GROUP 1 : ~ ANGGIKA PUTRA I. ~ AULIA CHOIRINA PUTRI ~ DALILAH BADZLIN ~ NUR MUHAMMAD ZAIN ~ YUSUF RIDHO H.

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Blood clotting mechanism occurs in three stages : A. B. If there is a wound, it will produce thromboplastine or trombocinase which is the activator of prothrombine. Thrombokinase cause changes in prothrombin to thrombin. Changes are driven by calcium ions. globulin and prothrombine in the form of a compound is always formed in the liver with the help of vitamin K. If vitamin K deficiency, will cause the velocity to decrease blood clotting. Thrombin worked as an enzyme which converts fibrinogen into fibrin threads. With the formation of fibrin threads that mesh, causing the red blood cells and plasma clot forming netted.

C.

For blood transfusion, thrombosis should be prevented and inhibited by : 1. Provide sodium oxalate salt or sodium citrate to precipitate calcium ions so that the conversion of prothrombin to thrombin inhibited 2. Cooling the blood near its freezing point to inhibit the formation of thrombin 3. Avoid contact with rough surfaces 4. Giving heparin or dicumarol which is an anticoagulant or anti-clotting substance of blood

A blood type (also called a blood group) is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system. Some of these antigens are also present on the surface of other types of cells of various tissues. Several of these red blood cell surface antigens can stem from one allele (or very closely linked genes) and collectively form a blood group system. Blood types are inherited and represent contributions from both parents.

Human blood type is determined based on the types of antigens and antibodies contained in blood, as follows: Blood type A has the red blood cells with antigen A on the surface of cell membranes and produce antibodies against antigen B in their blood serum. Thus, people with blood type A-negative can only receive blood from people with blood type A-negative or Onegative. Blood type B has B antigens on the surface of red blood cells and produce antibodies against antigen A in their blood serum. Thus, people with blood type B-negative can only receive blood from people with blood type B-negative or O-negative Blood type AB red blood cells with antigen A and B and does not produce antibodies against antigens A and B. Thus, people with blood type AB-positive blood can receive from a person with any ABO blood group and called the universal recipient. However, people with blood type AB-positive can not donate blood except to fellow AB-positive.

 Blood type O has no antigens of blood cells, but produce antibodies against antigens A and B. Thus, people with blood type O-negative can donate blood to people with any ABO blood type and is called the universal donor. However, people with blood type O-negative can only receive blood from another O-negative

In the blood plasma contained antibodies called aglutinin. Aglutinin is an antibody that reacts with the antigen and present in red blood cell surface. Appropriate type of aglutinogen, there are two types namely aglutinin aglutinin (anti-A) and aglutinin (anti-B). If both these aglutinin react with antigens, red blood cells will clump with each other or through lysis. Such a process called agglutination (blood clotting).

BLOOD TRANSFUSION
Blood transfusion is the transfer of someones blood into some one else that needs it. A harmful reaction may occur when a transfusion occurs between incompatible blood types. Transfused plasma is usually diluted so it does not cause agglutination. A person who gives his blood is called the donor and that who receives is the recipient.

A person with blood type AB is called universal recipient because s/he does not have agglutinins, therefore s/he can receive any blood type. The contrary, blood type O is called a universal donor. Type O lacks of agglutinogens on its erythrocytes so it will not trigger antibody-antigen reaction when given to others. This condition of being either universal recipient or donor is carried out only under emergency situations. Sensitivity reaction still may occur because of non ABO incompatibility.

1. Whole blood Whole blood (complete blood) is usually reserved for massive transfusion in bleeding. Normal whole blood is given to acute hemorrhage, hypovolemic shock and major surgery with bleeding> 1500 ml. Whole blood will increase oxygen-carrying capacity and increased blood volume. One unit of whole blood transfusion increases the hemoglobin of 1 g / dl

2. Packed Red Blood Cell (PRBC)

PRBC contain hemoglobin similar to whole blood, the difference is the amount of plasma, which contains fewer PRBC plasma. This causes higher levels of hematocrit PRBC compared with whole blood, which is 70% compared to 40%. PRBC commonly given to patients with slow bleeding, patients with anemia or heart abnormalities. When about to use, PRBC need to be warmed up first with body temperature (37 C). when not heated, will complicate the transfer of oxygen from the blood to the organs of the body.

3. Fresh Frozen Plasma

Fresh frozen plasma (FFP) contains all plasma proteins (clotting factors), especially factors V and VII. FFP usually given after massive blood transfusion, after warfarin therapy and coagulopathy in liver disease. Each unit of FFP usually can raise each clotting factor levels of 2-3% in adults. Same with PRBC, when about to be given to patients should be warmed beforehand according to body temperature.

4. Platelets
Platelet transfusion is indicated in patients with severe thrombocytopenia (<20,000 cells/mm3) with clinical symptoms of bleeding. However, if not found clinical symptoms of bleeding, platelet transfusion is not required. One unit of platelets could increase 7000-10000 trombosit/mm3 after 1 hour transfusion in patients weighing 70 kg. many factors that play a role in the success of platelet transfusions include splenomegaly, previous sensitization, fever, and active bleeding.

5. Cryoprecipitate
Cryoprecipitate containing factor VIII and fibrinogen in large quantities. Cryoprecipitate is indicated in patients with the disease hemophilia (factor VIII deficiency) and also in patients with fibrinogen deficiency.

Reshus or Rh is another antigen found on red blood cells. The term comes from the Rh "Rh", because the antigen was first discovered in 1940 by Landsteiner and AS Wenner in the blood of rhesus macaques Mocacus. Blood cells that have the Rh antigen are called Rh + (Rh positive), whereas that does not have the Rh antigen are called Rh-(Rhesus negative). If the person who has Rh negative blood transfusion with Rh positive (Rh +), people with blood type Rh negative (Rh-) are immediately will form anti-Rh antibodies, causing blood agglutination.