25 June 2016

Lecture #1: INTRODUCTION TO BLOOD BANKING



The term blood banking refers to the collection, processing, preservation, preparation and distribution of blood and blood components and derivatives.  The establishment where this procedure takes place is called a blood bank.

A related term which has been used synonymously nowadays with blood banking is immunohematology which is the study of blood–related antigens and antibodies as applied to situations such as blood transfusion and hemolytic disease of the newborn.

Scope of function of a modern blood bank:

1. Recruiting blood donors.
2. Collecting and storing whole blood or components from volunteer or autologous donor.
3. Typing, screening and preparing patient and donor for blood transfusion.
4. Detecting and identifying antibodies in potential blood recipients or pregnant women.
5. Establishing a database to support suspected or potential disorder.
6. Processing and dispersing blood components.
7. Performing paternity testing.
8. Conducting tissue typing prior to organ transplantation and participating in the processing of human materials (e.g. bone banking)

Related terminologies     

1. Blood groups – refers not only to groups of erythrocyte antigens but also to other blood components, including leukocytes, platelets and plasma.

2. Factor – used to include classic antigens as well as those recognized by immunologic methods not utilizing a specific antibody.

3. Hemotherapy – refers to the selection with preparation and infusion of appropriate blood, blood components or derivatives for each individual patient.

4. Specificity – refers to the appearance of a substance that can only recognized by immunologic techniques and is commonly used in reference to leukocyte antigens; it may also indicate a complex antigen or a fraction of an antigen.

Objectives of a blood bank technologist

1. Prevention of antigen–antibody interaction in the body. This is accomplished by identifying those patients who have an antibody supplying blood which lacks the corresponding antigen.

2. To prevent antibody production

Blood bank tests:

1. Blood grouping – is the process of testing cells to determine which antigens are present and which are absent

2. Antiglobulin test – to aid in weak agglutination

3. Compatibility testing – to ensure safe blood transfusion

4. Determination of unexpected antibodies.

a. Antibody screening tests – are used to detect those people whose sera contain one or more unexpected antibodies

b. Antibody identification tests – defines the specificity of the antibody


************  BLOOD GROUP GENETICS  ************

Genetics is the study of the basic concepts of inheritance and heredity. This is the basic foundation of blood banking as it determines how blood group is being passed to the newborn, thus preventing transfusion reaction.

Definition of terms:

1. Alleles, allelic genes, allelomorphs – alternate form of genes to occupy the same locus.

2. Allelic – when two alternate forms of genes have the capacity to occupy the same locus.

3. Locus – the specific position occupied by a gene on the DNA chain.

4. Chromosomes – long, thread – like structures found in the nucleus of a cell. They are made up of DNA on a protein framework.

5. Homozygous – when allelic genes are identical.

6. Heterozygous – when allelic genes are indifferent

7. Genes – segments of the chromosomes. They are responsible for all bodily characteristics. They are the basic units of heredity.

8. Dominant gene – a gene which is always expressed, whether it is in homozygous or heterozygous state.

9. Recessive gene – a gene which is expressed when it is in the homozygous state.

10. Genotype – refers to the sum of all genes inherited from both parents whether they are expressed or not.

11. Phenotype – refers only to a detectable products of a gene, demonstrated to direct testing.

12. Codon – a series of triplets making a gene.

13. Penetrance – refers to the degree of expression of a given gene in different individuals. It represents a graded response varying from person to person.

14. Expressitivity – describes the degree of expression of a given gene in different individuals. It represents a graded response to varying from person to person.

15. Structural gene – genes which direct the construction of proteins.

Basic facts about genetics

1. Human have 22 pairs of autosomes and a pair of sex chromosomes, XX in females and XY in males.

2. Chromosomes are made up DNA which carries the genetic message.

3. During the reduction division stage of meiosis, homologous chromosomes exchange segments of genetic material so that each chromosome entering the gamete contains variable amount of maternal and paternal genetic material. This process of exchanging segments of chromosomes is called crossing over.

4. A new organism is formed when an ovum and a sperm, each carrying one–half of the genetic material, unites to form a zygote.

5. The building blocks of DNA are called nucleotides, each of which is composed of a phosphate group, deoxyribose and a nitrogenous base. The phosphate group and deoxyribose group are the same in all nucleotides but there are four different nitrogenous bases – 2 purine bases (adenine and guanine) and 2 pyrimidine (cytosine and thymine). The genetic message is determined by the sequence in which these nucleotides are joined.

6. DNA serves as a template to produce messenger ribonucleic acid and the genetic message is transcribed to the mRNA. The message is made up of 3 letter words called codons, the letters being the nucleotides. Each codon designates one amino acid.

7. Messenger RNA moves into the cytoplasm and is read by the ribosomes.

8. Amino acids which are joined by peptide bonds are called polypeptides. Polypeptides are the basis for all proteins.

Genes determines blood group antigens

It is probable that those blood group antigens which are proteins are direct product of gene action. The polypeptide may be inserted into the membrane as a single chain or it may be folded, perhaps joined to other chains and inserted as a complex structure. On the other hand, because genes control the production of proteins only, the construction of oligosaccharide antigens must involve intermediate step. The intermediate step in the production of enzymes (which are proteins) called transferases which assemble individual sugars into chains and more complex molecules. Transferases catalyze the transfer of a particular sugar molecule from the source to a specific receptor molecule (substrate). As each transferase adds its sugar, a new structure is formed and this structure may then be the substrate used by another transferase.

Two types of gene interaction:

1. Epistatic – when the interaction is between genes at different loci.

2. Allelic – when it involves alleles at the same locus.


Mode of inheritance

A.  Autosomal Dominant or Codominant Inheritance

An autosomal dominant or codominant trait shows a very characteristic pattern that is easy to recognize. The trait never skips a generation and a mating of 2 heterozygots has a probability of producing a child positive for a trait three times out of 4.

Example:                     Blood group antigens


B.  Autosomal recessive Inheritance

Any of the following is suggestive of an autosomal inheritance

1. A great majority of affected (double recessive) parents being affected.

2. Usually, normal offspring from a mating of a normal parent with an affected parent, especially if the recessive trait is rare.

3. Consanguinity (common ancestry in paternal line) of the person showing the trait.

Example:                     Bombay phenotype

C. Sex linked Dominant or Codominant Inheritance

Sex linked dominant or codominant pedigrees show affected males with normal wives transmitting the trait to daughters only.

Example:                     Xga Blood group
                                                
D.  Sex–linked Recessive Inheritance

A much larger number of affected males than females is the first thing to look for. Affected males do not come from affected fathers but from carrier mothers, who may often be recognized affected brothers, fathers or uncles.