Anticoagulants-in-Hematology and correct technique to performcrossmatch.pptx

anticoagulants used in hematology and correct technique to perform crossmatch

1. Describe role of ANTICOAGULANTS IN HAEMATOLOGY 2. Describe correct technique to perform CROSSMATCH

2. DEFINITION Anticoagulant : It is an agent that is used to prevent the formation of blood clots . O ccur naturally in blood-eating animals such as leeches and mosquitoes .

3. CHARACTERISTICS OF ANTICOAGULANTS It must not alter the size of the cell It must not cause hemolysis It must minimize platelet aggregation It must minimize disruption of staining and morphology of leukocytes It must be readily soluble in water It should be soluble in blood It must be keep the blood in fluid condition

4. COLOR CODE TUBE SELECTION OF ANTICOAGULANTS COMMONLY USED Stopper color Additive Notes Red No additive Used for blood bank, some biochemistry Invst. Collection of serum Lavender (purple) EDTA Collection of whole blood ( binds calcium)

5. COLOR CODE TUBE SELECTION OF ANTICOAGULANTS COMMONLY USED Stopper color Additive Notes Green Sodium or lithium heparin Inhibits thrombin activation. bio chemistry studies Light blue Sodium citrate Coagulation studies (bind calcium) (PT &PTT) (ESR).

6. COLOR CODE TUBE SELECTION OF ANTICOAGULANTS COMMONLY USED Stopper color Additive Notes Gray Sodium fluoride & potassium oxalate Sodium iodoacetate : For glucose determination Yellow Acid citrate dextrose (ACD) For use in blood bank studies, HLA phenotyping, DNA and paternity testing (preserves red cells)

7. C L A S S IF I C A T I O N OF ANTICOAGULANTS 1- CALCIUM CHELATERS OXALATES 2- NON CALCIUM CHELATERS SODIUM HEPARI N WARFARIN AMMONIUM OXALATE POTASSIUM OXALATE DOUBLE OXALATE EDTA CITRATES SODIUM CITRATE ACD ( ACID CITRATE DEXTROSE)

8. COMMONLY USED ANTICOAGULANTS EDTA OXALATE SODIUM HEPARIN SODIUM CITRATE SODIUM FLUORIDE & POTASSIUM OXALATE

9. EDTA ( ETHYLENE DIAMINE TETRA ACETIC ACID) EDTA is the most frequently used anticoagulant . Mode of Action : It forms insoluble calcium salts by chelation . Advantages : Making a blood smear for cell morphology studies. U sed for Tests for CBC, microfilaria, coomb’s test.

10. O X A L A T E S Mode of Action : These acts by chelating calcium. Calcium oxalate is formed as insoluble precipitate. These are used for blood chemistry and hematocrit. Types : Potassium oxalate Ammonium oxalate Double oxalate

11. DOUBLE OXALATES Double oxalates is used for ESR and HCT Advantages : HB TLC RBC count ESR by Wintrobes method

12. HEPARIN N atural anticoagulant in the body , F ound in the liver, and may also be within basophils and mast cells . Mode of Action : It interferes with the formation and/or activity of thrombin and the activity of clotting factors IX, X, XI, XII . Advantages : Heparin is the choice of Anticoagulant for blood pH, and B lood G as Analysis and Acid B ase B alance.

13. SODIUM CITRATE Mode of action : It combines with calcium to form insoluble salt of calcium citrate . Advantages : Sodium Citrate is the anticoagulant for choice for studies of Platelets function and morphology.

14. ACID CITRATE DEXTROSE (ACD) It is the anticoagulant of choice for blood transfusion .

15. CROSS MATCH Cross matching is a procedure performed prior to transfusion of blood or blood products to detect any serological incompatibilities in the blood of donor and recipient . 

16. MAJOR CROSS MATCH Patient’s serum is tested against donor red cells to detect any antibodies in patient reacting with donor red cells. MINOR CROSS MATCH Patient’s red cells against donor serum to detect any donor antibodies reacting with patient’s red cells

17. Gel card technique Take 1ml of LISS (LOW IONIC SALINE SOLUTION ) Add 10 microlitre of donor unit red cells suspention to it to make it 1% dilution of red cells Take 50 microlitre of this dilution and add to gel column Now add 25 microlitre of patient serum to the gel column Incubate the gel card at 37 degree C for 15 mins Then centrifuge at 1000rpm for 10 mins Look for results any agglutination. If any agglutination is present,red cells are trapped in gel and can not travel through the gel. Unagglutinated red cells travel impended through the length of microtube , forming a pellet at the b ottom. 17

18. Interpretation of result Positive result show solid band at top of gel . Negative result show pellet at bottom. Grading 4+ =solid band at top 3+ =display agglutinated cells at upper half of gel column 2+ =dispersed throught out the length of column 1+ = dispersed mainly in lower half of gel column 18