These are Antibodies that DO NOT react with antigens present on the RBC's of the antibody producer
Alloantibodies (Non-self)
Alloantibodies are formed against the RBC antigens of who?
another individual
These are antibodies that react with antigens present on the RBC's of the antibody producer.
Auto antibodies (self)
"By testing the serum with each of the cells in the panel, a pattern of reactivity will be established," is the principle of what procedure?
Antibody Identification
The Antibody Identification procedure is based on a pattern from _________ and ___________ reaction seen in the antigram.
positive
negative
Antibody Identification is used to ID what three types of non-ABO antibodies?
unexpected
Atypical
Irregular
What is the class of antibody that is stimulated by pregnancy or transfusion?
Immune antibodies (IgG)
What is the class of antibody that has an unkown stimulus?
Naturally occuring (IgM)
a history of what five items is useful in antibody ID.
Pregnancy
Transfusion
Pt diagnosis
Pt drug therapy
Recent RhIg
A history or recent RhIg will cause a false positve for what reagent?
Anti-D
What are six problems that indicate the presence of unexpected antibodies?
incompatible crossmatch
ABO discrepancy
Positive IAT
Positive DAT
HDN
Transfusion Reaction
Serum or plasma for Antibody ID must be used within how many hours if refrigerated?
72hrs
Why must Serum or plasma be used within 72 hours if refrigerated?
antibodies degrade with time
Hemolysis causes what type of false result on Antibody ID?
positive
Serum separator will causes what type of false result in Antibody ID?
positive
what are the two tubes that Antibody ID can be collected in?
red top
purple top
An antibody panel is usually only done when other procedure indicates the presence of what?
atypical antibody
What are three procedures that can indicate a need for antibody panel?
IAT
DAT
Crossmatch incompatibility
An antibody panel contains _____ separate vials of commercially prepared red cells.
10-16
What blood type is used in comercially prepared red cell reagents for antibody ID?
O cells
Who indicates what antigens are on cells of each reagent vial in antibody ID?
manufacturer
what size of disposable glass tubes should be used for antibody ID?
12x75
in other than optimal conditions such as the field, fleet hospitals, and power outages blood products are stored how?
on ice in boxes
in other than optimal conditions ABO/Rh is preformed using what method?
finger stick and slide method
in other than optimal conditions, blood is issued under _________ status.
emergency only
Compatibility in other than optimal conditions is based on what?
donor and recipient ABO/Rh match only
Antibody panel is tested in what three phases?
Saline phase (IS)
37oC phase (LISS or Albumin phase)
AHG or coombs phase
In the saline phase suspension of red cells are mixed at what temperature?
room temp
Saline phase detects what class of antibodies?
IgM
What are the seven IgM antibodies?
I
P1
N
LeaLebLuaM
What is the phase where red cells and serum are incuated with enhancement media?
37oC phase
What are the IgG antibodies detected in the 37oC phase?
Rh
Anti-K
what are the occasional IgM antibodies detected in the 37oC phase?
Anti-LeaAnti-LebSome Ss antibodies
AHG detects what eight IgG antibodies?
Rh
Kell
Duffy
Kidd
Lewis
Lutheran
MNSs
Xg
in what phase are reactions read microscopically if macroscopically negative/
AHG
reactions should be read Macroscopically for ____________ and/or __________ in each phase.
agglutination
hemolysis
True or flase
Seological properties of the antibody are used only as a guide.
true
what are the two hemolytic antibodies?
lewis
Kidd
what system antibodies are capable of reacting in all phases and temps?
lewis
this may resemble agglutination due to increased serum protein.
Rouleaux
Rouleaux is detected only in what phases?
saline
Allbumin
how are Rouleaux resolved?
saline replacement
This is when serum contains anti-caprylate antibodies?
albumin agglutinating phenomenon
ALL red cells are agglutinated in albumin stabilized with caprylate only in what phase?
37oC
This is a mixutre of patient red cells and serum/plasma that is tested in parallel with other tubes through various phases and temps.
Autologous control (Auto control)
Auto control most often has what result?
negative
What are four situations that can cause positive auto control?
cold autoantibodies (Anti-I and anti-H)
Rouleaux
albumin agglutinating phenomena (anti-caprylate antibodies)
warm autoantibodies
non-reactive in all phases of antibody ID is considered to be what result?
negative
In antibody ID tubes that have what reaction should be reviewed?
negative
In atibody ID, antigens present in vial that is ________ are ruled out (crossed off).
negative
After the ruling out process of antibody ID antigens remaining match what?
pattern of reactivity
Antibodies are identified in antibody ID provided that it meets what three criteria?
vials containing antigen are positve
vials reacting have that anitgen
vials lacking antigen are negative
after the ruling out process in antibody ID, if more than one antigen remains there is a possibility of what?
multiple anitbodies
This is used when testing additional cells is necessary in antibody ID.
custom panel
In a custom panel, each additonal cell must ____ one of the antigens but _____ the other.
lack
possess
true or false
custom panels are tested in all phases.
true
if only one antigen remains in a custom panel, the serum has only ____ antibody.
one
if more than one antigen remains in a custom panel serum may have ______ antibodies.
multiple
this is done after antibody identification to determine if anitbody present is allo or auto.
phenotype patient red cells for corresponding antigen
in Antibody ID, patient should lack antigen unless what?
auto antibody (DAT positve)
antigens from donor cells.
what are the five special serological test procedures?
cold panel
adsorption
elution
enzyme
neutralization/inhibition
in a cold panel incubating at refigerator temperature is used to do what?
enhance reactions of cold agglutinins
what is the antibody that could mask other significant antibodies in a cold panel?
Anti-I
This is the removal of antibody from serum by reacting that antibody with the specific antigen on red cells.
Adsorption
Adsorption is used to __________ and __________ antibodies.
isolate
separate
In adsorption antigens ______ to corresponding antibody on red cells.
bind
In adsorption, an equal volume of serum and washed packed red cells, is centrifuged to separate serum and cells, red cells are saved and panel is preformed on adsorbed _______.
serum
what two things can cause inaccurate test results on adsorption?
incorrect ratio of serum to cells
incorrect incubation time or temperature
This is the removal and recovery of an antibody that is attached to a red cell surface.
elution
Elution is used to ________ anitbody, and _________ bound antibody.
liberate
recover
what are the four basic procedures for elution?
heat
ether
digitonin (acid)
lui-freeze thaw
in elution we are interestin in what antibodies?
antibodies bound to red cell membrane
how do you know the eluate is ready for antibody studies?
eluate will be hemolyzed
what two things can cause inaccurate test results on elution?
improper wasing
improper incubation time or temperature
This is used to pretreat red blood cells to modify antigens.
enzyme
Do enzyme modify anitgen or RBC's?
antigen
what are the four enzymes?
ficin
papain
bromelin
trypsin
enzyme enhances reactivity of what five antibodies?
Rh
Kidd
Lewis
P1
I
what are the three antigens destroyed by enzyme?
MNSs
Duffy
lutheran
what two things can cause inaccurate test results on enzyme?
destruction or enhancement of incorrect antibody
tested for incorrect antibody
this is used so antibodies are unable to react with antigens.
neutralization/inhibition
in neutralization/inhibition antibody binds to antigen substance, and antigen substance _______ reactivity of suspect antibody.
inhibits
What is used to neutralize lewis?
saliva of persons with Se genes
what is used to neutralize P1?
hydatid cyst fluid
pigeon egg reagent
what is used to neutralize Sda?
Urine (body fluids)
What two things can cause inaccurate test results in neutralization/inhibition?