10 Questions
What is the required enzyme for the normal structure of the T receptor in the Tk polyagglutination?
β-3-D-galactosyltransferase
Which of the following is NOT a requirement for autologous donation in predeposit autologous donation (AD)?
Cross-matching
What is the function of acetic anhydride in relation to the Tn polyagglutination?
Adds a N-acetyl group to galactosamine
Which of the following plants is positive for the Tk antigen?
Glycine soja
What is the characteristic of the Cad antigen?
Expressed on the surface of red blood cells
Which of the following is an example of acquired non-microbially associated polyagglutination?
VA polyagglutination
What is the name of the receptor related to the Tn polyagglutination?
Tetrasaccharide of Thomas and Winzler
Which of the following is related to the HEMPAS/CDA II?
Adult i Ag = òH Ag, òSialic acid
What is the function of the microbial fucosidase in relation to the VA polyagglutination?
Removes a fucose group from the oligosaccharide
Which of the following is an example of inherited polyagglutination?
Tn polyagglutination
Study Notes
Leukocyte Depletion Filter
- Speed of infusion: 15gtts = 1mL, 60gtts = 1min, 1min = 4mL, 1hr = 240mL, Rate = 240mL/hr
- 1 unit must be completed within 4hrs of blood transfusion
Polyagglutination
- Also known as Hubener-Thomsen-Fridenrich Phenomenon
- Cryptantigens (Hidden Ag9s) are covered with N-acetylneuraminic acid (NANA) or sialic acid
- When NANA is destroyed (by neuraminidase), Ag9s are exposed
- Exposed Ag9s react with tetrasaccharide of Thomas & Winzler (T receptor)
Microbially-Associated Polyagglutination
- Caused by bacteria that produce neuraminidase:
- C.perfringens
- V.cholerae
- S.pneumoniae
- E.coli
- Proteus sp.
ABO Hemolytic Disease of the Newborn (ABO HDN)
- Mother: Group O
- Child: Group A or B
Group I Discrepancies
- Weak reacting/missing Ab9s
- Occurs in:
- Newborns
- Elderly patients
- Hypogammaglobulinemia/agammaglobulinemia
Group II Discrepancies
- Weak reacting/missing Ag9s (less frequent)
- Occurs in:
- Leukemia
- Acquired B phenomenon
- Subgroups of A
- Hodgkin's disease
- BGSS (Remedy: Wash RBCs)
Group III Discrepancies
- Plasma abnormalities resulting in Rouleaux formation (Plasma factor)
- Caused by:
- ñ globulins: MM, WM, HL
- ñ fibrinogen
- Dextran and PVP
- Wharton's jelly (Remedy: Wash cord cells 6-8x)
Group IV Discrepancies
- Miscellaneous:
- Polyagglutination
- Anti-I (cold agglutinin)
- Cis > E > C > e (Least immunogenic)
Rh Blood Group System
- R or r
- D or d
- 1 or 8
- Ce
- 2 or 89
- cE
- Z or y
- CE
- G: D+C+ red cell
- Rh: 13, 14, 15, 16 (4 different parts of the D mosaic)
Weak D
- Genetic weak D: D Ag9s expressed appear complete but few in number
- D Mosaic (Partial D): if one or more parts of D Ag is missing → weakened expression of D Ag
- May produce anti-D (Ab against missing fragment)
Other
- C Trans: D ---(trans)---> C (Ex. Produce weaker neuraminidase)
- Tx: Bacterial and viral, unknown mechanism
- Tk: N-acetyl + galactosamine, Galactosamine = Group B
- Remedy: Add acetic anhydride
- VA: Vienna, Virginia, Microbial fucosidase = òfucose = òH
- Acquired Non-Microbially Associated Polyagglutination:
- Tn: (-) β-3-D-galactosyltransferase enzyme needed for the normal structure of T receptor (Tetrasaccharide of Thomas and Winzler)
- Inherited Polyagglutination:
- Cad: ñSd a
- HEPAS/CDA II: ñAdult i Ag = òH Ag, òSialic acid
- Others: HbM – Hyde Park, NOR = Norfolk, Virginia
Autologous Donation
- Predeposit AD: Before anticipated transfusion
- Requirements:
- No age limit
- No strict weight requirement (òvol)
This quiz covers the concepts of leukocyte depletion filters, speed of infusion, and polyagglutination phenomenon in blood transfusion. It also touches on cryptantigens and their hiding mechanisms.
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