Out with the new, in with the old - Blood · • A Positive forward group • A reverse group DP 0...
Transcript of Out with the new, in with the old - Blood · • A Positive forward group • A reverse group DP 0...
Out with the new, in with the old: Post‐transfusion group discrepancies caused by
density of aged red cells
Jenna Wright
A B D Ctrl A‐cells B‐cells
0 0 0 0 0 4+
AUTOMATED PIPETTING• ORTHO AutoVue®• O Negative forward group• A reverse group
Grouping Discrepancy
A B D Ctrl A‐cells B‐cells
MANUAL PIPETTING• ORTHO BioVue® System Cassettes
• A Positive forward group• A reverse group
DP 0 4+ 0 0 4+
Grouping Discrepancy
Red Cell Life Cycle
• Survive in the circulation for ~115 days (±15%)
• Red cell senescence:↓ Enzyme ac vity↓ Cell Deformability
↓ Size∆ Shape
• Eryptosis by macrophages in the spleen and liver
Density
+
‐
• Pre‐analytical separation by centrifugation
• Based on density gradient/ specific gravity
Blood Fractionation
• Biochemically supported• SAGM
Saline (NaCl): Isotonicity Adenine: ATP for cell viability Glucose: Nutrition Mannitol: reduces red cell lysis
• Storage• Up to 42 days• Refrigerated at 2‐6C
• Continue to age/ storage lesions• Red cell membrane loss
Red Cell Packs
O Negative
A+
A Positive
Density Gradient
Scenarios
TRAUMA
APLASTIC ANAEMIA
↓Autologous cells• Aplastic Anaemia• Thalassaemia• Cytopenia• Major Trauma
↑ Donor Cells• Transfusion dependant• MTP
• AABB (American Association of Blood Banks) (2014). Transfusion Manual. 18th Edition; Method 2‐22; pp.1‐2.
• Franco, R. (2012). Measurement of Red Cell Lifespan and Aging. Transfusion Medicine and Hemotherapy, 39(5), pp.302‐307.
• Kim‐Shapiro, D., Lee, J. and Gladwin, M. (2011). Storage lesion: role of red blood cell breakdown. Transfusion, 51(4), pp.844‐851.
• Ortho Clinical Diagnostics (2017). Important Product Notification. Visual Reference Guide For ORTHO BioVue System Cassettes. [online] Johnson and Johnson, pp.1‐5. Available at: http://www.hsa.gov.sg/content/dam/HSA/HPRG/Medical_Devices/Updates_and_Safety_reporting/Field_Safety_Corrective_Action.pdf [Accessed 10 Oct. 2017].
Thank you!
Further Reading