iMLS-BLOOD BANKING

The transfusion of blood to a patient in need is safer than it has ever been. However, safety and therapeutic benefit are dependent on guidelines established by the U.S. Food and Drug Administration (FDA) and AABB and are carried out by the qualified and trained personnel in blood collection centers. This lesson will explore the donor history and physical examination qualifications regarding allogeneic, autologous, and apheresis donors in addition to the testing requirements for each of those donations.

An autologous donor is one who donates blood for his or her own use; thus, such a donor is referred to as the donor-patient. Most autologous blood is used to treat surgical blood loss in very specific situations where there is a reasonable opportunity to avoid homologous transfusions or when compatible allogeneic blood is not available. However, there is still a risk of bacterial contamination, circulatory overload, cytokine-mediated reactions, and misidentification of the product or patient.

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Depending on the collection system used, a whole blood component typically contains either 450 mL (±10%) of whole blood with 63 mL of anticoagulant-preservative or 500 mL (±10%) of whole blood with 70 mL of anticoagulant preservative, collected from blood donors with a minimum hematocrit of 38%. 

Whole blood must be stored at 1° to 6°C, and the shelf life is dependent on the anticoagulant used.

Whole blood collected in ACD-A, CPD), or (CP2D) has a shelf life of 21 days; Whole blood collected in CPDA-1 has a shelf life of 35 days.

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“Transfusion therapy” encompasses all aspects of each blood component and its specific indications, expected outcomes, and other considerations.

“Transfusion therapy” is a broad term that encompasses all aspects of each blood component and its specific indications, expected outcomes, and other considerations.

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Adverse events are an inevitable consequence of blood transfusion in spite of the myriad processes to ensure safe transfusions.

Blood transfusion is not, and likely never will be, without risk. Adverse events are an inevitable consequence of blood transfusion in spite of the myriad processes to ensure safe transfusions.

An adverse event is an unintended and deleterious occurrence associated with blood component transfusion. It may occur before, during, or after a transfusion. Adverse events include incidents and adverse reactions.

An incident is any error that could affect the quality or effectiveness of a blood product or could have led to an adverse reaction to a transfusion recipient.

An adverse reaction is a harmful effect observed in a transfusion recipient that is temporally associated with a blood component transfusion.

This chapter focuses on noninfectious adverse reactions and transfusion-associated bacterial infection from bacterial contamination of blood products.

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Traditionally, the P blood group comprised the P, P¹, and P^k antigens and, later, Luke (LKE), PX2, and NOR.

There are two common phenotypes: P₁ and P₂, and three rare phenotypes: p, P₁^k, and P₂^k. The P1 phenotype describes RBCs that react with anti-P₁ and anti-P; the P₂ phenotype is RBCs that do not react with anti-P₁ but do react with anti-P.

RBCs of the p phenotype do not react with anti-P₁, anti-P, or anti-Pk. RBCs of the P₁^k phenotype react with anti-P₁ and anti-P^k but not with anti-P. RBCs of the P₂^k phenotype react with anti-P^k but not with anti-P₁ or anti-P.

Traditionally, the P blood group comprised the P, P¹, and P^k antigens and, later, Luke (LKE), PX2, and NOR.

There are two common phenotypes: P₁ and P₂, and three rare phenotypes: p, P₁^k, and P₂^k. The P1 phenotype describes RBCs that react with anti-P₁ and anti-P; the P₂ phenotype is RBCs that do not react with anti-P₁ but do react with anti-P.

RBCs of the p phenotype do not react with anti-P₁, anti-P, or anti-Pk. RBCs of the P₁^k phenotype react with anti-P₁ and anti-P^k but not with anti-P. RBCs of the P₂^k phenotype react with anti-P^k but not with anti-P₁ or anti-P.

HDFN occurs when the mother had been immunized to the father’s antigen through feto-maternal hemorrhage (FMH) and to low extent by previous transfusion. In the case of HDFN, the abs are directed against ags on the fetal RBCs that were inherited from the father

Pretransfusion testing is the use of serologic principles and tests to ensure compatibility and prevent an IMHTRs

Pretransfusion testing is the use of serologic principles and tests to ensure compatibility and prevent an immune-mediated hemolytic transfusion reaction.

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