Essential Guide to Blood Groups

Essential Guide to Blood Groups

Product Description:

Essential Guide to Blood Groups is essential information on blood group systems. The main aim of the blood transfusion laboratory is to promote safe blood transfusion. The avoidance of errors, from sample receipt and laboratory testing through to the release of blood for transfusion, is of paramount importance. Knowledge of immunohaematology theory and its application to blood transfusion together with the principles of good laboratory practice are essential. Essential Guide to Blood Groups will be very valuable for medical laboratory scientists and for postgraduate scientists and medical practitioners training to specialise in transfusion and transplantation.

Author:
by Geoff Daniels , Imelda Bromilow

Paperback: 112 pages
Publisher: Wiley-Blackwell; 1 edition (November 28, 2006)
Language: English
ISBN-10: 1405153490
ISBN-13: 978-1405153492

Contents:
1. An introduction to blood groups

• What is a blood group?
• Blood group antibodies
• Clinical importance of blood groups
• Biological importance of blood groups
• Blood group systems
• Blood group terminology and classification

2. Techniques used in blood grouping

• Factors affecting antigen–antibody reactions: Temperature, Time and ionic strength, PH, Antigen density.
• Stages of haemagglutination reactions
• Direct agglutination
• Indirect agglutination: Enzyme techniques, Antiglobulin tests,
• Elution techniques
• Automation of test procedures
• Flow cytometry
• Molecular blood group genotyping

3. The ABO blood groups

• Introduction
• ABO antigens, antibodies, and inheritance
• A1 and A2
• Antigen, phenotype, and gene frequencies
• ABO antibodies
• The importance of the ABO system to transfusion and transplantation medicine
• The biochemical nature of the ABO antigens
• Biosynthesis of the ABO antigens and ABO molecular genetics
• H, the precursor of A and B
• ABH secretion
• H-deficient red cells
• Further complexities
• Acquired changes
• Associations with disease and functional aspects

4. The Rh blood group system

• Introduction – Rh, not rhesus
• Haplotypes, genotypes, and phenotypes
• Biochemistry and molecular genetics
• D antigen (RH1); Molecular basis of the D polymorphism, D variants, Clinical significance of anti-D, D testing, Prediction of RhD phenotype from fetal DNA.
• C, c, E, and e antigens (RH2, RH4, RH3, RH5); Clinical significance of CcEe antibodies, Molecular basis of the C/c and E/e polymorphisms.
• Other Rh antigens; Compound antigens: ce, Ce, CE, cE (RH6, RH7, RH22, RH27) and G (RH12), Cw, Cx, MAR (RH8, RH9, RH51), VS, V (RH20, RH10).
• Rh-deficient phenotypes – Rhnull and Rhmod
• Putative function of the Rh proteins and RhAG

5. Other blood groups

• The Kell system; The Kell glycoprotein and the KEL gene, Kell-system antigens, Kell-system antibodies, K0 phenotype, McLeod syndrome, McLeod phenotype, and Kx (XK1) antigen.
• The Duffy system; Fya (FY1) and Fyb (FY2), Anti-Fya and -Fyb, Fy3 and Fy5, The Duffy glycoprotein, a receptor for chemokines, Duffy and malaria.
• The Kidd system; Jka (JK1) and Jkb (JK2); anti-Jka and -Jkb, Jk(a-b-) and Jk3, The Kidd glycoprotein is a urea transporter.
• The MNS system; M (MNS1) and N (MNS2); anti-M and -N, S (MNS3) and s (MNS4); anti-S and -s, S- s- U- phenotype and anti-U, Other MNS antigens and antibodies.
• The Diego system; Band 3, the red cell anion exchanger, Dia (DI1) and Dib (DI2); anti-Dia and -Dib, Wra (DI3) and Wrb (DI4); anti-Wra and -Wrb, Other Diego-system antigens.
• The Lewis system.
• Some other blood group systems; P, Lutheran, Yt, Xg, Scianna, Dombrock, Colton, Landsteiner–Wiener (LW), Chido/Rodgers, Gerbich, Cromer, Knops, Indian, I.
• Antigens that do not belong to a blood group system

6. Clinical significance of blood group antibodies

• Antibody production and structure
• Factors affecting the clinical significance of antibodies: Antibody specificity.
• Haemolytic transfusion reactions; Intravascular red cell destruction, Extravascular red cell destruction.
• Haemolytic disease of the fetus and newborn; Cross-matching for infants under 4 months old.
• Autoantibodies.
• Tests to assess the potential significance of an antibody.
• Decision-making for transfusion.

7. Quality assurance in immunohaematology

• Achieving total quality.
• Frequency and specificity of control material.
• Quality requirements for safe transfusion practice.
• Checklist of critical control points.
• QC for molecular blood group testing.

8. Trouble-shooting and problem-solving in the reference laboratory

• ABO grouping.
• Rh grouping.
• Problems in antibody screening, identification, and cross-matching.

9. Frequently asked questions
Recommended reading
Index

Sampel Chapter 1:

What is a blood group?

In 1900, Landsteiner showed that people could be divided into three groups (now called A, B, and O) on the basis of whether their red cells clumped when mixed with separated sera from people. A fourth group (AB) was soon found. This is the origin of the term ‘blood group’.

A blood group could be defined as, ‘An inherited character of the red cell surface, detected by a specific alloantibody’. Do blood groups have to be present on red cells? This is the usual meaning, though platelet- and neutrophil-specific antigens might also be called blood groups. In this book only red cell surface antigens are considered. Blood groups do not have to be red cell specific, or even blood cell specific, and most are also detected on other cell types. Blood groups do have to be detected by a specific antibody: polymorphisms suspected of being present on the red cell surface, but only detected by other means, such as DNA sequencing, are not blood groups. Furthermore, the antibodies must be alloantibodies, implying that some individuals lack the blood group.

Blood group antigens may be:

• proteins;
• glycoproteins, with the antibody recognising primarily the polypeptide backbone;
• glycoproteins, with the antibody recognising the carbohydrate moiety;
• glycolipids, with the antibody recognising the carbohydrate portion

Blood group polymorphisms may be as fundamental as representing the presence or absence of the whole macromolecule (e.g. RhD), or as minor as a single amino acid change (e.g. Fya and Fyb), or a single monosaccharide difference (e.g. A and B).

Blood group proteins and glycoproteins are integral structures of the red cell membrane. Diagrammatic representations of some blood group proteins and glycoproteins in the membrane are shown in Fig. 1.1. Some pass through the membrane once. These generally have an external N-terminal domain and a cytoplasmic C-terminal domain (Type 1), though

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