ICP/LAB/OO6
2 February 1979 ENGLISH ONLY
FINAL RBPORT
r'
-4-URS! ON LABORATORY METHODS IN BLOOD TRANSFUSION
Kuala Lumpur, 9-20 October 1978 by Dr Cynthia Gladys Lopezl
•
IDlrector, Mitienal Blood Transtusion Servioe, Blood servioes Centre, Hospital Besar, Kuala Lu.pur, Malaysia.
CONTENTS ~ '1 •
INTRODUCTION
10 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 10 • • • • • • • • •
1 2
2.
PLANNING THI!: COURSE ~
3. 4.
..................................... CONDUCT OF THE COURSE ............................... • • • • • • • • • • • • ,10 •••••••••••••••••• ~
2
CONCLUSIONS
•••••••••••••
3 1\
5.
RECOMMENDATIONS BY THE COURSE DIRECTOR
ANNEXES 1
LIST OF PARTICIPANTS PROGRAMME
.........................
5
2
3
4
(a)
.................................... LECTURE AND BENCHWORK SCHEDULE ............... PRACTICAL HANDOUTS ......... ................. . ~
9 11
17 19
(b)
LECTURE HANDOUTS
.............................
,
1.
INTRODUr.TIO~
The course on laboratory methods in blood transfullton, orFan1.zetl by the WHO Regional Of rice for the Western Pacific Region and hOAted by the OOVel'flllent of Malaysia, was held at the Jnllti.tute ror Hedi.cal Rf'lsearch, tUlIa Lumpur, from 9 to 20 October 1978. The objectives or the course were: (1)
to provide practical traini ng 1.n tAchniquM of' (a) (b) (c) (d) blood gl"oupinp;, preparation of groupl.np: sera and anU-human globu1.tn sera, preparation of pan!'l. I"ed cells, contl"ol of the quality or reagents;
(2)
to review laboratory invellti«attons in (a) (b) (c) (d)
blood tl"ansrusion, blood incompatibility, auto-immune diseases, massive transfusion, haemolytiC disease;
(e)
(3) to disouss the organization or the benchwork and methods of profioiency testing to assure a pel'lll8nent at1eqUlte oontroL 'nIere were 16 pal"ttci.pants from 13 countri.es/areas of the Western Pactfio Region and 26 local obsel"ve~s sponsored by the Malaysian Oovernaent. 1n addition, there were a number of non-offtcial observere. 'nIe Direotor of the course was Dr C.O. Lopez (Halaysta) while HI' John Case (United States America) was consultant, Derek Ford (Australia) and HI' Bob Cross (Australta) were temporary advisers. Dr A.D. Rajkovic, Regional Adviser on Health Laboratory Technology, VHO Reglonal Offioe for the Western PaCific, served as secretary and course ooordlnator assisted by the office of WHO Programme Coordinator In tUlIa Lumpur.
"'I'
,
The oourse was opened by the Minister of Hea 1til, Ma tRvsta, Tan ,'1ri Chong Hon t1yan, followed by a message from the WHO Regtonal Director, Dr Franoisco J. Dy, which was delivered by the act i.ng 14l!O Programme Coordinator in Malavsia, Mr P. Lauriault. cn tills message the Re~ional Df-reotor thanked the MalaY'llan Government ror hostinP: the seminar. He drew attention to the Justification fol" holding this course ln vi.ew or the rapt" expansion or blood transfusion services taking place in the Region. He Illent1.oned the essential part. laboratory lnveetlgation playet1 in protecttna; both the donor and recipient, '1nd the impol"tant respons1.bP. it. i es partioipllnts have in establ1shing and developinp: laboratory work in Mooti transtusion in their own countries.
.. .. ~
Il"
'fh.. 1,)<11.111'<; ".)t,ea. f> I'ad. i Cl,ll works he.,tB /lntl tf!lOIl"'fln!",!.inn wh t.,h Hnrvlt<\ a basi:<l for IIt.luly ar.~ glVlm in AMIIX 4.
Local arrangf.lmf:n 1.1l Im!"e II nnt. anll th" ,,:;;\ L.'It.qnn" '!II' !j I" rt' 1ft'"l1h'lrli <'If the Blood Servi tle:; COIn I,!"o .t1l(1 t.lln Gnnnra 1 lIospi ta \ in rr"'l'lIr in~ anti halping to sup~rv ("Ie th .. pI",d j '::11, ""'>\'l1o/l11 wall ftIIpeeiBlly v... lullhl,.. The Mmes of Hr S. Gnvill(jasalll'l. Hr' A I hurt. Anl.oni. Hr lrllvip.r Ch'ln 'ln,1 Hr Peter Yuan are 1'''1,,1.1 '~Il hrl y 'IH[I(lrv J 111\ nl' m''"t.lnn. 1.llh"rrl I:"r,v r'lot It ti",s Wflre provided !l~ thn Sehn" L 01' II",UC'.l,l Lahoratol'Y Tetlhn'll()gy through t.h'" courtesy of Dr G. de Witt, Dirp.ctor <'If t.hll Institute for H.,(itclll RIU''''artlh. Prior arrangements for lha teaching and social programmes were matle by organizing coDi ttees headed by Dr de Witt and Hr K. Krishnan. !.lllt of part10ipants 1s ~lven in Annex 1. 2.
t:. ""
PLANNING THE COURS!
In preparinp; tile _tent.1I ot t.he cellr,.., tlue IIti4nUol'I IIIIS INtI! tn til.. anticipated needs of the participant:<l, as Wflll ae to the declared objectives. Reference was made to the prograMmes for the two national selllinar-workshops Which were conduoted 1n Kuala LUlllpur 'Inder WHO sponsorship in 1973 and 1974, and subject matter was seleoted to Rohieve the objectives, while takin~ ma~illlUID advantage of the time avallabl~. Emphasis was given to the basic principles underlyln~ the t"ch"iqll~s applied in blood group serology. and e~~h day's pro~ramme wa~ deair.ned to include a generous proportion or time allocated to praotioal benohwnrk. A social programme was arrl1l1gf!'1 to .""oid IIndue pressure on participants, which included two half-day bus tours to places of int.,rell!:. around the city, and a wholp. S;ltllrdllY to'~r to th", ~l"""<i Bank, naner.l Hospital, Seremban, Port D1"":;'-'1) ;mtl Mah"r.a. Ev",ninl!! 'Iinn",r;1 w"r'" ,,1 at the invitatiollS 1)(' ttlL ['11,,,,:1 .. ,1' 0[' t.1I" N'itlo"'ll Hloo,j Tr"Hl~lrll'Ji,.,1'I S'3rvice, the Minister of fh,lth ·m.l t.h" MaL.w"jan ~o"i"I\' "r Path,'I·"~i:lt.".
""Y
v"'"
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'rHE CON [JUCT Or' THE COHRSF.
Each day's programme llommen"A<i wit.h tliO format lflctures, t'nll~p.tI bv '""I"'llng corr .... break. A I 1/4 h(\llr labor.lt"ry ""sainn pre""tfflr! t.h~ llmch iI,.r 1.'>11, follow",d by" t.wo-h""r hlhora t.ory lIes!!io" after lunoh ,,"<1 II if)-ml nil t.o d 1.8 ",I Al<i on I"jr J,,<1 I.::> rl\c1\ it 11 t.e considerati()n anti I'lt'lmp'Ir I linn /'If 1'~SUlt!! obtained.
'l
Thfl prl\et.1<::a 1 "1I111~ruftHl\ t.R 1>1I~"n wt t.h bl.l~1 cABO h tno<i p;roupl.,r. '''hnique:<l "nil i>rogrfl8~i vn Iy 3<ivrlll"f1t1 to M'lM d I rfiell) t proCll!ld1lrel'l ",. til .. ,."rf.ici I'Mtll gainee! confldenee <lnr! fa",ill arity w1t.h tll.. !r 'Slirroun<1i,npA. 1':.leh asaignment; ws explaln!'lr! in <1f!tall at. thf! baginninp;, and l'arUn1p"ntll w .. re aided by writ!.en inst.ruct.i(mll I"egardinll: tM proc .. r!urII:<I to hI! r.,Uowed. In '1t1t1l.tion, intlividlnl al!Ailltanoe W'lS ~lven to pllrt.it'if),mt.:s who ,..,amed to be exper!enllirw dlfn"lll Vf, oithl!lr by the WHO advtsl!lre, nr by 1.",,1ll sta rr all"i~ned tn he tp wi t.h t.ht, part! cular "f!!I!linn. I.
!
- 3 -
All particIpants enterert into the ~pirtt of the ll"'Antioa 1 work wHh enthusiasm, even though some were rtisadvant.aged by laok of benoh experienoe. There was no absenteeism" and ",enuinfl intflrest was shown hv all oonoerned. Prograftllle and schedule are given 1.n AYlnp.xes 2 'Ind 3, rl!spP.Ctivelv.
It WBS perhaps overly amhitious to attempt to oover sllch a broart rang;p. of subjeot matter in so short a time as nine wprkinp; davS. Wit.h parttolpants of such widely dHfering experience, tt. WBS l.nevttablv diftloult to ensure that the praotioal sessions (1n partioular) ran str10tlv to time. Those whose training and experlf1ftee was apl'ropr1.ate tn the technioal work were obviously more dextrous and effioient in oomDll!ting thetr praotioal assignments than those who ware approaohing; hp.nohwnrk for thetlrst time - or, in some oases, after a long period engsged in other work. As a oonsequence, some partioipants were fInished long before others,. and in a few cases the aSl'lignments had to be left unoOIDplet8d in order to aooomplish the disoussion of results, whioh was oonsidered to be vital to the suocess of the oourse. The oourse oould have heen extended by a further week with ~ore benefit to many of the partioipants, as there were a few important aspflots ot blood group serology that were outside the deolared ob,1eoUves and were therefore not oonsidered for inclusion. Should suoh an enterprise be oontemplated in the future, the ob.leotive to teaoh t.he preparation of basto blood grouping reagents should perhaps be separated f~ those oonneoted wit II basi 0 routine and with qual1.tv control. WhUe it is true that oonsiderable savings in expenrtiture can be aohieved by t~e preparation of oertain reagents from locally available materials, this '.s not praotioally possible in all blood banks, and should possibly be 1 Ulitad to regional or national oentres. Hence, this aspeot was mainly of interest onlv to a proportion of the partioipants, although it is oonoeded that all users of blood grouping reagents should be familiar' wi th the basio princIples involved tn their manufacture and standardi~ation. Suoh a knowledge is of value in understanding the need for a regular programme of qWlHtv oontrol and in establishing such a programme.
,
Language was not constri",recl a problem during the oourse, 3S most participants spoke and understood ~ng1ish"'e'1dt1y. The opportunitv for . eaoh to disouss variations tn teohnique anti or~ni~"t.ion wttll counterparts tl'Olll other oountries WIlS valUAble, but there is some doubt in the mind of the WHO advisers that the instruction given will he oal'l'led hack by all tile partioipants and disseminated to otllers in the partioular oountrv o~ orig!n. A series of national courses along simDar Ii.nes is Dosstl)lv worthy of oonsideration, most espech11v within suoh netions as tile RepubHo of Korea, the PhUippines and the 1.30 People's Tlemoor3tto Republio, where there appears to be a very Dressing neAd.
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"'1'1
OV""I\ n, t.he ('oursp. l'lflP"l'lrS t.o hllve heen '111(1(1"s",ru1. A "''',I''I"H.v nr Dlll"t lot Dllnts "Ilve ank" ..... lenp: .." 1t.", IIB""'I 1"""'''' '1ntj it. Is""" ,.t."" t.n !'ell" in their answers 1:0 the qllel'lttonnlltre t."l!It. thflY Int..."" t.., fm"1.'lftIA,,t. t."" pl'Ooedu~s taught on t.,,,lr "etu,"". 5. REC()MM1'~NnATTON:'I
flY
,."p;
~OllR:'IF,
IHRr.:r.TOll
5.1' ~l\t1.OI'Ial courses 'IlonR 1 I ne", simi '''I" t.... 1:hll ",.flS"l'\t. (11'\'I"BII "'''''111 tj hA oonsl dered tn order t.o extenll the henl!l rf. ts of 1:"'10" tnp: I" "as I.c "roo"du .... ", for blood transfuBton services. 5.2 SelAot.!on or P'lrt.i.ctp'lnt.s ""ou1" Mtu"l\llV he at. th .. "'Btl...... 1.,., or t."11 govemment ooneerneif, bllt. gill tj"l1.neB a!'e n"''''''~ wl'Ii,oh "U~"lIt. the trll1.ntlll! anll experl enoe or no...t nee", ","oul" h" "PP1"oprtat.I'! to t,\,,,, essenttll 11y praotloal natu .... or t.M OOU"SIl't.
t.,,,t.
.
,
5.3' ('!oursell coulti posstblv be extentiet! to a tohl (lr t.",..el!l wol"l{ln" wel'!kB, with division into separate periods ror at!vanceti and less advancer! workers. Perhaps an tnit.l.".,1 t.wo weeks oould he Mvotetj to the teach! np: of basio prino:!.ples and practtces, with the t1'11.rd week being conn"e" t.o t.ho,"", partioipants who it is consIdered wou11 benefit f'rom b"tng tllken t.O "., mo"p. advanoed level. Aspp.cts concerning the manufact.u,.e of "ea~ent8 woul" seem most appropriately tiealt with du,.ing this tht,.11 wep.k. 5.4 Some prior preparatton of participants 1.8 dA'It,.ablp., such as through the readl.ng of' certain basic tests, whtch could he SpP.cirlAtj.
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ANNEX 1
LIST OF
PAR·rIt~IPANT~
FIJI
Mr Orisi Seru Oaranivalu Lahoratory Superint.endent Pathologtnal Laboratory Lautoka Hospital I.autoka Mr Tuipine Fuimaono Clinical I,alloratory LBJ Tropioal Medical Center Pago-paRo, Tutuila Mr Joseph Duenas Medinal Teohnologist GUAm Memorial Hospital P.O. Box AX A«ana Mr Chu Wing-kai
AHBRICAN SAMOA
. GIlAM
!DIG lONG
Blood Bank Queen Elizalleth Hospital King's Park Kowloon LAO PEOPLE'S DI!HOCRATIC RBPUBLlC
Monsieur Bounthanh Mixap Servioe des Laboratoires Ministre de Is Sante publique de la Republique demooratique populaire lao Vientiane Monsieur Te Thammavong Servioe de8 Laboratoires M1nistre de la Sante publique de la Republique democratique populaire lao Vientiane
MALAYSIA
Mr Velautham slo Tharmal1ngam c/o Perkh1dmatan Pemindarah narab KebanRsaan Hospital Besar Kuala Lumpur Hr Thomas N. Talonu Acting Director 811)od Transfuaion l'IervlcA!l Port Moresby General Hospital Free Hail Bag Boroko
PAPUA NEW GUINEA
_ 6 _
Annex' , PJ/T1. TPPT~F..'; Dr Prntanln A. Arn~11~na r:h1.ef D9p~rtmftnt of Lahnratorip8 Dr .Io:.e R. Reyes Mftll\nr\~l JloRplt.~l Rlzal Avenu" ManUa Dr Meroedlls A. Santil)val r.l1l.e r P1 a Rilla :'!ecUon Ilureau of Research and l",hl)rJ\tnr\~ .. RtzlIl Avenull ManU a RPoPII"t. Ie: OF KORF.A
nr r.honR Moo La" P~re:.aor anti r.halrman DepartmElnt of e:Hntoal PathnloRV C.atholio Medtoal College Mvung Dong Seoul
Dr Han Ik Cho Department of Cltn1.oal Pl!\thoto~v Cathollc Medioal C:olleRe Myung Donl'l Seoul SINGAPORE loll'
Ko
Bel'll!: 1'1&.1'1
578 East r:oast Road Slngapore 15
SOLOMON ISLANDS
loll'
Brian EneU r.entral Hospital P.O. Box 349 Honiara Slone T. Follaki
TONGA
loll'
Box 920
Nuku'elofa TRIIST TF.RRT.TQRY OF TIlE
PACU'rr. ISLAtmR
HI' Paulino P. Rosario Ponap" Hospital Department of Hea\th :'Iervlc8R Knlon18, Ponape, E.r.. r. 969111 Harhna Islands HI'
SAMOA
Ta 11 1. kt IOIIne National. I.aborat.ory
Healt.~ ~partll\ent
Apta
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Ann,,!! 1 Other , Malaysian participant./! (spnnsnretl hy t,he OnVArnmAnt,) Hr Tan Knt, Hui Mr Ot.hm,",n hln ~Itt Ms f.vtll a HI nhlt'" Pulau Ptnanp; lir Rotl:>.i hln ll>1ttl Or Ratna nevi ~'I!I Hallmah htl'! Tilm'lll
Mr ROI!IH hin Ralllll Or ~. ThamhayanaR~m Mr Hohd. Nasir hin M'lllk
Malaooa Johore Pahang
Mr HO!'I~ H1.nR PtnR ~r
Or Jasbtr I{aur Basir Ibrahim
Mr Kasatm AwanR Mr Liow Ah Kaw Dr Vear llf.n8h au 1. Mr lhimtd bln Awang Ms Haamah bte Ismail Hr A. Aziz hin !lunan Mr T.taw Thlam Sui Mr John WonR Dr K. !ltvaM.tah Mr Bobby Tan r.hat Ho Mr Hi'! ,.." Hr A. PartnpRnuma~samv Rn,imah ht.e Kadlr Tve ,ql'lU HenR !lupramantam
Trenganu
Italant""
Sab.m Saralfllk
Kua la l.wI\pur
_8 _
~nnex
\ a'lv.!.!~
T8IIIpo,.ary
l:oU,.SII 1)1 rent ",.
01 ree t,or
n,.
t:ynth1.a Gladvs Lopez ~"vl
National Rlnn" 'l'rlln!'lflllll.nn Blood Ssrvioes CentrA Hospttal Resll,. Kuala Lumpur, Malavsill ~r
ee
Robert Cross BInpd Tran!lrus1.on Ss,.Vl0A 1111 FHnders Street Melbourne 3000, Austl"llll a National Blood Group Refel"enofll 1,llbol"llt.ol"V Commonwealth Se,.um Laborato.. tes 45 Poplar Road, Parkville Viotoria, Austrlll!a 3052
HI' nerek S. Ford
Consultant
HI" John Case
Gamma Biologicals 3700 Mangum Road Houston, Texas 77092 United States of Amerioa &laretariat Dr
A.D. Rajkovto
'Iegional Arlvt~er on R ..alth 1",1)0\"" tory Teohnology WHO Reg1.ona'l. Office rol' the W"et.ern "'lot 1'1 n MantIa, Philippines 0,. P. Lauriault
Acting WHO Programme CoordInator Kuala Lumpur, Malav~ta
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ANNF.X 2 PROGRAMME 1. Laboratory techniques in blood transfusion (relevant to specific objeotive no.l) Leotures: Introduotion to blood group serology, ABO blood groups. Quality oontrol in the blood bank laboratorv. Basic immunology. Nature of antibodies. r.omplement system. Saline reaoting, oomplement f:t.xtlU!, tp;G and III;M antibodies. Deteotion of antibodies. teohniques. Other blood group systems. typing. Saline, AIIO, albumin, enzyme Rh system. Teohniques in Rh
Deteotion of Rh antibodies and their charaoteristics. Deteotion of oommonly enoountered antibodies of other blood group systems. Techniques in oross-matching of blood. Preparation of antisera and oontrol of quality or reagents. Production of Coomb's reagent. Preparation and standardization of ABO grouping sera and other typing sera. Praotioal: ABO blood grouping; tube and tile methods. Preparation of reagents and cell suspensions used in blood bank serology. Techniques in antibody deteotions - saline, albumin, AHO, enzyme techniques. Techniques in oross-matching of blood under vary!np: conditions, and those assoctated wtth olinical problems. Preparation of antI-human globulin anti.sera. Control methods of specificity and purity to ensure quality of prepared reagents. Preparation of leotine. Recomitlon and identification of lIIi xtllres of antibocltel!. Proficiency testing methods.
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Annex 2 2, Review of IBhorllt.nr·, Inve"I.l/5",tions in relevant <11.1nln81 oonditton!! (relevant, 1:0 IIpen! rl,1 oh.l"rt.lve no. 2) '1'rnnl.lflllllnn p"ohlems In haemolyt.i.n ",naemIR" of VRr\ous etlolollY - autn-immunP., drUg-induoed, hRelllolytio Rnaemf.a, haflmnlyt.ln anRPmfa of the newborn. Exchange t.ransfuston in the newhorn. liazar~s
of hlnnd t,raMfuslon.
Investlgat.lcn or transfusion I"f!aot.ions. Praotioal: Crosa-matohtnp; of blood tn auto-1l11111une haemolytio anaemia, In haemolyUo anaemta of the newborn (exchange transfusion)
3.
Ortan1zatlon of bflnohwork (relevant to apeotfl.!,! ohjeotive no. 3) Laboratory nrglln1.zation of a National Transfusion aervloe and Hospital. Blood Imnk. QualIty oontrnl In the blood hank and profioienoy testIng. Practical: '3enohwork organ I. zatl on. Preparat.l.ol'! of m!lst'l1" dtl1ltions. Quality cnntrol of reagents and 0"111 suspensionR. Tests for potency. avldltv. Preparoat.1nn and standardization of r.oomb's reagent.. Titration stut1tes. Tests for speoif1.oity and purltv of Coomb's reap;ent~. P!'of1.oiency testing methods tn the detection of antibodies.
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v_ , Monday, 9 October 08]0 - 09]0 0930 - 1100 1100 - '"00 11105 - 1600
LEr.'I'lIftE ANn BF.Nr.HWORK .'1r.HF.DIJLE
ftelevant spAotfl.o ob.leottvl'l number ftel!ietration of part101P1\nt.s
I.eoturers
Opentng oel'lllltV\y
Adoption or a$ende Openin« ~arks by Dirflotor of O()urae Laboratory orRllnizat:l.on or a Nat\onal Transfusion Servioe and Hospital Blood Bank. Short reports on laboratorY or8Rnization of blood bank servioes f~ aadb partioipant or the dtfferent countries. 3 pr r..G. Lopez
3
Partioipsnts
TuesAA¥, 10 October LlC'l'UltIlS 0830 - 0915
Basto tm.unoloev and lenetios, Natural and tm.une antibodies. Definitton or t!lru. ABO blood group syste•• Detection or su~roups. ftes0111tion of atypioe1 or disorepant results. TEA BREAK
1
0930 .. 1015
1
Mr D. Ford
10]0 _ 1100
I.lBORATORY 1100 _ 1215
Benoh work organization. Preperation of dav-to-~ay reagents inoluding 01'111 suspension, eto. tt tratton teohn1 qUA. LUNCH
" J
Mr
n.
lI'orti
1215 • 1330
•
.• 12 •
Annex 3 1330. -. 1600 PRAr.Tlr.AI.
ABO bloot! /!!rouptn~ by t. He ant! tube techniques. Forward and reverse ~roupI.O/I!. InterpNltattnn of atypinal or llisorepant reactions.
1
"'.. n.
P'ord
LECTURES
0830.0915 09]9 .10lS
'!'he RR blond /!!,"oup systelll. . The nature flf Rnt. tbodtu. . "InQOMplete" and MOOMp'ete" .lAG , IBM, IliA. r.OIIIplemen t bindin/!!. TEA SREAI'{
1
M,"
n.
11'01'11
1
1030 • 1100 LABORATORY 1130 • 1215
The Du
Teohniques in Rh typing. test. Phenotyping, Auto oontrol!!!.
I
~r
J. Case
1215 • 1330 1330 • 1600
LUtfCR PRACTlr.AI.
Rh(D) typtng and phenotypinll:. Interpretation or results. Thursday, 12 Ootober
0830 - 0915 0930 ... 1015
Other blood group systelllS. Antibody deteotion systems. SaUne, Illbumin, antiglobuUne, enzymes. TEA BRJUI'{
1
I
~r
R. Cross
1030
~
1100
LABORATORY
1100 _ 1215 1330 .. 1600
Techniques in antibody detection. FREE _ Tour
I
HI' R. r.l"(lsa
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Annex Priday, 13 October L~TUR!s
~
0830 - 0915
lIllemo1ytio anaemh. IIut,o-illllllllnp. 1dtopathto, and dr~-lnduoed. Haemo1ytio dIsease of t.he newborn. eompatibi U ty test inp; for transt'uslon. Routine andemerp;ency situations.
2
nr
r.. r,.
!.oPp.z
0930 - 1015
2
M~
J.
r"",!<!
1030 - 1100 I..AlIOU'I'ORY
TEA SREAI(
1100 - 1215
COIIIpatibU tty test ilUl; for. transt'uston 1.n routine and emer~noy situatIon.
2
1215 - 1330 1330 - 1600
PRACTICAL Compatibility teRt1.ng/anttbody soreen inl!;. 2
Mr R. Cros",
saturday, 14 Ootnber Viatt to SereMban/Po~t
Diokson hospitalR
MOnday, 16 Ootober LBCTIJR8S
0830 - 1915
Rlu:ards of bloor! traM filS t"n: o1.lnioa). aspE>Cts. Tnrlloattons. oontrat~dioatlons.
0930 - 1015
"'he tdent1.f1.oat.i.on of hlood I!;rollp Antibodies and selectton of blood for tranafllsi on 1n Ilnt,i body OllR"'R. T~.A
1030 _ 1100
BREAI(
Annex 3
l.ABORATOllY
1100 - 1215
Tntl!~p,·"t;;t Inn nr p'Inll1 t.e!lt:.s, :3'" 1e(\1:. 1nn "'f 11.111.,1 ,.nn IIn""l1n""1; ne!1s.
1215 - n30 1330 - 1600 PIIACTICAL V1Ant.il't"''IU'm nr nnt.1.hnrlt'ls.
M ..
n.
Forrl
0830 - 0915
Tnenttfioatlon <If ant1.horlv ",txt'lre. ~ Absorptton and I!!lutton. lfeutralf.zlltlon wl.th soluble "nhlltanoe. Co",patabtllty tAllttng tn pattents wi. th ,.uto-anti hoot.es, no ld !lnd w!lr"'. Aut.,,-absnrptton.
093Q - 1015
2
"'I' .T.
('-aSI!!
1030 - 1100 I.ABORATORY
TEA BRBAK
1100 - 1215 1215 - 1330 1330 - 1600
P"'1ct. l",.l "snn"'.:.' nf ah'lorpt.ton :lnO .,1 Ilt i 1I~.
PRAr':TICAL T<lenti.ftoat.inn of 'lnttho<ly 'I1iltture3.
Wenne:o!oay, 18
n"t ol'>er
1)830 - 0915
.~el ... oti.""'
prE'l n" rat '-on nr ABO
an"
~tanrl"rrltZ>lttnn
1'>10011 ",rollpi,,!>; l'iar-'l
t)1}30 - 101<;
~l ...
~t'tntlartil7.qtlnn
"t.',.,n.
r> ..... !'I" rat.
",r
/1,"OlIn l
no: """11:""1. .. ,
other' bloon t "01'1<1 1"11:
i.""
>In"
1Aot' " ...
• - 1.5 -
Annex, 1015.1045 LABORATORY 1045-1130 1130 • 1330 Tel'Jt i ng ABO b] oocl ~I"oupl nil; sera for potenov, av1.dH.y snli '1pec1 ftclt.V HI" R.
TEA
IIR~AK
CrollI'!
PRACTICAL Titration or ABO blooli ~rollptnR rell.llents; tel'Jtln/l! ror avf.t1I.tv and speo1.t'tcttv 1
141" R.
('''0151'1
1330 - 1415 1415 - 1600
LUNCH
FREE - TOOl!
Thursday, 19 Ootober LECTURES 0830 - 0915 The antiglobulin test. Dtrect and indireot Cooabs. The role or oomplement. The preparati.on and stan('\ard1.zation of Cooabs reagent. TEA BREAK 1
141" R. ('ross
0930 -1015 1030 - 1100
1
141" J. ('ase
LABORATORY 1100 - 1215 Preparation or test ce1.1I'J for the flvalu'1t1.on of antiglobulin sera. Blook titration. LUNCH
1215 - 1330 1330 - 1600
PRACTICAL Titration and testing of ant tglobuUn sera fnr potency and I'Jpeotttotty.
141" ,J. Case
• 1.6 _
Annex 3 "'r\"ay, 20 Oet.char /,ECTlJRP'.s
1)830 - 0915 1)930 - 1015 1030 - 1100 /,ABORATORY
QUIll 1. tv
lin" performanoll cont.re 1 I n the blood bank. Prorto1ency t.fII\tl.ng.
~
H,. ,J,
~!lI'!'"
TEA BRF.AK
1100 - 1215 1215 - 1330 1330 - 1500 1500 - 1600
PreparatIon lintl tMtlng of leot.inl'!.
l
LUNCH Questtonnatre and general "1.sousston Closing oeremony RefreshJllents
1600 _ 1640
•
- 17/18 -
PRACTrc'AI. 1.
I!ANDOUT~
Instruotions to participants; bench layout; tt tl'st.1 Onl! 'Inti "1'111. lIuI'lp",nslon methods. Quantitative recording or URlut.tnatton.
2.
3. ABO grouping and intel'pretation of disc repent reactionll, 4. 5. Rhesus typ1nR and phenotyping. Teohniques in anUbody detection with a protoool cOIIpatibl1ity testlng. CompatibU ity testing and Ilnttbody soreening. Interpretation or panel tests (dry workshop). 'Identirioation or single antt.bodles. Identitioation or mt.xture or antibodies with elutton t.echnique ABO blood grouping sera tor pot.enoy, avidity, Ilnd speo1f'iC)ity Titratlon at ABO grouping reagents. T1tratiQn, testing and evaluation speclt.t101ty. p~oedure. tel'lt~ng.
or
the method
tOI'
6. 7.
8.
9.
'0. 11. •
12. 13. 14.
or
anUglobul1 n sel'a rol' potenay anrl
InvestigatiQn or transrusion reaotions (dry workshop). Preparation and testing ot leotins.
- 19 -
ANIIR,( LECTlJIlJi: HAtmnlJ'rl'
~
(h 1
1. 2. 3. If.
GloS8ary of terms used in blood hanklng. Intro~uctinn
to Immunology and senetlns.
aasic genet1cs. The ABO blood group syst.em. '/'I1e Mt,ure of anttbod1.es. The Rheaus blood group system. Other blood group systems - a gulde. Antibody deteot1on systems. Iaaune haemolytio anaemia. Haemolytic disease ot the newborn. Compatibility testlng for transfusion. Hazards of blood transfusion. Identification of atypioal antibodies, Identi f1cation ot anttbody llixtures. Compat1bil1ty testing with sere oont.aining auto-antibodiss. Seleotion, preparation, and atandardization of ABO blood srouping sere. Seleotion, preparation, and, standardization of other blood sera. The anti-human globulin test (A.n.T.). II
5. 6. 7.
8. 9. 10. 11. 12.
,
13. 14. 15. 16. 17. 18.
~roupin8 II
19. 20. 21, 22. 23.
'aotors atfectin/! t.he anti"lobulin test. Complement. Thl! preparatton and standardization of ant.ig1o!)ulln reagent.li. Quality and performance oontrol. The taboratorv lnvestisat:lon of suspected tranefusion reactions.