What does a DAT detect?
DAT presentation in WAIHA
Positive; IgG and/or C3
This reaction is immediate at the start of a transfusion. The patient also experiences fever, chills, pain at infusion site, hemoglobinemia and uria.
Hemolytic Transfusion Reaction
(occurs due to ABO incompatible and antigen/antibody reactions)
HLA matching should occur in these situations:
When is a DAT performed?
HDN, transfusion reaction, WAIHA, potentially antibody workups
Antibody associated with Paroxysmal cold hemoglobinuria (PCH)
Anti-P
Mom= O neg
Baby= B pos
Baby has a positive DAT and is showing jaundice. This is an example of this type of HDN
Prevention: Mom receives RhIg to prevent sensitization.
Severe anaphylactic reactions can occur in IgA deficient patients when transfused. This is the recommended type of product for future transfusions
What are washed products?
Where are HLA Class I antigens found?
Found on platelets and virtually all nucleated cells
(MHC on Chromosome 6)
What is the next step if the poly DAT is positive?
Perform a DAT Battery (IgG, C3, saline control)
Antibody associated with infection mononucleosis
anti-i
This type of HDN can occur at any pregnancy
ABO
(Rh after 1st pregnancy become sensitized)
Irradiation can help prevent this type of reaction
GVHD
Indicated in severe immunocompromised population and from a direct blood product from a relative.
HLA genes are present more often then expected
What is Linkage Disequilibrium ?
True or False- There is a small percentage of the population walking around with a positive DAT (no clinical significance)
True
What is a Donath Landsteiner test?
(Performed in PCH situations)
These antibodies are most commonly associated with HDN
What are Anti-D and Anti-K
A TRALI reaction occurs due to this reason:
Donor WBC antibodies react w/ patient WBC
(Aggregation of WBCs leads to blockage of pulmonary microvasculature)
HLA antibodies can be implicated in these transfusion reactions
FNTHRs, TRALI, GVHD
This blood group system can fix complement and can cause a positive DAT- IgG and Complement
What is the Kidd blood group system?
True or False Auto immune hemolytic anemias can be warm and cold
True
In hydrops fetalis, Unconjugated (“indirect”) bilirubin can reach toxic levels. This is called:
Kernicterus
Shaking and Chills and a >2C rise in temperature can be signs of this reaction
What is Sepsis?
These enes for HLA- DR, DP, and DQ are located on which HLA Class?
What is Class II?
Class I: -A, -B, -C