IH Chapter 1

• Deals with antigens, antibodies, and antigen-antibody reactions

  Immunohematology
• clinical significance

  Transfusion of blood and its components

  • Diagnosis, prevention, and management of immunization associated with

  pregnancy

  • Leukocyte testing for organ transplantation

  • Parentage problems
• First attempt at using blood for therapeutic use involving Pope Innocent VII. 1492
• English physician William Harvey discovers the circulation of blood. 1628
• • The first recorded successful blood transfusion occurs in England
  • Physician Richard Lower keeps dogs alive by transfusion of blood from other dogs. 1665
• Jean-Baptiste Denis in France and Richard Lower in England separately report successful transfusions from lambs to humans. 1667
• James Blundell, a British obstetrician, performs the first successful transfusion of human blood to a patient for the treatment of postpartum hemorrhage. 1818
• English surgeon Joseph Lister uses antiseptics to control infection during transfusions. 1867
• Karl Landsteiner, an Austrian physician, discovers the first three human blood groups, A, B, and CKarl Landsteiner, an Austrian physician, discovers the first three human blood groups, A, B, and C. Late what changed to blood type O. 1900
• Hektoen suggests that the safety of transfusion might be improved by crossmatching blood between donors and patients to exclude incompatible mixtures. 1907
• Reuben Ottenberg performs the first blood transfusion using blood typing and crossmatching in New York. 1907
• Ottenberg

  observed the mendelian inheritance of blood groups

  • recognized the “universal” utility of group O donors
• Hustin 1914

  • use of Sodium Citrate as an anticoagulant solution for transfusions
• Lewisohn 1915

  determined the minimum amount of citrate needed for anticoagulation and demonstrate nontoxicity in small amounts
• Edward E. Lindemann - first to successfuly designed device for performing the transfusions.
• Rous and Turner - introduced a citrate- dextrose solution for the preservation of blood. 1916
• Dr. Charles Drew on developing techniques in blood transfusion and Blood preservation
• 1941 - Dr. Charles drew was appointed director of the first American Red Cross blood bank at Presbyterian Hospital in Philadelphia
• 1943 - Loutit and Mollison introduced the formula for the preservative acid-citrate-dextrose (ACD)
• 1957 - Gibson introduced citrate-phosphate-dextrose (CPD)
• Why is CPD replaced ACD as standard preservative

  It is less acidic
• AABB stands for

  American Association of Blood Banks
• Traditionally, the amount of whole blood in a unit has been 450 mL ± 10% of blood (1 pint)
• recently, 500 mL ± 10% of blood is being collected. units are collected from donors with a minimum hematocrit of 38%.
• Units of the whole blood collected can be separated into three components: packed RBCs, platelets, and plasma.
• The plasma can be converted by cryoprecipitation to a clotting factor concentrate that is rich in fibrinogen.
• A unit of whole blood–prepared RBCs may be stored for 21 to 42 days, depending on the anticoagulant preservative
• The Donation Process in blood transfusion are

  Educational Materials - has information on the risks of infectious diseases transmitted by blood transfusion

  Donor Health History Questionnaire - identify donors who have been exposed to diseases that can be transmitted in blood

  Abbreviated Physical Examination - basic medical practices to ensure donor’s vital status before blood transfusion
• The RBC membrane represents a semipermeable lipid bilayer supported by a mesh-like protein cytoskeleton structure
• Phospholipids, the main lipid components of the membrane, are arranged in a bilayer structure comprising the framework in which globular proteins traverse and move.
• Proteins that extend from the outer surface and span the entire membrane to the inner cytoplasmic side of the RBC are termed integral membrane proteins
• Beneath the lipid bilayer, a second class of membrane proteins, called peripheral proteins, is located and limited to the cytoplasmic surface of the membrane forming the RBC cytoskeleton.
• normal length of RBC survival is 120 days in circulation.
• The external layer of RBC membrane is rich in glycolipids and choline phospholipids.
• The internal cytoplasmic layer RBC membrane of the membrane is rich in amino phospholipids
• The biochemical composition of the RBC membrane is approximately 52% protein, 40% lipid, and 8% carbohydrate
• RBC characteristics

  deformability and permeability
• The loss of adenosine triphosphate (ATP) (energy levels) leads to a decrease in the phosphorylation of spectrin and, in turn, a loss of membrane deformability.
• The loss of RBC membrane forms spherocytes and bite cells
• Permeability properties of RBC membrane transport prevent colloid hemolysis and control the volume of the RBCs