Clinical and Laboratory Effects on ABO and RhD Typing Results

Explain the clinical and laboratory effect on the results of ABO and RhD typing:

Blood typing (ABO and RhD typing), is the process of classification of blood type, based on absence and presence of inherent antigenic substances and antibodies on the surface of RBC [Red Blood Cells] (Noiphung et al. 2015). There are two important blood group system such as ABO and Rh, that is associated with four blood groups such as A, B, AB and O [with + and – denoting RH factors]. in laboratory the blood typing test is done in two process ABO typing and rhesus typing process. Students seeking healthcare dissertation help may explore the implications of blood typing in transfusions and organ donations, emphasising its critical role in medical practice.

ABO testing:

Forward testing:

In this type of testing, blood is tested against two solution in the clinical laboratory. On two solutions has antibodies against B antigen and other has the antibodies against th A antigen. The blood type is determined through analysing the way in which the antibodies react with antigens (Songjaroen and Laiwattanapaisal, 2016.). If one has A antigen it will react with A antibody and if it has B antigen then the blood will react with B antigen. If blood does not react with any of the antibodies, then the blood group is O.

Rhesus typing: (RhD typing)

This typing is done in order to determine the the rhesus blood type. In laboratory, an RBC sample is mixed with lab solution containing antibodies to RhD. If reaction occurs with the RhD then the blood is Rh+ and if the blood does not react with the RhD then it is Rh-.

Describe the principle and practice of investigating blood group anomalies in for example paediatric, eldely ans ans immunosuppressed patient group

Blood group anomalies is any abnormalities in blood group that is investigated in laboratory with applying proper clinical methods. ABO blood group is assigned based con Ag on the RBC and verified by determining absence of corresponding Ab serum. However, the overall process is nor hassle free (Nilghaz et al. 2016). Discrepancy can result due to clinical and biological reasons. Principles and practices that are applied during investigating blood group anomalies are as follows:

Clinicians need to conduct repeat test in order to rule out the ommon source of errors in the blood typing and detection process

Clinicians need to determine any errors in during mixing up of sample

They should check that there is any failure of negligence in adding reagents or serum

Clinician needs to determine that whether any out-dates as well as contaminated agents are used during blood typing process

They need to detect whether there is any errors in fibrin clot formation

Clinicians need to check whether there is background d haemolysis which is associated with restricting shown roper result of blood testing

Checking the concentration of cell, to determine whether it is too heavy or too light

Clinicians would check whether the lab assistants have followed the manufacturers instruction during conducting the bod typing tests.

Determine that whether there are any errors in the uncalibrated centrifugation.

Explain the principles and practices of investigating blood groups anomalies in following patients’ groups

a. Haemopoietic stem cell transplantation

Principles that are followed during detecting anomalies in this process are as follows:

Checking that there is any errors during the process of deriving stem cells from bone marrow, umbilical cord or peripheral blood (Mujahid and Dickert, 2016)

Clinicians need to ensure that all the instructions are maintained in proper manner in using allogenic or autologous process

Clinicians need to check errors in autologous process stem cells that are collected from patient own cells

b. The presence of cold agglutination

In order to detect whether there is cold agglutination in the blood, clinicians need to follow the principles;

They need to check the concentration of circulating sensitive antibodies in the blood, such as IgM and the autoantibodies (Songjaroen and Laiwattanapaisal, 2016) (Nilghaz et al. 2016).

Clinicians ned to check the temperature at which antibodies bind and react with RBC.

In case of, cold agglutination, RBC react with antibodies at very low temperature, such as at 28-31 0C.

c. Transfusions reactions

Transfusion reaction is the harmful reaction of body’s immune system with donor blood.

In order to detect this condition, blood and urine of patient would be detected in order to determine eth kidney failure or damaged BRC that are associated with harmful reaction of body’s immune process with the donor blood

d. Potential wrong blood in tube

Wrong blood in tube means blood that is in the tube on the name of patient is not actually of that patient’s blood (Casals‐Terré et al. 2019).

On detecting the wrong blood, clinicians use Machine Learning -Based Multianalyte Delta Check.

In this process blood specimen is collected from patient that is mislabelled with another person’s blood

Then the overall blood testing is done and the result is analysed with the previous result in order to resolute the mislabelling issues

Explain the scientific basis and significance of ABO subgroups and weak D/ partial D types in patients

ABO blood group is the classification of human blood, that assist to determine eth type of blood based on presence and absence antibodies and antigens in the blood.

ABO groups system has four subgroups such as A, B, O and AB. Due to presence and absence four types of antigens, there are four types of blood groups such as A group, in which only, A-antigen is present, B-group, in which only B-antigen is present, AB-group in which both the A and B antigens are present and O-group, in which both the A and B antigens are absent (Mujahid and Dickert, 2016). People who have D anti9gens in their blood, they are RhD positive, and who do not have D antigen in n their blood are RhD negative.

ABO are important di9rntg the blood transfusion process, in which blood is transferred to patient’s body. if patient’s immune system is incompatible with donor blood then it causes severe intravenous clumping as well as serious health issues. Therefore, clinicians and health professionals have to analyse the subgroup of blood in order to determine that which ABO subtype can be transferred to patient body for his or her recovery.

Partial or reduce D type patient:

There are two RH genes such as RHE and RHD which decodes two red cell membrane protein including Cc/Ee and D respectively. However, sometimes, point mutation occurs in these two genes in which the genetic rearrangement and exchanges occurs between them. Due to this mutations, new antigens are produced in the Rh blood group system that makes expression of D protein weak or reduced.

Describe how the limitations of the testing when using rare antisera

Rare antisera is monoclonal reagent that is used in order to determine the rare antigens in human RBC (Henderson et al. 2018). Limitations of this process, is unavailability of proper number of rare antisera. For example, Serotonin, is one of the most common anti sera which is used in clinical laboratory in determining the rare antigens in RBC. Sometimes, clinicians are unable to have sufficient amount of Serotonin which is needed to give the accurate results.

Explain how to interpret anomalous grouping results in the light of clinical and laboratory circumstances and how to select the safest component for patient

In order to interpret the anomalous groping in light of the clinical and laboratory circumstances, clinicians need to follow the below principles

Clinician needs to determine that whether any out-dates as well as contaminated agents are used during blood typing process

They need to detect whether there is any errors in fibrin clot formation

Clinicians need to check whether there is background d haemolysis which is associated with restricting shown roper result of blood testing

Checking the concentration of cell, to determine whether it is too heavy or too light (Songjaroen and Laiwattanapaisal, 2016.)

Clinicians would check whether the lab assistants have followed the manufacturers instruction during conducting the bod typing tests.

Determine that whether there are any errors in the uncalibrated centrifugation.

Describe the criteria trigger factors for further testing or referral before a blood group can be assigned

In order to assign the blood group different criteria and factors need to analyse such as:

Laboratory assistants and clinicians need to analyse that which Antigens presents in red blood cells. If there is only A-antigen then the blood type is A, if there is B antigen in the RBC, then the blood type is B (Noiphung et al. 2015). on the other hand, if the ria neither A nor B antigens, then the blood group is O and if there is both types of antigens then the blood group is AB.

They need to analyse which Rh factors i9s present in the RBC. If it is with D protein, then the Blood group is positive and if it is without D protein then the bod group is negative.

Demonstrate awareness of local policies and procedures and national guidelines covering all of the above

In the UK, National Health Service [NHS] and National Institute of Care and Excellence [NICE] has set following principle for accurate process of blood transfusion or blood typing:

Clinicians need to be highly skilled and professionals in order to avoid any type of abnormalities during blood typing (Nilghaz et al. 2016)

Laboratory assistant would be efficient in collecting stem cells, bloods and antigens from patients.

Clinicians needs to ensure that all during transfusion process, health professional would choose the blood type that will be compatible to patient’s immune system.

Reference list:

Casals‐Terré, J., Farré‐Lladós, J., Zuñiga, A., Roncero, M.B. and Vidal, T., 2019. Novel applications of nonwood cellulose for blood typing assays. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 107(5), pp.1533-1541.

Henderson, C.A., McLiesh, H., Then, W.L. and Garnier, G., 2018. Activity and longevity of antibody in paper-based blood typing diagnostics. Frontiers in chemistry, 6.

Mujahid, A. and Dickert, F., 2016. Blood group typing: from classical strategies to the application of synthetic antibodies generated by molecular imprinting. Sensors, 16(1), p.51.

Nilghaz, A., Ballerini, D.R., Guan, L., Li, L. and Shen, W., 2016. Red blood cell transport mechanisms in polyester thread-based blood typing devices. Analytical and bioanalytical chemistry, 408(5), pp.1365-1371.

Noiphung, J., Talalak, K., Hongwarittorrn, I., Pupinyo, N., Thirabowonkitphithan, P. and Laiwattanapaisal, W., 2015. A novel paper-based assay for the simultaneous determination of Rh typing and forward and reverse ABO blood groups. Biosensors and Bioelectronics, 67, pp.485-489.

Qadir, M.I. and Khursheed, S., 2019. How blood grouping impart affinity for badminton game.

Songjaroen, T. and Laiwattanapaisal, W., 2016. Simultaneous forward and reverse ABO blood group typing using a paper-based device and barcode-like interpretation. Analytica chimica acta, 921, pp.67-76.

Songjaroen, T., Primpray, V., Manosarn, T., Khumchanta, W., Sakuldamrongpanich, T., Kulkeratiyut, S. and Laiwattanapaisal, W., 2018. A simple and low-cost portable paper-based ABO blood typing device for point-of-care testing. Journal of Immunoassay and Immunochemistry, 39(3), pp.292-307.

Xu, T., Zhang, Q., Fan, Y.H., Li, R.Q., Lu, H., Zhao, S.M. and Jiang, T.L., 2017. Quantitative and multiplexed detection for blood typing based on quantum dot–magnetic bead assay. International journal of nanomedicine, 12, p.3347.