HIS 10 Blood Transfusion Describe the composition of whole blood & its components.

Plasma 55% Formed elements 45% o RBC = 99% o WBC = <1% o Platelets = <1%

Explain how blood group is determined with particular reference to the ABO & Rhesus blood group systems.
Determined by antigens or agglutinations present on the RBCs Type A = blood type A, Type AB = blood type AB Nothing = O blood type Anti-A and anti-B antibodies are found in plasma when the corresponding antigen is missing on the RBC. Ex: A-blood type will have floating Anti-B in plasma. These antibodies are produced because small amounts of different blood may enter the body through food or bacteria and initiate development of agglutinins. Rhesus blood group is mainly Type D, o Rh+ means D positive o Rh means D negative o Rhesus blood group is only expressed in the surface of RBC in the body o Rh antibody (In Rh) is only activated when previously exposed to Rh+

Discuss how blood is prepared for transfusion & the subsequent storage of blood.
Taken by aseptic technique into plastic bags containing anticoagulants Screening for disease on blood includes: o ABO & Rhesus blood groups o Syphilis, hepatitis B and C White blood cells are removed because they create an immune response

Distinguish between grouping & cross-matching.

Grouping Determining the red cell antigen in blood of the donor and recipient Agglutination The clumping of cells in the presence of an antibody (Can clump more than one antigen) Cross-matching Mixing of donor and recipient blood samples Agglutination occurs when donor and recipients blood is incompatible for that person Ensures no errors are done in the ABO grouping of donor/recipient and ensures recipient has no naturally occurring immune antibodies active against the donor cells

Explain transfusion reactions with particular reference to haemolytic disease of the newborn.
Universal Donor: O Rhesus negative (can be given in emergency situations) Universal Recipient: AB Rhesus positive Transfusion reactions occur when an incompatible blood group is put in a person Plasma in the transfusion usually very diluted in the recipient so rarely seen agglutination against recipients cells If recipient plasma has antibodies against donor cells = agglutination/haemolysis

Rhesus incompatibility - Haemolytic disease of newborn Mother = Rh-, Father = Rh+, and foetus = Rh+ Transfer of foetal Rh+ antigen to maternal circulation at birth which stimulates the production of the anti-Rh antibodies/agglutinins in mother. 1st child: mother recognizes Rh+ and creates antibodies 2nd child: the Rh+ antibodies cross the placenta and cause agglutination and hemolysis of foetal RBC -> anaemia, jaundice and death Treatment: D antigen is the primary cause of immunization o Administering anti-D antibodies post-partum to the mother o Reduces the incidence of disease by >90%

Autologous transfusion - Transfusion from the same individual Increased demand due to anxiety over blood borne viruses (AIDS, hep B/C) Pre-deposit of blood weeks before surgery and reinfused after surgery Salvage: Blood lost during surgery and collected and reinfused