BLOOD TRANSFUSION

BT the infusion of whole blood or a

blood component from D to R.
Main problem avoidance of immunological reactions resulting from the differences in the chemical constituent of RC.
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Kamis, 22 April 2004

 Compatibility donor a.g and recipients

a.b must be ensured >< potentially
fatal hemolytic reactions.
RC antigens :
400 red blood cell group a.g.
Different blood group a.g have diff.
potential for immunizing
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 Blood Grouping :
- ABO system
- Rhesus system

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Blood Group a.bodies :

Naturally occuring a.bodies :
- subjects who lack the corresponding a.g
- havent been transfused/been pregnant
- Anti-A and anti-B (!!), IgM (<)

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 Immune a.bodies
- by transfusion or transplacental passage
- ab Rhesus : anti D (!!) , Ig G (>>), Ig M (<).
ABO SYSTEM
Consists of 3 allelic genes : A, B, O
Determination of ABO : using 2 a.b; Anti-A
and Anti-B.
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 Gene A & B responsible for converting H

substance into A & B substance.
Gene O has no effects on H substance.
H subst. is a carbohydrate + lipid or
protein in RC membrane.

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 A terminal sugar molecules determine

a.g specificity :
A a.g : N. acetylgalactosamine
B a.g : galactosa

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 Determining the blood group :

genotype and phenotype
Genotype :
- specific genes that person carries
- determined by family studies
- AA, AO, BB, BO, AB and OO
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 Phenotype :
- observed characteristics agglutination reaction
- four phenotypes : A, B, AB and O
Although there are six possible genotypes, the absence of a specific anti-O
prevents the serological recognition of
more than four phenotypes (table 1)
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Table 1. BLOOD TYPES

Phenotype

O
A
B
AB

Genotype

OO
AA or AO
BB or BO
AB

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Antigens
on red cell

Antibodies in
plasma

O
A
B
AB

Anti-A, Anti B
Anti-B
Anti-A
None
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 Its important to transfuse blood with

the same ABO group
Group O Universal Donors
dangerous concept

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Rhesus System
There are 3 allelomorphic pairs of genes
: C and c, D and d, E and e.
Rh a.b >> immune (previous transfusion or pregnancy), naturally <<.
Differentiation of Rh positive and Rh
negative anti D antibody
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 Rh positive have D antigen

(homozygous DD or heterozygous
Dd)
Rh negative absence of D antigen
(genotype dd)
Barat : Rh (+) 85%, Rh () 15%
Indonesia : Rh (+) 100%
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CROSS MATCHING (REAKSI SILANG)

The purpose of cross matching : to ensure
there is no a.b present in the R plasma
which will react with any a.g on Ds cells
Rx silang mayor : memeriksa serum R
dgn sdm D utk mendeteksi ab R yg dpt
menyebabkan lisis sdm donor rx
transfusi hemolitik
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Rx silang minor : memeriksa serum

donor dgn sdm resipien

Kedua rx ini dikerjakan dlm 3 fase :

1. Medium NaCl 0,9%
2. Medium albumin
3. Coombs test

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THANK YOU

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