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Summary Haematology - Blood Groups notes

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Blood Donation, Immunohaematology, Transfusion Complications

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  • April 4, 2021
  • 3
  • 2020/2021
  • Summary
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kayrose
Blood Groups


Blood Donation

● Criteria: 17+, 50kg+, Hb >135g/L (M) or 125g/L (F). Exclude if: pregnant, viral infection, manual
occupation, previous cancer, drug user, foreign travel, M2M sex, piercings, tattoos
● Mandatory tests: ABO, Rh, Hb for gravimetric analysis, HIV, hep B, hep C, syphilis, human T cell
leukemia virus (HTLV).
○ On request: malaria, CMV, Chagas’ disease



Blood Transfusions

Fresh plasma | fresh frozen plasma | concentrated red cells | cryoprecipitate | platelets

● FFP - from one single donor, stored at -30℃ for up to 2 years
● Concentrated red cells - leukodepleted to prevent transfusion-associated GvHD. Stored for
32 days at 4℃, after that 2,3 DPG is too low
● Cryoprecipitate - contains necessary clotting factors obtained from FFP precipitate. Factors can
be tailored to suit patient’s needs
● Platelets - from donor units after centrifugation or from cell separators during donation
(higher yield). Stored for 7 days at 22℃.



Immunohaematology

● Around 400 red cell antigens identified eg. ABO, Rh, Kell, Duffy, Kidd
● ABO antigens are extrinsic and ‘naturally occurring’
○ predominantly IgM and activate complement system up to the MAC
○ Directly agglutinate at ‘cold’ temperatures (4℃)
■ Lab tests based on forward and reverse direct agglutination tests
○ A = N-acetyl-D-glucosamine to H substance to make A antigen
○ B = D-galactose to H substance to make B antigen
○ O = modification to H substance to cross-reacting antibody, anti-A,B
○ AB = universal recipient, O = universal donor
● Rh is transmembrane in response to immunisation/anti-human globulin
○ Predominantly IgG and activate complement up to the C3 stage (less efficient)
○ Have to be stimulated eg transfusion, pregnancy
■ IgG can cross placenta and haemolyse fetal red cells (HDFN)
○ Indirectly agglutinate at ‘warm’ temperatures (37℃)

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