Consist of an envelope of
been documented but parenteral or sexual
glycoprotein, core proteins and inner
transmission has not. It is most commonly
core of viral RNA and Reveres
seen in young adults
transcriptase
● HIV 1: common in US
Laboratory Diagnosis:
● HIV 2: common West Africa
1. IgM and IgG anti-HEV in serum using EIAs
● Primary infection:
and Western blot (IgM antibody usually
○ Asymptomatic or result in mild, chronic
present in acute infection but rapidly declines
lymphadenopathy with symptoms.
in the early recovery period)
○ Occurs 6 – 12 weeks
2. HEV-RNA in serum and stool using PCR
○ Persist for 2 weeks
3. HEV antigen in serum and liver by
● HIV enters the cell surface binding of virus
immunofluorescent antibody blocking assays
glycoprotein 120 with cell surface receptor.
○ Cells: CD4 lymphocytes,
● Administration of immune globulin pre- or post
macrophages and other antigen
exposure in endemic areas has not reduced
presenting cells.
the number of cases
● CD4 count less than 200/uL classified as
AIDS.
HEPATITIS G/GB virus C
● Two genotypes of the same enveloped RNA
virus that belongs to the Flaviviridae family. EPIDEMIOLOGY
● More common than HCV ● MOA:
● acute, chronic, and fulminant hepatic failure
cases have been associated with GBV-C/HGV
● HGV is thought to be transmitted parenterally,
and transmission through clotting factor
concentrates has been noted
● there appears to be a greater risk of infection
due to risky sexual behavior rather than
through parenteral transmission
● It has been found in intravenous drug users
and in higher rates among people with HIV.
Vertical/perinatal transmission from mother to
child has been documented
● Reverse transcription polymerase chain
reaction (RT-PCR)for GBV-C/HGV-RNA is
used to diagnose
Treatment:
______________________________________________________________________________________ 15
IMMUNOHEMATOLOGY
2nd SEM, 2022
○ sexual contact with an infected

person.
○ Use of contaminated needles during
drug use
○ blood transfusion or blood
components.
○ Congenital transmission
○ High risk: Men who have sex with men
and IV drug user
LABORATORY DIAGNOSIS:
● Window period: time after infection but before
antibody or antigen is detected.
● Antibodies: detected about 22 days after
infection.
● Screening test: EIA and ELISA
● Confirmatory: Western Blot, IFA, Culture.
● New: HIV RNA detection through NAT (Nucleic
amplification test); closes the window period
approx. 4 to 7 days.
HTLV
HTLV l/ll
HIV Prevention:
● HTLV-I: first retrovirus to be associated with a
● To reduce perinatal transmission, CDC
human disease
recommends routine HIV testing of all
● Associated with adult T-cell
pregnant women and screening of all
lymphoma/Leukemia (ATL).
neonates whose mothers have not been
● Immunodeficiency similar AIDS; susceptible to
tested.
other hematologic malignancies.
● Associated with the progressive neurological
Treatment:
disorder known as HTLVI-associated
● Highly active antiretroviral therapy
myelopathy or tropical spastic paraparesis
(HAM/TSP).
______________________________________________________________________________________ 16
IMMUNOHEMATOLOGY
2nd SEM, 2022
● Blood donors infected with HTLV-I or HTLV-II SYMPTOMS

have an excess of infectious syndromes, such ● Mild flu like disease.
as pneumonia, bronchitis, and urinary ● Headache
● extensive rash, eye pain, vomiting, inflamed
infections.
● lymph nodes, prolonged lymphocytopenia,
● HTLV-I is associated with uveitis and infective ● Muscle weakness, disorientation
dermatitis of children, Sjögren’s syndrome, ● acute flaccid paralysis
polymyositis, and facial nerve palsy. ● Poliomyelitis **
● Capable of crossing the blood-brain barrier
EPIDEMIOLOGY ● Causes:
● MOA: ○ West Nile encephalitis
○ West Nile meningitis
○ transmitted vertically (breastfeeding)
○ West Nile meningoencephalitis
○ Sexually (transmission from male to ● Birds are the primary amplifying hosts in a
female more common) mosquito-bird-mosquito cycle.
○ Parenterally (blood transfusion or IV ● Chief vector: Culex
drug abuse) ● Incubation period: 3 to 14 days following the
● strong correlation between disease mosquito bite
development and host factors such as ● symptoms lasting 3 to 6 days.
● Although mosquito bites are the most common
cytotoxic T lymphocytes and HLA types
route of infection, there is a slight risk of
● Susceptibility to ATL: correlate with contracting WNV from blood components,
polymorphisms of the tumor necrosis factor α organ transplants, pregnancy, and breast milk.
(TNF-α) that result production of TNF-α. ● Serologic tests for IgM antibodies to WNV
● HTLV risk of transmission: infected blood is using ELISA can be used for testing
estimated to be between 10% to 30%. symptomatic patients.
● Screening: NAT
● ATL occur in persons who were infected as
HTLV
infants, with a latent period → 67 years
LABORATORY TEST
● HAM/TSP is generally seen in individuals who
● IgM antibody-capture enzyme-linked
are infected in childhood or as an adult, with a
immunosorbent assay (ELISA): method
variable latency
used to detect IgM antibody to the WNV in
● HTLV-I and HTLV-II are seen primarily in IV
serum and cerebrospinal fluid (CSF).
drug users. HTLV-I is also seen in immigrants
● The plaque reduction neutralization test is
from endemic areas, such as southern japan,
the most specific test for arthropod borne
central and west africa, caribbean, middle
Flaviviruses: distinguish false-positive IgM
east, papua new guinea, solomon island
antibody-capture ELISA from crossreactivity
● HTLV-II is seen in some Native American
● Immunohistochemistry: testing brain tissue
populations.
with virus-specific monoclonal antibodies.
WEST NILE VIRUS
● Member of the Flavivirus family and is a TREATMENT:
human, avian, and equine neuropathogen. ● Research is ongoing for the use of ribavirin,
● It is a single-stranded RNA lipid enveloped interferon-α
virion.
● Common in Africa, West Asia, and the Middle
East. CYTOMEGALOVIRUS
● Member of the Japanese encephalitis virus ● Cytomegalovirus (CMV) is a member of the
antigenic complex:
herpesvirus group.
○ St. Louis encephalitis virus prevalent
in the Americas ● exposure occurs after birth to an individual
○ Japanese encephalitis virus prevalent with a competent immune system, there are
in East Asia generally few symptoms.
○ Murray Valley encephalitis virus and ● mononucleosis-like symptoms with fever and
Kunjin virus prevalent in Australia. mild hepatitis occur.
______________________________________________________________________________________ 17
IMMUNOHEMATOLOGY
2nd SEM, 2022
● CMV can remain latent in the tissues and ● CMV infection from transfusion is between 1%
leukocytes for years, with reactivation to 3%.
occurring from a severe immune system
impairment. Epidemiology and Transmission
● Highest risk of a CMV infection are fetuses ● person to person through contact with infected
and individuals receiving allogeneic marrow body fluids, which may include urine, semen,
transplants. saliva, blood, cervical secretions, and breast
● CMV-seronegative recipients transplanted with milk.
CMVseronegative allogeneic marrow are at ● CMV is the most frequently transmitted virus
risk if they receive untested and from mother to fetus.
non-WBC-reduced blood components. ● The rate of transmission of CMV to bone
○ Serum negative → recipient na walang marrow recipients or to neonates has been
antibody or walang anything na documented at 13% to 38%
presence ng sakit; di pa rin safe kase
merong time na CMV is not detected Laboratory Diagnosis
● CMV-seronegative women who become ● ELISA
infected in the first two trimesters have a 35% ● Other laboratory tests:
to 55% chance of delivering an affected infant, ○ Fluorescence assays
many of which will have clinically apparent ○ Indirect hemagglutination
disease. ○ Latex agglutination
● Intrauterine transfusions with CMV-positive
components is also a high risk to the fetus. TREATMENT
● No treatment for CMV for a healthy individual;
Moderate risk vaccines are still in the research
● recipients of solid organ transplants, persons
with HIV, and individuals who may require an
allogeneic marrow transplant in the future. OTHER VIRUS
● Individual becomes immunosuppressed, a
reactivation of a latent infection is possible. EPSTEIN-BARR VIRUS PARVOVIRUS B19
● Epstein-Barr ● small,
Low risk:
virus EBV is a single-stranded DNA
● Low-birth-weight neonates and autologous ubiquitous nonenveloped virus.
marrow recipients. member of the ● Common childhood
● Preterm, multitransfused neonates weighing herpesvirus illness called “fifth
family disease”:
less than 1,200 grams ● EBV was first transmitted through
discovered in respiratory
EXPOSURE: 1964 in secretions.
● The neonate: Burkitt’s ● Fifth disease
lymphoma presents with a mild
○ At the time of delivery cells rash, “slapped
○ Through breastfeeding ● Infants or cheek” when
○ Contact with seropositive individuals. young children occurring on the
are usually face and a lacy red
asymptomatic. rash when occurring
● The fetus: ● In on the trunk and
○ Exposed to the mother’s reactivation adolescence limbs.
of the virus during pregnancy. and young ● Primary infection:
adulthood, asymptomatic, but a
EBV causes rash or joint pain
● The autologous marrow recipient is not as infectious and swelling may
immunosuppressed as the allogeneic marrow mononucleosis occur transiently
in 30% to 50% ● B19 parvovirus
recipient, and therefore CMV infection does
of patients. enters the red blood
not present a problem.
______________________________________________________________________________________ 18
IMMUNOHEMATOLOGY
2nd SEM, 2022
BACTERIAL CONTAMINATION
● reactivation cell (RBC) via the P
usually occurs antigen and ● Common sources: donor skin and blood.
only in replicates in the ● Less common: sources are the environment
immunocompro erythroid and disposables.
mised progenitor cells. ● Platelets: most frequent source of septic
individuals. ● Severe RBC aplasia transfusion reactions, due to the fact that room
● EBV has been or chronic anemia temperature storage promotes bacterial
called the patients with chronic growth
“kissing or acquired ● Most common signs and symptoms of
disease” immunodeficiency or
transfusion associated with sepsis are rigors,
because the malignancies or in
virus usually organ transplant fever, and tachycardia.
replicates in recipients. ● Other symptoms may include shock, low back
the cells of the ● Hydrops fetalis and pain, disseminated intravascular coagulation
oropharynx, fetal death: during (DIC), and an increase or decrease in systolic
possibly in pregnancy blood pressure.
infected B ● The mortality rate from sepsis and toxemia
cells. due to bacterially contaminated RBC units is
● virus is shed in greater than 60%.
the saliva and
● Bacterial contamination usually originates with
is most
frequently the donor, either through skin contamination at
associated with the phlebotomy site or an asymptomatic
infectious bacteremia.
mononucleosis ● Yersinia enterocolitica is the most common
isolate found in RBC units, followed by the
Pseudomonas species. Together, these two
account for more than 80% of all bacterial
HHV and HHV 8 infections transmitted by RBCs.
● Propionibacterium acnes, a common isolate of
● Human herpesvirus 6 human skin, was the most common bacterial
(HHV-6) is a very common contaminant in RBCs. It is a slow growing
virus that causes a lifelong anaerobic bacteria
infection. ● P. acnes has been implicated in only a few
● The virus replicates in the cases of transfusion- related sepsis,
salivary gland and then associated with sarcoidosis.
remains latent in ● Staphylococcus epidermidis (gram pos cocci;
lymphocytes, monocytes, normal flora), and Bacillus cereus (gram pos
and perhaps other tissues. aerobic spore forming bacili) are the
● HHV-6 causes roseola organisms most frequently recovered from
infantum, also known as donated blood and contamination of platelets.
exanthem subitum or sixth
disease. Symptoms are Laboratory Diagnosis
those of a mild, acute ● Before the unit of RBCs or platelets is issued,
febrile disease. the unit should be inspected for discoloration
● HHV-8 Kaposi’s sarcoma (dark purple or black), which strongly indicates
(KS), primary effusion contamination.
lymphoma, and multicentric ● clots in the unit and hemolysis may also ind
Castleman’s disease. icate contamination.
● Spread is generally ● Because the bacteria in the unit consume the
through sexual contact. oxygen, the cells may lyse, resulting in
● Post-transplant patients discoloration in the unit
who develop KS, it appears
to be due to reactivation. Prophylaxis and Treatment
● The transmission of HHV-8 ● Use of apheresis platelets, careful phlebotomy
has been associated with technique, and phlebotomy diversion.
organ transplants and ● Use of apheresis platelets
injection drug use. ● Phlebotomy diversion consists of collecting the
first 20 to 30 mL of blood in a separate
______________________________________________________________________________________ 19
IMMUNOHEMATOLOGY
2nd SEM, 2022
container to be used for testing. very effective

hemagglutinat
in reducing Staphylococcus species
ion (TTHA)
contamination.
● Micro heme
● Leukodepletion: Removing phagocytized
agglutination
bacteria along with the leukocyte. Reduce
treponemal
Yersinia contamination.
pallidum
● Treatment: IV Antibiotics
(MHATP)
● Heme
agglutination
SYPHILIS treponemal
● French disease, great pox, or the evil pox test for
● Causative agent: Treponema pallidum; syphilis
sphirochetes (HATS)
○ yaws → Treponema pallidum
subspecie pertenue
○ Endemic syphilis → Treponema TICK-BORNE BACTERIAL AGENTS
pallidum subspecie endemicum Lyme Disease: Borrelia burgdorferi; Rocky
○ Pinta → Treponema carateum Mountain spotted fever: Rickettsia ricketsii;
○ Rabbit syphilis → Treponema cuniculi Ehrlichiosis: Ehrlichia spp.
● MOA: Sexual contact and Through blood
TRANSFUSION-ASSOCIATED PARASITES
transfusion. BABESIA
● Refrigerated: becomes inactivated ● Disease: Babesiosis (zoonotic disease)
● MOA: bite of an infected deer tick
STANDARD SEROLOGIC TEST FOR SYPHILIS ● Infects RBC (maltese cross app)
(STS) ● Causative agent:
● Do not detect donor in spirochetemia phase ○ Babesia microti
○ Babesia duncani (WA1-type Babesia)
● Phase is short and seroconversion usually
○ CA1-type Babesia
take place after this phase. ○ B. divergens-like agents (MO1-type
● Test is still required for donors. Babesia)
*Donors confirmed positive: reinstated for
donation after 12 months Epidemiology and transmission
● US (Northest, mid-Atlantic, upper Midwestern)
Confirm the presence of Antigen ● High: Spring and Summer
● Polymerase chain reaction ● Infected persons who donate blood during the
● Southern blotting asymptomatic period pose the greatest risk to
● Label probe blood supply.
● Methodologies: ● Packed RBC and Platelets: associated with
○ Nontreponemal EIA transmission
○ Fluorescent treponemal antibody ● B. microti can survive in refrigerated,
absorption test (FTA-ABS) uncoagulated blood for 21 to 35 days.
○ Treponema pallidum hemagglutination
○ Treponema pallidum immobilization Laboratory Test:
Test ● No specific test; No screening test
○ Confirmatory Test: FTA-ABS ● Thick and Thin blood smears
● Immunofluoresence assay
NON TREPONEMAL TREPONEMAL
Treatment:
● VDRL ● Treponemal ● No specific drug of choices
● RPR agglutination ○ Quinine
test ○ Clindamycin
● Treponemal
______________________________________________________________________________________ 20
IMMUNOHEMATOLOGY
2nd SEM, 2022
● Effective Antibiotic therapy ● Abbott Prism Chagas: highly sensitive and

● Life threthening: Atovaquone and Azithromycin specific
● Apheresis: Pt. fail to respond to Antibiotic
MALARIA
TRYPANOSOMA CRUZI ● Intra/extraerythrocytic protozoan infection
● Flagellate protozoan ● Cause: Genus Plasmodium (P. malariae, P.
● Disease: Chaga’s disease (American falciparum, P. vivax and P. ovale)
trypanosomiasis) ● MOA: Bite of female Anopheles mosquito,
● MOA: Bite of Reduviid bug transfusion of infected blood and congenital
○ Transmitted by blood transfusion and infection
organ transplant, Congenitally or ● Most common parasitic complication of
transplacentally transfusion.
ACUTE PHASE: Signs and Symptoms:

● Initiated when organisms enter the host ● Fever, chills, headache, anemia, hemolysis
● Reduviid bug produces a localized nodule and splenomegaly.
called Chagoma
● Chagoma: painful, 3 months to heal, Epidemiology and Transmission:
symptoms mild to absent. ● Malaria endemic tropical and subtropical area
● Symptoms: anemia, weakness, chills, and in West Africa.
intermittent fever, edema, lymphadenopathy,
myocarditis and gastrointestinal symptoms Natural Immunity:
● Death: within few weeks or months ● Sickle cell anemia/trait, G6PD deficiency and
RBC lack’s Duffy blood group
LATENT PHASE ● Associated with history of travelling to an
● Last up to 40 years; asymptomatic endemic area.
● Transfusion-associated Chaga’s disease; ● Transfusion-associated malaria: receiving
occur during this phase. blood products from an asymptomatic carrier.
● Plasmodium can survive in blood component
CHRONIC PHASE stored in RT or 4C for at least a week and
● Organism begins to cause damage to cardiac deglycerolized RBC.
tissue → Cardiomyopathy.
Laboratory diagnosis:
EPIDEMIOLOGY AND TRANSMISSION ● Thick (identification) and thin (quantification)
● Chaga’s dse: endemic in Central and South blood smears
America, some Mexico
● Can survive in platelets, RBC units, Treatment:
cryopreservation and thawing. ● Chemoprophylaxis: Chloroquine
● P. vivax in Indonesia or Papua New Guinea:
LAB DIAGNOSIS: Best treated with Atovaquone-Proguanil.
● ACUTE ● Alternative: Mefloquine or Quinine plus
○ Blood smear: C- or U- shaped tetracycline or doxycycline
trypomastigote
○ Anticoagulated blood or buffy coat: PRION DISEASE
Motility Creutzfeldt-Jakob Disease
● Part of the transmissible spongieform
● CHRONIC
encephalopathies (TSE).
○ Serologically: Complement fixation,
● Characterized by: Fatal neurodegeneration
immunofluorescence and ELISA.
that results in spongelike lesions in the brain.
● Definitive diagnosis: Made only at autopsy,
TREATMENT:
______________________________________________________________________________________ 21
IMMUNOHEMATOLOGY
2nd SEM, 2022
● Preliminary diagnosis: neurological signs and

symptoms and disease progression.
● TSE affects: Animals and humans
○ Animals: sheep, cattles, goat, cats
deer, elf
Human
● Sporadic CJD: most common form, 85-90%,
late middle age (average 60 y/o)
● Inherited form CJD: due to gene mutation
accounts for 5 to 10%
● Iatrogenic CJD: acquired through
contaminated
● Neurosurgical equipment, cornea or dura
mater transplants or human-derived pituitary
growth hormones, 5% of cases.
● vCJD: affect younger individuals. Linked vCJD
to bovine spongiform encephalopathy. Eating
of contaminated beef. Most cases in UK
● Causative agent of TSE: Prion
● Prion: Self replicating protein; does not contain
nucleic acid but formed when the confirmation
of the normal cell surface glycoprotein. →
ADVERSE EFFECTS OF TRANSFUSION
prion protein is changed to an abnormal form.
● Blood transfusion is an irreversible event that
● Abnormal form accumulates in the brain
carries potential benefits and risks to the
tissue.
recipient
● Resistant to inactivation by heat, radiation and
● “transfusion reaction” is any unfavorable
formalin.
transfusion-related event occurring in a patient
during or after transfusion of blood
NOTES:
components
➔ Duration of Illness of vCJD: 13 to 14 months
➔ Incubation period in Human: 4 to 20 years
HEMOLYTIC TRANSFUSION REACTIONS (HTR)
➔ Prion particles found in lymphoreticular tissue
● occur either at the time of transfusion
like tonsils, spleen and lymph nodes.
(immediate) or a few (3 to 7) days after
➔ No reliable diagnostic test
transfusion (delayed)
● Common causes:
○ transfusion of incompatible RBC
○ transfusion of ABO-incompatible
plasma containing products
○ chemically or physically induced
ADDED NOTES:
➔ immediately stop the transfusion and give a .9
sodium chloride or normal saline to the patient;
then the nurse will check if there’s any clerical
error;
Physician
● will evaluate and treat accordingly or if
needed; will order transfusion investigation or
reaction workup; he/she will consult the
transfusion service physician in a form of a
pathologists
Pathologists
● will give an order for investigation in blood
bank
______________________________________________________________________________________ 22
IMMUNOHEMATOLOGY
2nd SEM, 2022
Laboratory Technician or RBC stromata

● Perform primary testing on postreaction
sample; THERAPY AND PREVENTION
● Report findings to the transfusion service ● Patient care in IHTR is focused on prevention
physician; and supportive measures
● Perform additional testing as per transfusion ● monitor the patient closely for risk factors to
service physician orders will make the final DIC, hypotension, and acute renal failure
report of what’s the real cause of HTR ● renal diuresis and to prevent renal failure
mannitol
IMMEDIATE HEMOLYTIC TRANSFUSION ● improve renal blood flow and induce diuresis
REACTION (IHTR) ethacrynic acid and furosemide
● Occurs very soon after or during transfusion of ● Hypotension intravenous fluids and vasoactive
incompatible RBCs drugs (dopamine)
● Reaction period: 1-2 hours ● Blood component fresh frozen plasma (FFP),
● The RBCs are rapidly destroyed releasing cryoprecipitate, and platelet concentrates
hemoglobin and RBC stromata into the ● Extravascular IHTR usually does not require
circulation therapeutic intervention
● signs and symptoms can occur within minutes
after starting the transfusion
DELAYED HEMOLYTIC TRANSFUSION REACTION
(DHTR)
● Response in a patient who has previously
Common signs and symptoms: been sensitized by transfusion, pregnancy, or
● Hemoglobinuria & Hemoglobinemia (if transplant
intravascularly & possible extravascularly) ● Not detectable by standard pretransfusion
● abnormal bleeding at the surgical wound site methods
● hypotension ● Clinical signs and symptoms
● ABO-incompatible transfusions may be life ○ Usually mild
threatening, causing shock, acute renal failure, ○ Severe DHTR cases and fatalities are
and disseminated intravascular coagulation uncommon.
(DIC) ○ Unexpected or unexplained decreases
in hemoglobin or hematocrit
PATHOPHYSIOLOGY
● The underlying cause of IHTR is transfusion of PATHOPHYSIOLOGY
an incompatible whole blood or RBC product ● Two different types of DHTR have been
to a recipient identified:
● Common antibodies: anti-A, anti-Kell, ○ Secondary (anamnestic) response
anti-Jka, and anti-Fya. to transfused RBCs
● IHTR two mechanisms: intravascular or ○ Primary alloimmunization
extravascular hemolysis
● Extravascular hemolysis is the mechanism
INTRAVASCULAR HEMOLYSIS: of RBC destruction for both types of DHTR
● Initial event is the binding of patient antibody
to the transfused incompatible RBCs, which SIGNS AND SYMPTOMS
forms an antigen-antibody (Ag-Ab) complex on ● Mild than IHTR because of the extravascular
the RBC surface hemolysis and may be undetected clinically
● Hemoglobin, RBC stromata, and intracellular ● DHTR, complement is not activated; therefore,
enzymes, manifesting in hemoglobinemia and no intravascular hemolysis occurs
hemoglobinuria
THERAPY AND PREVENTION
EXTRAVASCULAR HEMOLYSIS: ● Renal function can be supported with
● characterized by Ag-Ab complex formation on intravenous fluid therapy to maintain a
RBCs with incomplete activation of normovolemic status
complement ● Only symptomatic anemia should be treated
● Because RBC lysis does not occur with RBC
intravascularly, there is no release into the ● Clinical signs and symptoms of hemolysis or
circulation of free hemoglobin, RBC enzymes, DIC should be monitored to reduce the risk of
______________________________________________________________________________________ 23
IMMUNOHEMATOLOGY
2nd SEM, 2022
renal failure for antibody such as

IMMEDIATE NON-HEMOLYTIC TRANSFUSION formation diphenhydramine
REACTIONS (Benadryl)
● FEBRILE NONHEMOLYTIC TRANSFUSION SIGNS, SYMPTOMS ● In patients with
● Fever with or histories of
REACTION (FNHTR) without chills and, repeated allergic
● ALLERGIC (URTICARIAL) TRANSFUSION rarely, hypotension reactions, plasma
● Severe rxns include: is often removed
REACTION hypotension, from blood
● ANAPHYLACTIC AND ANAPHYLACTOID cyanosis, components
tachycardia,
REACTION tachypnea,
● TRANSFUSION RELATED ACUTE LUNG dyspnea, cough,
INJURY (TRALI) limited fibrinolysis,
and transient
● TRANSFUSION-ASSOCIATED leukopenia
CIRCULATORY OVERLOAD (TACO)
THERAPY AND
● BACTERIAL CONTAMINATION REACTIONS PREVENTION
● PHYSICALLY OR CHEMICALLY INDUCED ● Blood component:
pre-storage,
TRANSFUSION REACTIONS (PCITR) leukoreduced, pack
RBC & platelet
FEBRILE NONHEMOLYTIC ALLERGIC (URTICARIAL)
TRANSFUSION REACTION TRANSFUSION REACTION
(FNHTR)
Occurs in about 1 percent of Allergic reaction is of the

transfusions Along with immediate hypersensitivity
allergic reactions, FNHTR is type FNHTR:
the most commonly
● Diagnosis - direct antiglobulin testing negative
encountered type of Two mechanisms:
transfusion reaction ● The donor or DAT (-)
Associated with: 1C plasma has a ● Treatment: antipyretics; if there's a rigors treat
temperature rise having no foreign protein w/ heperidine
medical explanation other than (allergen) in which
blood component transfusion immunoglobulins
in the patient’s
➔ Increase of 1C of plasma react (IgE,
ANAPHYLACTIC AND TRANSFUSION
body temperature IgG or both)
accompanied by ● The donor plasma ANAPHYLACTOID RELATED ACUTE LUNG
chills, nausea, has reagins (IgE REACTION INJURY (TRALI)
vomiting, or IgG or both)
tachycardia, that combine with Anaphylaxis can range Other names:
increase in blood allergens in the from mild urticaria (hives) noncardiogenic,
pressure & patient plasma. and pruritus to severe pulmonary edema
tachypnea ● Primary mediator
shock and death. Any (NCPE), pulmonary
➔ Occasionally of the allergic
shaking, chills (initial response: organ of the body can be hypersensitivity reaction,
presenting Histamine involved, such as the allergic pulmonary edema
symptoms) followed (leukotrienes: lungs, blood vessels,
by increase 1,000 more potent nerves, skin, and PATHOPHYSIOLOGY
temperature up to than histamine) gastrointestinal tract. ● Most consistent
30 mins discontinue finding is
of blood transfusion SIGNS, SYMPTOMS PATHOPHYSIOLOGY leukocyte
● Erythema
● Associated with: antibodies in
PATHOPHYSIOLOGY (redness), pruritus
● Caused by: (itching), and IgA deficient donor or patient
leukocyte AB in the hives (raised, firm, patients who have plasma
patient’s plasma red welts) developed ● Anti-leukocyte
● Directed against ● Fever may or may anti-IgA antibodies in
antigens present on not be present antibodies; donor or
monocytes, ● Laryngeal edema, patient plasma
granulocytes, or and bronchial ● Anaphylactic:
lymphocytes asthma
seen in patients SIGNS, SYMPTOMS
● Alloimmunization by
prior blood deficient in IgA ● TRALI is usually
transfusion, tissue who have class characterized by
transplantation, or THERAPY AND specific IgA chills, cough,
pregnancy is the PREVENTION antibodies fever, cyanosis,
causative stimulus ● Antihistamine hypotension,
______________________________________________________________________________________ 24
IMMUNOHEMATOLOGY
2nd SEM, 2022
● Anaphylactoid: and increasing pulmonary edema endotoxin

Normal levels of respiratory produced by
IgA but a limited distress shortly SIGNS AND SYMPTOMS bacteria capable
type-specific after transfusion ● dyspnea, of growing in
anti-IgA that of blood coughing, cold
reacts with light component cyanosis, temperatures
chain (kappa or volumes that orthopnea, chest (psychrophilic)
lambda) of the usually do not discomfort,
donor’s IgA. produce headache,
hypervolemia restlessness, SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS tachycardia, ● Septic reactions
● Anaphylactic THERAPY AND systolic usually appear
rxn: sudden in PREVENTION hypertension rapidly during
onset ,include ● adequate (greater than transfusion or
coughing, respiratory and 50mmHg within about 30
dyspnea, nausea, hemodynamic increase), and minutes after
emesis, supportive abnormal transfusion
bronchospasm, treatment electrocardiogram ● Dryness and
flushing of skin, ● TRALI results flushing of the
chest pain, pulmonary patient’s skin
hypotension, infiltrates usually Therapy and Prevention ● Fever,
abdominal clear after ● Rapid reduction of hypotension,
cramps, diarrhea, several days hypervolemia and shaking, chills,
possible shock, ● If TRALI is patient respiratory muscle pain,
loss of caused by and cardiac vomiting,
consciousness, patient support are abdominal
and death anti-leukocyte primary goals cramps, bloody
antibodies ● Oxygen therapy diarrhea,
● Anaphylactoid (Leukoreduced and intravenous hemoglobinuria,
rxn: less severe RBC, platelets) diuretics • shock, renal
and are ● Therapeutic failure, and DIC
characterized by phlebotomy can
urticaria, be used THERAPY AND
periorbital ● Cardiac PREVENTION
swelling, arrhythmias or ● Broad-spectrum
dyspnea, and myocardial antibiotics
perilaryngeal function should be should be
edema corrected immediately
administered
Usual rate of transfusion: intravenously
200 mL/hr; for TACO: <100
TRANSFUSION-ASSOCIA BACTERIAL mL/hr
TED CIRCULATORY CONTAMINATION
OVERLOAD (TACO) REACTIONS
PHYSICALLY OR CHEMICALLY INDUCED
Patients at risk: children, Septic reaction can have
elderly patients, and a rapid onset and lead to
TRANSFUSION REACTIONS (PCITR)
patients with chronic death Most are caused by ● Can cause:
normovolemic anemia, blood components ○ RBC damage
cardiac disease, contaminated by: Yersinia ○ depletion and dilution of coagulation
thalassemia major, or enterocolitica factors and platelets
sickle cell disease (Pseudomonas, E.coli) ○ hypothermia
○ citrate toxicity
PATHOPHYSIOLOGY PATHOPHYSIOLOGY ○ hypokalemia or hyperkalemia
● transfusion of a ● Transfusion ○ air embolism
unit at too fast a reactions
rate attributed to
● Hypervolemia bacterial PATHOPHYSIOLOGY
associated with contamination ● RBCs are susceptible to membrane damage
transfusion leads reactions are and intravascular lysis by hypertonic or
to congestive commonly hypotonic solutions, heat damage from blood
heart failure and caused by warmers, freezing damage in the absence of a
cryoprotective agent, and mechanical damage
______________________________________________________________________________________ 25
IMMUNOHEMATOLOGY
2nd SEM, 2022
such as that caused by roller pumps in a blood ➔ May result from ➔ Rare,usually
pumps. prior exposure to involving platelet
● During massive transfusion (replacement of donor blood concentrates
patient’s total blood volume within 24 hours), components ➔ occurs within 7
➔ As an adverse days after
rapid depletion and dilution of platelets and effect of blood transfusion
plasma coagulation factors can occur. component ➔ PTP is
● Hypothermia, a core body temperature lower transfusion, characterized by a
than 35C, is usually associated with large alloimmunization rapid onset
is a significant production of
volumes of cold fluid transfusions. complication platelet
● *Excess citrate from transfusions can act on ➔ Even very small alloantibody.
the patient’s ionized calcium in the plasma and amounts of ➔ Post-transfusion
may result in hypocalcemia. donor antigenic purpura usually
RBCs can elicit occurs in
● Transfusion-associated hyperkalemia can be an alloimmune multiparous
caused by the intracellular loss of potassium response females. The lag
from RBCs during storage in the blood unit time between
plasma PATHOPHYSIOLOGY transfusion and
● exposure to onset of
● Transfusion-induced hypokalemia is most foreign antigens thrombocytopenia
likely to be caused by infusion of intracellular by blood is approximately 7
potassium-depleted RBC blood components, component to 14 days
such as washed RBCs or frozen washed RBC transfusions,
tissue PATHOPHYSIOLOGY
transplantation, ● Associated with:
SIGNS AND SYMPTOMS or pregnancy anti-PLA1
● clinical signs and symptoms of PCITR are that may cause ● Platelet
nonspecific a patient’s alloantibody
immune system attaches to the
● The more common signs and symptoms to produce platelet surface,
include facial numbness, chills, generalized antibodies which permits
numbness, muscle twitching, cardiac extravascular
arrhythmias, nausea, vomiting, perioral SIGNS AND SYMPTOMS destruction by the
● Clinical signs RES in the liver
tingling, altered respirations, and anxiety and symptoms and spleen
may be mild,
THERAPY AND PREVENTION including slight SIGNS AND SYMPTOMS
● Treatment is directed at correcting the fever and falling ● Purpura and
hemoglobin and thrombocytopenia
underlying cause of the signs and symptoms hematocrit occur about 1 to 2
● Hypothermia: warming blanket and giving levels; or severe, weeks after
● Citrate toxicity is often rapidly self-correcting, including platelet transfusion
but administration of a calcium-rich product refractoriness ● Thrombocytopenia
with bleeding can be severe, with
(milk, calcium gluconate) platelet counts of
DELAYED NON HEMOLYTIC TRANSFUSION THERAPY AND less than
REACTIONS PREVENTION 10,000/mm3
● ALLOIMMUNIZATION ● Treatment ● Hematuria, melena,
depends on the and vaginal
● POST-TRANSFUSION PURPURA type and severity bleeding
● TRANSFUSION-ASSOCIATED of the
transfusion THERAPY AND
GRAFT-VERSUS-HOST DISEASE reaction. Most PREVENTION
(TA-GVHD) reactions are ● corticosteroids,
mild and often exchange
● IRON OVERLOAD - DELAYED missed clinically. transfusions, and
● IMMUNOSUPPRESSION plasmapheresis
TRANSFUSION-ASSOCIATED
GRAFT-VERSUS-HOST DISEASE (TA-GVHD)
ALLOIMMUNIZATION POST-TRANSFUSION ● Complication of blood component therapy or
PURPURA bone marrow transplantation
● Members of the at-risk:
○ Patients experiencing lymphopenia or
bone marrow suppression
○ Fetuses receiving intrauterine
transfusions,
______________________________________________________________________________________ 26
IMMUNOHEMATOLOGY
2nd SEM, 2022
○ Newborn infants receiving exchange

transfusions SIGNS AND SYMPTOMS
○ Individuals with congenital ● muscle
immunodeficiency syndromes, weakness,
patients with certain hematologic and fatigue, weight
oncologic disorders loss, mild
○ Patients receiving blood components jaundice,
from blood relatives. anemia, mild
diabetes, and
cardiac
PATHOPHYSIOLOGY
arrhythmias
● TA-GVHD is caused by a proliferation of
T-cell lymphocytes derived from the donor
blood that is responding immunologically
to major and minor histocompatibility THERAPY AND
antigens in the patient PREVENTION
● Removal of
SIGNS AND SYMPTOMS accumulated
● Appear in about 3 to 30 days after transfusion tissue iron stores
without lowering
● Pancytopenia; Other effects include fever,
patient
elevated liver enzymes, copious watery hemoglobin
diarrhea, erythematous skin rash progressing levels is the
to erythroderma, and desquamation treatment of
choice
THERAPY AND PREVENTION ● Subcutaneous
● Corticosteroids, cyclosporine, methotrexate, infusion of an
azathioprine & anti-thymocyte globulin iron-chelating
● Blood component: Irradiated RBC agent
(desferrioxamine
)
IRON OVERLOAD IMMUNOSUPPRESSION
● long-term Immunosuppression is a HEMOLYTIC DISEASE OF THE NEWBORN (HDN)

complication of generalized, nonspecific effect ● Destruction of the red blood cells (RBCs) of
RBC transfusion that diminishes the activity of the fetus and neonate by antibodies produced
is iron overload the recipient’s immune system by the mother
(aka soon after blood component
transfusion transfusion
● Signs and symptoms:
hemosiderosis) ○ Less severe form: Mild anemia
● Patients with PATHOPHYSIOLOGY ○ Severe form: Icterus gravis
certain diseases ● To date, no specific neonatorum (Kernicterus)
are chronically mechanism or
dependent on mechanisms have ○ Intrauterine death: Hydrops fetalis
RBC transfusion been definitely proved ■ Edematous, ascites, bulky
support as part as the pathway for swollen & friable placenta
of therapy post-transfusion
■ Pathophysiology:
(congenital immunosuppression
hemolytic Extravascular hemolysis with
anemias, SIGNS AND SYMPTOMS extramedullary erythropoiesis
aplastic anemia, ● No specific signs or Rh HEMOLYTIC DISEASE OF THE NEWBORN
chronic renal symptoms have been ● More severe than ABO HDN
failure) attributed to
immunosuppression
● Caused by maternal antibodies (anti-D, anti-c,
PATHOPHYSIOLOGY anti-E) directed against antigens present on (D
● Accumulated THERAPY AND PREVENTION antigen) fetal red cells
iron begins to ● no specific therapy ● Mother: Rh-Negative (no Rh antigen have Rh
affect the regimen is available antibody); Fetus: Rh-positive (have Rh
function of heart, antigen)
liver, and ● Steps:
endocrine 1. Fetal red cells crosses the placenta
glands. into the maternal circulation
______________________________________________________________________________________ 27
IMMUNOHEMATOLOGY
2nd SEM, 2022
2. Red cells are recognized by the

maternal immune system B. Mini/Microdose RhIg
3. Maternal red cells are sensitized and ● 50 ug of anti-D; protects up to 5 mL D
produces anti-D positive WB and 2. mL PRBCs
4. Anti-D crosses the placenta and will ● Given before 12 weeks of gestation
coat fetal red cells causing hemolysis
RECOMMENDED OBSTETRIC PRACTICE FOR HDN TO DETERMINE THE NUMBER OF RHIg vials to be
● History; including previous pregnancies or any given
disease needing blood transfusion 1. KLEIHAUER BETKE TEST
● ABO and Rh testing a. Fetal hemoglobin (HbF) resists acid
● Antibody screening and identification elution
○ To detect clinically significant IgG b. Fetal cells: Deep pink
alloantibodies which reacts at 37C c. Maternal cells: ghost cells - 2000 cells
○ Repeat testing required at 24 or 28 d. Result will be: % fetal cells
weeks if first test negative
2. COMPUTE FOR NUMBER OF RHIG VIALS
➔ Common antibodies: Anti-D, Anti-C, Anti-E, ➔ # of RhIg vials: volume of FMH/30
Anti-c, Anti-e, Anti-K (yung 30 galing sa full dose)
➔ Rare causing HDN: Anti-Fya, Anti-s, Anti-M, ***volume of FMH: % fetal red cells
Anti-N, Anti-S, Anti-JKa x 50 plus 1
➔ Never: Anti-Lea, Anti-Leb, Anti-I, Anti-IH,
Anti-P1
FORMULA
● Parental phenotype
● Amniocentesis and cordocentesis
○ Concentration of bilirubin
○ Spectrophotometric scan
■ Indirect method: Increasing
or un-change OD as
pregnancy advance shows
worsening of the fetal
hemolytic disease (OD=450)
● Fetal blood sample can be taken and tested

for: Hb, Hct, blood grouping, DAT
ADDED NOTES:
➔ Anti-kell: most common antibody, non-Rh
system antibody that considered most
clinically significant
ADDED NOTES:
HEMOLYTIC DISEASE OF THE NEWBORN (HDN) 1. # fetal cells / 2000 adult cells x 100
PREVENTION OF Rh HDN = % fetal cells
● Prevention by active immunization
● Use of RhIg (Rhogam) 2. % fetal cells x 50 (constant ang 50) = # of mL
○ Purified anti-D of fetal blood or volume of FMH
○ After 1st pregnancy
○ Administered within 72 hours after 3. mL of fetal blood (vol of FMH) / 30 (not
delivery constant) = # vials of RHIg
○ Mother must be Rh-negative with no
anti-D in the circulation 4. Plus 1 - additional dose of rogam to ensure the
adequate suppression of immune production
of allo anti-D
ADMINISTRATION OF RhIg
A. Full dose RhIg
● 30 ug of anti-D; protects up to 30 mL COMPUTATION
of D positive WB and 15 mL PRBCs
● Given after 12 weeks of gestation
______________________________________________________________________________________ 28
IMMUNOHEMATOLOGY
2nd SEM, 2022
1st Example:
- 26 Fetal cell while counting 2000 maternal
cells or adult cells
Step 1:
= 26 fetals / 2000 x 100
→ 0.013 x 100 = 1.3% fetal cells
Step 2:
= 1.3% x 50 = 65 mL fetal blood or (vol of FMH)
Step 3:
= 65 mL / 30 (full dose) → 2.1666 or 2.2 # vials
needed
Step 4:
Plus 1 = 2.2 + 1 → 3 vials
COMPUTATION
2nd Example:
Step 1:
= 60 fetals cell / 2000 → 0.003 x 100 → 3% fetal
cells
Step 2:
= 3% Fetal cells x 50 → 150 mL of FMH (fetal blood
Step 3:
= 150 mL / 30 (full dose) → 5 vials
Step 4:
Plus 1 = 6 vials
______________________________________________________________________________________ 29

Week 13 - Donor Selection

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Week 13 - Donor Selection

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IMMUNOHEMATOLOGY

DONOR SELECTION/DONOR SCREENING (WEEK 13/FINALS)

Donor Selection/Donor Screening restriction; donor-patient must be

EDTA and red top - thick and thin smear

Full-Length Donor History Questionnaire

Medication deferral list

➔ 110 if pounds; 50 if kilogram

● Temperature: Orally should not exceed 99.5’F

Copper Sulfate Mtd. (CuSo4)

ticlodine and plavix same as aspirin

○ Donor received vaccination for yellow ○ Hemoglobin/hematocrit – should not

● Storage: 1’C to 6’C causes we need to increase the Hgb and by

outdate. should prevent reactions that

● Contain sufficient plasma typically 40 to 70mL

FRESH FROZEN PLASMA

● Contains all stable proteins found in FFP, has deficiencies

● Treat patient with Hemophilia A or classical

HEPATITIS B IMMUNE GLOBULIN (HBIG)

IMMUNE SERUM GLOBULINS (ISG)

TRANSFUSION-TRANSMITTED DISEASE ● Incubation period 28 days and peak viremic

hepatomegaly, anorexia, malaise, fever, ◆ 1st marker to appear: Hepa B

● Recombinant immunoblot assays (RIBA),

○ sexual contact with an infected

● Blood donors infected with HTLV-I or HTLV-II SYMPTOMS

container to be used for testing. very effective

● Effective Antibiotic therapy ● Abbott Prism Chagas: highly sensitive and

ACUTE PHASE: Signs and Symptoms:

● Preliminary diagnosis: neurological signs and

Laboratory Technician or RBC stromata

renal failure for antibody such as

Occurs in about 1 percent of Allergic reaction is of the

● Anaphylactoid: and increasing pulmonary edema endotoxin

○ Newborn infants receiving exchange

● long-term Immunosuppression is a HEMOLYTIC DISEASE OF THE NEWBORN (HDN)

2. Red cells are recognized by the

● Fetal blood sample can be taken and tested

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