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    BO/Rh

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    ARIF AHAMMED
    The document discusses testing procedures that must be performed on blood donors. It states that ABO grouping requires forward and reverse testing using anti-A, anti-B reagents on RBCs and reagent A1 and B cells on serum/plasma. Rh typing involves anti-D testing at immediate spin and 37C incubation to check for weak D. Screening for unexpected antibodies uses a pooled cell panel. HBsAg, anti-HBc, anti-HCV, and anti-HIV-1/2 involve FDA approved methods like ELISA, RIA, and NAT to detect markers. Positive results require further testing and disposal of donations.

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    BO/Rh

    Uploaded by

    ARIF AHAMMED
    23 views2 pages
    The document discusses testing procedures that must be performed on blood donors. It states that ABO grouping requires forward and reverse testing using anti-A, anti-B reagents on RBCs and reagent A1 and B cells on serum/plasma. Rh typing involves anti-D testing at immediate spin and 37C incubation to check for weak D. Screening for unexpected antibodies uses a pooled cell panel. HBsAg, anti-HBc, anti-HCV, and anti-HIV-1/2 involve FDA approved methods like ELISA, RIA, and NAT to detect markers. Positive results require further testing and disposal of donations.

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    BO

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    The document discusses testing procedures that must be performed on blood donors. It states that ABO grouping requires forward and reverse testing using anti-A, anti-B reagents on RBCs and reagent A1 and B cells on serum/plasma. Rh typing involves anti-D testing at immediate spin and 37C incubation to check for weak D. Screening for unexpected antibodies uses a pooled cell panel. HBsAg, anti-HBc, anti-HCV, and anti-HIV-1/2 involve FDA approved methods like ELISA, RIA, and NAT to detect markers. Positive results require further testing and disposal of donations.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    23 views2 pages

    BO/Rh

    Uploaded by

    ARIF AHAMMED
    The document discusses testing procedures that must be performed on blood donors. It states that ABO grouping requires forward and reverse testing using anti-A, anti-B reagents on RBCs and reagent A1 and B cells on serum/plasma. Rh typing involves anti-D testing at immediate spin and 37C incubation to check for weak D. Screening for unexpected antibodies uses a pooled cell panel. HBsAg, anti-HBc, anti-HCV, and anti-HIV-1/2 involve FDA approved methods like ELISA, RIA, and NAT to detect markers. Positive results require further testing and disposal of donations.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    BO/Rh

    Testing for the donors ABO group must include both forward and reverse grouping. The ABO group must be determined by testing the donor RBCs with anti-A and anti-B reagents and by testing the donor serum or plasma with reagent A1 cells and B cells. The Rh type of the donor should be determined by testing with anti-D reagent at the immediate spin phase. In the event the initial testing is negative, a test for weak D should be performed. This involves a 37_C incubation and an antihuman globulin (AHG) phase. If both the immediate spin and test for weak D are negative, label the donor as Rh-negative; if, however, any part of the testing yields a positive test for D, the donor unit should be labeled as Rh-positive.

    Antibody Screen
    AABB Standards requires that donors with a history of pregnancy or transfusion be tested for unexpected antibodies to RBC antigens.57 In the case of donors, a pooled screening cell is usually tested against donor serum or plasma. The pooled screening cell contains antigens directed toward significant alloantibodies. A control system must be in place for the method used. For example, in the tube system, cells sensitized with IgG are added to all negative tubes after the AHG phase; if the Gel system is used, the blood center must follow the manufacturers guidelines. Most blood centers choose to perform a test for unexpected antibodies on all donors, not just those with a history of pregnancy or transfusion. The introduction of automated instruments for donor processing has helped to lessen the tedious workload of ABO/Rh and antibody screens on donors. See the later section on automation.

    HBsAg
    The test procedure used must be one approved by the FDA58 or a documented equivalent method. The methods currently approved are the radioimmunoassay (RIA), enzyme-linked immunosorbent assay (ELISA), and reverse passive hemagglutination (RPHA). Of the three, the ELISA is the most common procedure used. In this method, serum or plasma is incubated with antigen to HBsAg. An enzyme-conjugate mixture is added, and if the antibody is specific to the antigen, a color change develops and can be quantified spectrophotometrically. If the ELISA yields negative results, no further testing is warranted; however, in the case of reactive results, the screening test must be repeated in duplicate, and a positive result is one in which one or both of the repeated tests are positive. All components must be discarded when results are positive. A supplemental test for HBsAg is neutralization.59 In this method, the donor specimen is reacted with serum known to contain antibody to HBsAg. If the positive reaction dissipates upon incubation by at least 50 percent, the original screening result is confirmed as a true positive as long as controls work as expected. In the event the donor unit is needed in an emergency that precludes completion of viral marker testing, a notation indicating testing is not yet completed must be conspicuously attached to the unit. If positive tests are found, the transfusion service must be notified as soon as

    possible.

    Anti-HBc
    Antibody to the core or interior protein on the hepatitis B virus has been implicated in hepatitis C disease. This test was once part of surrogate testing, along with its counterpart alanine transferase (ALT). In 1995 a National Institutes of Health consensus panel voted to discontinue the ALT test for blood donors because of the increased sophistication and sensitivity for anti-HCV testing60; however, testing for anti-HBc has remained a requirement of blood donors in the prevention of post-transfusion hepatitis B. The methods employed are similar to those for HBsAg.

    Anti-HCV and NAT


    The hepatitis C virus was identified in 198861 and was initially referred to as non-A, non-B hepatitis. Screening tests for anti-HCV involve enzyme immunoassay (EIA) methods whose sensitivity has increased through three generations of screening kits. Current assays detect antibodies to c200, c223, and NS-5 proteins of the HCV genome. In 1999 NAT for HCV RNA was implemented as a donor screening assay under FDAsanctioned Investigational New Drug applications.62 NAT is able to detect small amounts of viral nucleic acid in blood before antibodies or viral proteins such as HCV core antigen are detectable by current methods. The window period for detection of HCV is reduced by approximately 70 percent, from a mean of 82 days to 25 days.63 Confirmatory methods include the RIBA (recombinant immunoblot assay). In this assay, fusion of HCV antigens to human superoxide dismutase and a recombinant superoxide dismutase is incorporated to detect nonspecific reactions. The test is reported as positive, negative, or indeterminate. An individual who is positive by RIBA is considered to have the HCV antibody.

    Anti-HIV-1/2 and NAT


    All donor units must be screened for the presence of the HIV1/2 antibody using an FDA-approved EIA method.58 If the initial screening test is negative, the unit is suitable for transfusion; if it is positive, the test must be repeated in duplicate. If any one of the duplicate tests is reactive, the unit must be discarded as well as any in-date components from prior donations. Confirmation tests for HIV include the Western blot (Wb) and the immunofluorescence assay (IFA). The Wb is performed using donor serum. HIV virus material is separated into bands according to their molecular

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