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“RBC B-GONE” The Pathophysiology of Red Cell Clearance

“RBC B-GONE” The Pathophysiology of Red Cell Clearance. Cynthia Steinmetz, MT(ASCP) Lead Reference Technologist LifeShare Blood Centers. Immune RBC Destruction. Definition Mechanisms Intravascular Extravascular. Intravascular RBC Destruction. Definition

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“RBC B-GONE” The Pathophysiology of Red Cell Clearance

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  1. “RBC B-GONE” The Pathophysiology of Red Cell Clearance Cynthia Steinmetz, MT(ASCP) Lead Reference Technologist LifeShare Blood Centers

  2. Immune RBC Destruction • Definition • Mechanisms • Intravascular • Extravascular

  3. Intravascular RBC Destruction • Definition • Usually seen following transfusion of ABO incompatible blood • Complement Binding • Results

  4. Extravascular RBC Destruction IgG Coating Only • Definition • Process of complement and the Reticuloendothelial System • Role of the macrophage • IgG Subclass

  5. Extravascular RBC Destruction IgG and C3 Coating • Role of Macrophages • Spleen vs. Liver

  6. Extravascular RBC Destruction C3 Coating Only • Limited and rather inefficient • Spleen vs. Liver • Complement Cascade

  7. In Vivo Clearance of IgM-Coated RBCs • Role of Macrophages • Mechanism of removal by the body

  8. Hemolytic Disease of the Newborn(HDN) • Definition • Cascade of events • Diagnosis and Management

  9. Summary • The mechanisms of in vivo red cell destructions are all very similar, whether they be for incompatible red cell transfusions or for red cells coated with an autoantibody. • The body is very efficient in removing what if does not want…inthis case, RBCs.

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