Life's Blood

INTRODUCTION TO IMMUNOHEMATOLOGY

DEFINITIONS

• Immunity: Protection against infection or disease caused by foreign particles
• Immunology: Study of the immune system and the immune response; study of antigen-antibody reactions in vivo
• Serology: Study of antigen-antibody reactions in vitro
• Hematology: Study of the cellular components of the blood
• Immunohematology (Blood Banking): The detection, identification, and/or quantitation of antibodies involved primarily with red cells, although white cells and platelets may also be involved

TYPES OF IMMUNOHEMATOLOGY FACILITIES

Transfusion Service:

1. Examples: UW Hospital, Meriter Park, St. Mary's, VA

2. Work primarily with patient's blood

3. Primary areas of responsibility:

• blood typing
• antibody detection and identification
• compatibility testing (crossmatching)
• blood component therapy (hemotherapy)
• transfusion reaction workups
• autoimmune hemolytic anemia workups
• hemolytic disease of the newborn (HDN) workups
• determining Rh immune globulin eligibility

Donor Center (Blood Center)

1. Examples: Red Cross, Blood Center of SE Wis.

2. Works primarily with donor blood

3. Major areas of responsibility:

• donor recruitment
• donor screening
• blood collection
• testing (typing, infectious disease screening)
• blood component preparation
• component preservation
• may provide reference lab services
• may store rare donor blood

Blood Bank

1. Appleton, Manitowoc

2. Combination of donor center and transfusion service

• bleeds most of its own donors
• tests its own donor blood
• uses the donor blood for its own patients

The term "Blood Bank" used synonymously with transfusion service or donor center as well as the true Blood Banks, which collects donor blood and serve as a transfusion center.

NATURE OF BLOOD BANKING:

Blood banking involves less automation than Hematology and Clinical Chemistry.  The results are not numerical other than grading reactions as 1+, 2+. 3+ and 4+.

There is a heavy emphasis on the thought processes of logic, interpretation, decision making and problem solving. You need to think about what is happening in the test tube and whether the patient's red cell antigens or antibodies are involved.

Blood banking can be very rewarding since there are visible life-saving aspects of providing the patient with the needed blood components. Unfortunately it is also prone to human error  and the consequences of error can be fatal.  There are not many places in the clinical laboratory where a patient may die from an erroneous result, but giving A or B blood to an O individual can do that.

OBJECTIVES - INTRODUCTION TO IMMUNOHEMATOLOGY

1. Differentiate between immunology and serology.
2. Describe the study of immunohematology
3. List the functions of a transfusion service.
4. List the functions of a donor center.
5. Explain the difference between a blood bank and a donor center and transfusion service
6. Explain how blood banking may differ from the other laboratory sciences in terms of:

• type of methodology
• kinds of results obtained
• type of thinking required
• consequences of error