Immunohematology Blood Bank

I.     Course Prefix/Number: MLT 113

       Course Name: Immunohematology Blood Bank

       Credits: 4 (3 lecture; 3 lab)

II.    Prerequisite

MLT 105, 106, 111, and 112 with a minimum grade of C in each course.

III.   Course (Catalog) Description

Course introduces basic concepts in immunology and blood banking. Lectures and laboratory sessions focus on performing all routine and some special procedures currently practiced in blood bank departments. 

IV.   Learning Objectives

Upon successful completion of this course the student will be able to:

  1. Describe the fundamentals of the immune system pertaining to immunohematology including cellular and humoral immunity; characteristics and properties of antigens and antibodies; primary and secondary immune response; antigen/antibody interaction, the factors affecting the process and methods of detection.
  2. Compare the classical and alternate pathways of the complement system including recognition, enzymatic activation, membrane attack and its biological effects.
  3. Outline the basic mode of gene inheritance, descriptive genetic terms, and gene expression.
  4. Differentiate the basic inheritance and interaction of the ABO, Hh, and Sese gene systems; include the ABO antigens and antibodies, methods of detection, clinical significance in transfusion medicine and hemolytic disease of the newborn.
  5. Compare common and uncommon ABO genotypes; include resolutions to common ABO discrepancies.
  6. Identify the basic inheritance of Rh genes; include various nomenclatures.
  7. Differentiate Rh antigens and antibodies, the methods of detection, and clinical significance in transfusion medicine and hemolytic disease of the newborn; include common and uncommon Rh genotypes and resolutions to common discrepancies.
  8. Summarize the principle and procedures of the antiglobulin tests; include their clinical applications; various reagents used; and common sources of error.
  9. Trace the mode of inheritance and interaction of Lele, Sese and ABO gene systems,; include Lewis antigens and antibodies, methods of detection, and clinical significance in transfusion medicine and hemolytic disease of the newborn.
  10. Differentiate the blood groups system such as Kidd, Duffy, Kell, Lutheran, P, I, MNSs, and various less encountered blood group systems in terms of mode of inheritance, their antigens and antibodies, methods of detection and clinical significance in transfusion medicine and hemolytic disease of the newborn.
  11. Compare various methods of antibody detection and identification including additional techniques to assist identification.  Apply the theory of "ruling out" and the criteria for 95% confidence in antibody specificity.
  12. Compare the AABB requirements for routine and special circumstance pre-transfusion testing including patient and specimen identification; patient records; clinical testing performed; and proper selection, labeling and issuing of blood components.
  13. Identify various causes and symptoms of adverse reactions to transfused blood components and the related clinical testing performed. 
  14. Compare various causes, symptoms and prevention of hemolytic disease of the newborn and the related clinical testing performed.
  15. Identify various pathologic and benign causes for a positive direct antiglobulin test and the related clinical testing performed. 
  16. Compare various techniques to identify autoantibodies and detect underlying alloantibodies.  State the clinical significance of autoantibodies.
  17. Outline the proper selection and phlebotomy of routine and special blood component donors.
  18. Discuss the purpose of preserving blood components; include anticoagulants used and preservative solutions.
  19. Compare the methods of preparation, storage requirements and clinical indications for the various blood products.
  20. Identify various infectious diseases acquired through transfusion of blood products.
  21. Evaluate various Quality Assurance activities employed in a transfusion service.
  22. Summarize future trends in Blood Banking including blood substitutes and monoclonal antibodies.
  23. Compare the roles and requirements of agencies such as the FDA, CAP, AABB, HHS, and the JCAHO that regulate blood banks.
  24. Perform practice laboratory exercises to include ABO/Rh typings, problem solving ABO/Rh discrepancies, Rh phenotyping, direct and indirect antiglobulin tests, pretransfusion testing, antibody identification, transfusion reaction and cord blood workups, and screening tests to detect fetomaternal bleed.
  25. Be able to discuss the different types of Blood Bank Instrumentation and the principles for how the equipment functions (Types and screens, Crossmatch, DAT etc.).
  26. Orally present on selected Blood Bank topic according to established criteria.
  27. Demonstrate teaching ability through peer teaching and group discussion.

V.    Academic Integrity and Student Conduct

Students and employees at Oakton Community College are required to demonstrate academic integrity and follow Oakton's Code of Academic Conduct. This code prohibits:

• cheating,
• plagiarism (turning in work not written by you, or lacking proper citation),
• falsification and fabrication (lying or distorting the truth),
• helping others to cheat,
• unauthorized changes on official documents,
• pretending to be someone else or having someone else pretend to be you,
• making or accepting bribes, special favors, or threats, and
• any other behavior that violates academic integrity.

There are serious consequences to violations of the academic integrity policy. Oakton's policies and procedures provide students a fair hearing if a complaint is made against you. If you are found to have violated the policy, the minimum penalty is failure on the assignment and, a disciplinary record will be established and kept on file in the office of the Vice President for Student Affairs for a period of 3 years.

Please review the Code of Academic Conduct and the Code of Student Conduct, both located online at
www.oakton.edu/studentlife/student-handbook.pdf

VI.   Sequence of Topics

  1. The Immune Response
    1. T and B cells
    2. Antigens
    3. Immunoglobulins
    4. Immune Response
  2. Antigen/Antibody Interactions
    1. Bonds
    2. Agglutination
    3. Factor Influencing Antigen/Antibody Interaction
    4. Enhancing Antigen/Antibody Interaction
    5. Detection of Antigen/Antibody Interaction
  3. Complement
    1. Classical Pathway
    2. Alternate Pathway
    3. Biological Effects
    4. Detection
    5. Stability
  4. Genetics
    1. Types of Genes
    2. Descriptive Terms
    3. Mendelian Laws
    4. Gene Expression
    5. Hardy-Weinberg Principle
  5. ABO Blood Group System
      1. Genetic Interaction of ABO, Hh, and Sese
        1. Antigens
      2. Subgroups
        1. Antibodies
        2. Clinical Significance
      3. Detection
        1. Discrepancies
  6. Rh Blood Group System
      1. Mode of Inheritance
        1. Fisher-Race
        2. Wiener
        3. Rosenfield
      2. Phenotyping and Most Probable Genotype
      3. Antigens
      4. Antibodies
      5. Clinical Significance
      6. Detection
  7. Antiglobulin Testing
    1. Principle
    2. Indication for Use
    3. Reagents
    4. Procedure
    5. Sources of Error
  8. Lewis Blood Group System (Le)
    1. Mode of Inheritance
    2. Antigens
    3. Antibodies
    4. Clinical Significance
    5. Detection
  9. Warm Blood Group Systems (Kell, Kidd, Duffy, Lutheran)
    1. Mode of Inheritance
    2. Antigens
    3. Antibodies
    4. Clinical Significance
    5. Detections
  10. Cold Blood Group Systems (MNSs, P, I)
    1. Mode of Inheritance
    2. Antigens
    3. Antibodies
    4. Clinical Significance
    5. Detection
  11. Miscellaneous Blood Group Systems
    1. System Characteristics
  12. Antibody Detection & Identification
    1. Detection of Red Cell Antibodies
    2. Methodologies/Reagents
    3. Special Techniques
    4. Red Cell Panel
    5. Confirmation of Antibody Specificity
    6. Compatible Units
  13. Compatibility Testing
    1. Specimen Requirements
    2. Procedure
    3. Selection of Blood
      1. Routine
      2. Emergency
    4. Problem Crossmatches
  14. Adverse Effects of Transfusion
    1. Non-immunological causes
    2. Febrile and Allergic Reactions
    3. Hemolytic Reactions
      1. Red Cell Destruction
    4. Clinical Investigation
  15. Hemolytic Disease of the Newborn (HDN)
    1. Etiology
      1. Antigen Exposure/Antibody Production.
    2. Diagnosis/Clinical Investigation
    3. Treatment
    4. Prevention
  16. Positive Direct Antiglobulin Test
    1. Benign Causes
    2. Autoimmune Hemolytic Anemia (AIHA)
      1. Cold Agglutinin Disease
      2. Warm Autoimmune Disease
      3. Drug Induced Hemolytic Anemias
  17. Blood Preservation
    1. Red Cell and Platelet Preservation
    2. Anticoagulants/Preservation Solutions
  18. Donor Selection and Phlebotomy
    1. Selection
    2. Phlebotomy
    3. Adverse Reactions
    4. Special Donors
  19. Components and Transfusion Therapy
    1. Clinical Indication
    2. Methods of Preparation
    3. Storage Requirements
    4. Advantages/Disadvantages
  20. Infectious Diseases Acquired through Transfusion
    1. Viral
    2. Bacterial
    3. Parasitic
  21. Quality Assurance
    1. General Principles and Purpose
    2. Reagents
    3. Equipment
    4. Components
    5. Records
  22. Future Trends in Immunohematology
    1. Blood Substitutes
    2. Monoclonal Antibodies
  23. Blood Bank Regulatory Agencies

VII.  Methods of Instruction

Methods of presentation will include lectures, reading assignments, videocassettes, and slide‑tape series.  In addition study questions and case studies will be used to guide the students learning.

Student laboratory practice sessions will be used to supplement information given in the lectures and readings and to allow the student to develop skill and accuracy in performing immunohematology procedures.


Course may be taught as face-to-face, hybrid or online course.

VIII. Course Practices Required

  1. Course is taught face-to-face, hybrid or online course.
  2. Read assigned material.
  3. Attend all lectures and laboratory sessions.
  4. Complete lab assignment each week in a satisfactory manner.
  5. Complete study questions, case study assignments, and any other specific assignments for class.
  6. Complete all assigned Media Lab modules.

IX.   Instructional Materials

Note: Current textbook information for each course and section is available on Oakton's Schedule of Classes.

X.    Methods of Evaluating Student Progress

Students’ final grade will be based on the number of points earned on lecture and laboratory quizzes; 4 Lecture Exams; 1 Cumulative Final Exam; 1 Laboratory Practical Exam; laboratory assignments; completion of special exercises; class participation and attendance.

There will be approximately 1000 possible points for the semester broken down as follows:

Exam 1 100 points
Exam 2 100 points
Exam 3 100 points
Exam 4 100 points
Final Comprehensive Exam 100 points
Quizzes 115 points
Laboratory exercises (13) 145 points
Laboratory Practical Exam 100 points
Study Questions/homework/case studies 130 points
Oral presentation 10 points
Total Points Possible 1000 points

The final grade will be based on the total points earned as follows:

Points Earned  Grade Equivalent
920 – 1000 A
840 – 919 B
760 – 839 C
700 – 759 D
Below 700 F

XI.   Other Course Information

Students must notify the instructor if they will be late or absent. Attendance and class participation are included in grading.  Points will be deducted for excessive absences and late arrivals to class as they disrupt class for your classmates.

Students must successfully complete both the lecture and laboratory components of the course (this means earning a 76% or above in each component).

No makeup quizzes or exams will be given unless the instructor agrees (to give the exam) prior to the class meeting.  Students will be permitted to make up only one exam.  The exam must be completed in a timely manner for full credit.  Instances where the exam is not completed before the next class session may result in a reduction of points.  Students that do not complete an exam in the regularly scheduled time slot will still be required to complete it, but may receive little or no credit depending on the circumstances.

Students are responsible for material covered in class, even if missed.  If absent, it is advised that students contact someone in class for this information prior to the next class session.  Your instructor is willing to assist you in reviewing any material you do not understand.  Please initiate the contact for such help.

All assignments are due at the beginning of class on the date specified; late papers will have points deducted. If you are absent on the date an assignment is due you must make arrangements with the instructor to be allowed to turn it in for credit. All assignments must be completed in order to earn a grade for the class.

Failure to comply with established laboratory waste disposal policies will result in loss of laboratory points.

Established laboratory safety protocol must be followed while in the laboratory including: no eating or drinking in the lab, removal of personal protective equipment and washing of hands before leaving lab, and others discussed in class.

Proper clothing must be worn to all laboratory sessions which includes no shorts or open toe shoes.  Long hair must also be tied back.   If shorts or open toe shoes are worn to class, you will not be allowed to participate in the lab session.  You will be asked to leave and points will be deducted for an absence.  The lab will need to be made up in open lab.

No special projects or term papers will be accepted in lieu of class assignments, written exams, or active participation in class.

College policies regarding Academic Dishonesty, Student Procedure for Appeal of a Final Grade, and Code of Student Conduct, are described in the catalogue.

Oakton Community College recognizes the broad diversity of religious beliefs of its constituencies.  The college has embraced a practice of shared responsibility in the event a religious observance interferes with class work or assignments.  Students who inform instructors in advance of an intended absence for a major religious observance will not be penalized.  The instructor will make reasonable accommodation for students, which may include providing a make-up test, altering assignment dates, permitting a student to attend another section of the same course for a class period or similar remedies.  Instructors are not responsible for teaching material againInstructors should inform students of this practice at the beginning of the semester so that arrangements can be made accordingly.

If you have a documented learning, psychological, or physical disability you may be entitled to reasonable academic accommodations or services.  To request accommodations or services, contact the Access and Disability Resource Center at the Des Plaines or Skokie campus.  All students are expected to fulfill essential course requirements.  The College will not waive any essential skill or requirement of a course or degree program.

Health Status Change Policy Statement – Any change in health status of currently enrolled students, resulting in the inability to meet the course/program objectives and standards as outlined in the Essential Skills requirement policy will require documentation and medical approval for the student to return to clinical, theory, and lab-which require lifting without restrictions.

  1. Any change in health status must be reported to the Chair of the department.  Examples may include but are not limited to, back injury, pregnancy, infection such as shingles, fractures, etc.
  2. Students must provide documentation of care by an Illinois licensed physician or an Illinois certified nurse practitioner and submit a medical release without restrictions before returning to clinical/class.
  3. Releases from physicians or nurse practitioners must state that the student “can return to the laboratory and clinical facility without any work restrictions.”

A change in health status must be reported to the Chair of the department.  Failure to submit a medical release or information regarding a change in health status within 30 days is grounds for immediate dismissal from a Health Career Program.



If you have a documented learning, psychological, or physical disability you may be entitled to reasonable academic accommodations or services. To request accommodations or services, contact the Access and Disability Resource Center at the Des Plaines or Skokie campus. All students are expected to fulfill essential course requirements. The College will not waive any essential skill or requirement of a course or degree program.

Oakton Community College is committed to maintaining a campus environment emphasizing the dignity and worth of all members of the community, and complies with all federal and state Title IX requirements.

Resources and support for
  • pregnancy-related and parenting accommodations; and
  • victims of sexual misconduct
can be found at www.oakton.edu/title9/.

Resources and support for LGBTQ+ students can be found at www.oakton.edu/lgbtq.