Clinical Biochemistry And Blood Transfusion Assignment Sample

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Introduction

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Clinical Biochemistry is one of the aspects of laboratory medicinal techniques that is performed for the purpose of measuring the number of different types of chemicals that are present in the blood or in the urine, or in various fluids present within the human body. The results acquired through the tests are used in the cases of identification of the health problems, for the determination of the prognosis as well as finalizing the therapies for a patient. Blood transfusion, on the other hand, is the process of providing blood into the human body, which might have been lost due to surgical procedures, accidental injuries, or any other medical condition. The clinical assessment of the blood sample of the donor as well as the receiver is required to be clinically assessed to analyze the chemical properties of both the blood samples. 

The information about the chemicals presented within both the blood samples provided an idea about the suitability between the blood provider and receiver (Chacham et al. 2019). The pieces of information about the blood serum testing and the chemicals present in them provide the chance of analyzing the compatibility of the blood samples with each other. The genes are considered sources of biological variation. The techniques of clinical assessment of the blood sample are performed include the Indirect Antiglobulin Technique (IAT) and the Enzyme panel technique. The principles of the assessment are to analyze the chemicals present within the blood serum of different samples and provide pieces of information about them before the process of blood transfusion.

Materials and procedure

The clinical assessment technique that will be used for analyzing the blood serum samples will be performed using the IAT techniques for analyzing the blood samples (Viberg et al. 2018). Therefore, various particulars of the IAT technique are discussed below. 

Principles of IAT technique

This test is performed for the purpose of identification of the antibodies present within the red blood cells. The Antihuman Globulin (AHG) is used in this test for the purpose of detecting the In-vitro sensitivity of the red blood cells. In this procedure, the plasma of the patients is processed through incubation with the red cells that work as the reagents for the procedure. Moreover, in this process, an antigen phenotype is used which known in nature along with a solution is meant for potentiating. In the case of the presence of any antibodies of the red cell, it is meant to be bound with the reagent of the red cell along with the antigen that is corresponding. 

• Materials

There are various materials that are required for the purpose of analyzing the blood samples. These materials include

• “NHSBT is a panel of 10 cells within the Alsevers (3%) which is known as the Liverpool Reagents”
• Glass tubes measuring 10x12mm x 7.5mm
• Some racks for holding the tubes of the measured mentioned above in the count of 12x2
• Centrifuge for the tubes that allow being set at 1000g for a time of 30 seconds. 
• A bath of water the temperature of which can be controlled to remain at 37 degrees celsius
• Phosphate Buffered Saline (PBS)

• Low Ionic Strength Solution (LISS) is available from the Lorne Laboratories

  Antihuman Globulin which is Polyspecific in nature

• Cells that are made sensitized to the IgG. This is required in a measurement of 1 for each of the blood groups.

• Pipettes with the measurements of 50ul and ranging up to 200ul or maximum capacity for disposition of 1ml and made of plastic (Lee et al. 2019)

• Some plasma samples that are screened in nature must be sourced from the antisera of commercial types. That might include a “Weak anti-D” or “anti Fya”
• A box contain with lights or a portion within the lab that consist with appropriate light being present within the area. 
• PPE kits are need for wearing during the tests such as gloves, waste removing containers, disinfectants, and many more. 
• Clean towels, timers for counting the time, and markers for marking the tubes. 
• Panel sheets are used for keeping the records after analyzing them. 

These materials are required for performing the clinical trial of the blood serums. 

• Step by Step Procedure

The procedure of analysis includes various steps such as 

Preparation 

During this step all the preparations are made including the preparation of the reagents of the red cells, preparation of the water bath at 37degree Celsius, setting off the antigen identification panel, marking the tubes according to panel numbers and also by labeling the 11th tube to the tubes used for the “Pos control”. 

Adding the Reagents

All the reagents including the samples of the blood of the patient, the reagents of the red cells are added and then they are added within the panel meant for the read cell. Moreover, 50µl of the LISS solution is also added to the panel. Then the temperature of the panel is set to be at 37 degrees Celsius and then the panel is left to incubate for 30 minutes. 

Washing the cells

All the tubes are washed and centrifugation of each tube is performed at 1000g for a time period of 1 minute. The supernatant is decanted without making any disturbance to the button of the cell of each tube. Then the washing process is repeated for one more time including Saline. After this 100µl, AHG reagent is added to each of the tubes. After this, the tubes are centrifuged at 1000g following a rolling procedure in the light box. These are performed for agitating the tubes. 

Reading as well as interpretation of the results

The samples are visually analyzed and it is actively marked as per their agglutination reactions. 

Then after grading the agglutination reaction, the results are recorded against the cells of the provided antigram panel. 

Safety precautions

Some safety precautions that are required to be practiced while performing such tests include

Washing the reagents of the red cells, properly using lots of water as these reagents contain Sodium Azide, which forms an explosive compound by reacting with the copper in the pipes (Jackson et al. 2020). 

Protective clothes must be used for protection while handling the materials such as the reagents of the red cells as well as the plasma due to the bio-hazardous nature of these materials. 

Description and Interpretation of the results 

• The results include the anti D, C, Lua, as well as K. 
• The antigens that were destroyed include M, fya, N, fyb, S, and s pink. 
• The 0 value of the IAT results signifies the negative nature of the test results. The negative value of the IAT test results signifies the absence of the antibodies for the donor cells and that will lead to the blood not being clumped. On the other hand, if the results were positive it would signify incompatibility between the two blood samples. 
• The positive results are shown in the Enzyme test signify the presence of the antigens. 

Compare and contrast

Similar to the IAT technique there is also Direct Antiglobulin Testing (DAT) that is used for the clinical assessment of the blood samples before the blood transfusion process. 

There are differences present in the procedure of DAT with that of IAT despite them being used for the same purpose of assessing blood serum samples. The Direct Antiglobulin Test is performed by the process of incorporation of the Antihuman Globulin (AHG) with the RBCs of the patients. On the other hand, in the case of the Indirect Antiglobulin Test, the plasma of the patients is used for testing the RBS after the addition of the Antihuman Globulin (AHG) is performed. Despite the difference in the processes, the RBC is agglutinated due to the presence of the Anti-RBC antibody, which might include either autoantibody as well as alloantibody. This agglutination occurs after the addition of the AHG is done (Bellairs et al. 2018). 

The agglutination in the Direct Antiglobulin Test (DAT) occurs when the cross linking between an Antihuman globulin & Anti-RBC antibody occurs. The Anti-RBC antibodies are found to be bound with the antigen of the patient's RBCs. 

On the other hand, in the case of the Indirect Antiglobulin Test (IAT), the process of agglutination is seen to be taking place when the cross-linking process takes place between the Antihuman Globulin with that of the Anti-RBC antibody present within the plasma of the patient. The RBCs for the test are added to this Anti-RBC antibody found in the plasma of the patient. 

Despite these differences, the main purpose of these tests is to analyze the antigens and antibodies present within the two blood samples that include the patient as well as the donor samples before the process of blood sampling. This is very important for determining the compatibility of two blood samples before processing with the transfusion procedure.