Blood type.docx

1. Bloodtype
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Thisarticle isabout bloodtype inhumans.Forotheruses,see Bloodtype (disambiguation).
Bloodtype (orbloodgroup) isdetermined,inpart,bythe ABO bloodgroup antigenspresentonred
bloodcells.
A bloodtype (alsoknownasa bloodgroup) isa classificationof blood,basedonthe presence and
absence of antibodiesandinheritedantigenicsubstancesonthe surface of redbloodcells(RBCs).These
antigensmaybe proteins,carbohydrates,glycoproteins,orglycolipids,dependingonthe bloodgroup
system.Some of these antigensare alsopresentonthe surface of othertypesof cellsof varioustissues.
Several of these redbloodcell surface antigenscanstemfrom one allele (oranalternative versionof a
gene) andcollectivelyformabloodgroupsystem.[1]
Bloodtypesare inheritedandrepresentcontributionsfrombothparentsof anindividual.Asof 2021, a
total of 43 humanbloodgroupsystemsare recognizedby the InternationalSocietyof BloodTransfusion
(ISBT).[2] The twomostimportantbloodgroupsystemsare ABOand Rh; theydetermine someone's
bloodtype (A,B,AB, and O,with+ or - denotingRhDstatus) forsuitabilityinbloodtransfusion.
Contents
1 Bloodgroupsystems
1.1 ABO bloodgroupsystem
1.2 Rh bloodgroupsystem
1.3 ABO andRh distributionbycountry
1.4 Otherbloodgroupsystems
2 Clinical significance
2.1 Bloodtransfusion
2.2 Hemolyticdiseaseof the newborn(HDN)
2.3 Bloodproducts
2.4 Redbloodcell compatibility
2.5 Plasmacompatibility

2. 2.6 Universal donorsanduniversal recipients
3 Bloodtyping
3.1 Bloodgroupgenotyping
4 History
5 Societyandculture
6 See also
7 References
8 Furtherreading
9 External links
Bloodgroupsystems
Main article:Humanbloodgroupsystems
A complete bloodtype woulddescribe eachof the 43 bloodgroups,and an individual'sbloodtype isone
of manypossible combinationsof blood-groupantigens.[2] Almostalways,anindividual hasthe same
bloodgroupfor life,butveryrarelyanindividual'sbloodtype changesthroughadditionorsuppression
of an antigenininfection,malignancy,orautoimmune disease.[3][4][5][6] Anothermore commoncause
of bloodtype change isa bone marrowtransplant.Bone-marrow transplantsare performedformany
leukemiasandlymphomas,amongotherdiseases.If apersonreceivesbone marrow fromsomeone of a
differentABOtype (e.g.,atype A patientreceivesatype Obone marrow),the patient'sbloodtype
shouldeventuallybecomesthe donor'stype,asthe patient'shematopoieticstemcells(HSCs) are
destroyed,eitherbyablationof the bone marrow orby the donor'sT-cells.Once all the patient'soriginal
redbloodcellshave died,theywill have beenfullyreplacedbynew cellsderivedfromthe donorHSCs.
Providedthe donorhada differentABOtype,the new cells'surface antigenswillbe differentfromthose
on the surface of the patient'soriginal redbloodcells.[citationneeded]
Some bloodtypesare associatedwithinheritance of otherdiseases;forexample,the Kell antigenis
sometimesassociatedwithMcLeodsyndrome.[7] Certainbloodtypesmayaffectsusceptibilityto
infections,anexample beingthe resistance tospecificmalariaspeciesseeninindividualslackingthe
Duffy antigen.[8] The Duffyantigen,presumablyasa resultof natural selection,islesscommonin
populationgroupsfromareashavingahighincidence of malaria.[9]
ABO bloodgroupsystem
ABO bloodgroupsystem:diagramshowingthe carbohydrate chainsthat determine the ABOblood
group

3. Main article:ABObloodgroupsystem
The ABO bloodgroupsysteminvolvestwoantigensandtwoantibodiesfoundinhumanblood.The two
antigensare antigenA and antigenB.The two antibodiesare antibodyA andantibodyB.The antigens
are presentonthe redbloodcellsandthe antibodiesinthe serum.Regardingthe antigenpropertyof
the bloodall humanbeingscanbe classifiedintofourgroups,those withantigenA (groupA),those with
antigenB (groupB),those withboth antigenA and B (groupAB) and those withneitherantigen(group
O).The antibodiespresenttogetherwiththe antigensare foundasfollows:[citationneeded]
AntigenA withantibodyB
AntigenBwithantibodyA
AntigenABwithneitherantibodyA norB
Antigennull (groupO) withbothantibodyA andB
There isan agglutinationreactionbetweensimilarantigenandantibody(forexample,antigenA
agglutinatesthe antibodyA andantigenBagglutinatesthe antibodyB).Thus,transfusioncanbe
consideredsafe aslongasthe serumof the recipientdoesnotcontainantibodiesforthe bloodcell
antigensof the donor.[citationneeded]
The ABO systemisthe mostimportantblood-groupsysteminhuman-bloodtransfusion.The associated
anti-A andanti-Bantibodiesare usuallyimmunoglobulinM,abbreviatedIgM,antibodies.Ithasbeen
hypothesizedthatABOIgMantibodiesare producedinthe firstyearsof life bysensitizationto
environmental substancessuchasfood,bacteria,andviruses,althoughbloodgroupcompatibilityrules
are appliedtonewbornandinfantsasa matterof practice.[10] The original terminologyusedbyKarl
Landsteinerin1901 forthe classificationwasA/B/C;inlaterpublications"C"became "O".[11] Type Ois
oftencalled0 (zero,ornull) inotherlanguages.[11][12]
Phenotype andgenotypeof bloodtypes
Phenotype Genotype
A AA or AI
B BB or BI
AB AB
O II
Rh bloodgroupsystem
Main article:Rh bloodgroupsystem

4. The Rh system(RhmeaningRhesus) isthe secondmostsignificantblood-groupsysteminhuman-blood
transfusionwithcurrently50antigens.The mostsignificantRhantigenisthe D antigen,because itisthe
mostlikelytoprovoke animmune systemresponse of the fivemainRhantigens.ItiscommonforD-
negative individualsnottohave any anti-DIgG or IgM antibodies,becauseanti-Dantibodiesare not
usuallyproducedbysensitizationagainstenvironmental substances.However,D-negative individuals
can produce IgG anti-Dantibodiesfollowingasensitizingevent:possiblyafetomaternal transfusionof
bloodfroma fetusinpregnancyor occasionallyabloodtransfusionwithDpositiveRBCs.[13] Rhdisease
can developinthese cases.[14] Rhnegative bloodtypesare muchlesscommoninAsianpopulations
(0.3%) than theyare inEuropeanpopulations(15%).[15]
The presence orabsence of the Rh(D) antigenissignifiedbythe + or − sign,sothat, forexample,the A−
groupis ABOtype A and doesnothave the Rh (D) antigen.[citationneeded]
ABO andRh distributionbycountry
Main article:Blood type distributionbycountry
As withmanyothergenetictraits,the distributionof ABOandRh bloodgroupsvariessignificantly
betweenpopulations.[citationneeded]
Otherbloodgroupsystems
Main article:Humanbloodgroupsystems
As of 2021, 41 blood-groupsystemshave beenidentifiedbythe International SocietyforBlood
Transfusioninadditiontothe ABOand Rh systems.[2] Thus,inadditiontothe ABOantigensandRh
antigens,manyotherantigensare expressedonthe RBC surface membrane.Forexample,anindividual
can be AB,D positive,andatthe same time Mand N positive (MNSsystem),Kpositive (Kell system),Lea
or Leb negative (Lewissystem),andsoon,beingpositive ornegativeforeachbloodgroupsystem
antigen.Manyof the bloodgroupsystemswere namedafterthe patientsinwhomthe corresponding
antibodieswereinitiallyencountered.BloodgroupsystemsotherthanABOandRh pose a potential,yet
relativelylow,riskof complicationsuponmixingof bloodfromdifferentpeople.[16]
Followingisacomparisonof clinicallyrelevantcharacteristicsof antibodiesagainstthe mainhuman
bloodgroupsystems:[17]
ABO Rh Kell Duffy Kidd
Naturallyoccurring Yes No No No No
Most commonin immediate hemolytictransfusionreactions A Yes Fya Jka

5. Most commonin delayedhemolytictransfusionreactions E,D,C Jka
Most commonin hemolyticdisease of the newborn Yes D,C Yes
Commonlyproduce intravascularhemolysis Yes Yes
Clinical significance
Bloodtransfusion
Main article:Bloodtransfusion
Transfusionmedicine isaspecializedbranchof hematologythatisconcernedwiththe studyof blood
groups,alongwiththe workof a bloodbankto provide atransfusionservice forbloodandotherblood
products.Acrossthe world,bloodproductsmustbe prescribedbya medical doctor(licensedphysician
or surgeon) ina similarwayasmedicines.[citationneeded]
Main symptomsof acute hemolyticreactiondue tobloodtype mismatch.[18][19]
Much of the routine workof a bloodbankinvolvestestingbloodfrom bothdonorsandrecipientsto
ensure thateveryindividual recipientisgivenbloodthatiscompatible andisassafe as possible.If aunit
of incompatible bloodistransfusedbetweenadonorandrecipient,asevere acute hemolyticreaction
withhemolysis (RBCdestruction),kidneyfailureandshockislikelytooccur,and deathisa possibility.
Antibodiescanbe highlyactive andcan attack RBCs andbindcomponentsof the complementsystemto
cause massive hemolysisof the transfusedblood.[citationneeded]
Patientsshouldideallyreceive theirownbloodortype-specificbloodproductstominimize the chance
of a transfusionreaction.Itisalsopossibletouse the patient'sownbloodfortransfusion.Thisiscalled
autologousbloodtransfusion,whichis alwayscompatible withthe patient.The procedure of washinga
patient'sownredbloodcellsgoesasfollows:The patient'slostbloodiscollectedandwashedwitha
saline solution.The washingprocedure yieldsconcentratedwashedredbloodcells.The laststepis
reinfusingthe packedredbloodcellsintothe patient.There are multiple waystowashredbloodcells.
The two mainwaysare centrifugationandfiltrationmethods.Thisprocedurecanbe performedwith
microfiltrationdeviceslike the Hemoclear filter.Riskscanbe furtherreducedbycross-matchingblood,
but thismaybe skippedwhenbloodisrequiredforanemergency.Cross-matchinginvolvesmixinga
sample of the recipient'sserumwithasample of the donor'sredbloodcellsandcheckingif the mixture
agglutinates,orformsclumps.If agglutinationisnotobviousbydirectvision,bloodbanktechnicians
usuallycheckforagglutinationwithamicroscope.If agglutinationoccurs,thatparticulardonor'sblood
cannot be transfusedtothat particularrecipient.Ina bloodbankitis vital thatall bloodspecimensare
correctlyidentified,solabellinghasbeenstandardizedusingabarcode systemknownasISBT 128.

6. The bloodgroup maybe includedonidentificationtagsoron tattoosworn bymilitary personnel,incase
theyshouldneedanemergencybloodtransfusion.FrontlineGermanWaffen-SShadbloodgroup
tattoosduringWorldWar II.
Rare bloodtypescancause supplyproblemsforbloodbanksandhospitals.Forexample,Duffy-negative
bloodoccurs muchmore frequentlyinpeople of Africanorigin,[20] andthe rarity of thisbloodtype in
the rest of the populationcanresultina shortage of Duffy-negative bloodforthese patients.Similarly,
for RhD negative people thereisariskassociatedwithtravellingtopartsof the worldwhere suppliesof
RhD negative bloodare rare,particularlyEastAsia,where bloodservicesmayendeavortoencourage
Westernerstodonate blood.[21]
Hemolyticdiseaseof the newborn(HDN)
Main article:Hemolyticdisease of the newborn
A pregnantwomanmaycarry a fetuswitha bloodtype whichisdifferentfromherown.Typically,thisis
an issue if a Rh- motherhas a childwitha Rh+ father,and the fetusendsupbeingRh+like the
father.[22] Inthose cases,the mothercan make IgG bloodgroupantibodies.Thiscanhappenif some of
the fetus'bloodcellspassintothe mother'sbloodcirculation(e.g.asmall fetomaternalhemorrhageat
the time of childbirthorobstetricintervention),orsometimesafteratherapeuticblood transfusion.This
can cause Rh disease orotherformsof hemolyticdisease of the newborn(HDN) inthe current
pregnancyand/orsubsequentpregnancies.Sometimesthisislethalforthe fetus;inthese casesitis
calledhydropsfetalis.[23] If a pregnant womanisknownto have anti-Dantibodies,the Rhbloodtype of
a fetuscan be testedbyanalysisof fetal DNA inmaternal plasmatoassessthe riskto the fetusof Rh
disease.[24] One of the majoradvancesof twentiethcenturymedicinewastopreventthis diseaseby
stoppingthe formationof Anti-DantibodiesbyDnegative motherswithaninjectable medicationcalled
Rho(D) immune globulin.[25][26] Antibodiesassociatedwithsome bloodgroupscancause severe HDN,
otherscan onlycause mildHDN andothersare not knowntocause HDN.[23]
Bloodproducts
To provide maximumbenefitfromeachblooddonationandtoextendshelf-life,bloodbanksfractionate
some whole bloodintoseveral products.The mostcommonof these productsare packedRBCs,plasma,
platelets,cryoprecipitate,andfreshfrozenplasma(FFP).FFPisquick-frozentoretainthe labile clotting
factors V and VIII,whichare usuallyadministeredtopatientswhohave apotentiallyfatal clotting
problemcausedbya conditionsuchas advancedliverdisease,overdose of anticoagulant,or
disseminatedintravascularcoagulation(DIC).[citationneeded]
Unitsof packedredcellsare made byremovingasmuch of the plasmaas possible fromwhole blood
units.

7. Clottingfactorssynthesizedbymodernrecombinantmethodsare now inroutine clinical use for
hemophilia,asthe risksof infectiontransmissionthatoccurwithpooledbloodproductsare avoided.
Redbloodcell compatibility
Furtherinformation:Bloodcompatibilitytesting
BloodgroupAB individualshave bothA andB antigensonthe surface of theirRBCs,and theirblood
plasmadoesnotcontainany antibodiesagainsteitherA orB antigen.Therefore,anindividual withtype
AB bloodcan receive bloodfromanygroup(withABbeingpreferable),butcannotdonate bloodtoany
groupother thanAB. Theyare knownasuniversal recipients.
BloodgroupA individualshave the A antigenonthe surface of theirRBCs,and bloodserumcontaining
IgMantibodiesagainstthe Bantigen.Therefore,agroupA individual canreceive bloodonlyfrom
individualsof groupsA or O (withA beingpreferable),andcandonate bloodtoindividualswithtype A
or AB.
BloodgroupB individualshave the Bantigenonthe surface of theirRBCs,and bloodserumcontaining
IgMantibodiesagainstthe A antigen.Therefore,agroupB individual canreceive bloodonlyfrom
individualsof groupsBor O (withB beingpreferable),andcandonate bloodtoindividualswithtype Bor
AB.
BloodgroupO (or bloodgroupzeroin some countries) individualsdonothave eitherA or B antigenson
the surface of theirRBCs,and theirbloodserumcontainsIgManti-A andanti-Bantibodies.Therefore,a
groupO individual canreceive bloodonlyfromagroupO individual,butcandonate bloodtoindividuals
of anyABO bloodgroup(i.e.,A,B,O or AB).If a patientneedsanurgentbloodtransfusion,andif the
time takento processthe recipient'sbloodwouldcause adetrimentaldelay,Onegative bloodcanbe
issued.Because itiscompatible withanyone,Onegative bloodisoftenoverusedandconsequentlyis
alwaysinshort supply.[27] Accordingtothe AmericanAssociationof BloodBanksandthe BritishChief
Medical Officer'sNational BloodTransfusionCommittee,the use of groupO RhD negative redcells
shouldbe restrictedtopersonswithOnegative blood,womenwhomightbe pregnant,andemergency
casesin whichblood-grouptestingisgenuinelyimpracticable.[27]
Redbloodcell compatibilitychart
In additiontodonatingtothe same bloodgroup;type O blooddonorscan give to A,B and AB; blood
donorsof typesA and B can give to AB.
Redbloodcell compatibilitytable[28][29]
Recipient[1] Donor[1]
O− O+ A− A+ B− B+ AB− AB+
O− Greentick RedX RedX RedX RedX RedX RedX RedX
O+ Greentick Greentick RedX RedX RedX RedX RedX RedX

8. A− Greentick RedX Greentick RedX RedX RedX RedX RedX
A+ Greentick Greentick Greentick Greentick RedX RedX RedX RedX
B− Greentick RedX RedX RedX Greentick RedX RedX RedX
B+ Greentick Greentick RedX RedX Greentick Greentick RedX RedX
AB− Greentick RedX Greentick RedX Greentick RedX Greentick RedX
AB+ Greentick Greentick Greentick Greentick Greentick Greentick
Greentick Greentick
Table note
1. Assumesabsence of atypical antibodiesthatwouldcause anincompatibilitybetweendonorand
recipientblood,asisusual forbloodselectedbycrossmatching.
An Rh D-negative patientwhodoesnothave anyanti-Dantibodies(neverbeingpreviouslysensitizedto
D-positive RBCs) canreceive atransfusionof D-positive bloodonce,butthiswouldcause sensitizationto
the D antigen,anda female patientwouldbecome atriskforhemolyticdisease of the newborn.If aD-
negative patienthasdevelopedanti-Dantibodies,asubsequentexposure toD-positive bloodwould
leadto a potentiallydangeroustransfusionreaction.RhD-positivebloodshouldneverbe giventoD-
negative womenof child-bearingage orto patientswithDantibodies,sobloodbanksmustconserve Rh-
negative bloodforthese patients. Inextreme circumstances,suchasfora major bleedwhenstocksof D-
negative bloodunitsare verylowatthe bloodbank,D-positivebloodmightbe giventoD-negative
femalesabove child-bearingage orto Rh-negative males,providingthattheydidnothave anti-D
antibodies,toconserve D-negative bloodstockinthe bloodbank.The converse isnottrue;Rh D-
positive patientsdonotreactto D negative blood.
Thissame matchingis done forotherantigensof the Rh systemasC, c, E and e and for otherblood
groupsystemswitha knownriskforimmunizationsuchasthe Kell systeminparticularforfemalesof
child-bearingage orpatientswithknownneedformanytransfusions.
Plasmacompatibility
Plasmacompatibilitychart
In additiontodonatingtothe same bloodgroup;plasmafrom type ABcan be giventoA, B and O;
plasmafromtypesA,B andAB can be giventoO.
Bloodplasmacompatibilityisthe inverseof redbloodcell compatibility.[30] Type ABplasmacarries
neitheranti-A noranti-Bantibodiesandcanbe transfusedtoindividualsof anybloodgroup;buttype AB

9. patientscanonlyreceive type ABplasma.Type Ocarriesboth antibodies,soindividualsof bloodgroup
O can receive plasmafromanybloodgroup,buttype O plasmacan be usedonlybytype O recipients.
Plasmacompatibilitytable[31]
Recipient Donor
O A B AB
O Greentick Greentick Greentick Greentick
A RedX Greentick RedX Greentick
B RedX RedX Greentick Greentick
AB RedX RedX RedX Greentick
Table note
1. Assumingabsence of strongatypical antibodiesindonorplasma
Rh D antibodiesare uncommon,sogenerallyneitherDnegative norD positive bloodcontainanti-D
antibodies.If apotential donorisfoundtohave anti-Dantibodiesoranystrongatypical bloodgroup
antibodyby antibodyscreeninginthe bloodbank,theywouldnotbe acceptedasa donor (orin some
bloodbanksthe bloodwouldbe drawnbutthe productwouldneedtobe appropriatelylabeled);
therefore,donorbloodplasmaissuedbyabloodbankcan be selectedtobe free of D antibodiesand
free of otheratypical antibodies,andsuchdonorplasmaissuedfroma bloodbankwouldbe suitable for
a recipientwhomaybe D positive orD negative,aslongasbloodplasmaandthe recipientare ABO
compatible.[citationneeded]
Universal donorsanduniversal recipients
A hospital workertakessamplesof bloodfromadonor fortesting
In transfusionsof packedredbloodcells,individualswithtype ORhD negative bloodare oftencalled
universal donors.Those withtype ABRh D positive bloodare calleduniversal recipients.However,these
termsare onlygenerallytrue withrespecttopossiblereactionsof the recipient'santi-A andanti-B
antibodiestotransfusedredbloodcells,andalsopossible sensitizationtoRhD antigens.One exception
isindividualswithhhantigensystem(alsoknownasthe Bombayphenotype) whocanonlyreceive blood
safelyfromotherhhdonors,because theyformantibodiesagainstthe Hantigenpresentonall red
bloodcells.[32][33]

10. Blooddonorswithexceptionallystronganti-A,anti-Boranyatypical bloodgroupantibodymaybe
excludedfromblooddonation.Ingeneral,while the plasmafractionof abloodtransfusionmaycarry
donorantibodiesnotfoundinthe recipient,asignificantreactionisunlikelybecause of dilution.
Additionally,redbloodcell surface antigensotherthanA,Band Rh D, mightcause adverse reactions
and sensitization,if theycanbindto the correspondingantibodiestogenerate animmune response.
Transfusionsare furthercomplicatedbecause plateletsandwhite bloodcells(WBCs)have theirown
systemsof surface antigens,andsensitizationtoplateletorWBC antigenscanoccur as a resultof
transfusion.
For transfusionsof plasma,thissituationisreversed.Type Oplasma,containingbothanti-A andanti-B
antibodies,canonlybe giventoOrecipients.The antibodieswillattackthe antigensonanyotherblood
type.Conversely,ABplasmacanbe giventopatientsof any ABObloodgroup,because itdoesnot
containany anti-A oranti-Bantibodies.
Bloodtyping
Main article:Bloodtyping
Typically,bloodtype testsare performedthroughadditionof abloodsample toa solutioncontaining
antibodiescorrespondingtoeachantigen.The presence of anantigenonthe surface of the bloodcellsis
indicatedbyagglutination.Inthese tests,ratherthanagglutination,apositive resultisindicatedby
decolorizationasredbloodcellswhichbindtothe nanoparticlesare pulledtowardamagnetand
removedfromsolution.
Bloodgroup genotyping
In additiontothe currentpractice of serologictestingof bloodtypes,the progressinmolecular
diagnosticsallowsthe increasinguse of bloodgroupgenotyping.Incontrastto serologictestsreporting
a directbloodtype phenotype,genotypingallowsthe predictionof aphenotype basedonthe
knowledge of the molecularbasisof the currentlyknownantigens.Thisallowsamore detailed
determinationof the bloodtype andtherefore abettermatchfortransfusion,whichcanbe crucial in
particularfor patientswithneedsformanytransfusionstopreventallo-immunization.[34][35]
History
Bloodtypeswere firstdiscoveredbyanAustrianphysician,Karl Landsteiner,workingatthe
Pathological-Anatomical Institute of the Universityof Vienna(now Medical Universityof Vienna).In
1900, he foundthat bloodserafromdifferentpersonswouldclumptogether(agglutinate) whenmixed
intest tubes,andnotonlythat, some humanbloodalsoagglutinatedwithanimal blood.[36] He wrote a
two-sentence footnote:

11. The serumof healthyhumanbeingsnotonlyagglutinatesanimalredcells,butalsooftenthose of
humanorigin,fromotherindividuals.Itremainstobe seenwhetherthisappearance isrelatedtoinborn
differencesbetweenindividualsoritisthe resultof some damage of bacterial kind.[37]
Thiswas the firstevidence thatbloodvariationexistsinhumans.The nextyear,in1901, he made a
definitiveobservationthatbloodserumof anindividual wouldagglutinate withonlythose of certain
individuals.Basedonthishe classifiedhumanbloodsintothree groups,namelygroupA,groupB,and
groupC. He definedthatgroupA bloodagglutinateswithgroupB,butneverwithitsowntype.Similarly,
groupB bloodagglutinateswithgroupA.GroupC bloodisdifferentinthatitagglutinateswithbothA
and B.[38] Thiswas the discoveryof bloodgroupsforwhichLandsteinerwasawardedthe Nobel Prize in
PhysiologyorMedicine in1930. (C waslaterrenamedtoO afterthe GermanOhne,meaningwithout, or
zero,or null.[39]) Anothergroup(laternamedAB) wasdiscoveredayearlaterbyLandsteiner'sstudents
AdrianoSturli andAlfredvonDecastellowithoutdesignatingthe name (simplyreferringittoas"no
particulartype").[40][41] Thus,afterLandsteiner,three bloodtypeswereinitiallyrecognised,namelyA,
B, and C.[41]
CzechserologistJanJanskýwasthe firstto recognise anddesignatefourbloodtypesin1907 that he
publishedinalocal journal,[42] usingthe Romannumerical I,II,III,andIV (correspondingtomodernO,
A,B, and AB respectively).[43] UnknowntoJanský,anAmericanphysicianWilliamL.Mossintroduced
almostidentical classificationin1910;[44] but hisI and IV correspondingJanský'sIV andI.[45] Moss
came acrossJanský'spaperas his wasbeingprinted,mentioneditinafootnote.[41] Thusthe existence
of twosystemsimmediatelycreatedconfusionandpotential dangerinmedical practice.Moss'ssystem
was adoptedinBritain,France,andUS, while Janský'swaspreferredinmostotherEuropeancountries
and some partsof US. It was reportedthat"The practicallyuniversal use of the Mossclassificationat
that time wascompletelyandpurposelycastaside.Therefore inplace of bringingorderoutof chaos,
chaos wasincreasedin the largercities."[46] Toresolve the confusion,the AmericanAssociationof
Immunologists,the Societyof AmericanBacteriologists,andthe Associationof Pathologistsand
Bacteriologistsmade ajointrecommendationin1921 that the Janskyclassificationbe adoptedbasedon
priority.[47] Butitwas not followedparticularlywhereMoss'ssystemhadbeenused.[48]
In 1927, Landsteiner,whohadmovedtothe RockefellerInstitute forMedical ResearchinNew York,and
as a memberof a committee of the National ResearchCouncil concernedwithbloodgroupingsuggested
to substitute Janský'sandMoss'ssystemswiththe lettersO,A,B,and AB.There was anotherconfusion
on the use of O whichwasintroducedbyPolishphysiciansLudwikHirszfeldandGermanphysicianEmil
vonDungernin 1910.[49] It was neverclearwhetheritwasmeantforthe figure 0, Germannull for zero
or the uppercase letterOfor ohne,meaningwithout;Landsteinerchose the latter.[50]

12. In 1928 the PermanentCommissiononBiological StandardizationadoptedLandsteiner'sproposal and
stated:
The Commissionlearnswithsatisfactionthat,onthe initiativeof the HealthOrganizationof the League
of Nations,the nomenclature proposedbyvonDungernandHirszfeldforthe classificationof blood
groupshas beengenerallyaccepted,andrecommendsthatthisnomenclature shall be adoptedfor
international use asfollows:0A B AB.To facilitate the change fromthe nomenclature hitherto
employedthe followingissuggested:
Jansky....0(I) A(II) B(III)AB(IV)
Moss ... O(IV) A(II) B(III) AB(I)[51]
Thisclassificationbecamewidelyaccepted;however,notall hospitalsanddoctorsusedbloodtypingfor
transfusioneveninthe late 1940s. The new systemwasgraduallyacceptedandbythe early1950s, it
was universallyfollowed.[52]
HirszfeldandDungerndiscoveredthe inheritance of bloodtypesasMendeliangeneticsin1910 andthe
existence of sub-typesof A in1911.[49][53] In1927, Landsteiner,withPhilipLevine,discoveredthe MN
bloodgroupsystem,[54] andthe P system.[55] Developmentof the Coombstestin1945,[56] the advent
of transfusionmedicine,andthe understandingof ABOhemolyticdisease of the newbornledto
discoveryof more bloodgroups.Asof 2020, the International Societyof BloodTransfusion(ISBT)
recognizes41 bloodgroups.[2]
Societyandculture
Main article:Bloodtype personalitytheory
A popularpseudoscientificbelief inEasternAsiancountries(especiallyinJapanandKorea;[57] knownas
血液型ketsuekigata/hyeoraekhyeong)isthata person'sABObloodtype ispredictive of their
personality,character,andcompatibilitywithothers.[58] Researchershave establishednoscientific
basisexistsforbloodtype personalitycategorization,andstudieshave foundno"significantrelationship
betweenpersonalityandbloodtype,renderingthe theory"obsolete"andconcludingthatnobasisexists
to assume thatpersonalityisanythingmore thanrandomlyassociatedwithbloodtype."[57]
See also
Bloodtype (non-human)
Human leukocyte antigen
hh bloodgroup

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Furtherreading
Dean,Laura (2005). BloodGroups andRed Cell Antigens,aguide tothe differencesinourbloodtypes
that complicate bloodtransfusionsandpregnancy.BethesdaMD: National CenterforBiotechnology
Information.ISBN 1-932811-05-2. NBK2261.
MollisonPL,EngelfrietCP,ContrerasM(1997). BloodTransfusioninClinical Medicine (10th ed.).Oxford
UK: Blackwell Science.ISBN 0-86542-881-6.
External links
WikimediaCommonshasmediarelatedtoBloodtypes.
BGMUT BloodGroupAntigenGene MutationDatabase at NCBI,NIHhas detailsof genesandproteins,
and variationsthereof,thatare responsible forbloodtypes
Online MendelianInheritance inMan(OMIM): ABOGlycosyltransferase;ABO - 110300
Online MendelianInheritance inMan(OMIM): RhesusBloodGroup,D Antigen;RHD - 111680
"Bloodgrouptest".Gentest.chGmbH.Archivedfromthe original on2017-03-24. Retrieved2017-03-23.
"BloodFacts – Rare Traits".LifeShare BloodCenters.Archivedfromthe original onSeptember26, 2006.
RetrievedSeptember15,2006.
"ModernHuman Variation:Distributionof BloodTypes".Dr.DennisO'Neil,Behavioral Sciences
Department,PalomarCollege,SanMarcos, California.2001-06-06. Archivedfromthe original on2001-
06-06. RetrievedNovember23,2006.
"Racial and EthnicDistributionof ABOBloodTypes – BloodBook.com, BloodInformationforLife".
bloodbook.com.Archivedfromthe original on2010-03-04. RetrievedSeptember15,2006.
"MolecularGeneticBasisof ABO".RetrievedJuly31,2008.
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18. Transfusionreactions
and adverse effects
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overloadTransfusion-associatedgraftversushostdiseaseFebrile non-hemolytictransfusion
reactionHemolyticreactionacutedelayedSerumsicknessTransfusiontransmittedinfection
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