LectureLecture

Blood Blood TransfusionTransfusion

Reader: R. Ya. KushnirReader: R. Ya. Kushnir

Blood is fluid substance of organism, Blood is fluid substance of organism, which executes the most important which executes the most important functions. On this you are acquaint functions. On this you are acquaint in the course of physiology. However in the course of physiology. However with this tissues in the clinic you will with this tissues in the clinic you will be meet several on especial, because be meet several on especial, because with old - and on today it presents a with old - and on today it presents a riddle, but attempts its use for the riddle, but attempts its use for the treatment stay tempting, because in treatment stay tempting, because in number of events are magic number of events are magic efficient.efficient.

The idea of replacement of lost blood The idea of replacement of lost blood appeared in XIV-XV century. But, as appeared in XIV-XV century. But, as Harvey described the anatomy-Harvey described the anatomy-physiological bases of circulation physiological bases of circulation only in 1728, therefore transfusion only in 1728, therefore transfusion of blood could not be carried out of blood could not be carried out before this time.before this time.

In 1697 Merklin and in 1682 In 1697 Merklin and in 1682 Attenmuller reported the results of Attenmuller reported the results of the observation, according to which the observation, according to which at mixing blood of two individuals at mixing blood of two individuals agglutination sometimes occured. agglutination sometimes occured. That specifies incompatibility of That specifies incompatibility of blood. Despite of obscurity of this blood. Despite of obscurity of this phenomenon, in 1820, Blandel phenomenon, in 1820, Blandel (England) successfully carried out (England) successfully carried out transfusion of blood from man to transfusion of blood from man to man.man.

However, agglutination and However, agglutination and coagulation of blood prevented the coagulation of blood prevented the application of blood transfusion. application of blood transfusion. After opening blood groups by After opening blood groups by K.Landsteiner and Y.Yansky (1901-K.Landsteiner and Y.Yansky (1901-1907) these obstacles were 1907) these obstacles were eliminated. Hustin in Brussels eliminated. Hustin in Brussels carried out the first successful use of carried out the first successful use of sodium citrate as an anticoagulant sodium citrate as an anticoagulant for stored blood in 1914 at St. Jean for stored blood in 1914 at St. Jean Hospital. Hospital.

From a moment of blood From a moment of blood transfusions and before our days transfusions and before our days hemotrunsfusiology passed complex, hemotrunsfusiology passed complex, time tragic, way. This is stipulated time tragic, way. This is stipulated by an absence of knowledge on that by an absence of knowledge on that length of time-knowledge in length of time-knowledge in anatomy, physiology, knowledges anatomy, physiology, knowledges about the role of blood in the about the role of blood in the organism of person. organism of person.

Beginning of current age was Beginning of current age was signified by the opening of blood signified by the opening of blood types in 1901 by Landshteiner (three types in 1901 by Landshteiner (three groups) and 1907 Yanskiy (fourth groups) and 1907 Yanskiy (fourth group). Studied mechanisms of group). Studied mechanisms of action transfuse blood action transfuse blood (Filomalfiyskiy), condition of its (Filomalfiyskiy), condition of its keeping (1914 Yurevich and keeping (1914 Yurevich and Rozengard - had offered a citrate of Rozengard - had offered a citrate of Na), sources of getting blood (1919 Na), sources of getting blood (1919 Shamov- a putrid blood). Shamov- a putrid blood).

Blood type - is genetic stipulate sign Blood type - is genetic stipulate sign and showing by the combination of and showing by the combination of antigens, which basing in forming antigens, which basing in forming elements and plasma of blood. As far elements and plasma of blood. As far back as 1901 years Lanshteyn - a back as 1901 years Lanshteyn - a Viennese physician had opened such Viennese physician had opened such phenomena as agglutination, having phenomena as agglutination, having separated people on 3 groups, he had separated people on 3 groups, he had installed that under the first blood installed that under the first blood type a serum agglutinating with type a serum agglutinating with erythrocytes of II and III groups. erythrocytes of II and III groups.

In II blood type a serum is In II blood type a serum is agglutinating erythrocytes of III agglutinating erythrocytes of III groups, but III group agglutinating groups, but III group agglutinating erythrocytes of II group. Later erythrocytes of II group. Later Yanskiy had opened IVth group. Yanskiy had opened IVth group. Such a phenomena was explained by Such a phenomena was explained by existence of system AB0, in other existence of system AB0, in other words – a kit of agglutinogens and words – a kit of agglutinogens and agglutinins within one individual.agglutinins within one individual.

42-44% people have a second blood 42-44% people have a second blood type;type;

38-39% - first;38-39% - first; 12-14% - third;12-14% - third; 4-6% - fourth. 4-6% - fourth.

On statistical Europe On statistical Europe datadata

Each blood type define a Each blood type define a combination an agglutinins and combination an agglutinins and agglutinogens. So, in the first group agglutinogens. So, in the first group there are agglutinins there are agglutinins and and and and agglutinogen 0; in second agglutinogen 0; in second accordingly - A and accordingly - A and ; in third- B and ; in third- B and ; and in fourth AB0.; and in fourth AB0.

Indication of blood type is accepted Indication of blood type is accepted on presence of agglutinogen: 0(I); on presence of agglutinogen: 0(I); A(II); B(III); AB(IV).A(II); B(III); AB(IV).

Serological characteristics of Serological characteristics of Blood GroupsBlood Groups

Determination of Blood Determination of Blood Groups In System ABOGroups In System ABO

Determination of Blood Determination of Blood Groups In System ABOGroups In System ABO

Determination of Blood Determination of Blood Groups In System ABOGroups In System ABO

Blood TransfusionBlood Transfusion

Determination Of Blood Determination Of Blood Compatibility Of Donor And Compatibility Of Donor And

RecipientRecipient

Determination Of Blood Determination Of Blood Compatibility Of Donor And Compatibility Of Donor And

RecipientRecipient

Individual Biological TestIndividual Biological Test

Otenberg’s rules were held under Otenberg’s rules were held under hemotransfusion. These rules stated that during hemotransfusion. These rules stated that during blood transfusion agglutinating introduced blood transfusion agglutinating introduced erythrocytes (agglutinogens) because the erythrocytes (agglutinogens) because the incorporated plasma (agglutinins) are diluting in incorporated plasma (agglutinins) are diluting in general volume of liquid and their titre becomes general volume of liquid and their titre becomes to be insufficient for agglutination of patient's to be insufficient for agglutination of patient's erythrocytes. Truth, clinicists forewarned that in erythrocytes. Truth, clinicists forewarned that in events an edge of anemia, attempt of quick events an edge of anemia, attempt of quick indemnity of bleeding by the donor’s blood of indemnity of bleeding by the donor’s blood of first group was observe agglutination of first group was observe agglutination of patient’s erythrocytes because was saved high patient’s erythrocytes because was saved high concentration introduced agglutinins -named concentration introduced agglutinins -named else "inverse agglutination". else "inverse agglutination".

Pseudoagglutination Pseudoagglutination

At the account of reactions possible to find At the account of reactions possible to find agglutination where it practically is absent agglutination where it practically is absent and reason to this phenomena are toand reason to this phenomena are to bebe::

low temperaturelow temperature indoorsindoors,, this below 15° C; this below 15° C; account to reactions later 5 minutes;account to reactions later 5 minutes; eating of erythrocytes (momental columns), eating of erythrocytes (momental columns),

their easy find of staggering of plate;their easy find of staggering of plate; concentrate (is sub narrow) standard whey;concentrate (is sub narrow) standard whey; at presence infesting blood the immune at presence infesting blood the immune

antibody, if patient suffers a sepsis, system antibody, if patient suffers a sepsis, system disease of blood.disease of blood.

Sometimes agglutination is impossible Sometimes agglutination is impossible to notice, this can be at number of to notice, this can be at number of conditions:conditions:

Determination of blood types is lead Determination of blood types is lead at temperature over 25-30at temperature over 25-30C;C;

If it is take reaction less than 5 If it is take reaction less than 5 minutes into account;minutes into account;

If low titre of agglutinins (below If low titre of agglutinins (below 1:32), in other words, you define 1:32), in other words, you define blood type by one series of serum;blood type by one series of serum;

Unless it is keep correlation a whey-Unless it is keep correlation a whey-blood and last much.blood and last much.