ABO Rhesus blood typing and some information about blood transfusion

1. BLOOD TYPES &
BLOOD TRANSFUSION
Presenter: Gia Phong Vu, MD PhD

2. OUTLINES
• Introduction:
Blood group systems:
- ABO blood group
system
- Rh blood group
system

3. Blood transfusion
v Introduction
v Precautions
v Adverseeffect Of Blood
Transfusion
v Exchange Transfusion

4. A blood group also called a BloodType
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.

5. BLOOD
TYPES ABO &
Rh

6. • 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
o for example
rodents and
apes such
as
chimpanzee
s, bonobos
and gorillas.

7. • Determination of ABOblood
groups depends upon the
immunological reaction
between antigen and antibody.
• Antigens are also
called agglutinogens
because of their
capacity to cause
agglutination of
RBCs.

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

9. • Janský is credited with the first
classification of blood into the
four types (A, B, AB, O) in 1907,
which remainsin 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

10. 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’.

11. 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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12. • Blood with antigen B and
α-antibody belongs to‘B’
group.
• If both the antigens are
present, blood group iscalled
‘AB’ group and serum of this
group does notcontain
• 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.

13. ABO
Group
Antigen
Present
Antigen
Missing
Antibody
Present
A A B Anti-B
B B A Anti-A
O None A and B Anti-A&B
AB A and B None None
Antigen and Antibody Present
in ABO BloodGroup

14. Ab and Ag in the Blood

15. Principle of Blood
Grouping
• Blood grouping is done on
the basis of agglutination.
• Agglutination means the
collection of separate particles like
RBCs into clumps or masses.
• 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 mixed with anti-B.

16. IMPORTANCE OF ABO
GROUPS IN BLOOD
TRANSFUSION
• During blood transfusion, only compatible
blood must be used.
• The one who gives blood is called the
‘donor’ andthe one who receives the blood
is called ‘recipient’.
• While transfusing the blood, antigen of
the donor and the antibody of the recipient
are considered.

17. • 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’.

18. • Plasma of AB group blood has
no antibody. Thisdoes not cause
agglutination of RBC from any
other group of blood.
• People with AB group
can receive blood fromany
blood group persons. So,
people with this blood
group are called ‘universal
recipients’.

19. • 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.

20. Blood Compatibility

21. TRANSFUSION REACTIONS
DUE TO ABO INCOMPATIBILITY
Transfusion reactions are the adverse reactions in the
body, 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.

22. Rh Blood Types
Rhesus blood group

23. These types are designated C,D, E, c, d, and e.
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.
It is the most important blood group system after ABO.
The Rh blood group system is one of thirty- five current human blood
group systems.

24. 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.

25. 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’.

26. • 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.

27. Symptoms and signs in
the fetus:
• Enlarged liver spleen, or heart
• fluid buildup in the fetus' abdomen
seen via ultrasound.

28. • 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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31. ØThirty-five major blood group systems were
recognized by the International Society of Blood
Transfusion (ISBT) in October 2012.
ØIn addition to the ABO antigens and Rhesus
antigens, many other antigens are expressed on
the red blood cell surface membrane.

32. ØAn 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.

33. Other blood groups include
q Auberger groups
q Diego group
q Bombay group
q Duffy group
q Lutheran group
q P group
q Kell group
q I group
q Kidd group
q Sulter Xg group
q Kidd group
q Duffy group

35. • 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.

36. • 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.

37. • Before a blood transfusion is given, there
are manysteps 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.

38. 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)

39. • All donated blood is tested
for infections like HIVs,
Hepatitis B, Hepatitis C,
Syphilis
• All donated blood is
also tested forABO and
Rh groups, along with the
presence of any red
blood cell antibodies.
• Pathogen Reduction
treatment done.

40. CONDITIONS
WHENBLOOD
TRANSFUSION IS
NECESSARY
• Anemia
• Hemorrhage
• Trauma
• Burns
• Surgery

41. PRECAUTIONS TO BE TAKEN
BEFORE THE TRANSFUSION
OF BLOOD
Donor must be healthy, without any diseases like:
•Sexually transmitted diseases such as syphilis
•Diseases caused by virus like hepatitis, AIDS, etc.
1
Only compatible blood must be transfused
2
Both matching and cross-matching must be done
3
Rh compatibility must be confirmed.
4

42. PRECAUTIONS TO BE
TAKENWHILE
TRANSFUSING 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.

43. Adverse effect
of Blood
transfusion
• Transfusions of blood products are associated
with several complications, many of which can
be groupedas immunological or infectious such
as:
• Acute hemolytic reaction Delayed
hemolytic reaction Allergic reaction
• Post-transfusion purpura
• Transfusion associated acute lunginjury HIV
• Hepatitis C

44. • EXCHANGE TRANSFUSION
• - is the procedure which
involves
• removal of
patient’s blood
completely and
replacement
• with 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 as
• severe jaundice, sickle cell
anemia, erythroblastosis
fetalis, etc.

45. • Guyton-Physiology-
11th edition
• Essentials of Medical
Physiology, 6th Edition ByK
Sembulingam