• Responsible for expression of ABH antigens in the ▪ 3-6 months mag start ang ab

secretions: production
o Hh • Inidviduals with Rh null phenotypes:
o Hh o Have: short RBC life, anemia with
o Sese genes reticulocytosis, and presence of
o Lele stomatocytsosis
o Se genes minimally interacts with the type 2 • Upon initial phenotyping, patients of bombay
precursor chains phenotype will appear Type O
▪ So expect na meron pa ring • Anti-Jk antibodies
expression o Easily masked by other antibodies because
• Lectin used for differentiation of A1 from A2 titers easily dropped
o Bandeiraea simplicifolia: for B antigen o Labile in stored serum and plasma
o Ulex europaeus: H antigen o Frequent cause of delayed hemolytic
o Dolichous biflorus: A1 from A2 transfusion reaction
o Iberris abarra: Anti – M • Anti-S and anti-s are:
o Visea graminea: Anti – N o Mostly IgG reacting to 37C and antiglobluin
o Bauhinya variagatta and Bauhinya purpura: test
Anti – N o Remember: Rich Daring Kidd can Kill – Sir
• Results of a forward typing of a patient’s RBC are Greg
shown. What is the most likely genotype? ▪ Rich – Rh (Cc Ee), except D
o D, C, e (+) and c, E (-) ▪ Duffy
o Choices: ▪ Kidd
▪ R2R2 ▪ Kell
▪ R1r’ ▪ Ss
▪ r’r” • Duffy (a-b): resistant to P. vivax
▪ RzRz • Yta and Ytb are antigens of the Cartwright blood
• What discrepancy is the most likely examination? group antigens.
• Px on Aspirin medications are allowed donate blood
components except platelet concetrates
• Tattoo and ear peircings are
o Acquired B phenotype • RBC freezing
o For rare blood types
o Use cryoprtectice agent like HES and
glycerol
▪ Glycerol is most commonly used in
protecting rbcs in freezing.
• Karl Landsteiner – first to discover forward and However, it is toxic to the body.
reverse Thus, during thawing, glycerol
• The current concept on the inheritance of Rh genes should be < 1%
is that: • Platelet and granulocytes are stored at room temp.
o Choices FFP is stored frozen or on ice. Packed RBC is
▪ One Rh locus refrigerated.
▪ Two closley linked loci (RHAG and • Glycerol is the most commonly used cryoprotective
RHCE) o Moa: forms a barrier in the rbc’s inner
o Three closley linked loci membrane so the water won’t go put
o There is only one gene with multiple flood o Hes moa: non-penetrative
factors • Open system blood products = issued withing 24
• Newborn hours
o Causes Group 1 discrepancy • Cryoprecipitate – indicated for px with
o Do not perform reverse typing on newborn hypofibrinogenemia
because the antibodies that will be reacting o 150 mg Factor 1
are maternal in origin and not that of the • Washed RBC – indicated for anti-IgA antibodies
baby.
• Irradiated blood is indicated for
o Irradiation is done to inhibit proliferation of
T cells
o For: BM transplant, px with WAIHA, AIDS
▪ Immunocompromised patients
cannot overcome possible T cell
proliferation
o Odd one out: Exchange transfusion
▪
• In leukemic patients, give leuko-reduced blood
components
• Study neutralization, autoadsorption and elution
• LISS: 5-15 minutes
• Red Cell destruction in Rh-related hemolytic disease
of the newborn is mediated by:
o SPLEEN
o It is not complement because you need 2
IgG molecules and their distance matter
also. Complement woukd not be activated
• Most common: ABO HDFN, but most severe is RH
HDFN
• Rhogam is an example of artifical passive immunity
• Washed RBC should be used within 24 hours; done
in an open system
• 30 mins – once a blood is removed from a 2-8C,
how long can it be left before commencing a
transfusion?
o Bottomline: transufse within 30 minutes or
ibalik sa ref. If you did not, blood product
will be fore disposal.