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.

Download Handbook Here

(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.

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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.

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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.

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Download Module 3 Practice Panels

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.

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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.

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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.

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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.

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Download Module 7 Handouts

Download Module 7 Panels for Practicing Rule-Outs Using Differential Adsorptions

Additional Modules

Titration Module

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.

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Inhibition Module

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.

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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.  

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Download Anti-G Studies Module Handouts