Types Of Blood from Rtibloodinfo
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Types Of Blood from Rtibloodinfo Types Of Blood from Rtibloodinfo Presentation Transcript

  • BLOOD GROUPS & TYPES
  • HISTORICAL
    • 19 th CENTURY: Boer War
    • Massive deaths of people:
      • Many infections
      • Severe blood loss
    • Attempts to transfuse blood began.
    • They had confusing results.
    • Some people recovered fully.
    • Others died.
  • WHY? WHY? WHY?
    • Either all should die
    • Or all should live.
    • Why this difference?
    • This question haunted a researcher called Karl Landsteiner.
    • He worked hard to find out why.
  • KARL LANDSTEINER, NOBEL LAUREATE, 1930. 1 8 6 8 1 9 4 3
  • KARL LANDSTEINER
    • Wondered about this phenomenon.
    • Studied this extensively.
    • Discovered Blood Groups and types single handedly.
    • Framed the Landsteiner’s Law in 1904.
    • Continued to research on Blood groups and types till his death in 1943.
  • LANDSTEINER’S LAW
    • 1.“If an agglutinogen is present in the red cells of a blood, the corresponding agglutinin must be absent from the plasma.”
    • 2. “If an agglutinogen is absent in the red cells of a blood, the corresponding agglutinin must be present in it’s plasma.”
  • LANDSTEINER’S LAW: APPLICABILITY
    • The first law is applicable to all groups and types of blood.
    • It is a logical conclusion.
    • The second part is a fact, but not necessarily true always.
    • It is a fact for ABO Blood groups.
    • The Rh, M,N and other groups or types do not follow the second part of the Landsteiner’s Law.
  • ABO BLOOD GROUPS The most common type of blood grouping in use.
  • AGGLUTINOGENS
    • Also called antigens.
    • These agglutinogens are present on the outer surface of the Erythrocyte membranes.
    • They are antigenic and have epitopes or antigenic determinants, which are glycoproteins.
    • In ABO groups, three types of agglutinogens can be present.
  • AGGLUTINOGENS (Contd)
    • Some individuals will have Erythrocytes with an agglutinogen called as “A”.
    • Others have one called “B”
    • The third type of agglutinogen is non antigenic and it is called “H”
    • H doesn’t cause production of antibodies.
    • So those having H antigen are called O group individuals.
  • A AND B, INDIVIDUALS
    • Those having the A agglutinogen on their erythrocytes are called A blood group people.
    • Those having the B agglutinogen are called the B blood group people.
    • Some have both the A and B agglutinogens on their erythrocytes and they are called AB type.
    • Others have neither A nor B agglutinogens . They have the non antigenic H on their RBCs and are called O group people.
    AB & O INDIVIDUALS
  • AGGLUTININS
    • The antibodies to the agglutinogens are called Agglutinins.
    • These are present naturally in ABO groups.
    • They are always present in the plasma of the individual.
    • There are two types of agglutinins in the ABO blood system:
      • Anti A or α : Alpha
      • Anti B or β : Beta
  • AGGLUTININS (Contd)
    • The A group people have the Beta or anti B agglutinin in their plasma.
    • Similarly the B group people have the Alpha or Anti-A agglutinin in their plasma.
    • The AB group of people have no agglutinins in their plasma.
    • The O group people have both Alpha and Beta types of agglutinins in their plasma.
  • ABO BLOOD GROUPS GROUP AGGLUTINOGEN/S ON RBC AGGLUTININ/S IN PLASMA A A β B B α AB Both A & B None O Neither A nor B Both α and β
  • ABO BLOOD GROUP TEST
    • Why test?
    • To determine the blood groups.
    • How is the test done?
    • The erythrocytes of the patient are exposed to the two different types of anti sera.
    • Antisera are solutions containing the respective agglutinins.
    • Anti A agglutinin is present in Antisera A
    • Anti sera B contains Beta agglutinin or anti B agglutinin.
    • In this test the patients erythrocytes are exposed separately to both these antisera.
    • Agglutination is seen in one or more of the solutions.
    ABO BLOOD GROUP TEST
  • AGGLUTINATION
    • Agglutination or clumping is seen whenever the respective agglutinogens and agglutinins are mixed.
    • Agglutinogen A + Agglutinin Alpha = Agglutination.
    • Agglutinogen B + Agglutinin Beta = Agglutination.
    • Both agglutinogens + Both antisera = Agglutination.
    • No agglutinogens = No agglutination.
    • If there is agglutination with antisera A, the blood group of the individual will be A.
    • If there is agglutination with antisera B, the blood group of the individual is B.
    • If there is agglutination with both the antisera, then the blood group is AB.
    • If there is no agglutination with either of the two antisera, then the person is of the group O.
    ABO BLOOD GROUP TEST
    • By doing this test we can determine the blood group of individuals.
    • Knowing one’s blood group helps us in times of need. If a patient is of Group A, he can receive blood as transfusion from group A or group O individuals. He cannot receive it from Group B or Group AB people.
    ABO BLOOD GROUP TEST
    • Why?
    • Because the agglutinogens in the donor’s blood can agglutinate with the agglutinin in the recipient’s blood and cause hemolysis.
    • This is called transfusion mismatch and can be fatal.
    ABO BLOOD GROUP TEST
  • UNIVERSAL DONOR & RECEPIENTS
    • The blood group O can be given to any other of the ABO group persons and so is called the “Universal Donor”
    • The blood group AB persons lack agglutinins and so can receive blood from any of the ABO group persons. So this AB group is called as the “Universal Recipient”
  • DONATION BLOOD
  • DONATIONS…
    • A Blood group person can donate blood to A and AB groups.
    • B Blood group person can donate blood to B and AB groups.
    • AB Blood group person can donate blood only to AB group.
    • O blood group person can donate blood to O, A, B and AB groups.
  • ABO BLOOD GROUP TEST: SUMMARY RED CELLS ANTISERA ALPHA ANTISERA BETA A AGGLUTINATION NO AGGLUTINATION B NO AGG. AGGLUTINATION AB AGGLUTINATION AGGLUTINATION O NO AGGLUTINATION NO AGGLUTINATION
  • CROSS MATCHING
    • This is a test done just before the blood is transfused.
    • It helps rule out other group mismatches.
    • It has two parts: Major & Minor cross matching.
  • MAJOR CROSS MATCHING
    • The effects of the recipient’s serum agglutinins on the donors erythrocytes.
    • This is called major because about 300 ml of the Blood cells of the donor are sent into the circulation of the recipient.
    • Donor’s Erythrocytes+ Recipient’s plasma= ?
  • MINOR CROSS MATCHING
    • The Effect of the donor’s serum agglutinins on the recipient’s erythrocytes.
    • This is called minor because these agglutinins get diluted by the larger volume of the recipient’s plasma.
    • Donor’s Serum + Recipient’s Erythrocytes
  • PERCENTAGE OF BLOOD GROUPS
  • PERCENTAGE OF BLOOD GROUPS
  • Rh TYPING: INTRODUCTION
    • It is the second most important typing of blood.
    • These blood groups were originally discovered in Rh esus monkeys
    • Rh is another type of agglutinogen .
    • It is also present on the outer surface of the erythrocytes.
  • Rh Positive and Negative people
    • People who have the Rh agglutinogen on their RBC membranes are called Rh Positive.
    • Those who do not have the Rh agglutinogen are called Rh Negative people.
    • Rh-ve people do not NATURALLY carry the corresponding Anti-Rh antibody .
  • DISTRIBUTION OF Rh TYPES
  • DISTRIBUTION OF Rh TYPES
  • Rh or D Agglutinins
    • Anti-D agglutinins or antibodies do not occur naturally.
    • They are produced by the Immune systems as and when it is exposed to the D antigens.
    • So these Anti D agglutinins are found only in some of the Rh Negative people.
    • Those who have been exposed to the Rh or D antigen
  • Exposure to Antigens: How?
    • The Rh+ve people will never manufacture Anti D antibodies.
    • Only Rh – ve individuals can develop these Agglutinins.
    • When these Rh-ve people receive Rh+ve blood by mistake, they get exposed to the antigen.
    • Then they will develop the antibody.
    • In case of an Rh-ve woman , if she is married to an Rh+ve man , she can conceive an Rh+ve child .
    • In this case, the D antigen present on the erythrocytes of the fetus does not go into the maternal circulation throughout the pregnancy (due to the Feto-Placental barrier)
    Exposure to Antigens: How?
    • During the delivery of the baby, some blood of the fetus spills over into the maternal circulation.
    • The maternal circulation is exposed to the D antigens from the fetal erythrocytes.
    • The maternal circulation slowly develops Anti D antibodies .
    • The first child is however spared .
    Exposure to Antigens: How?
  • ERYTHROBLASTOSIS FETALIS
    • The second child in such a woman, if also Rh+ve, can develop a disease called as Erythroblastosis fetalis .
    • This is due to the Anti D antibodies developed in the mother.
    • These antibodies traverse through the placenta , enter the fetal circulation and cause agglutination of the erythrocytes of the fetus.
  • PATHOPHYSIOLOGY OF ERYTHROBLASTOSIS FETALIS P L A C E N T A MATERNAL CIRCULATION FETAL CIRCULATION Anti-D Antibodies Agglutination of RBCs Hemolysis Hemoglobin in Plasma Bilirubin Jaundice Blocks Renal Tubules Renal Failure Kernicterus
  • NORMAL JAUNDICED NEONATES
    • Rh+ve children of an Rh-ve mother
    • If it is of severe nature, bilirubin may enter te brain to cause “ kernicterus ”
    • The fetus may become groosly edematous (swollen).
    • This is called “ Hydrops fetalis ”
    • Such fetuses may die in utero or hours after preterm or term birth
    ERYTHROBLASTOSIS FETALIS or ICTERUS GRAVIS NEONATORUM
  • ERYTHROBLASTOSIS: PREVENTION
    • All pregnant women to be tested for Rh.
    • If any are Rh-ve , their husbands also to be tested for Rh.
    • The first baby’s blood to be tested for Rh.
    • If Rh+ve, then the mother to be given Rhogam injection within 24 hrs after delivery.
  • TREATMENT OF ERYTHROBLASTOSIS
    • EXCHANGE TRANSFUSION.
    • The entire blood of the fetus is replaced by O Rh-ve blood.
    • This is done in small installments.
    • Once it is done, slowly the baby will recover, as erythropoiesis occurs while these O –ve cells die.
  • EXCHANGE TRANSFUSION
  • AFTER SUCCESSFUL THERAPY NOMAD:2006: BP:BldgpsI
  • USES OF BLOOD GROUPS
    • CLINICAL:
      • For transfusion of blood
      • To prevent Erythroblastosis fetalis
    • MEDICOLEGAL:
      • Determination of suspected parentage
      • Can say whether one could or could not have been the father of a child.
      • DNA fingerprinting is more specific.
    • GENETIC STUDIES: EPIDEMIOLOGY.
  • INCOMPATIBLE TRANSFUSIONS CAUSE…
    • MILD REACTIONS SUCH AS:
    • Chills and rigors
    • Fever
    • Inapparent Hemolysis.
    • Post transfusion Jaundice.
    • Severe transfusion reactions.
  • SEVERE TRANSFUSION REACTIONS
    • Violent Backaches.
    • Tightness in the chest.
    • Jaundice.
    • Oliguria.
    • Renal Shutdown/Failure.
    • Anuria
    • Death