Resident Rotation: Immunohematology Reference Laboratory
The following modules provide fundamental information that you will need to know in order to perform testing in the Immunohematology Reference Lab (IRL). You’ll want to follow along with your handbook while you work through the modules, as your handbook contains valuable supplemental information and provides a place to take notes.
(Modules are best viewed using Chrome as a browser.)
Module 1: Introduction to IRL & ABO/Rh Testing
Welcome to the IRL! This module provides an overview of your week in the IRL, an explanation of what an IRL is, and an introduction to the first testing you’ll perform: ABO/Rh testing.
Module 2: ABO System and Discrepancies
This module provides information on the most clinically significant blood group system: ABO. In addition, you’ll work through interactive ABO discrepancy cases. Finally, D antigen typing discrepancies are discussed.
Module 3: Antibody Detection and Identification
This module provides a review of pre-transfusion testing and explains the antibody identification process, including interpreting antigrams and performing rule outs. It is advisable to print out the document entitled “Module 3 Panels,” so that you can follow along.
Module 4: Blood Bank Testing Methods
This module provides an overview of the three different methods used in pre-transfusion testing: tube, gel and solid phase.
Module 5: Antigen Typing
This module discusses the importance of antigen typing both patients and donors. The difference between a serologic phenotype and a molecular genotype is discussed. Finally, calculations to determine the probability of finding antigen-negative units are reviewed.
Module 6: DATs & Eluates, Rh Nomenclature
This module focuses on the direct antiglobulin test (DAT), and preparing/testing eluates from antibody-coated red cells. In addition, Rh nomenclature is reviewed to prepare for choosing alloageneic adsorbing cells.
Module 7: Adsorptions
This module describes the process of adsorbing warm autoantibody in cases of panreactivity, in order to identify underlying alloantibodies. You may want to print out the handout “Module 7 Practice Rule-outs with Differential Adsorptions” so that you can follow along.
This module describes the rationale behind titration of antibodies, demonstrates how to perform titration studies, and provides a few applications for titrations in the blood bank.
This module describes the use of inhibition (neutralization) of antibodies during antibody identification. It covers what inhibition is and when it is used. In addition, it includes case studies that demonstrate how to interpret the results of inhibition studies.
Anti-G Studies Module
This module focuses on the complex serologic techniques utilized to differentiate anti-G from anti-D + anti-C. By utilizing a combination of adsorption and elution, one can distinguish anti-G from anti-D + anti-C, and make appropriate recommendations for administration of Rh immune globulin.