MLT 260 - Immunohematology Last Date of Approval: Spring 2021
4 Credits Total Lecture Hours: 30 Total Lab Hours: 60 Total Clinical Hours: 0 Total Work-Based Experience Hours: 0
Course Description: Blood transfusion science is presented including the inheritance of blood groups, donor procedures, quality control, antibody testing, and crossmatching of blood. Transfusion safety and federal regulations are also included. This course will help students gain scientific literacy vital to making important life decisions. This course will help students develop the hands-on and critical thinking skills needed to function as an entry-level medical laboratory technician and satisfies curriculum requirements of the National Accrediting Agency for Clinical Laboratory Sciences.
Prerequisites: BIO 173 , MLT 171 Mode(s) of Instruction: traditional/face-to-face
Credit for Prior Learning: There are no Credit for Prior Learning opportunities for this course.
Course Fees: Course Materials: $35.00
Common Course Assessment(s): None
Student Learning Outcomes and Objectives: Student Learning Outcomes:
- Demonstrate general methodologies used in a blood bank including proper specimen collection and identification, accurate testing, recording and interpretation of results, safety, proper equipment use and maintenance.
- Describe the properties of major human blood groups and their antibodies as they apply to testing and identification techniques.
- Identify processes that are required by regulatory agencies such as quality control and quality assurance measures, including proper preparation and storage requirements for blood products and donor history and physical examination for autologous and allogenic donations.
- Describe clinical conditions and testing associated with immunohematologic conditions including HDFN, hemolytic anemias and adverse effects of transfusion and describe the clinical benefits derived from administration of blood products to treat these conditions.
- Demonstrate professionalism by following written and verbal instruction, responding positively to suggestions, working well with peers and instructors, and developing a commitment to quality work by repeating assignments if necessary.
Unit Objectives:
Unit 1: Immunology & Genetics
1. Diagram basic Ig structure and compare IgG & IgM molecules.
2. Describe the direct antiglobulin test including technique, sources of error, and application.
3. Explain the significance of using Coombs control cells.
4. Describe the indirect antiglobulin technique including technique, application, and source of error.
5. Differentiate between sources of false positive and false negative antiglobulin results.
6. List tests in the blood bank and the source of antibody and antigen in each.
7. Define select terms associated with the immunohematology lab.
8. Describe the source and uses of reagents used in ABO Rh and AHG testing.
9. List the composition and use of reagent red blood cells.
10. Describe the principle of a gel test.
11. Define select terms associated with blood group genetics.
12. Distinguish homozygous from heterozygous for a blood group system.
13. Use a Punnett Square to determine characteristic of possible offspring.
14. Construct a pedigree chart using appropriate symbols.
15. Calculate the probability of finding compatible RBC units using appropriate symbols.
Unit 2: Red Blood Cell Groups, ABO and Rh
1. Discuss the discovery of the ABO blood group system and its importance in modern blood transfusion and transplantation practices.
2. Name the most and least common ABO phenotypes in Caucasians.
3. Interpret ABO and Rh typing results.
4. Describe the inheritance of RBC and soluble A, B, and H antigens and the interaction of the A, B, H, Se, and Z genes.
5. Discuss the subgroups of A and B and how they are distinguished.
6. Describe the ABO antibodies according to 3 characteristics.
7. Describe the different causes, testing patterns, and methods for resolving ABO discrepancies.
8. Recite and convert between the Rh nomenclatures.
9. Describe the Fisher-Race and Wiener theories of genetic control of the Rh blood group system.
10. Describe the variations of inheritance of the D antigen.
11. List the other alleles inherited at the Rh loci.
12. List the characteristics and reactivity of Rh system antibodies.
13. Discuss the selection of red cells and plasma for safe transfusion.
Unit 3: Other Blood Groups
1. Discuss the genetics and phenotype frequency of antigens of the Kell blood group system.
2. Summarize the clinical significance and detection methods for antibodies of the Kell system.
3. List the four phenotypes and frequency of antigens of the Duffy blood group system.
4. Describe the genetics and biochemistry associated with Duffy antigens.
5. Summarize the clinical significance and detection methods for antibodies of the Duffy system.
6. Describe the biochemical and serological characteristics of antigens and antibodies of the Kidd system.
7. Describe the biochemical and serologic characteristics of the Lutheran system.
8. Name the major antigens in the Lewis blood group system and their phenotype frequency and development.
9. Relate the inheritance of the Le, Se, and H genes to the presence of Lewis antigens on RBC’s and in secretions.
10. Summarize the antibodies of the Lewis system including clinical significance and testing methods.
11. Describe the biochemistry and development of the Ii antigens.
12. Summarize the antibodies of the Ii system including clinical significance and detection.
13. Describe the common phenotypes in the P blood group system including genetics and biochemistry.
14. Summarize antibodies of the P blood group system including clinical significance and detection.
15. Describe the genetics and biochemistry of the MNS blood group system antigens.
16. Summarize the clinical significance, detection methods, and dosage effect of antibodies in the MNS system.
Unit 4: Blood & Blood Components
1. List information necessary when registering a donor.
2. Describe the medical health history criteria for the protection of a donor.
3. Describe the medical health history criteria for the protection of the recipient.
4. Describe the physical examination requirements of a suitable donor.
5. Explain the donor phlebotomy procedure.
6. Discuss the autologous procedure, including required testing.
7. Define other types of autologous donation.
8. List the testing requirements for donor blood.
9. Compare the shelf life of products collected in different types of collection systems.
10. Discuss the types of red blood cell preservation techniques used in blood banks.
11. Discuss use, labeling, storage, temperature, and shelf life for whole blood, packed red blood cells, washed red blood cells, and frozen deglycerolized red blood cells.
12. Discuss use, labeling, storage temperature, and shelf life of plasma components.
13. Discuss use, labeling, storage temperature, and shelf life of other blood products.
14. Explain procedures to ensure safe transport of blood products from one facility to another.
Unit 5: Transfusion Practices
1. Define select terms associated with antibody detection.
2. Discuss the purpose of reagent red cells in antibody screens and antibody identification.
3. Interpret antibody reactions in a panel by using the “cross out” method.
4. Describe resolution of all antibody problems other than those due to a single alloantibody.
5. Explain processes necessary to the identification of autoantibodies.
6. List techniques to aid in antibody identification.
7. Describe the type of sample required for pretransfusion testing.
8. Describe measures involved in serologic blood bank testing.
9. Define two types of crossmatches and describe incompatible crossmatch situations and their cause.
10. Describe the limitations of major crossmatches.
11. List the criteria that are essential when administering uncrossmatched blood in an emergency situation.
12. Describe regulatory requirements for blood issue.
Unit 6: Clinical Conditions
1. Describe signs, symptoms, causes, and investigation of immediate hemolytic reactions (intravascular).
2. Describe signs, symptoms, and prevention of delayed hemolytic transfusion reactions.
3. Describe signs, symptoms, and treatment of immediate nonhemolytic transfusion reactions.
4. List causes of pseudohemolytic reactions.
5. Summarize the cause and signs of a bacterial reaction.
6. Define miscellaneous reactions to blood or blood products.
7. List the specific AABB requirements for investigation of adverse reactions.
8. Explain the cause and effects of HDFN.
9. Describe the physiologic issues and lab findings in HDFN.
10. Select the antenatal and postnatal tests for detecting HDN and fetal-maternal hemorrhage.
11. Determine patients for RhIg, including dosage, time tables, and serologic response.
12. Discuss treatment options for babies in cases of HDN.
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