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(Download PDF) Immunohematology and Blood Banking Principles and Practice Pritam Singh Ajmani Online Ebook All Chapter PDF
(Download PDF) Immunohematology and Blood Banking Principles and Practice Pritam Singh Ajmani Online Ebook All Chapter PDF
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Immunohematology
and Blood banking
Principles and Practice
Pritam Singh Ajmani
123
Immunohematology and Blood banking
Pritam Singh Ajmani
Immunohematology
and Blood banking
Principles and Practice
Pritam Singh Ajmani
Ruxmaniben Deepchand Gardi Medical College
Surasa, India
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Singapore Pte Ltd. 2020
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore
189721, Singapore
This book is dedicated to Dr Amrita and C.A. Priyanka
Preface
vii
viii Preface
voice and for preparation for postgraduate entrance exam with content that is
easily assimilated by the reader.
The book is an introductory text designed to provide faculty member in
academics with core concept of effective teaching on focused chapters with
practicals and labs.
An attempt has been made on a learner-centered perspective and empha-
sizes outcomes for student learning.
The approach of the book is simple and user friendly. I hope that clinical
consultants, pathologists, medical technology students, graduate medical
education trainees, resident in pathology and related disciplines will find the
book useful. They can use this edition to attain information in the knowledge
and learning process, for inpatients care and for continuous reading, to pro-
mote continuous medical education and lifelong learning.
ix
Acknowledgements
Writing a medical book about the story of your life is a surreal process. It is
harder than I thought and more rewarding than I could have ever imagined.
The experience is both internally challenging and rewarding. Any effort
becomes successful when there is the effect of synergy—the concept that two
and two makes more than four. This book has also the effect of synergy, with-
out prejudice to my own contribution. I wish to start by thanking my daughter
Dr Amrita for sharing her truthful and illuminating views on a number of
topics related to the book and to my daughter C.A. Priyanka who always
cheers me up, never failing in inspiring and encouraging me which helped me
to finish this book in half the time. Without their support, it would not have
been possible to complete the task.
My deepest and most intimate gratitude is reserved for my awesome wife
Rajender for her eternal support and understanding of my goals and aspira-
tions. She is my inspiration and the reason why I work so hard. Her uncondi-
tional love and support have always been my strength. Her patience and
sacrifice will remain my inspiration throughout my life. It is a boom to me to
have such a lovely and caring family, standing beside me with their love and
unconditional support. My love for you shall live forever.
I am forever indebted to entire staff of Springer publication for their coop-
eration tireless, diligent, and meticulous work, careful indexing and editorial
help that made getting this book in front of you. Special thanks to, the ever-
patient Publishing Manager, and, the greatest cover designer I could ever
imagine. I wish to acknowledge the valuable contributions of the reviewers
regarding the improvement of quality, coherence, and content presentation of
chapters.
I would also like to show my gratitude to Dr Y.K. Mahadik, Medical
Director, R.D. Gardi Medical College, Ujjain, for sharing his pearls of wis-
dom with me during the course of writing this book.
xi
Contents
1 Introduction�������������������������������������������������������������������������������������� 1
1.1 Introduction������������������������������������������������������������������������������ 1
1.2 Uses of Blood Grouping ���������������������������������������������������������� 2
1.2.1 Exclusion of Paternity on the Basis
of MN Grouping ���������������������������������������������������������� 2
1.3 Discovery of Human Blood Groups������������������������������������������ 3
1.3.1 Blood Tests for Transplant�������������������������������������������� 3
1.3.2 Blood Typing���������������������������������������������������������������� 3
1.3.3 Selection of Donor for Organ Donation������������������������ 3
1.3.4 Serum Crossmatch�������������������������������������������������������� 4
1.3.5 Types of Donor for Organ Transplant �������������������������� 4
Further Reading �������������������������������������������������������������������������������� 4
2 Blood Group and Immunology ������������������������������������������������������ 7
2.1 Introduction������������������������������������������������������������������������������ 7
2.2 Principles of Immunohematology�������������������������������������������� 8
2.2.1 The Basic Blood Group System ABO�������������������������� 8
2.2.2 Red Blood Cell Antigens Can Be
Proteins or Sugars �������������������������������������������������������� 9
2.2.3 What Do Co-dominant Genes Mean? �������������������������� 9
2.2.4 Nomenclature���������������������������������������������������������������� 10
2.2.5 Antibodies �������������������������������������������������������������������� 10
2.2.6 Recognition of Immunological Reaction
in Blood Banking���������������������������������������������������������� 11
2.3 Factors Affecting the Antigen–Antibody Reaction������������������ 11
2.3.1 Effects of Time�������������������������������������������������������������� 11
2.4 Stages of Immunological Reaction ������������������������������������������ 12
2.4.1 Elution�������������������������������������������������������������������������� 12
2.5 Summary of Antigen–Antibody Reactions ������������������������������ 12
2.5.1 The Direct Antiglobulin Test Will Detect
Red Cell Sensitization In Vivo�������������������������������������� 13
2.5.2 The Basic Blood Group System ABO�������������������������� 14
2.5.3 ABO Antibodies������������������������������������������������������������ 14
2.5.4 Subgroups of ABO Blood Group System �������������������� 14
xiii
xiv Contents
Table 2.2 Showing genotypes of the offspring Table 2.3 Showing antibody characteristics of IgG and
ABO genotype of the off ABO alleles inherited IgM types
spring from the mother Antibody characteristics IgM IgG
ABO alleles inherited A B O Reaction enhanced—by enzyme- Yes Yes
from the father A A AB A treating cells
B AB B B Reaction enhanced—by lowering Yes No
O A B O temperature
Readily inhibited by soluble A or B Yes No
antigens
2.2.4 Nomenclature Inactivated by 2—Me or dithiothreitol Yes No
Predominant in non-immunized group Yes No
A and B donors
These alleles were termed A (which produced the
A antigen), B (which produced the B antigen),
and O (which was “non-functional” and pro- ies leak through placental barrier. Non-
duced no A or B antigen) (Table 2.2). penetration of the natural antibodies from the
mother to the fetus protects the latter from incom-
patible maternal blood..
2.2.5 Antibodies Antibodies present in plasma are a part of
our immune system. Hence, for the identification
Antibodies (also known as immunoglobulins) are of the antibody, clotted blood, which yields
large Y-shaped proteins. They are produced by serum, is required.
circulating lymphocytes and plasma cells follow- Immune antibodies produced by infectious
ing antigenic stimulation. Antibodies combine agents do not interfere normally in the blood
chemically with substances which the body rec- banking procedures except in case of myco-
ognizes as alien, such as bacteria, viruses, and for- plasma infection which causes atypical pneumo-
eign substances in the blood. The antibodies are nia and develop cold-reacting antibodies. These
found in serum or other body fluids and can be cold-reacting antibodies agglutinate the person’s
demonstrated serologically by reacting with cor- own red cells at 4 °C. Many bacteria are also
responding antigen (immunological reaction). known to affect the red cell antigens.
Antibodies are the main elements in the adap- Most often the antibody reacts specifically
tive immune system. The antibody recognizes a with its corresponding antigen that stimulated its
unique part of the foreign target called an anti- production (D antigen with anti-D). Occasionally,
gen. Antibody against red cells can be present however, two antigens have certain chemical
naturally in an individual from birth without any groups in common, and an antibody made against
known antigenic stimulation. These are called one of them will react to some degree with oth-
natural antibody (anti-A and anti-B). ers. This apparent dual specificity is known as
Immune antibodies are produced when red cross reactivity (Table 2.3).
cells carrying the corresponding antigen enter Iso antibodies are antibodies produced by an
into an individual who normally lacks the invad- organism in response to a constituent of their own
ing antigen, for example, anti-D and anti-fy. tissues. They are produced in the same species as
The immune and natural antibodies differ in the antigen source.
physical and chemical characteristics. The natu- Anti-D (anti-Rh) produced by an Rh-negative
ral antibodies are IgM class with large molecular fetus, after receiving Rh-positive transfusion of Red
weight (900,000), whereas the incomplete anti- cells, is an example of isoantibody production.
bodies are of smaller molecular weight (150,000). Heteroantibodies, however, originate in spe-
This may be the reason why the immune antibod- cies other than the source of antigen. The antihu-
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