1. BLOOD GROUP SYSTEMS. Page 1. Haematology LECTURE 10. BLOOD GROUPS AND TRANSFUSIONS OVERVIEW. 1. Blood Group Systems

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1 Undergraduate Course in Veterinary Clinical PathologySocrates Programme Haematology LECTURE 10. BLOOD GROUPS AND TRANSFUSIONS 10-1 OVERVIEW 1. Blood Group Systems 2. Blood group testing and cross-matching 3. Definition, aims and indications for blood transfusion BLOOD GROUP SYSTEMS 10-3 Page 1

2 BLOOD GROUP SYSTEMS In Simple Terms: Blood groups are determined according to the antigens expressed on the erythrocyte Combinations of blood groups make up a blood group system HOWEVER: Antibodies against different blood group antigens are extremely important in determining the success or failure of a blood transfusion 10-4 RED BLOOD CELL ANTIGENS: GENERAL CHARACTERISTICS - Generally glycoproteins or glycolipids anchored to the surface of the erythrocyte - Usually detected by antibodies (naturally occurring or induced by deliberate immunisation) - Grouped in blood group systems encoded by alleles at single or multiple gene loci 10-5 BLOOD GROUP ANTIBODIES: GENERAL FEATURES - The presence of antibodies directed against RBC antigens will reduce survival of transfused cells (transfusion reaction) - Some species have high titres of naturally-occurring antibodies which may cause transfusion reactions after the first transfusion - Antibodies can be induced following a transfusion. Therefore the risk of transfusion reactions in subsequent transfusions is greater - Neonates can receive these antibodies in colostrum causing neonatal isoerythrolysis 10-6 Page 2

3 BLOOD GROUP SYSTEMS: DOGS - Dogs have 14 blood groups determined by the Dog Erythrocyte Antigens (DEA) - DEA 1.1, DEA 1.2, and DEA 7 are the most immunogenic - Naturally occcuring antibodies are rare - Reactions rarely occur after first un-matched transfusions nomenclature DEA Blood group prevalence in dogs (%) 1.1 (A) (B) 6 4 (C) (D) 22 6 (F) (Tr) (o) 31 J 34 K 2 L 51 M 19 N BLOOD GROUP SYSTEMS: CATS - Cats have A, B and rarely AB blood groups - Prevalence of blood groups varies between countries and with breed Blood Reaction Natural antibodies blood group in serum group with type frequency prevalence A anti-a anti-b rare very high 80-90% B anti-b anti-a high low 10-20% AB anti-a & absent absent rare anti-b Transfusion reactions can occur after first transfusion due to naturally occurring antibodies 10-8 BLOOD GROUP SYSTEMS HORSE - Horses have up to 33 different blood groups belonging to 7 systems - Aa, Qa, and Ca are the most immunogenic blood groups CATTLE - Cattle have up to 70 different blood groups belonging to 11 systems - The J blood group system is not a true RBC antigen but adsorbed from plasma Alloantibodies are produced following transfusion in at least 50% of recipients 10-9 Page 3

4 2. BLOOD GROUP TESTING (BLOOD TYPING) AND CROSS-MATCHING BLOOD GROUP TESTING (BLOOD TYPING) - Detects the antigens pattern on the erythrocyte surface using polyclonal or monoclonal antisera - Does not determine the presence of antibodies BLOOD GROUP TESTING: DOGS AND CATS THIS DOG IS NEGATIVE FOR DEA 1.1 THIS CAT IS TYPE AB (RARE) Page 4

5 BLOOD GROUP TESTING HORSE AND/OR COW AGGLUTINATION TEST HAEMOLYSIS TEST BLOOD CROSS-MATCHING (BCM) Assess blood compatibility between the donor and the recipient A simple technique without any specific reagent Major cross-match detects if the recipient s serum contains any antibodies against the donor s RBCs Minor cross-match detects if the donor s serum contains any antibodies against the recipient s RBCs CROSS MATCHING TECHNIQUE - Collect a blood sample both from donor and recipient into anticoagulant (EDTA or heparin) - Centrifuge the samples, remove and retain the plasma - Resuspend RBCs in saline, centrifuge, and discard the supernatant; repeat 3 times (washed RBC). - Prepare a 3-5% RBC suspension with saline MINOR CROSS-MATCH Mix recipient RBC suspension with plasma from the donor (ie two drops each) MAJOR CROSS-MATCH Mix donor RBC suspension with plasma from the recipient (ie two drops each) - Incubate at 3 different temperature (37 C, 20 C, and 4 C) - Check after minutes for haemolysis and/or agglutination by visual inspection or eventually microscopically Page 5

6 Haem Haem Cont Aggl Cont Aggl CROSS-MATCH (CM) TEST ON SLIDES CROSS-MATCH (CM) TEST ON TUBES DEFINITION, AIMS AND INDICATIONS FOR BLOOD TRANSFUSION BLOOD TRANSFUSION: DEFINITION AND AIMS Definition: A form of temporary organ transplantation Must respect the blood group systems of the species and the individual A useful symptomatic treatment in many blood disorders Aims: - Supplying oxygen to body tissue - Restoring the blood volume Page 6

7 BLOOD TRANSFUSION: MAIN INDICATIONS - Severe and/or acute anaemia: Haemorrhagic Haemolytic Non regenerative - Severe coagulopathy - Severe thrombocytopenia BLOOD AND BLOOD PRODUCTS - Whole Blood: fresh or stored (FWB or SWB) - Packed Red Blood Cells (PRBC) -Plasma: fresh frozen (FFP) frozen (FP) cryoprecipitate (Cryo) + cryosupernatant - Platelet rich plasma or concentrate (PLTC) BLOOD AND BLOOD PRODUCTS: ACTIVITIES Source of or activity FWB SWB PRBC FFP FP PLTC Cr yo Supernatant RBC Album in / PLT FII,VII,IX,X FVIII,vWF /- ATI I I other / proteins Page 7

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