blood group

Mujtaba Ashraf 1

BLOOD GROUPS&BLOOD TRANSFUSION

Presented by:Dr. Mujtaba AshrafMDS JR-1Dept. of Prosthodontics

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Introduction

Blood group systems ABO blood group system

Rh blood group system

Contents

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Blood transfusionIntroduction

Precautions

Adverse effect Of Blood Transfusion�Exchange Transfusion

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Introduction A blood group also called a Blood Type

Classification of blood is 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.

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ABO Blood Group System

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The ABO blood group system is the most important blood type system (or blood group system) in human blood transfusion.

ABO blood types are also present in some other animals for example rodents and apes such as chimpanzees, bonobos and gorillas.

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Determination of ABO blood groups depends upon the immunological reaction between antigen and antibody.

Antigens are also called agglutinogens because of their capacity to cause agglutination of RBCs.

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Karl Landsteiner discovered the ABO Blood Group System in 1901. Adriano Sturli and Alfred von Decastello who were working under Landsteiner discovered type AB a year later in 1902 Landsteiner was awarded the 1930 Nobel Prize in

Physiology or Medicine for his work.

History

Karl Landsteiner

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Janský is credited with the first classification of blood

into the four types (A, B, AB, O) in 1907, which remains in

use today.

Reuben Ottenberg successfully transfused blood between

two people at Mount Sinai Hospital in New York. He was

the first person to record pre-transfusion testing for blood

compatibility in a clinical setting.

Later in 1954 he was the first to be awarded with Karl

Landsteiner Award 16/09/2015

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Landsteiner Rule

If an antigen is present on a patients red blood

cells (RBCs) the corresponding antibody will NOT

be present in the patients plasma, under ‘normal

conditions’.

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ABO BASICS

Based on the presence or absence of antigen A and

antigen B, blood is divided into four groups:

‘A, B, AB and ‘O’ group.

Blood having antigen A belongs to ‘A’ group. This

blood has β-antibody in the serum.

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Blood with antigen B and α-antibody belongs to ‘B’

group.

If both the antigens are present, blood group is called

‘AB’ group and serum of this group does not contain

any antibody.

If both antigens are absent, the blood group is called

‘O’ group and both α and β antibodies are present in

the serum.

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ABO Group

Antigen Present

Antigen Missing

Antibody Present

A A B Anti-BB B A Anti-AO None A and B Anti-A&B

AB A and B None None

Antigen and AntibodyPresent in ABO Blood Group

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Principle of Blood Groupingo Blood grouping is done on the basis of agglutination.o Agglutination means the collection of separate particles like RBCs into clumps or masses.o Agglutination occurs if an antigen is mixed with its corresponding antibody which is called isoagglutinin, i.e. occurs when A antigen is mixed with anti-A or when B antigen is mixedwith anti-B.

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IMPORTANCE OF ABO GROUPSIN BLOOD TRANSFUSION

During blood transfusion, only compatible blood must

be used.

The one who gives blood is called the ‘donor’ and the

one who receives the blood is called ‘recipient’.

While transfusing the blood, antigen of the donor and

the antibody of the recipient are considered.

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The antibody of the donor and antigen of the

recipient are ignored mostly.

Thus, RBC of ‘O’ group has no antigen and so

agglutination does not occur with any other group

of blood. So, ‘O’ group blood can be given to any

blood group persons and the people with this blood

group are called ‘universal donors’.

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Plasma of AB group blood has no antibody. This does

not cause agglutination of RBC from any other group

of blood.

People with AB group can receive blood from any

blood group persons. So, people with this blood

group are called ‘universal recipients’.

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In mismatched transfusion,the transfusion reactions occur between donor’s RBC and recipient’s plasma.So, if the donor’s plasma contains agglutinins against recipient’s RBC, agglutination does not occur because these antibodies are diluted in the recipient’s blood.

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Blood Compatibility

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TRANSFUSION REACTIONSDUE TO ABO INCOMPATIBILITY

Transfusion reactions are the adverse reactions in thebody, which occur due to transfusion error that involves transfusion of incompatible (mismatched) blood.The reactions may be mild causing only fever and hives (skin disorder characterized by itching) or may be severe leading to renal failure, shock and death.

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Rh Blood Group System

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The Rh blood group system is one of thirty-five current human blood group systems.

It is the most important blood group system after ABO.

Rh blood group system consists of 50 defined blood-group antigens, among them there are six common types of Rh antigens.

Each of which is called an Rh factor. These types are designated C,D, E, c, d, and e.

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The type D antigen is widely prevalent in the

population and considerably more antigenic than

the other Rh antigens.

Anyone who has this type of antigen is said to be

Rh positive, whereas a person who does not have

type D antigen is said to be Rh negative.

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This antigen was discovered by Karl

Landsteiner and Alexander Wiener in 1940.

It was first discovered in Rhesus macaque and

hence the name 'Rh factor’.

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Erythroblastosis Fetalis (“Hemolytic Disease of the Newborn”)

Erythroblastosis fetalis is a disease of the fetus and newborn child characterized by agglutination and phagocytosis of the fetus’s red blood cells.In most instances of erythroblastosis fetalis, the mother is Rh negative and the father Rh positive.The baby has inherited the Rh-positive antigen from the father, and the mother develops anti-Rh agglutinins from exposure to the fetus’s Rh antigen.In turn, the mother’s agglutinins diffuse through the placenta into the fetus and cause red blood cell agglutination.

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Symptoms and signs in the fetus:Enlarged liver spleen, or heart

fluid buildup in the fetus' abdomen seen via ultrasound.

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Symptoms and signs in the newborn:• Anemia that creates the newborn's pallor

(pale appearance).• Jaundice or yellow discoloration of the

newborn's skin, sclera or mucous membrane. • Enlargement of the newborn's liver and

spleen.• Severe edema of the entire body.• Dyspnea or difficulty breathing.

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Other Blood Group System

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Thirty-five major blood group systems were recognized by the International Society of Blood Transfusion (ISBT) in October 2012.

In addition to the ABO antigens and Rhesus antigens, many other antigens are expressed on the red blood cell surface membrane.

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An individual can be AB Rh D positive, and at the same time M and N positive (MNS system), K positive (Kell system), and Lea or Leb positive (Lewis system). Many of the blood group systems were named after the patients in whom the corresponding antibodies were initially encountered.

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Other blood groups include

Auberger groups Diego group Bombay group Duffy group Lutheran group P group Kell group I group Kidd group Sulter Xg group Kidd group Duffy group

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Blood Transfusion

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Blood transfusion is generally the process of receiving blood products into one's circulation intravenously.

Transfusions are used for various medical conditions to replace lost components of the blood.

Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors, and platelets.

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Blood transfusion is the process of transferring blood or blood components from one person (the donor) into the bloodstream of another person (the recipient).

Richard Lower pioneered the first blood transfusion from animal to human in 1665 at the Royal Society.

In 1840 Dr. Blundell, performed the first successful whole blood transfusion to treat haemophilia.

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•Before a blood transfusion is given, there are many steps taken to ensure quality of the blood products, compatibility, and safety to the recipient.

•Blood transfusions typically use sources of blood: one's own (autologous transfusion), or someone else's (allogeneic or homologous transfusion).

•The latter is much more common than the former.•Using another's blood must first start with donation of blood.

•Blood is most commonly donated as whole blood intravenously and collecting it with an anticoagulant.

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Processing and Testing of Blood

Donated blood is usually subjected to processing after it is collected, to make it suitable for use in specific patient populations.

Collected blood is then separated into blood components by centrifugation: red blood cells, plasma, platelets, albumin protein, clotting factor concentrates, cryoprecipitate, fibrinogen concentrate and immunoglobulins (antibodies)

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All donated blood is tested for infections like HIVs, Hepatitis B, Hepatitis C, Syphilis

All donated blood is also tested for ABO and Rh groups, along with the presence of any red blood cell antibodies.

Pathogen Reduction treatment done.

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CONDITIONS WHEN BLOOD TRANSFUSIONIS NECESSARY

Anemia Hemorrhage Trauma Burns Surgery

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PRECAUTIONS TO BE TAKEN BEFORETHE TRANSFUSION OF BLOOD Donor must be healthy, without any diseases like: a. Sexually transmitted diseases such as syphilis b. Diseases caused by virus like hepatitis, AIDS, etc. Only compatible blood must be transfused Both matching and cross-matching must be done Rh compatibility must be confirmed.

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PRECAUTIONS TO BE TAKEN WHILETRANSFUSING BLOOD

Apparatus for transfusion must be sterile

Temperature of blood to be transfused must be same as the body temperature

Transfusion of blood must be slow. The sudden rapid infusion of blood into the body increases the load on the heart, resulting in many complications.

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Adverse effect of Blood transfusionTransfusions of blood products are associated with several complications, many of which can be grouped as immunological or infectious such as:

Acute hemolytic reactionDelayed hemolytic reactionAllergic reactionPost-transfusion purpuraTransfusion associated acute lung injuryHIVHepatitis C

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EXCHANGE TRANSFUSION- is the procedure which involvesremoval of patient’s blood completely and replacementwith fresh blood or plasma of the donor.

Also known as replacement transfusion.

It is an important in life-saving procedure carried out in conditions such assevere jaundice, sickle cell anemia, erythroblastosisfetalis, etc.

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References•Guyton-Physiology-11th edition

•Essentials of Medical Physiology, 6th Edition By K Sembulingam

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