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Prenatal diagnostics and haemolytic disease in newborns
Matějček, Martin ; Petrtýlová, Květoslava (advisor) ; Kracíková, Jitka (referee)
The first part of my thesis describes the Hemolytic Disease of Newborn (HDN), its etiology, pathogenesis and clinical process including the possibilities of its medication. Further, the paper outlines immunohematology methodical approaches used for diagnostics, for monitoring of the gravidity process alloimunization and also for the laboratory diagnostic systems in common use. There are several interesting casuistries of examinant pregnant women during the period 2001-2005 mentioned. Finally, the thesis mentions the importance of a good laboratory practice (GLP) and quality control of methods. Powered by TCPDF (www.tcpdf.org)
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Automation in imunohematology
DOMINOVÁ, Alena
Nowadays automation in immunohematologic testing is becoming part of routine methods used in transfusion laboratories.It also has got considerable importance for pretransfusion testing of patients and for immunohematologic testing of blood donors.Immunohematology was the last among all medical laboratories into which automation was introduced.The use of robust techniques made it possible.These techniques are column agglutination carried out on gel or on glass microballs and solid phase technique.The latest method is Erytrocytes Magnetizer technology and it is not so widespread yet.The aim of this thesis is practical performance of immunohematologic methods blood group,antibody screening.Tube testing,testing on microtiter plates and using column agglutination.Manual performance was compared with Qasar and Techno analyzers.Other aims were quantitative description of reagent saving,human labor force and to assess other effects which are more sensitive methods,greater safety and exclusion of possible mistake during the automated testing process.The theoretical part deals with particular tests and their possible performance techniques.Automation contributes to minimize possible risks.Automation reduces process steps,the need for worker intervention and exponentially decreases the number of potential mistakes.Introduction of automation also helps to standardize procedures and reagents to increase reliability,result interpretation and results of the tested process.On top of that automation is useful for generation of reliable results,their objective interpretation,better documentation,monitoring and traceability and labour force saving.It brings security not only to patients but also to medical workers.Inseparable necessities are space conditions and device service.The practical part of this thesis was performed in the Blood Bank Department of Hospital České Budějovice.Samples examined in this thesis included 24patient samples,24blood donor samples and 2samples for inner quality control.In all 50samples blood group was tested manually in test tubes and on microtiter plates.Antigen screening was tested in test tubes,on microtiter plates and using column agglutination.Patient samples were analysed using Techno analyser and blood donor samples were analysed using semiautomatic machine Qasar.10slightly positive screenings of patient antigens(previously tested using Techno analyser)and 10positive screenings of blood donor antigens(previously tested using semiautomatic machine Qasar)were manually tested again in test tubes and on microtiter plates during 2013.It was found out that both manual and automatic testing give same results.Only in manual testing of antibody screening in test tube the reaction in both positive testing Basic QC,was a bit smaller which is caused by lower sensitivity of the test tube method.In antibody screening the quantitative saving of reagents in column agglutination is bigger when tested both manually and with the use of both analysers than when tested in test tube.Concerning the difficulty,longwindedness and especially lower sensitivity of tube testing,the decision not to use this method was a correct choice.This comparison confirms assessments described above and also the correctness of decision to use column agglutination for antibody screening tests.Different time consumption of testing of particular samples gave possibility for simple quantitative calculation of human labour force saving.It gave clear result saving of 2human labour forces thanks to each analyser.Individual steps during testing are shown in table and the chance of bringing the possibility of a mistake.Manual testing includes possibility of making a mistake in all mentioned critical moments of testing.Automatized only once using semiautomatic machine Qasar,where there is a possibility of mistaken exchange during preparation of reagents.Reagents do not have bar codes.Techno analyser succeeded in all critical steps without a mistake.
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Pretransfusion measures - compatibility testing before transfusion of red cell product in Blood establishment and blood bank of Nemocnice České Budějovice, a. s.
TESAŘOVÁ, Lucie
Blood is a body fluid which,despite all the scientific progress,still cannot be replaced by any other artificial product.The first records of transfusion were found in the ancient Egyptian,Assyrian,Jewish and Roman societies.The first historically recorded attempt at blood transfusion was described by a historian and lawyer Stephano Infessura 1492.The first known blood transfusion in the Czech Republic was performed in 1879 by Prague physician Anthony Erpek.Pretransfusion testing is a set of immunohematology examination performed prior to blood transfusion to the patient,which aims to ensure effective substitution for the patient,during which the transfused RBCs will survive long enough in recipient?s bloodstream and will not be destroyed.The basic principle of the whole pre-transfusion testing is laboratory confirmation that the recipient?s blood is compatible with the donor?s blood.The complex of pretransfusion testing before administration of RBCs includes methods of mandatory testing of the recipient?s blood group,antibody screening,possibly identification of special antibodies,and the cross match test itself.All these tests are performed using the agglutination method.Compatibility test is a reaction between donor?s and recipient?s serum,which is used for confirmation that the recipient?s blood is compatible with the donor?s blood.It can be examined either serologically(on a slide,in a tube,by gel column agglutination,by methods of solid phase)or electronically(type and screen strategy,electronic test of compatibility).Validity of the compatibility test is 72hours,counting from the moment of sampling of recipient?s blood.My thesis deals with the examination of the actual test of the compatibility of the transfusion product,literary comparison of various methods and comparison of the manual performance of the column gel agglutination method(LISS/NAT)and performance with the use of the Techno TwinStation machine.My work also includes comparison of an operational perspective and an economic perspective.The practical part of this work was carried out in Blood bank of Hospital Budweis.With the use of literary comparison of methods of compatibility test,I conclude that the most sensitive method used to investigate the compatibility test is the indirect anti-globulin test(NAT)performed using column gel agglutination or solid phase methods.My recommendation corresponds to the findings of Společnost pro transfuzní lékařství.The thesis confirms that the cross match testing via using the gel column agglutination method(LISS/NAT)was the best choice made by the Blood bank.Benefits of the gel column agglutination compared to the tube methods are the speed,smaller consumption of reagents and blood samples,the possibility of standardization,automation and documentation.Finally,the method has higher sensitivity,which increases the safety of blood transfusion for the patient.Examination of compatibility testing using the gel column agglutination method(LISS/NAT)was done in 52 patients manually and using the Techno TwinStation(a total of 118 tests).Examination results were identical regardless the chosen method.There was also no significant difference concerning the operational and economic costs of the two methods(manual was about 24CZK,automated was about 26CZK).In manual performance human errors cannot be eliminated, whereas in automation these errors are eliminated.Another advantage of automation is the traceability of all the elements involved in the analytical process,which are archived and will remain accessible after the test.The advantage of the manual compatibility tests is shorter total examination time(about 30-35min compared to about 45-60min when using automated method;depending on the number of samples).The disadvantage of automated method of compatibility testing using the Techno TwinStation machine is the impossibility to add more samples during pipetting.
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