all you need to know about blood and blood groups as a physiotherapist...

1. BLOOD GROUPS
BY
SHRAVAN T.V
JUNIOR THERAPIST
BANGALORE

2. INTRODUCTION

3. KARL LANDSTEINER’S LAW
• Karl Landsteiner is an Austrian scientist.
• He figured out the problem causing agglutination in RBC
and he came up with “LANDSTEINER’S LAW”
• If a particular agglutinogen (antigen) is present in
the RBCs, corresponding agglutinin (antibody) must
be absent in the serum.
• If a particular agglutinogen is absent in the RBCs,
the corresponding agglutinin must be present in the
serum. GROUP ANTIGEN ANTIBODY
A A anti – B
B B anti – A
AB AB -----------
O ------------ anti-A anti-B

4. RHESUS FACTOR
• Landsteiner and Weiner found an antigen in rhesus monkey which was
present in human RBC too, and named it ‘D’ antigen.
• People with D antigen are called “Rh positive”
• People without D antigen are called “Rh negative”

5. • When a Rh negative person will receive Rh positive blood for the first time, he will not be much effected since the reaction will
occur slowly.
• The RBC which will be present in the recipient will get agglutinated but they will be engulfed by macrophages. Hence the
transfusion reaction will be slow.
• But when the same recipient will receive the Rh positive blood for the second time, the DONOR RBC will get agglutinated and
severe transfusion reactions will occur.
NO PROBLEM,
antibodies are generated
(hemolysis at a slower rate)
Rh –ve person
receives for the first
time
Second time, the Rh antibodies formed before
will react with the Rh antigen and leads to severe
hemolysis

6. Revisiting Antigen – Antibody reaction.
When Antigen and corresponding antibody is mixed, it leads to agglutination, it is also called as isoagglutinin

7. DETERMINATION OF BLOOD GROUP
• For finding out the blood group of the
person, few drops of RBC is taken from the
person and are mixed with isotonic saline

8. BLOOD TRANSFUSION.
• Blood transfusion is the process of transferring blood or blood components from one person
(the donor) into the bloodstream of another person (the recipient).
• During this process it is very important to check the compatibility of the blood groups.
• Since blood group “O” has no antigens, people of this group can donate blood to any group.
Hence, this group is called as “UNIVERSAL DONOR” group.
• Also since blood group “AB” has no antibodies, the people of this group can receive blood from
any blood group ( agglutination will not take place since there is no antibody ).
Matching = Recipient’s RBC + Test sera.
Cross-matching = Recipient’s serum (plasma) + Donor’s RBC.
Test sera are –
1. Antiserum A- containing anti-A or α- antibody.
2. Antiserum B, containing anti-B or β-antibody.)

9. Inheritance of ABO blood group
• Inheritance of ABO blood group
depends on the genes from the parents.
• The agglutinins are absent till the foetus
is 2 or 3 months.
• At birth the concentration of it is 1/5
of that of the adult. They will increase
at puberty.
• They are also present in salivary glands,
pancreas, kidney, liver, lungs etc.
Agglutinins are the IgG or IgM immunoglobulins

10. ABO INCOMPATIBILITY
In a transfusion reaction, if the blood groups mismatch -
{ if you are LUCKY }
The adverse effects maybe mild like itching, fever skin disease
But sometimes it may lead to renal failure, cardiac shock, jaundice etc.
In this type of reaction – there are two types
• Non hemolytic transfusion
• Hemolytic transfusion

11. Non – Hemolytic transfusion reactions
• In this type of transfusion reactions, hemolysis will not take place hence, the
symptoms will be mild like fever, itching difficulty in breathing etc.

12. Hemolytic transfusion reactions
• In this type of transfusion reaction, there will be hemolysis, hence it is a very
serious condition
• The symptoms maybe rapid or delayed. This is because of the rapid
hemolysis.
• Symptoms are fever, chills, increased heart rate, low blood pressure,
shortness of breath, nausea, vomiting, red urine, chest pain, back pain. Some
of them may even have Cardiac failure.

13. Jaundice
• This occurs due to increase in bilirubin in the serum
(more than 2mg/dL)
• When hemolysis takes place, haemoglobin is released from the degraded
RBC and hence bilirubin is formed from it.

14. CARDIAC SHOCK
• Due to hemolysis, haemoglobin is released into to the blood, this will
increase the viscosity of blood leading to heart failure.
Also, toxic substances released from hemolyzed cells reduce the arterial blood
pressure and develop circulatory shock

15. RENAL FAILURE
• . This stoppage or formation of urine is also called as anuria.
Haemolysed cells
Thickening of blood vessels in kidney
The toxic substance pass through the
glomerular membrane, since the rate of
reabsorbtion will be less, they precipitate
Leads to obstruction of
renal tubule
Stops the formation of
urine.

16. ERYTHROBLASTOSIS FETALIS
• It is a hemolytic disorder in foetus due to the erythroblast entering blood
circulation
• When the mother is Rh negative and the foetus is Rh positive
D D
d dD dD
d dD dD
D d
D DD Dd
d dD dd

17. • The first pregnancy, this problem will not occur since the Rh antigen cannot pass to the mother due
to the presence of placental barrier. During the time of delivery the foetal blood may leak into the
mother’s blood circulation due to the placental detachment. But within a month of delivery the
mother will develop Rh antibody.
• BUT when the mother conceives for the second time, the Rh antibody produced during the first
pregnancy will enter the placenta, hence the Rh antigen cannot enter but the Rh antibody can.
• The Rh antibody which entered will cause agglutination and leads to hemolysis. Hence, the RBC
production in the foetus also will be high so the production will be from the bone marrow, spleen and
liver. Due to this the erythroblasts also will enter the circulation.

18. • Due to the severe hemolysis in the infant –
• Hemolytic anemia
• Hydrops fetalis
• Kernicterus

19. Hemolytic Anemia
• Destruction of huge amount of RBC in a short time leads to severe
hemolytic anemia, and hence the person will die..

20. HYDROPS FETALIS
• It is a serious condition which leads to
edema (accumulation of serous fluid )
• It happens in unusual places like the
abdomen, liver and lungs.

21. KERNICTERUS
• If the infant survives the anemia, this disease will affect the infant.
• Due to haemolysis, the excess bilirubin will cause jaundice in the infant and this will
lead to “kernicterus”. Since the blood-brain barrier is not well developed in infants,
the bilirubin will directly enter the brain and cause permanent brain damage.
• Most commonly affected parts are basal ganglia, cerebrum, geniculate bodies,
cranial nerve nuclei, hippocampus
• Quick tip -
• Boys Caught a Goat on NH
Basal ganglia
cerebrum
Geniculate
bodies
Cranial Nerve nuclei
hippocampus

22. Features of Kernicterus
• The babies become lethargic and sleepy. They have high-pitched cry,
hypotonia and arching of head backwards.
• Later they develop hypertonia and opisthotonos. Inability to suck milk,
irritability and crying, bicycling movements, choreoathetosis spasticity,
seizures, fever and coma.

23. Measures to be taken to prevent
Erythroblastosis Fetalis
• If mother is found to be Rh negative and fetus is Rh positive, anti D
(antibody against D antigen) is given to the mother between 28 – 34 weeks
of gestation
• if the Rh –ve mother delivers the Rh +ve child, Within 48 hours of delivery,
this anti D has to be given.
• If the baby is born with this disease condition, the Rh –ve blood is
transfused into the infant, it will replace the blood present in the infant to Rh
–ve ( it will take 6 months)

24. LEWIS BLOOD GROUP
• It was found in a patient names Mrs. Lewis
• When the blood sample of this patient was mixed with the RBC, they reacted with the
antigens on RBC and with the body fluids like saliva, gastric juice etc.. These antigens
are formed in the tissues and are secreted in body secretions LATER they are
reabsorbed into the RBC
• These blood groups may cause retarded growth in kids and sometimes to transfusion
too.
ANTIGENS
SECRETED IN BODY
SECRETONS
REABSORBED BY
RBC

25. MNS BLOOD GROUP
• It is named MNS because of its reaction with anti-M anti-N and anti-S
anti – M and anti – N are IgM type of immunoglobulins and anti – S is a type
of IgG immunoglobulins.

26. OTHER RARE BLOOD GROUPS
• I LiKE AuDi BoDy So I Keep.
I group
Lutheran group
Kell group
Auberger group
Diego group
Bombay group
Duffy group
Sulter Xg group
Kidd group
P group

27. Importance of knowing your blood group.
• It is really important In case of emergency
• Important during organ transplant.
• In couples it is important to understand each others blood groups in order to avoid risky
diseases like erythroblastosis fetalis
• It is good to know because it can save a person’s life !!!!
DONATEBLOODSAVELIVES