Blood Banking (Immunohematology) Quiz

Course Objectives

• Understand principles of Immunohematology, including blood collection, processing, preservation, and distribution.
• Perform blood grouping and compatibility testing accurately in Immunohematology.
• Explain Blood Bank operations and organization concepts.
• Demonstrate quality assurance in Immunohematology testing.
• Apply immunohematological knowledge to real-life situations through case studies.

Blood Banking Overview

• Involves activities ensuring proper collection, preservation, storage, and dispensing of blood for transfusions.
• Transfusion Medicine focuses on the proper use of blood and components to treat or prevent diseases.

Blood Transfusion

• Transfusion is the process of inserting blood or components from one individual into another's circulatory system.
• Types include:
  • Autologous transfusion: donor and recipient are the same.
  • Allogenic transfusion: transferred blood is from a different donor.
• Component therapy targets specific blood components for patient needs.

Historical Perspective

• Blood transfusion has roots in prehistoric rituals and practices dating back to ancient civilizations.
• Key historical milestones include:
  • 1492: First recorded blood transfusion to Pope Innocent VII.
  • 1628: William Harvey's work on blood circulation.
  • 1666: Richard Lower's successful canine blood transfusion.
  • 1816: John Henry Leacock's published work on blood transfusion in hemorrhage.
  • 1829: James Blundell's successful human transfusion for postpartum hemorrhage.

ABO Blood Group Discovery

• 1901: Karl Landsteiner discovers ABO blood groups, paving the way for safe transfusions.

Anticoagulant Preservative Solutions Evolution

• 1914: Albert Hustin uses sodium citrate as an anticoagulant.
• 1943: Rous and Turner introduce citrate-dextrose solution for blood preservation.
• 1957: Gibson develops citrate-phosphate-dextrose (CPD) solution.

Blood Preservation Goals

• Aim to maintain the viability of blood components post-transfusion.
• RBCs should show 75% survival after 24 hours of transfusion.
• Optimal RBC storage temperature: 10°C to 60°C, determined by preservative solutions used.

RBC Storage Lesions

• Quality indicators include decreased viable cells, glucose, and ATP, along with increased lactic acid and a left shift in the oxygen dissociation curve.

Anticoagulant Solutions and Their Functions

• Chemicals include:
  • Citrate: Prevents clotting by binding calcium.
  • Sodium phosphate: Maintains pH and supports 2,3-DPG levels.
  • Dextrose: Provides energy.
  • Adenine: Extends shelf-life by ATP production.

Additive Solutions

• Added post-plasma removal to enhance storage life and nutritional content of RBCs.
• Developed in 1970; benefits include extended shelf life of up to 42 days.

Freezing and Rejuvenation of RBCs

• Freezing is crucial for autologous units and rare blood type storage.
• Rejuvenating solutions restore ATP and 2,3-DPG levels, enhancing RBC functionality.

Notable Additive Solutions

• ADSOL (AS-1): Contains SAGM, providing a shelf-life of 42 days.
• NUTRICEL (AS-3): Similar composition, also with a shelf-life of 42 days.
• OPTISOL (AS-5): Advanced formulation aiming for lower hemolysis and extended shelf life.

Rejuvenation Processes

• Utilizes specific solutions (PIGPA ingredients) to restore RBC effectiveness.
• RBCs can be rejuvenated at room temperature or opened up to 3 days post-outdate.

Conclusion

• Blood banking and transfusion practices have significantly evolved over centuries, enhancing patient care and safety.
• Understanding these processes is crucial for effective immunohematology practice.