EDUCATIONAL COMMENTARY ANTIBODY TITRATIONS
|
|
- Alisha Mason
- 7 years ago
- Views:
Transcription
1 EDUCATIONAL COMMENTARY ANTIBODY TITRATIONS Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits click on Earn CE Credits under Continuing Education on the left side of the screen. LEARNING OUTCOMES On completion of this exercise, the participant will be able to explain clinical reasons to perform antibody titration. explain the testing phases for antibody titration. discuss causes for discrepant antibody titration results. describe ways to standardize titration studies. Educational Commentary Blood banks routinely detect and identify antibodies; in some clinical situations, however, it is important to semiquantitate the concentration of an antibody. Antibodies are titrated by making serial, two-fold dilutions of the patient s plasma and grading the strength of reactivity with selected red blood cells (RBCs) that possess the corresponding antigen. The results of a titer are reported as the reciprocal of the highest dilution of plasma demonstrating macroscopic agglutination. In blood banking, standardization of both qualitative and quantitative testing has ensured that laboratories report similar results for many tests. Antibody titrations, however, are among the few tests in blood banking that have not been standardized. Indications for Antibody Titration Antibody titration is clinically indicated in prenatal studies, separating multiple antibodies, antibody identification, and performing ABO isohemagglutinin titers on apheresis donor platelet units or organs that are to be transplanted across ABO boundaries. When a clinically significant antibody capable of causing hemolytic disease of the newborn or fetus is detected in a pregnant woman, it is important to determine the antibody titer, particularly if the father has the corresponding RBC antigen. Throughout pregnancy, the mother s antibody titer is repeated to determine if there is a rise in titer or concentration of the antibody. A rise in antibody titer by two dilutions is considered clinically significant and suggests the fetal RBCs possess the antigen to the corresponding antibody. Once the titer reaches a critical threshold and the fetus is at least eighteen weeks gestational age, additional studies, such as ultrasound, Doppler sonography, amniocentesis, or cordiocentesis, will be performed. These procedures monitor the level of anemia in the fetus and indicate the necessity of intrauterine transfusion or other interventions.
2 Antibody titration can also be used to identify antibodies. Some antibodies react weakly in the antihuman globulin (AHG) phase, but when titers are performed, these antibodies have remarkably high titers. Known as high-titer, low-avidity (HTLA) antibodies, they are directed against high frequency RBC antigen systems that include Chido, Rogers, York, Knops, McCoy, John Milton Hagen, and others. These antibodies are not clinically significant for transfusion, but they mask underlying alloantibodies capable of causing hemolytic transfusion reactions. Since these antibodies are directed against high-frequency antigens, all donor RBC products will be crossmatch incompatible; physicians should administer transfusions conservatively to such patients. In some cases, multiple antibodies can be detected and identified by performing antibody titers. The specimen can be diluted before testing with reagent RBCs, thereby removing one antibody and allowing identification of the second, underlying antibody with the higher titer. Some institutions perform titers of anti-a and anti-b antibodies, also known as isohemagglutinin titers, on group O apheresis donor platelets before dispensing to non group O patients. Apheresis platelets from group O donors contain large plasma volumes and may contain unusually high titers of anti-a or anti-b antibodies. There are multiple reports of patients who have suffered from passively mediated hemolytic transfusion reactions due to minor ABO incompatibilities. Medical centers have implemented policies to minimize this risk for hemolytic transfusion reactions in patients who receive ABO-incompatible platelet transfusions. Some have focused on performing isohemagglutinin titers on all apheresis group O platelets. The challenges in this practice include a lack of standardization for performing isohemagglutinin titers; an agreed-upon critical titer to restrict these products for transfusion to group O patients; and variable reports that document a wide range of titers implicated in causing hemolytic transfusion reactions. To avoid this risk completely, some institutions will not transfuse group O apheresis platelets to frequently transfused, non group O patients. Recently, immunosuppression medication combined with apheresis has allowed for successful ABO-incompatible renal and liver transplant. Performing ABO titers is critical for determining both the effectiveness of pretreatment regimens and when titers are low enough to permit transplant, but there is no uniform method for determining a safe anti-a or anti-b titer. In some cases, patients may be undertreated or overtreated for their ABO-incompatible transplant, owing to the inconsistency in performing and monitoring ABO titers during the conditioning regimen. Even after transplant has taken place, ABO titers must be monitored and compared with previous levels to determine if antibody-mediated rejection is a threat to the graft. Antibody Titration Methodology When performing an antibody titration for the first time for a patient, some laboratories will require that two technologists perform the titration. It is also a common practice to freeze an aliquot of the sample so the titration can be repeated alongside a subsequent sample. The conventional tube titration is performed by labeling tubes according to the specimen dilution. The first tube will contain a volume of undiluted sample and the second and subsequent tubes will contain an equal volume of saline. An equal volume of sample is added to the second tube, which is mixed, and one volume of the mixture is transferred to the next tube. The same process is
3 continued for all dilutions with a clean pipette tip to mix and transfer each dilution. After the dilutions, two drops of the RBC suspension possessing the antigen are added to the tubes. Some laboratories add an enhancement medium, such as low ionic saline solution, and some do not. The tubes are incubated for times and temperatures appropriate for the antibody. The tubes may simply be centrifuged and read for reactivity or washed and AHG or anti-immunoglobulin G (IgG) added before centrifugation and interpretation of results (Table I). Gel cards may also be used for antibody titration. The dilutions are performed in a test tube and then the sample is transferred to the gel cards. The type of gel card used, temperature, and time of incubation are dependent on the type of antibody titrated (Table II). Table I. Conventional Tube Methods for Antibody Titers Clinically Significant Antibodies,such as: Rh, Kell, Kidd, Duffy Enhancement None or LISS Reagent RBC concentration 2%-5% Incubation 37 C For m 4 Times with saline Anti-A/ Anti-B Titers Enhancement None or LISS Reagent RBC concentration 2%-5% First incubation 30 m at room temperature, centrifuge and read Second incubation 37 C for 30 m 4 Times with saline AHG indicates antihuman globulin; IgG, immunoglobulin G; LISS, low ionic saline solution; RBC, red blood cell; and m, minute(s). Table II. Gel Card Antibody Titration Clinically Significant Antibodies, such as: Rh, Kell, Kidd, and Duffy Gel card type Anti IgG Reagent RBC concentration 0.8% Incubation 37 C for 15 m Anti-A/Anti-B Titers, 2 Separate Cards Gel only card Room temperature incubation, 15 m, centrifuge and read Anti IgG card 37 C for 15 m Reagent RBC concentration 0.8% 4 times with saline AHG indicates antihuman globulin; IgG, immunoglobulin G; LISS, low ionic saline solution; RBC, red blood cell; m, minute(s).
4 Testing Inconsistencies Antibody titrations have been difficult to standardize in the laboratory. It has been a longstanding practice to repeat an antibody titration on a subsequent sample alongside the previously tested sample. This practice was established to reduce inconsistencies of technique and interpretation among technologists performing titrations in the same laboratory. Because technical variables can significantly affect results, uniform practices within the same laboratory should be emphasized. Some variables include pipetting technique and changing tips between dilutions to prevent carryover from one dilution to the next. The zygosity, phenotype, age, and concentration of the reagent RBCs can also influence results; therefore, the same reagent RBCs, or RBCs of the same phenotype, should be used for subsequent samples. The optimal incubation time, temperature, and centrifugation speed and time should be consistent when performing titrations. In addition, interlaboratory titration methods vary significantly in methodology, incubation time, temperature, testing phase, and endpoint to interpret the results. The College of American Pathologists (CAP) has demonstrated significant disparity in titration results in proficiency testing. Even when results are grouped by methodology, the results can vary between laboratories by five or more dilutions. In an effort/attempt to combat this variation, the Transfusion Medicine Resource Committee for CAP created a detailed and uniform procedure for performing antibody titrations and provided proficiency samples to 36 participating laboratories. This investigation found that, even when providing a detailed procedure, there was wide variation in the results from each laboratory. The detailed procedure instructed laboratories to use a grade of 1+ as the uniform endpoint; however titration results still varied significantly. The committee then asked for laboratories to review their results and provide titers on samples using a weak positive endpoint. Applying this weak positive endpoint reduced the variance of results. The investigation also found that the gel-card technique generated less variance between laboratories than tube testing, although fewer laboratories used the gel technique than tube method. (1,2) Anti-A and anti-b titers can be performed in conventional test tubes both at room temperature and at the AHG phase, and both of these titers may be reported to the clinical team. A recent study at Johns Hopkins Hospital reported that room-temperature ABO titers performed in tube are not necessary and do not offer any more data pertinent to clinical decision making than AHG titers. Researchers compared AHG tube titers to IgG gel-card titers and found 86% of the titer results were identical. They concluded that the AHG tube method and IgG gelcard ABO titers were comparable, but the gel card method reduced turnaround times in half by decreased incubations and by performing titrations in batches. (3) Summary Antibody titrations are important in antenatal evaluations, antibody identifications, transfusing ABO-incompatible plasma products, and performing and monitoring ABO-incompatible organ transplants. Unfortunately, standardization of antibody titers has continued to elude laboratorians, and proficiency testing performed by CAP has demonstrated up to a 5-fold disparity in titration results. By using a detailed procedure and a weak positive
5 endpoint, the CAP Transfusion Medicine Resource Committee has been able to reduce the interlaboratory variation. The committee also concluded that using detailed and consistent laboratory methods for antibody titers may render the current practice of repeating titers from a previous sample with the current sample unnecessary, because the variation of titers reduces over time in each laboratory. SUGGESTED READING 1. AuBuchon JP, de Wildt-Eggen J, Dumont LJ. Reducing the variation in performance of antibody titrations. Vox Sang. 2008;95: AuBuchon JP, de Wildt-Eggen J, Dumont LJ. Reducing the variation in performance of antibody titrations. Arch Pathol Lab Med. 2008;132: Shirey RS, Cai W, Montgomery RA, et al. Streamlining ABO antibody titrations for monitoring ABOincompatible kidney transplants. Transfusion. 2010;50: Walker PS. Identification of antibodies to red cell antigens. In: Roback J, Combs MR, Grossman BJ, et al, eds. Technical Manual. 17th ed. Bethesda, MD: American Association of Blood Banks; Judd WJ, Johnson ST, Storry JR, eds. Judd s Methods in Immunohematology. 3rd ed. Bethesda, MD: American Association of Blood Banks; Cooling L, Downs T. Immunohematology. In: McPherson RA, Pincus MR, eds. Henry s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; ASCP 2012
Direct Antiglobulin Test (DAT)
Exercise 8 Direct Antiglobulin Test (DAT) Objectives: 1. State the purpose for performing the DAT. 2. State what a positive DAT indicates. 3. List the reagents which are used for performing the DAT. 4.
More informationCORD BLOOD EVALUATION
CORD BLOOD EVALUATION Principle: When there is incompatibility between a mother s antibodies and an infant s red blood cell antigens, the infant is at risk of developing Hemolytic Disease of the Fetus
More informationImmunohematology. Immunohematology. Blood Group Antigens
Immunohematology Immunohematology Jeffrey S. Jhang, MD Assistant Director, Transfusion Medicine Demonstration of red cell antigen-red cell antibody reactions is the key to immunohematology Combination
More informationDirect Antiglobulin Test (DAT)
Exercise 8 Exercise 9 Direct Antiglobulin Test (DAT) Elution Study Task Aim Introduction To perform the DAT and elution procedure with correct interpretation of results. To perform with 100% accuracy the
More informationQUICK REFERENCE TO BLOOD BANK TESTING
QUICK REFERENCE TO BLOOD BANK TESTING All Blood bank Tests are performed on demand 24 hours a day, 7 days a week. Feto/Maternal Bleed Quantitation estimates will be available within 4 hours of blood bank
More informationSerotyping Techniques
Serotyping Techniques Thomas A. Kruzel, M.T., N. D. Southwest College of Naturopathic Medicine & Health Sciences ABO Blood Groups Blood Group RBC Antigens Serum Antibodies Percentage O none Anti A & B
More informationSTANDARD OPERATING PROCEDURE FOR THE DIRECT ANTIGLOBULIN TEST
STANDARD OPERATING PROCEDURE FOR THE DIRECT ANTIGLOBULIN TEST TITLE: Standard Operating Procedure for Performing the Direct Antiglobulin Test 1.0 Principle To detect in vivo sensitization of red blood
More informationComparing the Tube and Gel Techniques for ABO Antibody Titration, as Performed in Three European Centers 林 良 豐 100.07.18
Comparing the Tube and Gel Techniques for ABO Antibody Titration, as Performed in Three European Centers 林 良 豐 100.07.18 Introduction Data from 60 consecutive ABO-incompatible kidney transplantations performed
More informationIntroduction. Laboratory Procedure Manual
Exercise 9 Elution Study Objectives: 1. State when an elution procedure may be performed. 2. List four situations in which the performance of an elution may provide helpful information. 3. List three types
More informationValidation of column agglutination technology for blood group alloantibody titration
Validation of column agglutination technology for blood group alloantibody titration Melanie J Adriaansen and Holly E Perry Abstract Objective: To compare the performance of column agglutination technology
More informationSTANDARD OPERATING PROCEDURE FOR RESOLVING ABO & Rh BLOOD GROUP DISCREPANCIES
STANDARD OPERATING PROCEDURE FOR RESOLVING ABO & Rh BLOOD GROUP DISCREPANCIES TITLE: STANDARD OPERATING PROCEDURE FOR RESOLVING ABO & RH BLOOD GROUP DISCREPANCIES 1.0 Principle 1.1 To resolve ABO and Rh
More informationChapter 18. Blood Types
Chapter 18 Blood Types Blood Types blood types and transfusion compatibility are a matter of interactions between plasma proteins and erythrocytes Karl Landsteiner discovered blood types A, B and O in
More informationRh Immune Globulin Workup (RhIgW)
Exercise 10 Rh Immune Globulin Workup (RhIgW) 1. State the purpose for giving Rh Immune Globulin (RhIg). 2. State the population which is most frequently given RhIg. 3. State the severity of HDFN. 4. State
More informationTime Frame 15 minutes. Student should strive to be able to perform multiple procedures simultaneously.
Name Direct Antiglobulin Test (DAT) (Direct Coombs) Principle The DAT detects the in vivo sensitization of RBC with IgG incomplete or non-agglutinating antibodies. After thorough washing of RBC with saline
More informationREQUEST FOR TESTING TRANSFUSION SERVICES
REQUEST FOR TESTING TRANSFUSION SERVICES 921 Terry Avenue Seattle, WA 98104-1256 TO REORDER FORMS CALL 425-656-3019 PSBC Tech PSBC ID / CL # Time Received See the back of this order form for sample requirements.
More informationLAB 1 - Direct agglutination. Serology-the study of the in vitro reactions between antibody and antigen
LAB 1 - Direct agglutination Serology-the study of the in vitro reactions between antibody and antigen Serological reaction: - quantitative (weight/volume) - qualitative Agglutination - the aggregation
More informationUnit 8 Pretransfusion Compatibility Testing
Unit 8 Pretransfusion Compatibility Testing A. The purpose of pretransfusion testing is to select, for each recipient, blood components that, when transfused, will have acceptable survival and will not
More informationAntibody Identification. Part 1. Prerequisites. When Do We I.D.? Part 1: The Basics. A Blood Bank Guy Video Podcast
Antibody Identification Part : The Basics A Blood Bank Guy Video Podcast D. Joe Chaffin, MD March Part Prerequisites Geography of a panel Antibody ID method Case examples Prerequisites When Do We I.D.?
More informationCold Agglutination Titer detecting Cold Reacting Antibodies
Objectives: Cold Agglutination Titer detecting Cold Reacting Antibodies 1. Perform a serial dilution to determine the amount of cold reacting antibody present in a patient specimen with the results obtained
More informationDEPARTMENT OF CLINICAL LABORATORY SCIENCES SCHOOL OF HEALTH TECHNOLOGY AND MANAGEMENT THE UNIVERSITY AT STONY BROOK STONY BROOK, NEW YORK 11794-8205
DEPARTMENT OF CLINICAL LABORATORY SCIENCES SCHOOL OF HEALTH TECHNOLOGY AND MANAGEMENT THE UNIVERSITY AT STONY BROOK STONY BROOK, NEW YORK 11794-8205 IMMUNOHEMATOLOGY COMPETENCY EVALUATION FORM STUDENT
More informationEDUCATIONAL COMMENTARY WARM AUTOANTIBODIES AND TRANSFUSION
EDUCATIONAL COMMENTARY WARM AUTOANTIBODIES AND TRANSFUSION Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits
More informationCHAPTER 10 BLOOD GROUPS: ABO AND Rh
CHAPTER 10 BLOOD GROUPS: ABO AND Rh The success of human blood transfusions requires compatibility for the two major blood group antigen systems, namely ABO and Rh. The ABO system is defined by two red
More informationMLT 118L Clinical Immunology/Immunohematology Lab
Page 1 of 5 MLT 118L Clinical Immunology/Immunohematology Lab Approval Date: Effective Term: Department: MEDICAL LABORATORY TECHNICIAN Division: Allied Health/Public Safety Units: 1.00 Grading Option:
More informationBlood Physiology. Practical 4. Contents. Practical tasks. Erythrocytes The blood types
Blood Physiology Practical 4 Contents Erythrocytes The blood types Practical tasks Determination of blood groups of the ABO system Determination of the Rhesus system (Rh factor) The cross matching test
More informationStandardization and Evaluation of IgA and IgM Gel Column Agglutination for Direct Antiglobulin Testing
Standardization and Evaluation of IgA and IgM Gel Column Agglutination for Direct Antiglobulin Testing ABSTRACT BACKGROUND: Diagnosis of autoimmune hemolytic anemia is commonly confirmed with a positive
More informationBlood Typing Laboratory Exercise 40
Blood Typing Laboratory Exercise 40 Background Blood typing involves identifying protein substances called antigens that are present in red blood cell membranes. Although there are many different antigens
More informationRhD typing. Practice for IV year medical students. Zita Csernus MD. National Blood Transfusion Service Blood Transfusion Centre Pécs
immunisation Bed side test Antibody tests RhD typing Practice for IV year medical students Zita Csernus MD National Blood Transfusion Service Blood Transfusion Centre Pécs Rh Blood Group System Discovery:
More informationEcho. Compact Immunohematology automation. Echo is designed to bring the benefits of automation to labs of all sizes and volumes.
Echo Compact Immunohematology automation Echo is designed to bring the benefits of automation to labs of all sizes and volumes. Transfuse Transplant Transform a life Echo Instrument Map A D B C E I want
More informationComparison of test tube, gel column agglutination and solid phase red cell adherence methods
Comparison of test tube, gel column agglutination and solid phase red cell adherence methods with and without drug added for detection of drug-dependent antibodies Phyllis Kirchner, MT(ASCP)SH, SBB ABSTRACT
More informationBasic Immunologic Procedures. Complex Serological Tests
Basic Immunologic Procedures Complex Serological Tests Amal Alghamdi 2014-2015 1 Classification of antigen-antibody interactions: 1. Primary serological tests: (Marker techniques) e.g. Enzyme linked immuonosorben
More information1. To permit the resident to attain expertise in the methodological, diagnostic and scientific aspects of transfusion medicine and coagulation.
BLOOD BANK CORE ROTATION Introduction The core rotation in blood banking is designed to expose the resident to a wide range of transfusion medicine and coagulation problems and provide training in solving
More informationSelecting Appropriate Blood Products for Recipients of ABO/Rh Mismatched Stem Cell Transplants. Summary of Significant Changes. Purpose.
This Specification replaces SPN/DDR/RC/023/05 (SPN215/1) Copy Number Summary of Significant Changes Change to new document reference numbers. Effective 18/10/11 Removal of ABO titres from sections 3.1
More informationJOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR. 2nd Edition
JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR CliniCAl laboratories 2nd Edition Effective 1 April 2010 International Patient Safety Goals (IPSG) Goals The following is a list of all goals.
More informationBlood-Based Cancer Diagnostics
The Biotechnology Education Company Blood-Based Cancer Diagnostics EDVO-Kit 141 Store entire experiment at room temperature. EXPERIMENT OBJECTIVE: The objective of this experiment is to learn and understand
More informationTRANSFUSION MEDICINE
TRANSFUSION MEDICINE Transfusion medicine is a one-month per year rotation for a total of three months. During each rotation the resident is exposed to the basic concepts of transfusion medicine. Specific
More information1. BLOOD GROUP SYSTEMS. Page 1. Haematology LECTURE 10. BLOOD GROUPS AND TRANSFUSIONS OVERVIEW. 1. Blood Group Systems
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
More informationBLOOD GROUP ANTIGENS AND ANTIBODIES
BLOOD GROUP ANTIGENS AND ANTIBODIES Over 20 blood group systems having approximately 400 blood group antigens are currently recognised. The ABO and Rhesus (Rh) blood group systems are of major clinical
More informationExercise 9: Blood. Readings: Silverthorn 5 th ed, 547 558, 804 805; 6 th ed, 545 557, 825 826.
Exercise 9: Blood Readings: Silverthorn 5 th ed, 547 558, 804 805; 6 th ed, 545 557, 825 826. Blood Typing The membranes of human red blood cells (RBCs) contain a variety of cell surface proteins called
More informationABORhCard Applications and Performance Studies White Paper
ABORhCard Applications and Performance Studies White Paper Contents Background....................................... 2 ABORhCard Simple, Accurate, Fast Blood Typing....... 2 Product Design....................................
More informationINSTRUCTIONS FOR USE
Blood Grouping Reagent A/B/D Monoclonal and Reverse Grouping Card MTS080515 Intended Use For the performance of a forward and reverse ABO and D antigen grouping on a single Gel Card For use with the ID-Micro
More informationLaboratory Procedure Manual. Rh Phenotyping
Exercise 4 Textbook: Quinley, Chapter 8 Skills: 20 Points Objectives:. State the antigens of the Rh blood group system. 2. Define the terms dominant, codominant, heterozygous, and homozygous as they relate
More informationRole of the Medical Director
Role of the Medical Director Beth Shaz, MD Assistant Professor, Emory University School of Medicine Director, Transfusion Services, Grady Memorial Hospital Atlanta, GA 1.1.1 Medical Director Responsibilities
More informationXV.Quality Assurance in the Blood Bank
XV.Quality Assurance in the Blood Bank A. Overview 1. Goals 2. Terms B. Record Keeping a. Safe transfusion b. Careful adherence to SOPs by trained personnel c. Develop comprehensive guidelines to be in
More informationSome Immunological Test. Presented by Alaa Faeiz Ashwaaq Dyaa Aseel Abd AL-Razaq Supervised by D.Feras
Some Immunological Test Presented by Alaa Faeiz Ashwaaq Dyaa Aseel Abd AL-Razaq Supervised by D.Feras Alaa Faeiz Antigen -Antibody Reactions. Antigen antibody reactions are performed to determine the presence
More informationVI. ABO and H Blood Groups
MLAB 243 4 A. History of ABO System. Discovered in 900 by Karl Landsteiner and remains the most important of the blood group systems as far as the transfusion of blood is concerned. 2. Landsteiner tested
More informationLAB 14 ENZYME LINKED IMMUNOSORBENT ASSAY (ELISA)
STUDENT GUIDE LAB 14 ENZYME LINKED IMMUNOSORBENT ASSAY (ELISA) GOAL The goal of this laboratory lesson is to explain the concepts and technique of enzyme linked immunosorbent assay (ELISA). OBJECTIVES
More informationExecutive summary. Executive summary 12
Executive summary Health Council of the Netherlands. Pregnancy immunisation by red blood cells. The Hague: Health Council of the Netherlands, 2009; publication no. 2009/04. This advisory report concerns
More informationCan receive blood from: * I A I A and I A i o Type A Yes No A or AB A or O I B I B and I B i o Type B No Yes B or AB B or O
Genetics of the ABO Blood Groups written by J. D. Hendrix Learning Objectives Upon completing the exercise, each student should be able: to explain the concept of blood group antigens; to list the genotypes
More informationMother s blood test to check her unborn baby s blood group
Mother s blood test to check her unborn baby s blood group This leaflet explains why it is important to have a blood test to check the baby s blood group, so that only those who need it, receive anti-d
More informationBLOOD BANK ANNUAL STATISTICS (HOSPITALS)
New Jersey Department of Health Clinical Laboratory Improvement Services PO Box 361 Trenton, NJ 08625-0361 BLOOD BANK ANNUAL STATISTICS (HOSPITALS) County Code Number Address Name of Individual Completing
More informationBlood Stains at the Crime Scene Forensic Investigation
Blood Stains at the Crime Scene Forensic Investigation Introduction Blood stains at a crime scene can be crucial in solving the crime. Numerous analytical techniques can be used to study blood stains.
More informationABO-Rh Blood Typing Using Neo/BLOOD
ABO-Rh Blood Typing Using Neo/BLOOD Objectives Determine the ABO and Rh blood type of unknown simulated blood samples. Prepare a simulated blood smear. Examine a prepared blood smear under the microscope
More informationHaemolytic disease of the newborn. 09.06.2016 Burak Salgin
Haemolytic disease of the newborn 09.06.2016 Burak Salgin Innovation and excellence in health and care Addenbrooke s Hospital I Rosie Hospital Haemolytic disease of the newborn......used to be synonymous
More informationTESTING BLOOD PRE-TRANSFUSION COMPATIBILITY IN A GROUP OF CATS Meda Moldovan, L. Ognean, Alexandra Arion, I. Morar
TESTING BLOOD PRE-TRANSFUSION COMPATIBILITY IN A GROUP OF CATS Meda Moldovan, L. Ognean, Alexandra Arion, I. Morar UNIVERSITY OF AGRICULTURAL SCIENCE AND VETERINARY MEDICINE, FACULTY OF VETERINARY MEDICINE,
More informationFalse Neonatal ABO Blood Typing due to Contamination of the Cord Blood
False Neonatal ABO Blood Typing due to Contamination of the Cord Blood Caroline M. Schrader, BS 1 ; Adrian N. Billings, MD, PhD 1,2 1 Texas Tech University Health Sciences Center School of Medicine, Odessa,
More informationINDICATIONS FOR BLOOD PRODUCT TRANSFUSIONS
INDICATIONS FOR BLOOD PRODUCT TRANSFUSIONS Sarah Perry, LVT, BS, VTS (ECC) Licensed Veterinary Technician Animal Neurology, Rehabilitation and Emergency Center 1120 Welch Rd. Commerce, MI 48390 A very
More information2nd Ed. 2004. Prepared by. Scientific Subcommittee of the Australian & New Zealand Society of Blood Transfusion Inc
G u i d e l i n e s f o r B l o o d G r o u p i n g & A n t i b o d y S c r e e n i n g i n t h e A n t e n a t a l & P e r i n a t a l S e t t i n g 2nd Ed. 2004 Prepared by Scientific Subcommittee of
More informationBlood Type Testing Lab Report Section 1101 Nattanit Trakullapphan (Nam) Chawalnrath Wongdeshanan (Kat)
Blood Type Testing Lab Report Section 1101 Nattanit Trakullapphan (Nam) Chawalnrath Wongdeshanan (Kat) Introduction: figure 1.1 (Blood type n.d.) figure 1.2 (Blood type, Antigens-Antibodies n.d.) Multiple
More informationHemolysis. Intravascular vs. Extravascular. Classification. Warm vs. Cold Auto. Warm Auto. WAIHA Serologic Investigation
Positive Direct Antiglobulin Test and Autoimmune Hemolytic Anemias Jeffrey S. Jhang, M.D. Assistant Professor of Clinical Pathology College of Physicians and Surgeons of Columbia University Direct Antiglobulin
More informationBLOOD BANK SPECIMEN COLLECTION PROCEDURE
BLOOD BANK SPECIMEN COLLECTION PROCEDURE INTRODUCTION Scientific and technical advances in blood group serology have made the transfusion of blood a relatively safe procedure, but serious adverse effects
More informationDAT Principle and Application of the DAT DAT Panel Evaluation of a Positive DAT. Case Studies Case 1 Case 2 Factors Affecting the Antiglobulin Test
05Harmening-05 01/17/2005 C H 5:17 PM A Page 93 P T E R five The Antiglobulin Test Ralph E.B. Green, B. App. Sci., FAIMLS, MACE, and Virginia C. Hughes, MS, MT(ASCP)SBB, CLS(NCA)I Introduction Principles
More informationAnti-Zona Pellucida Antibody Latex Agglutination Test
Instructions for use Anti-Zona Pellucida Antibody Latex Agglutination Test Cat. No.: BS-20-10 Size: 50 Determinations Storage: 2 C 8 C (36 F 46 F) Screening test for the determination of anti-zona pellucida
More informationLab 02: Blood Cytology (20 points)
Pierce College Putman/Biol 242 Name: Lab 02: Blood Cytology (20 points) Reference: Marieb & Mitchell 9 th Ed: 29A (Activities 1, 2, 3, 4, 7); 10 th Ed: Exercise 29 (Activities 1, 2, 3, 4, 7). Pierce College
More informationThe Rh Factor: How It Can Affect Your Pregnancy
The American College of Obstetricians and Gynecologists f AQ FREQUENTLY ASKED QUESTIONS FAQ027 PREGNANCY The Rh Factor: How It Can Affect Your Pregnancy What is the Rh factor? How does a person get the
More informationBlood Grouping Reagent DG Gel 8 ABO/Rh + Kell REF 210383 3034946
Blood Grouping Reagent DG Gel 8 ABO/Rh + Kell REF 210383 3034946 Instructions for Use INTENDED USE The DG Gel 8 ABO/Rh + Kell card is for the determination of ABO forward and reverse group, and D and K
More informationCharacteristics and Serologic Determination of Antibodies to High Frequency Antigens
Characteristics and Serologic Determination of Antibodies to High Frequency Antigens Nicole Thornton The International Blood Group Reference Laboratory Bristol, United Kingdom. 23 rd Regional Congress
More informationC. Note that this discussion will be mostly limited to transfusion service actions
(Basic Immunohematology Part 2) February 2012 D. Joe, MD www.bbguy.org I. Outline: A. Overview of pretransfusion testing B. Testing methods C. Required components of the process D. Nomenclature of tests
More informationPrepublication Requirements
Issued Prepublication Requirements The Joint Commission has approved the following revisions for prepublication. While revised requirements are published in the semiannual updates to the print manuals
More informationGuidance manual on ABO and Rh blood grouping
NIB/BRL/GM/02 Guidance manual on ABO and Rh blood grouping NATIONAL INSTITUTE OF BIOLOGICALS (Ministry of Health & Family Welfare) Government of India A-32, Sector -62, Institutional Area NOIDA- 201307
More informationBlood Sticky, opaque fluid with a metallic taste (Fe 2+ ) Varies from scarlet (P O2 = 100) to dark red (P O2 = 40) ph is between 7.35 and 7.45 Average volume in an adult is 5 L (7% of body weight) 2 L
More informationThe Monocyte Monolayer Assay (MMA): An Adjunct to Compatibility Testing
The Monocyte Monolayer Assay (MMA): An Adjunct to Compatibility Testing Ghislain Noumsi MD,SBB(ASCP) CM Molecular ImmunoHematologist Scientific Support Services LifeShare Blood Centers Shreveport, LA Objectives
More informationBLOOD-Chp. Chp.. 6 What are the functions of blood? What is the composition of blood? 3 major types of plasma proteins
6.1 Blood: An overview BLOOD-Chp Chp.. 6 What are the functions of blood? Transportation: oxygen, nutrients, wastes, carbon dioxide and hormones Defense: against invasion by pathogens Regulatory functions:
More informationSafe Blood and Blood Products
Safe Blood and Blood Products Module 3 Blood Group Serology Safe Blood and Blood Products Module 3 Blood Group Serology Conversion of electronic files for the website edition was supported by Cooperative
More informationTHE Rh BLOOD GROUP SYSTEM
CHAPTER 10 THE Rh BLOOD GROUP SYSTEM CONNIE WESTHOFF OBJECTIVES After completion of this chapter, the reader will be able to: 1. Describe the Rh system antigens, including: a. The alleles inherited at
More informationUser guide for referring samples to the IBGRL Molecular Diagnostics Laboratory
International Blood Group Reference Laboratory (IBGRL) IBGRL provides specialist diagnostic services to NHS Blood and Transplant. The Molecular Diagnostics department is a CPA accredited laboratory and
More informationThe use of records of past testing to increase the
TRANSFUSION PRACTICE The immunohematologic and patient safety benefits of a centralized transfusion database_3789 771..776 Meghan Delaney, Steve Dinwiddie, Theresa N. Nester, and James A. AuBuchon BACKGROUND:
More informationCPT Codes for Bone Marrow Transplant January 2015 James L. Gajewski, MD
The blood and marrow transplant field has 15 dedicated CPT codes. These CPT codes can be categorized into three groups: 1. Collection Codes 2. Cell Processing Codes 3. Cell Infusion Codes Collection Codes
More informationHARVARD MEDICAL SCHOOL FELLOWSHIP PROGRAM IN TRANSFUSION MEDICINE CORE CURRICULUM
BETH ISRAEL DEACONESS MEDICAL CENTER BRIGHAM AND WOMEN'S HOSPITAL CHILDREN S HOSPITAL, BOSTON DANA FARBER CANCER INSTITUTE MASSACHUSETTS GENERAL HOSPITAL HARVARD MEDICAL SCHOOL HARVARD MEDICAL SCHOOL FELLOWSHIP
More informationRed blood cell transfusions in the Netherlands Towards (very) low use
Red blood cell transfusions in the Netherlands Towards (very) low use Marian G.J. van Kraaij, MD PhD hematologist/ transfusion medicine specialist Director Dept Transfusion Medicine Sanquin Blood Supply,
More informationCorporate Medical Policy Fetal RHD Genotyping Using Maternal Plasma
Corporate Medical Policy Fetal RHD Genotyping Using Maternal Plasma File Name: Origination: Last CAP Review: Next CAP Review: Last Review: fetal_rhd_genotyping_using_maternal_plasma 1/2014 9/2015 9/2016
More informationGENETICS OF HUMAN BLOOD TYPE
GENETICS OF HUMAN BLOOD TYPE Introduction The genetics of blood types is relatively simple when considering any one blood protein. However, the complexity increases when one considers all the different
More informationBlood Group Incompatibility
Joyce Poole, International Blood Group Reference Laboratory, Bristol, UK Blood group antibodies present in plasma can bind with blood group antigens on red cells and cause a reaction (blood group incompatibility).
More informationGUIDELINE FOR BLOOD GROUPING AND RED CELL ANTIBODY TESTING IN PREGNANCY
GUIDELINE FOR BLOOD GROUPING AND RED CELL ANTIBODY TESTING IN PREGNANCY British Committee for Standards in Haematology Address for correspondence: BCSH Secretary British Society for Haematology 100 White
More informationEDUCATIONAL COMMENTARY RED BLOOD CELLS AND WHITE BLOOD CELLS IN URINALYSIS
URINALYSIS Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits click on Earn CE Credits under Continuing
More informationGuidelines for pre-transfusion compatibility procedures in blood transfusion laboratories.
Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories. British Committee for Standards in Haematology Address for correspondence: BCSH Secretary British Society for
More informationMedical Laboratory Technology Program. Student Learning Outcomes & Course Descriptions with Learning Objectives
Medical Laboratory Technology Program Student Learning Outcomes & Course Descriptions with Learning Objectives Medical Laboratory Technology Student Learning Outcomes All Colorado Mesa University associate
More informationTransfusion medicine clinical training and experience is provided at three major teaching hospitals.
Blood Bank and Transfusion Medicine - Multi-institutional Rotation Residency training in Transfusion Medicine prepares a person to provide laboratory and clinical transfusion services at community basic
More information1.5 Function of analyte For albumin, see separate entry. The immunoglobulins are components of the humoral arm of the immune system.
Total protein (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Total protein 1.2 Alternative names None 1.3 NMLC code 1.4 Description of analyte This is a quantitative measurement
More informationHigh Titre Anti-A/B Testing of Donors within NHS Blood and Transplant (NHSBT)
INFORMATION INF178/1.1 Effective: 10/08/11 Purpose To minimise the risk of causing clinically significant haemolysis due to the presence of high-titre anti-a or anti-b when plasma-rich blood components
More informationParvovirus B19 Infection in Pregnancy
Parvovirus B19 Infection in Pregnancy Information Pack Parvovirus B19 Infection in Pregnancy Information Booklet CONTENTS: THE VIRUS page 3 CLINICAL MANIFESTATIONS page 6 DIAGNOSIS page 8 PATIENT MANAGEMENT
More informationreferred to in the previous studies (6)); and (3) patients and members of the hospital staff who were free of respiratory
COLD AGGLUTININS. III. OBSERVATIONS ON CERTAIN SERO- LOGICAL AND PHYSICAL FEATURES OF COLD AGGLUTININS IN CASES OF PRIMARY ATYPICAL PNEUMONIA AND OF HEMOLYTIC ANEMIA By MAXWELL FINLAND, OSLER L. PETERSON,
More informationTable of Contents. September 2012 Page 1 of 1
Table of Contents Section Title 1 General Information 2 Quality Assurance 3 Disasters and Emergencies 4 Blood Services Agreement 5 Finance and Billing Policies 6 CPT/HCPCS Codes 7 Client Relations/Customer
More informationChapter 6: Antigen-Antibody Interactions
Chapter 6: Antigen-Antibody Interactions I. Strength of Ag-Ab interactions A. Antibody Affinity - strength of total noncovalent interactions between single Ag-binding site on an Ab and a single epitope
More informationserology Agglutination Techniques and Blood Cell Identification
Serology: Agglutination Techniques and Blood Cell Identification S erology is a branch of immunology dealing with techniques to identify and measure antigens, and to detect serum antibodies. Agglutination
More informationTopic: Serological reactions: the purpose and a principle of reactions. Agglutination test. Precipitation test. CFT, IFT, ELISA, RIA.
Topic: Serological reactions: the purpose and a principle of reactions. Agglutination test. Precipitation test. CFT, IFT, ELISA, RIA. Serology is the study and use of immunological tests to diagnose and
More informationHiPer Blood Grouping Teaching Kit
HiPer Blood Grouping Teaching Kit Product Code: HTI008 Number of experiments that can be performed: 100 Duration of Experiment: Protocol: 15 minutes Storage Instructions: The kit is stable for 6 months
More informationQuantiFERON TB Gold In Tube Method (QGIT Test) Manufacturer: Cellestis Inc. (USA) a QIAGEN Company
QuantiFERON TB Gold In Tube Method (QGIT Test) Manufacturer: Cellestis Inc. (USA) a QIAGEN Company P1078 TB APPRISE TB Ante vs. Postpartum Prevention with INH in HIV Seropositive mothers and their Exposed
More informationDiagnosis of HIV-1 Infection. Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University
Diagnosis of HIV-1 Infection Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University Tests Used to Diagnose HIV-1 Infection HIV antibody (today s topic) HIV p24 antigen HIV DNA HIV
More informationTransplant Options When You Don t Have a Good Match
Transplant Options When You Don t Have a Good Match 1 Transplant Options When You Don t Have a Good Match Being told you need a transplant may bring about many feelings, including anxiety and uncertainty.
More informationWhat Forensics Information Does Blood Typing Provide?
The Biotechnology Education Company EDVO-Kit 191 What Forensics Information Does Blood Typing Provide? See Page 3 for storage instructions. EXPERIMENT OBJECTIVE: The objective of this experiment is to
More information