15 Blood Groups
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- ABO: natural antibodies
- Rh: acquired
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ABO
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- formation of A and B driven by exposure to bacterial antigens
- do not cross placenta: no problem for different babies and mom
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- 4 sugar molecules
- O: H antigen, default
- A: add galactosamine
Rh
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- in contrast with sugar on surface
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- antibody does not occur naturally like ABO
Newborn Hemolytic Disease
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- antibodies from mom cross placenta, attack baby
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- low antibody titer: mild case
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- screen D- mother for antibodies to antigen
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- D+ RBC from fetus to maternal circuit, IgG binds
- clearance before immune response
Transfusion
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- Type and screen: determine AB, Rh antigens and perform antibody screening test for rare antigens
Blood Type
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Type and Screen
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- screen for antibodies to rare antigens
- further testing to determine which antigen
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- many transfusions in life: many different antibodies
Type and Cross
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Blood products
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- FFP: for clotting factors
Transfusion reactions
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- reason for typing and cross matching
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- leukoreduction: eliminate WBC to reduce frequency of FNHTR
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- inflammation in lungs
- neutrophils in patient's lung exposed to product and activated to release enzymes
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- answer always stop transfusion first
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