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Tables of Contents for Blood Transfusion in Clinical Medicine
Chapter/Section Title
Page #
Page Count
PREFACE TO TENTH EDITION
xvii
2
PREFACE TO FIRST EDITION
xix
2
ABBREVIATIONS
xxi
CHAPTER 1 THE WITHDRAWAL OF BLOOD
1
36
Blood donation
1
4
The blood donor
1
2
Conditions which may disqualify a donor
3
2
Donation of whole blood
5
7
Effect on iron balance
5
1
Untoward effects during venesection
6
2
Autologous transfusion
8
4
Pre-operative collections
9
2
Red cell salvage
11
1
Directed donations
12
1
Exchange transfusion
12
2
Calculation of volume replaced
13
1
Indications for red cell exchange
14
1
Collection of blood to provide components
14
1
Preparation of platelet concentrates from single units
14
1
Plasmapheresis
15
3
Plasmapheresis vs. plasma exchange
15
1
Plasmapheresis using multi-unit bags
15
1
Use of cell separators
16
1
Effects of intensive plasmapheresis
17
1
Care of plasmapheresis donors
18
1
Harvesting of platelets, leucocytes and progenitor cells
18
8
Intermittent-flow cell separators
18
1
Continuous-flow cell separators
18
3
Collection of platelets by cell separators
21
1
Collection of granulocytes by leucapheresis
22
1
Collection of progenitor cells from peripheral blood and cord blood
23
1
Effects of repeated cytapheresis
24
1
Symptoms and signs in donors giving blood via cell separators
24
2
Therapeutic plasma exchange
26
7
Volumes of fluid exchanged
27
1
Rationale of plasma exchange
27
1
Vascular access
28
1
Replacement fluid
28
1
Indications for plasma exchange
28
3
Methods for the selective removal of plasma components
31
1
Side effects of plasma exchange
32
1
Therapeutic cytapheresis
33
1
Various clinical conditions
33
1
Leucapheresis and plasmapheresis in cancer immunotherapy
34
1
Extracorporeal photopheresis
34
1
Anticoagulants
34
3
Heparin
35
1
Citrate
35
2
FIGURES
1.1 Changes in Hb concentration following blood donation
7
1.2 Diagram of an intermittent-flow cell separator
16
1.3 Diagram of a continuous-flow cell separator with chambers
19
1.4 Diagram of a dual-channel continuous-flow cell separator
20
TABLE
1.1 Indications for therapeutic apheresis
30
CHAPTER 2 TRANSFUSION IN OLIGAEMIA
37
24
History
37
1
The response to blood loss
38
4
Circulatory effects of blood loss
38
1
Spontaneous restoration of blood volume
38
1
Oligaemic shock
39
1
Assessment of the degree of haemorrhage
39
3
Restoration of blood volume by transfusions or infusions
42
7
Physiological considerations in fluid replacement
42
1
Choice of intravenous fluid in oligaemia: use of whole blood
42
1
The need for plasma fractionation: use of albumin
43
1
Infusions of saline; crystalloid or colloid?
43
2
The rate of transfusion
45
1
Transfusion in burns
46
1
Massive transfusion
47
2
Transfusion in elective surgery
49
2
Pre-operative haemoglobin levels
49
1
Haemodilution
49
1
Cardiopulmonary bypass
50
1
Plasma substitutes
51
3
Clinical dextran
52
1
Gelatin
53
1
Hydroxyethyl starch
54
1
Comparisons between different plasma substitutes
54
1
Red cell substitutes
54
7
Haemoglobin solutions
54
4
Perfluorocarbons
58
1
Conclusions
59
2
FIGURE
2.1 Comparison of the oxygen-carrying capacity of blood, haemoglobin solution and two perfluorocarbons
59
TABLES
2.1 Regimens for fluid replacement in burned patients
47
2.2 Properties of haemoglobin preparations as red cell substitutes
55
CHAPTER 3 IMMUNOLOGY OF RED CELLS
61
55
Discovery of the blood group systems
61
2
Red cell antigens
63
8
The red cell membrane
63
3
Inheritance of red cell antigens
66
2
DNA techniques for determining genotypes
68
1
Inherited markers on blood cells and predisposition to disease
69
1
Effect of neoplastic change
69
1
Development of red cell antigens
70
1
Red cell antibodies
71
10
Characteristics of different immunoglobulins
72
6
Methods of separating and identifying immunoglobulins
78
1
Naturally occurring antibodies
79
2
Immune responses to red cell antigens
81
16
Antigen recognition
81
1
Primary and secondary responses
81
1
Classes of immunoglobulin produced
82
2
Individual differences in response
84
2
Monoclonal antibodies
86
1
Frequency of immune red cell alloantibodies
87
4
Relative potency of different antigens
91
2
Autoantibodies associated with alloimmunization
93
1
Immunological tolerance
94
1
Suppression of the immune response by passive antibody
94
2
Augmentation by passive antibody
96
1
Tolerizing effect of oral antigen
96
1
Lectins
97
1
Reaction between antigen and antibody
97
10
Combination of antigen and antibody
98
2
Factors involved in red cell agglutination
100
2
Elution of antibodies
102
1
Effects of antibodies on red cells
102
1
Interaction of antibody-coated red cells with monocytes, etc.
103
2
Cellular bioassays
105
2
Complement
107
9
Activation of the classical pathway
107
4
Activation of the alternative pathway
111
1
Other aspects of complement
112
1
Complement activation by blood group antibodies
113
3
FIGURES
3.1 Red cell membrane proteins
64
3.2 Structure of blood group-active proteins
66
3.3 Independent inheritance of ABO and Kell genes
67
3.4 IgG molecule
72
3.5 IgG subclass molecules
73
3.6 IgM molecule
74
3.7 Ig concentrations in first year of life
77
3.8 Carboxymethyl-cellulose chromatography: separation of some blood group antibodies from bulk of IgG
78
3.9 Interaction of monocyte Fc receptor (FcR) with IgGI bound to an antigen surface
103
3.10 Extracellular lysis of red cells by monocytes
104
3.11 Activation of the classical pathway of complement
108
3.12 Steps in the degradation of C3
110
3.13 Activation of the classical and alternative pathways of complement
111
TABLES
3.1 The first ten blood group systems discovered
61
3.2 Surface proteins of the red cell
65
3.3 Frequency of some blood group antigens in different races
68
3.4 Immunoglobulins
75
3.5 Naturally occurring red cell alloantibodies
81
3.6 Relative frequency of immune red cell alloantibodies other than anti-D
89
3.7 Response to K, Fy(a), Jk(a) and s in relation to Rh D compatibility of injected red cells
92
CHAPTER 4 ABO, LEWIS, AND P GROUPS AND Ii ANTIGENS
116
36
The ABO and Hh systems
116
16
Antigens of the ABO system
116
7
ABO phenotypes in different populations
116
1
Subgroups of A
116
2
Subgroups of B
118
1
Competition between A- and B-transferases
118
1
CisAB
118
1
B(A) and A(B)
119
1
H antigen on red cells
119
1
Numbers of A, B and H sites on red cells
119
1
O(h), A(h) and B(h) red cells
120
1
Development of A, B and H antigens
120
1
Weakening of A, B and H antigens in acute leukaemia
120
1
Acquired B antigen in A(1) subjects
121
1
Conversion of O cells to A or B
121
1
Conversion of B cells to O
121
1
Secretors and non-secretors
121
1
A, B and H substances in serum
122
1
A, B and H on leucocytes, platelets, other cells and bacteria
122
1
Antibodies of the ABO system
123
6
Anti-A and anti-B
123
1
Development of anti-A and -B
123
1
Monoclonal anti-A and -B
124
1
IgM, IgG and IgA anti-A and -B
124
2
Concentration and equilibrium constants
126
1
Crossreacting anti-AB
127
1
Anti-A(1)
127
1
Anti-A and -B as autoantibodies
128
1
Anti-H and anti-HI
128
1
Anti-A, -A(1) and -H lectins
128
1
Immune responses to A and B
129
3
Incompatible transfusions
129
1
Injections of human blood group substances
130
1
Pregnancy
130
1
Animal blood group substances
130
1
Clinical significance of response to vaccines
131
1
Ig classes in relation to immune responses
131
1
The Lewis system
132
6
Lewis groups of adults
132
2
Lewis groups of infants
134
1
Uptake of Lewis substances on to red cells
134
1
Antibodies of the Lewis system
135
3
The P(1) system and Globoside collection
138
3
Antigens
138
1
Antibodies
139
2
Anti-P(1)
139
1
Anti-PP(1) P(k)
139
1
Anti-P
140
1
Ii antigens and antibodies
141
1
Antigens
141
1
Anti-I and -i
142
1
Biosynthesis of P, HAB (ABH), Lewis and Ii
142
10
Chemistry of the P antigens
143
1
Chemistry of HAB, Ii and Lewis antigens
144
4
Structure of ABO, H, and Se genes
148
1
Chemistry of Ii antigens
149
3
FIGURES
4.1 Immune responses to group B blood and group A serum
129
4.2 Immune response to group A blood
129
4.3 Biosynthetic pathways of the P(k), P and P(1) antigens
143
4.4 Biosynthesis of Lewis and HAB antigens in secretions
146
4.5 Biosynthesis of P, HAB and Lewis antigens
147
4.6 Depicted products of the commonest ABO genes
149
TABLES
4.1 Antigens and antibodies in the ABO system
116
4.2 ABO groups in selected populations
117
4.3 Numbers of A, B and H sites on red cells
119
4.4 Lewis groups of adults
132
4.5 P(1) and related antigens and antibodies
138
4.6 Products of Se, Le, A and B genes in secretions
145
4.7 Amino-acid substitutions determining various ABO genes
148
CHAPTER 5 THE RH BLOOD GROUP SYSTEM (AND LW)
152
34
Rh antigens and genes
152
11
CDE nomenclature
152
1
Other nomenclatures
152
1
Rh genes
153
1
Rh phenotypes
153
1
Determination of genotype
154
1
Common phenotypes and genotypes
154
1
Weak D
155
1
Partial D
156
2
Antigens other than simple D, C, c, E and e
158
1
Red cells lacking some Rh antigens
159
1
Structures of Rh genes and proteins
160
2
Rh-related glycoproteins
162
1
LW
163
1
Rh antibodies
164
5
Naturally occurring antibodies
164
1
Immune Rh antibodies
165
3
Quantitation
168
1
Rh D immunization by transfusion
169
10
Response to large amounts of red cells
169
1
Response to small amounts of red cells
169
1
Responders and non-responders
170
1
Other aspects of primary Rh D immunization
171
3
Immunization by red cells present as contaminants
174
1
Secondary Rh D immunization
175
2
Immunization to Rh antigens other than D
177
1
Development of a positive direct antiglobulin test (DAT) following Rh D immunization
178
1
Suppression of Rh D immunization
179
7
Minimum amount of IgG anti-D which will suppress immunization
180
2
Possible augmentation by passive antibody
182
2
Treatment of inadvertent D-positive transfusion
184
2
FIGURES
5.1 Possible genetic background of two types of D(VI)
161
5.2 The Rh membrance complex
163
5.3 Cr survival of a second injection of D-positive red cells; responders and non-responders
170
5.4 Repeated Cr survival tests in a poor responder
171
5.5 Disappearance of anti-D despite restimulation
172
TABLES
5.1 Rh antigens in three nomenclatures
152
5.2 Frequencies of common haplotypes in selected populations
153
5.3 Epitopes of D detected in the different categories of partial D
157
5.4 Formation of anti-D after injections of red cells of different Rh genotypes
172
5.5 Experiment on the suppression of Rh D immunization
181
5.6 Administration of anti-D immunoglobulin to D-negative women inadvertently transfused with D-positive blood
182
CHAPTER 6 OTHER RED CELL ANTIGENS
186
29
The Kell and Kx systems
186
4
Antigens
186
2
Antibodies
188
2
The Duffy system
190
2
Antibodies
191
1
The Kidd system
192
1
Antibodies
193
1
The MNSs system
193
6
Antigens
193
3
Antibodies
196
3
The Lutheran system
199
2
Antibodies
200
1
The Di, Yt, Xg, Sc, Do, Co, Ch/Rg, Ge, Cr, Kn and In systems
201
7
Collections of antigens
208
1
Other antigens with a very high or very low incidence
208
2
HLA antigens on red cells
210
2
Membrane abnormalities involving red cell antigens
212
1
FIGURE
6.1 MN and Ss sialoglycoproteins
195
TABLE
6.1 Notations and frequencies of antigens in the Kell blood group system
187
CHAPTER 7 RED CELL ANTIBODIES AGAINST SELF ANTIGENS BOUND ANTIGENS AND INDUCED ANTIGENS
213
29
Red cell autoantibodies
213
1
Harmless cold
214
1
Harmful cold
215
6
Cold haemagglutin disease with autoimmune haemolytic anaemia
215
5
Cold (biphasic) autohaemolysins
220
1
Harmless warm
221
3
Positive direct antiglobulin test in apparently normal subjects
222
2
Harmful warm
224
6
Incomplete warm
224
1
Warm autohaemolysins and agglutinins
225
1
Cold and warm autoantibodies occuring together
226
1
Negative direct antiglobulin test in autoimmune haemolytic anaemia
226
1
Specificity
226
4
Antibodies against bound, or induced, antigens
230
3
Drug-induced immune haemolytic anaemia
230
2
Antibodies against other bound antigens
232
1
Lactose- or Glucose-treated red cells
233
1
Antibody against chemically altered red cells (the LOX antigen)
233
1
Polyagglutinability
233
6
T activation
233
3
Other kinds of polyagglutinability due to bacterial enzymes or bacteria
236
1
Tn red cells
237
1
NOR on inherited form of polyagglutinotion
238
1
Agglutinins for other normally hidden antigens
239
1
Antigens on enzyme-treated red cells
239
1
Antigens on stored red cells and freshly washed cells
239
1
Red cell agglutination not due to antibodies
239
3
Rouleaux formation
239
1
Other causes of non-specific agglutination
240
2
FIGURES
7.1 Survival of e + and e- red cells in a patient with auto-anti-e
227
7.2 Structure of T and Tn antigens
234
TABLES
7.1 Some cold autoantibodies
214
7.2 Presence or absence of red cell destruction in patients with incomplete warm autoantibodies of only one IgG subclass
225
7.3 Reactions of polyagglutinable red cells
235
CHAPTER 8 DETECTION OF THE REACTION BETWEEN RED CELL ANTIGENS AND ANTIBODIES
242
36
Need to wash cells
242
1
Red cell antigens
242
1
Quantitative difference between donors
242
1
Effect of storage
242
1
Factors affecting red cell-antibody interactions
243
3
Serum vs. plasma
243
1
Storage of sera
243
1
Potentiators
244
1
Proteolytic enzymes
244
2
Low ionic strength
246
1
Polycations
246
1
Monoclonal vs. polyclonal antibodies
246
1
Agglutination tests
246
4
Tests with untreated red cells in saline
247
1
Methods using proteolytic enzymes
247
1
The manual polybrene test (MPT)
248
1
Mixed field agglutination
249
1
Tests for lysis of red cells
250
1
The antiglobulin test
251
9
Antibodies required in antiglobulin reagents
251
1
Production of antiglobulin reagents
252
1
The reaction with bound immunoglobulin
252
3
The reaction with bound complement
255
1
Technique of antiglobulin tests
255
5
Automation of serological tests
260
2
Continuous flow systems
260
1
Systems using individual reaction wells
260
1
Microplate systems
260
1
Solid-phase systems
261
1
Quantitation of antibodies
262
2
Antibody titres
262
1
Use of the AutoAnalyzer
262
1
(125)I-labelled antiglobulin
262
1
ELISA
263
1
Flow cytometry
263
1
Relative sensitivity of different methods
263
1
Reference preparations
264
1
Selection of compatible blood
264
14
Determining recipient's ABO and Rh D groups
264
1
Error rates in blood grouping
265
1
Screening tests on recipient's serum
265
1
Selection of donor blood
266
1
Crossmatching tests
267
5
Errors in identifying donor or recipient
272
1
Omission of compatibility tests in desperate cases
273
1
Identification of antibodies
273
1
Isolation of antibodies
274
2
Investigations to determine the serological cause of a haemolytic transfusion reaction
276
2
TABLES
8.1 Optimal dilutions of an anti-human globulin serum
253
8.2 Effect of cell concentration and of using low-ionic-strength solution
256
CHAPTER 9 THE TRANSFUSION OF RED CELLS
278
39
The survival of transfused red cells
278
10
Estimation of survival by antigenic differentiation
279
1
Survival of transfused red cells in normal subjects
279
3
Estimation of survival using (51)Cr
282
3
Other methods of random labelling
285
1
Cohort labelling
285
1
Summary of normal survival of red cells
286
1
Rapid destruction of transfused red cells in certain haemolytic anaemias
287
1
Survival of transfused red cells in haemolytic anaemias due to an intrinsic red cell defect
287
1
Storage of red cells in the liquid state
288
12
History
288
1
Deleterious changes during storage
289
3
Effect of storage medium
292
1
Reversibility of storage changes
293
1
Best methods of storing red cells
294
1
Rejuvenation of stored red cells in vitro
295
1
Estimation of viability
295
3
Effect of storage temperature
298
1
Effect of plasticizers
299
1
Effect of irradiation
299
1
Storage of red cells in the frozen state
300
4
Substances that protect against damage by freezing
300
1
Use of glycerol
300
2
Methods suitable for routine use
302
1
Use of substances other than glycerol
303
1
Indications for frozen red cells
303
1
The transfusion of red cells in anaemia
304
13
Physiological compensations for anaemia
304
1
Effect of transfusion on the circulation
304
3
Effect of transfusion on red cell production
307
1
Transfusion in intermittent blood loss
307
2
Red cell transfusion in premature infants
309
1
Transfusion in chronic anaemia
310
1
Exchange transfusion in treating anaemia
311
1
Transfusion other than intravenously
312
1
Transfusion of red cell suspensions
312
5
FIGURES
9.1 Normal survival of transfused red cells
282
9.2 Post-transfusion survival of red cells stored in acid-citrate-dextrose
290
9.3 Disappearance of `non-viable' red cells from the circulation during the minutes after transfusion
296
9.4 Changes in haemoglobin concentration following transfusion in chronic renal insufficiency
305
9.5 (51)Cr red cell survival curve in a patient with chronic renal insufficiency
306
9.6 Effect of blood transfusion on red cell production
308
9.7 Estimation of red cell survival from packed cell volume changes following transfusion in aplastic anaemia
308
9.8 Rate of entry of red cells into the circulation following intraperitoneal transfusion
313
TABLES
9.1 Normal Cr survival and correction factors for conversion to true red cell survival
283
9.2 T(50)Cr, true red cell life span and relative rate of destruction
284
9.3 Survival of allogeneic and autologous red cells labelled with (51)Cr
286
9.4 Effect on red cell viability of incubation at 37(XXX)C before storage
297
CHAPTER 10 RED CELL INCOMPATIBILITY IN VIVO
317
41
Estimation of survival of incompatible red cells
317
1
Qualitative aspects of red cell destruction by alloantibodies
318
16
Predominantly intravascular destruction
318
2
Predominantly extravascular destruction
320
1
Relation between antibody characteristics and patterns of red cell destruction
321
1
Complement-binding IgM antibodies
322
3
Complement-binding IgG antibodies
325
1
Acquired resistance to complement-mediated destruction
326
2
Non-complement-binding IgM antibodies
328
1
Non-complement-binding IgG antibodies
328
3
Non-destructive antibodies
331
1
Relation between cellular bioassays and destruction in vivo
331
1
Effect of antigen content of red cells
332
1
Survival curves with more than one component
333
1
Quantitative aspects of red cell destruction by alloantibodies
334
15
Relation between number of antibody molecules per cell and rate of clearance
334
5
Destruction of relatively large volumes of incompatible red cells
339
5
Interpretation of tests made with small numbers of incompatible red cells
344
2
Attempts to inhibit the destruction of incompatible red cells
346
3
Destruction of transfused red cells without serologically demonstrable antibodies
349
5
Antibody demonstrable at some stage
349
1
Antibody never demonstrable
349
5
Destruction of recipient's red cells by transfused antibodies
354
4
Destruction of recipient's red cells by anti-A and anti-B
355
2
Destruction of recipient's red cells by anti-D
357
1
FIGURES
10.1 Mixing of injected, labelled red cells, as observed in samples from a peripheral vein
318
10.2 Rapid extravascular destruction beginning about 1 min after injection
319
10.3 Intravascular haemolysis of ABO-incompatible red cells
319
10.4 Haemoglobinaemia following extravascular destruction
321
10.5 Destruction of Le(a+b+) and Le(a+b-) red cells by anti-Le(a)
323
10.6 (a) Destruction of P(1)-positive red cells by anti-P(1) (warm and cold red cell suspensions)
324
10.7 Destruction of KK and KK red cells by complement-binding anti-K
325
10.8 Destruction by complement-binding anti-Fy(a)
326
10.9 Destruction of non-complement-binding anti-K
329
10.10 Destruction by anti-c
330
10.11 Examples of two-component curves of destruction caused by non-complement-binding antibodies
333
10.12 Destruction of D-positive red cells coated in vitro with various amounts of IgG anti-D (from a single donor, Avg.)
335
10.13 Examples from Fig. 10.12, with tangents to initial slopes
336
10.14 Destruction of red cells coated in vitro with similar amounts of complement-binding and non-complement binding antibodies
337
10.15 Destruction of a very small dose of D-positive red cells by 1 XXXg injected anti-D
338
10.16 Survival of successive injections of non-viable red cells in rabbits
340
10.17 Survival of one or more units of D-positive blood in three D-negative recipients
343
10.18 Survival of Lewis-incompatible red cells before and after injecting Lewis substances
347
10.19 Changes in titre of Lewis antibodies following injection of Lewis substances
347
10.20 `Collapse' type of curve
350
10.21 Unexplained shortening of red cell survival, starting at the time of transfusion
351
10.22 Destruction of all transfused red cells within 24 h in the absence of serologically demonstrable antibody
351
TABLES
10.1 Anti-D concentration in plasma at intervals after i.m. and i.v. injection of anti-D
338
10.2 Clearance of large and small amounts of D-positive red cells
341
10.3 Frequency of `collapse' curves after transfusion of 1-10 ml red cells
353
CHAPTER 11 HAEMOLYTIC TRANSFUSION REACTIONS
358
32
Intravascular and extravascular destruction
358
1
Intravascular destruction
359
13
Destruction by anti-A, anti-B and other rapidly lytic antibodies
359
1
Frequency of ABO-incompatible transfusions
360
1
Mortality rate associated with ABO-incompatible transfusions
361
1
Destruction of recipient's own red cells by transfused anti-A or anti-B
362
2
Complement activation and liberation of cytokines
364
1
Symptoms and signs associated with i.v. haemolysis
365
1
Disseminated intravascular coagulation associated with i.v. haemolysis
365
1
Renal failure following i.v. haemolysis
366
1
Management of suspected immediate haemolytic transfusion reaction associated with i.v. haemolysis
367
1
Haemolysis from osmotic effects
368
1
Transfusion of lysed blood
368
1
Haemoglobinuria following transfusion in patients with haemolytic anaemia
369
1
Clearance of haemoglobin from the plasma
369
3
Extravascular destruction
372
4
Destruction by antibodies which are non-lytic or only slowly lytic in vitro
372
1
Destruction by antibodies which fail to activate complement or activate it only to the C3 stage
373
1
Febrile reactions associated with e.v. destruction of antibody-coated red cells
374
1
Destruction of red cells rendered non-viable by storage
375
1
Delayed haemolytic transfusion reactions (DHTR)
376
9
Clinical features
377
3
Haematological and serological features
380
2
Antibodies involved
382
1
Frequency
383
1
Mortality
383
1
Haemolytic syndrome due to grafted lymphocytes
384
1
Investigation of haemolytic transfusion reactions
385
5
Methods of investigation
386
4
FIGURES
11.1 Transfusion of potent anti-A to group A recipient
363
11.2 Fate of haemoglobin liberated into the plasma
370
11.3 Destruction of non-viable stored red cells
375
11.4 Delayed haemolytic reaction due to anti-D
377
11.5 Delayed haemolytic reaction due to anti-Jk(a)
378
11.6 Delayed haemolytic reaction due to anti-A
379
CHAPTER 12 HAEMOLYTIC DISEASE OF THE FETUS AND THE NEWBORN
390
35
Definition
390
1
Transfer of antibodies from mother to fetus
391
1
IgG red cell antibodies causing haemolytic disease
391
1
Rh D haemolytic disease
392
23
Immunization by pregnancy: transplancental haemorrhage
392
5
Frequency of opportunities for Rh D immunization in pregnancy
397
1
Primary Rh D immunization caused by pregnancy in the absence of immunosuppressive therapy
398
2
Clinical manifestations of Rh D haemolytic disease
400
1
Routine tests to detect Rh D immunization
401
1
Antenatal assessment of severity
402
4
Assessment of severity in the newborn infant
406
1
Antenatal treatment of haemolytic disease
406
3
Postnatal treatment of haemolytic disease
409
1
Suppression of Rh D immunization
410
4
Changes in incidence and mortality of haemolytic disease
414
1
The most important steps in preventing Rh D immunization by pregnancy
414
1
Haemolytic disease due to antibodies other than anti-D anti-A and anti-B
415
3
Rh antibodies other than anti-D
415
1
Kell antibodies
416
1
Other antibodies
417
1
ABO haemolytic disease
418
7
Incidence
418
2
Serological findings in mothers
420
1
Serological findings in infants
420
2
Haematological findings
422
1
Management
422
2
Haemolytic disease due to anti-H
424
1
FIGURES
12.1 Extent of transplacental haemorrhage at time of delivery
396
12.2 Rate of fall of haemoglobin concentration in mild haemolytic disease
400
12.3 Spectral absorption curve of pigmented amniotic fluid
404
12.4 Relation between OD 450 of amniotic fluid and severity of haemolytic disease
404
12.5 Haemoglobin concentrations at 17-40 weeks of gestation in fetuses with HDN due to anti-D
405
12.6 Masking of anaemia on the first day of life
407
12.7 Accidental intramuscular injection of anti-D to a D-positive infant
407
TABLES
12.1 Controlled trials of anti-D dosage
411
12.2 Effect of ABO incompatibility on cord blood findings
418
CHAPTER 13 IMMUNOLOGY OF LEUCOCYTES, PLATELETS AND PLASMA COMPONENTS
425
34
The HLA system
425
11
The function of the HLA system
425
1
HLA genes and antigens
425
7
HLA antibodies
432
1
HLA and tissue grafting
433
3
Tests for HLA alleles, antigens and antibodies
436
1
Other antigens found on leucocytes
437
4
Antigens found only on granulocytes
437
2
Neonatal alloimmune neutropenia
438
1
Tests for granulocyte antibodies and antigens
439
1
Antigens found only on lymphocytes
440
1
Antigens found only on monocytes
441
1
Antigens on platelets
441
15
Antigens shared with other cells
441
1
Antigens found on platelets and not on other blood cells
441
3
Alloimmunization to platelet antigens
444
1
Prevention of alloimmunization against HLA class I antigens
445
2
Management of alloimmunized patients
447
2
Neonatal/alloimmune thrombocytopenia
449
2
Tests for platelet alloantibodies
451
3
Autoimmune thrombocytopenia
454
2
Serum protein antigens and antibodies
456
3
IgG
456
1
IgA
457
1
Determinants on light chains
458
1
Tests for immunoglobulin allotypes
458
1
FIGURES
13.1 DNA of the class I and class II chromosomal regions
427
13.2 Structure of HLA class I and class II molecules
428
13.3 Crystallized structure of a class I HLA molecule, showing antigen-binding site
428
13.4 Genomic organization of the HLA-DR region and encoded products (specificities)
430
13.5 Principle of the MAIPA assay
453
TABLES
13.1 Antigens found only on granulocytes
438
13.2 Alloantigens found on platelets and not on other blood cells
442
13.3 Results obtained with polyster flat bed filters
446
CHAPTER 14 THE TRANSFUSION OF PLATELETS, LEUCOCYTES, HAEMOPOIETIC CELLS AND PLASMA COMPONENTS
459
28
Transfusion of platelets
459
7
Survival of platelets in vivo
459
3
Storage of platelets in the liquid state
462
2
Storage of platelets in the frozen state
464
1
Indications for platelet transfusions
465
1
Some other aspects of platelet transfusions
466
1
Transfusion of leucocytes
466
2
Storage of granulocytes
467
1
Indications for granulocyte transfusions
467
1
Transfusion of haemopoietic cells
468
2
Peripheral-blood-derived progenitor cells
469
1
Cord blood progenitor cells
469
1
Haemopoietic growth factors
470
2
Erythropoietin
470
1
Colony stimulating factors
471
1
Thrombopoietin
472
1
Transfusion of plasma components
472
15
Fresh-frozen plasma
473
2
Albumin
475
1
Fibrinogen
476
1
Factor VIII
476
3
Treatment of Factor IX deficiency
479
1
Prothrombin-complex concentrates
480
1
Use of some other coagulation factors
480
1
C1 esterase inhibitor
481
1
Immunoglobulins
481
4
Antithrombin III
485
1
Fibronectin
485
1
XXX1-antitrypsin
485
2
FIGURES
14.1 Survival of (111)In-labelled platelets
461
14.2 Fractionation scheme
474
CHAPTER 15 SOME UNFAVOURABLE EFFECTS OF TRANSFUSION
487
23
Reactions due to leucocyte antibodies
487
6
Febrile reactions
487
2
Role of anti-HLA
489
1
Transfusion-related acute lung injury (TRALI)
489
1
Crossmatching of leucocytes
490
1
Removal of leucocytes from red cell concentrates
491
1
Effect of drugs in suppressing febrile reactions
491
1
Graft versus host disease
492
1
Reactions due to platelet antibodies
493
3
Febrile reactions
493
1
Post-transfusion purpura
493
2
Effect of transfusing platelet alloantibodies
495
1
Reactions due to transfused proteins
496
4
Plasma
496
1
IgA
496
2
Other immunoglobulins
498
1
Atopens
499
1
Prophylaxis and treatment of allergic reactions
499
1
Some non-immunological reactions
500
4
Effects of vasoactive substances
500
1
Bacterial pyrogens
500
1
Endogenous pyrogens
500
1
Effects of ice-cold blood
500
1
Citrate toxicity
501
2
Potassium toxicity
503
1
Transfusion of extraneous matter
504
3
Air embolism
504
1
Particulate matter
504
2
Toxic substances in plastic
506
1
Thrombophlebitis
507
1
Transfusion haemosiderosis
507
3
FIGURES
15.1 Effect of transfusing `buffy coat' to a patient with leucoagglutinins
488
15.2 Febrile transfusion reactions
489
CHAPTER 16 INFECTIOUS AGENTS TRANSMITTED BY TRANSFUSION
510
48
Screening assays
510
3
Hepatitis B virus (HBV)
513
7
HBV-associated antigens and antibodies
514
2
Screening tests for HBsAg in donations
516
1
Transmission of HBV
517
3
Hepatitis delta virus (HDV)
520
1
Hepatitis C virus (HCV) and Non-A, non-B hepatitis (NANBH)
520
4
NANBH
520
1
Identification of HCV
520
2
Clinical course of HCV
522
1
Tests for HCV antibodies
522
1
Screening and confirmatory assays for HCV antibodies
522
1
Transmission of HCV
523
1
Residual risk of post-transfusion hepatitis
524
1
Hepatitis due to HEV and to GB viruses (GBV)
524
1
Hepatitis A virus (HAV)
525
1
Human immunodeficiency viruses (HIV)
525
11
Retroviruses and blood transfusion
525
1
HIV-1 and HIV-2
526
1
Course of HIV infection
527
2
Transmission of HIV by blood transfusion
529
3
Prevention of transfusion-transmitted HIV infection
532
4
Human T-cell leukaemia viruses, types I and II
536
3
HTLV-I and -II
536
2
HTLV and blood transfusion
538
1
Cytomegalovirus (CMV)
539
3
Characteristics of the virus and of CMV infection
539
1
Prevalence of anti-CMV
539
1
Transmission of CMV by transfusion
540
2
Other viruses
542
2
Epstein-Barr virus (EBV)
542
1
Other herpes viruses
543
1
Human parvovirus B19
543
1
Methods of inactivating viruses
544
2
Plasma and plasma products
544
1
Cellular components
545
1
Creutzfeld-Jakob disease
546
1
Bacteria
546
6
Treponema pallidum
546
2
Brucella abortus
548
1
Miscellaneous
548
1
Exogenous and endogenous bacteria and bacterial products as contaminants
549
3
Malaria
552
3
Transmission of malaria by blood transfusion
552
3
Trypanosoma cruzi
555
3
Other parasites
556
2
FIGURES
16.1 Microbiological assays
510
16.2 The polymerase chain reaction
513
16.3 The virus (Dane particle) of hepatitis B and its constituents
514
16.4 The hepatitis C virus (HCV) genome and HCV antigens
521
16.5 Structure of HIV-1
527
16.6 Sequence of events following HIV infection
528
APPENDICES
558
9
1 Preparation of platelet concentrates
558
1
2 Estimation of red cell volume ((99m))Tc, (111)In and (51)Cr)
559
1
3 Estimation of plasma volume ((125)I-labelled albumin)
560
1
4 Derivation of blood volume from red cell volume or plasma volume
561
1
5 Prediction of normal blood volume from height and weight
561
1
6 Estimation of red cell survival using (51) Cr
561
1
7 Red cell survival methods based on antigenic differences between donor and recipient
562
1
8 Citrate solutions for storage of whole blood
562
1
9 Red cell additive solutions
563
1
10 Citrate solutions used in apheresis and plasma exchange
563
1
11 Glycerol solutions for frozen storage of red cells
563
1
12 Acid-elution method for detection of fetal red cells
564
1
13 Technique of exchange transfusion in newborn infants, using the umbilical vein
565
2
REFERENCES
567
146
INDEX
713