MLSP112 LECTURE: MEDICAL LABORATORY SCIENCE PRACTICE 2

WEEK 8: IMMUNOLOGY, SEROLOGY, AND BLOOD BANKING

2ND SEMESTER | MIDTERM| 2023 – 2024
PROFESSOR: JHASTINE UMALI, RMT

Immunology / Serology Section - The ability to react specifically with the

 Immunology antibody or cell that caused it to be produced.
- study of the reactions of a host when foreign  Immunogens
substances are introduced into the body. - Molecule that induces an immune response
o Antigen - Non-self
- substances that can induce immune response. It - At least 2 antigenic determinants
can be harmful/harmless. __________________________________________
o Antibody ____
- Serum factors in the blood formed in response
to foreign substance exposure.  Haptens
 Serology - Molecule that is NOT IMMUNOGENIC by itself
- Study of serum and is known for the qualitative but can react with a specific antibody.
detection or quantitative analysis of antibodies  Antibody
or antigens concerning infection or disease - A.K.A Immunoglobulins
diagnosis. o A gamma globulin protein
Basic Concept of Immunity - Produced by “Plasma Cells”
 Immunity - Play an essential role during “Antigen
- How the body can protect itself from invasion Recognition” and in biological activities related
by pathogenic microorganisms and provide a to immune response such as “opsonization”
defense against their harmful effect. and “complement activation”.
Classified into two groups: Major Ig Classes
1. Non-Specific Immunity  IgG: gamma heavychain
2. Specific Immunity  IgA: alpha heavychain
Two Types of Adaptive Immunity
 IgM: mu heavychain
 Active
 IgE: epsilon heavychain
1. Natural Active
 IgD: Delta heavychain
- Exposure to subclinical infections
Specimen Preparation and Processing for Serological Test
2. Artificial Active
 Blood is collected aseptically by venipuncture into a
- Vaccination
clean, dry, sterile tube.
 Passive
 Care must be taken to avoid hemolysis, since this may
1. Natural Passive
produce a false positive test.
- Placental Transfer of IgG
 Serum should be promptly separated into another
- Colostral Transfer of IgA
tube without transferring any cellular elements.
2. Artificial Passive
 Fresh, non-heat inactivated serum is usually
- Antibodies or Immunoglobulins
recommended for testing.
- Immune Cells
o There is a certain serological test that
Antigen vs. Immunogens
requires inactivated serum.
 Antigens
o Like VDRL and FTA-Abs
- Molecules that react with antibodies
o Serum should be heated at 56 C for 30
- Compound that does not necessarily elicit an
immune response. minutes.
- Target of response o If testing cannot be performed
Properties of Antigens: immediately 2-8 C for up to 72hrs,
o Immunogenicity -20oC if >72 hours delay.
- Ability to induce a specific response resulting Transporting Patient Specimen
in the formation of antibodies or immune  Depending on the scope of testing performed in an
lymphocytes. immunology laboratory, transporting and receiving
patient specimens must be considered.
o Antigenicity / Specificity  Regulations for packaging and labeling developed by

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 WEEK 8: IMMUNOLOGY, SEROLOGY, AND BLOOD BANKING
the U.S. Department of Transportation (DOT), the for use in a transfusion. Units of blood is
International Air Transport Association (IATA), and the collected from donors, and tested for the
United Nations must be followed. presence of bloodborne pathogens such as
Characteristics of a Transport Container Suspected Infectious hepatitis viruses and human immunodeficiency
Specimen DOT and IATA rules. virus (HIV)
 Watertight primary containers made of glass, metal, Blood Components Available for Transfusion
or plastic with a positive (screw-on) cap.  Whole Blood
 The primary container must be wrapped with enough  Packed Red Cells
absorbent material to be capable of absorbing all of  Platelet Concentrate
its contents. Multiple specimens must be wrapped  Cryoprecipitate
individually before placing them in the leak-proof  Fresh Frozen Plasma
secondary container. Sample Collection and Handling
 The secondary container is placed in a sturdy outer  Blood bank samples are collected in plain red (serum),
container made of corrugated fiberboard, wood, lavender, or pink (plasma) stopper tubes. Serum
metal, or rigid plastic. An itemized list of contents in a separator tubes containing gel are not acceptable
sealed plastic bag is also placed in the outer container. because the gel will coat the RBCs and interfere with
Ice packs are placed between the secondary and the testing. Hemolysis also interferes with the
outer container. Additional measures must be taken interpretation of test results.
when using ice and dry ice.  Patient identification is critical in the blood bank, and
___________________________________________________ phlebotomists must carefully follow all patient
 In January 2007, the labeling of the outer container identification and sample labeling procedures to
changed. The terms clinical specimen and diagnostic ensure that a patient does not receive a transfusion
specimen have been replaced with biological with an incompatible blood type.
substances, Category B. This wording is placed next to Test Performed in the Blood Bank Section
the label UN 3373.

Governing Agencies in Blood Bank

 The American Association of Blood Banks (AABB)-
Tests Performed in Immunology/Serology Section was established in 1947. It is an international
association of blood banks that includes hospital and
community blood centers, transfusion and
transplantation centers, and individuals involved in
transfusion medicine. The mission of AABB is to
establish and provide the highest standard of care for
patients and donors in all aspects of transfusion
medicine.
 Blood Bank Section  Food and Drug Administration (FDA) inspects blood
- Section in the laboratory where blood may be banks on an annual basis; its regulations for donors
collected, stored, and prepared for transfusion. are outlined in the Code of Federal Regulations, parts
- In the blood bank, blood from patients and 211, 600-799.
donors are tested for their blood group (ABO) ___________________________________________________
and Rh type.  Donor Screening
- Encompasses the medical history requirements
for the donor, the physical examination, and
serologic testing of the donor's blood.
Medical History and Physical Examination
- The presence and identity of abnormal It is designed to answer two questions:
antibodies, and its compatibility (crossmatch)
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 WEEK 8: IMMUNOLOGY, SEROLOGY, AND BLOOD BANKING
1. Will a donation of approximately 450 mL of whole
blood at this time be harmful to the donor?
2. Could blood drawn from this donor at this time?
potentially transmit a disease to the recipient.
Donor Screening: Medical History
 Obtaining an accurate medical history of the donor is
essential to ensure benefit to the recipient.
 The interviewer should be familiar with the questions,
and the interview should be conducted in a secluded
area of the blood center.
 The questions are designed so that a simple “yes” or
“no” can be answered but elaborated if indicated.
 The medical history is conducted on the same day at
the donation.
 Medications the donor is taking are present in plasma
and may cause deferral.
 Infections the donor has may be passed to the
recipient and may be cause for deferral.
Donor Screening: Physical Examination
 Provides a general screening of health and vital signs
to ensure good health on the day of donation.
 Specific screening assessments are performed, and
the results are recorded in the donor record.
Criteria for Donor Screening
 General Appearance
 Observe the prospective donor for the
presence of excessive anxiety, drug or alcohol
influence, or nervousness.
 This should be done gently to not deter the
donor from donations in the future.
 Temperature
- Less than or equal to 37.5 C or 99.5 F.
 Blood Pressure
- Systole: Less than or equal to 180mm Hg.
- Diastole: Less than or equal to 100mm Hg.
 Pulse
- 50-100 beats per minute
 Hemoglobin
- Greater than or equal to 12.5 g/dL
 Hematocrit
- Greater than or equal to 38%
 Weight
- 50kg or 110 lbs.

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