Blood grouping/ orthodontic seminars

865 views

Published on



Indian Dental Academy: will be one of the most relevant and exciting

training center with best faculty and flexible training programs

for dental professionals who wish to advance in their dental

practice,Offers certified courses in Dental

implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic

Dentistry, Periodontics and General Dentistry.

Published in: Education
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
865
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
0
Comments
0
Likes
3
Embeds 0
No embeds

No notes for slide

Blood grouping/ orthodontic seminars

  1. 1. BLOODBLOOD GROUPINGGROUPINGINDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. INTRODUCTIONINTRODUCTION When blood transfusion from oneWhen blood transfusion from one person to another were first attempted,theperson to another were first attempted,the transfusion were succesful only in sometransfusion were succesful only in some instances often immediate or delayedinstances often immediate or delayed agglutination and hemoolysis of RBCagglutination and hemoolysis of RBC occurred resulting in typical transfusionoccurred resulting in typical transfusion reactions that often lead to death.reactions that often lead to death. www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. The Discovery of bloodThe Discovery of blood groupsgroups  Karl landsteiner – 1901Karl landsteiner – 1901 Awarded Noble prize –Awarded Noble prize – 19301930 He discovered that bloodHe discovered that blood clumping was anclumping was an immunological reaction, whichimmunological reaction, which occurs when the receiver of aoccurs when the receiver of a blood transfusion hasblood transfusion has antibodies against the donorantibodies against the donor blood cellsblood cells www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. DEFINITIONDEFINITION  The process of identifying an individualsThe process of identifying an individuals blood group by serologic testing of ablood group by serologic testing of a sample of bloodsample of blood Also calledAlso called BLOOD TYPINGBLOOD TYPING www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. AGGLUTINOGENSAGGLUTINOGENS type Atype A Antigen occur onAntigen occur on surface ofsurface of RBCRBC type Btype B Because of the way the agglutiinogens areBecause of the way the agglutiinogens are inherited,people may have neither of them oninherited,people may have neither of them on their cells,they may have one or they mayhavetheir cells,they may have one or they mayhave both simultaneouslyboth simultaneously www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. Phenotype Genotype A AA or AO B BB or BO AB AB www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. ABO-SYSTEMABO-SYSTEM  First type discovered.First type discovered.  The associated anti-A & anti-B abs are usually immunoglobullinM (IgM)The associated anti-A & anti-B abs are usually immunoglobullinM (IgM) ABO IgM Abs are produced in first years of life by sensitization to environmentalABO IgM Abs are produced in first years of life by sensitization to environmental substances such as food,bacteria&virussubstances such as food,bacteria&virus RELATIVE FREQUENCEISRELATIVE FREQUENCEIS O 47%O 47%  A 41%A 41% B 9%B 9% AB 3%AB 3% HOW IS BLOOD GROUP TESTING DONE?HOW IS BLOOD GROUP TESTING DONE?  Sample of your blood is mixed with different sample of plasma known toSample of your blood is mixed with different sample of plasma known to contain different Abscontain different Abs eg:If plasma which contains antiA Abs makes the red cells in your blood clumpeg:If plasma which contains antiA Abs makes the red cells in your blood clump together,then you have A antigens on your blood cellstogether,then you have A antigens on your blood cells www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. GENITIC DETERMINATION OFGENITIC DETERMINATION OF AGGLUTINOGENSAGGLUTINOGENS  2 genes, one on each of two paired chromosomes,determine2 genes, one on each of two paired chromosomes,determine the O-A-B blood typethe O-A-B blood type  These 2 genes are allelomorphic genes that can be any one ofThese 2 genes are allelomorphic genes that can be any one of 3 types but only one type on each chromosome3 types but only one type on each chromosome  The type O gene is either functionless or almost functionless,The type O gene is either functionless or almost functionless, so that it causes no significant type O agglutinogen on the cells.so that it causes no significant type O agglutinogen on the cells. Conversely, the type A and B genes do cause strongConversely, the type A and B genes do cause strong agglutinogens on the cellsagglutinogens on the cells  The six possible combinations of genes areThe six possible combinations of genes are OO,OA,OB,AA,BB,AB. These combination of genes are knownOO,OA,OB,AA,BB,AB. These combination of genes are known asas GENOTYPESGENOTYPES & each person is one of six genotypes.& each person is one of six genotypes. www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. BLOOD CHIPBLOOD CHIP  A new approach to the identification of blood group patterns wasA new approach to the identification of blood group patterns was announonced 7announonced 7thth sept 2006 at a meeting of the international society forsept 2006 at a meeting of the international society for blood transfusion in southafricablood transfusion in southafrica BLOOD CHIP Like the current serological tests,bloodchip identifies the conventionalLike the current serological tests,bloodchip identifies the conventional groupings & also determines the status of up to 9 other variations in bloodgroupings & also determines the status of up to 9 other variations in blood including Rhc,RhE,Diego, Duffy,Kell,Kidd & MNSincluding Rhc,RhE,Diego, Duffy,Kell,Kidd & MNS IMPORTANCEIMPORTANCE  Blood transfusions are inherently safe when compatibility between donorBlood transfusions are inherently safe when compatibility between donor and recipient is tested.and recipient is tested. however patients with conditions such ashowever patients with conditions such as sickle cell anaemiasickle cell anaemia andand thalasemiathalasemia that require multiple blood transfusions can develop antibodiesthat require multiple blood transfusions can develop antibodies against blood group antigens that are not normally tested.transfusion withagainst blood group antigens that are not normally tested.transfusion with blood containing these antigens leads to serious and potentially lifeblood containing these antigens leads to serious and potentially life threatening reactionsthreatening reactions  Blood chip will allow exact matching of blood patterns of donor and recipientBlood chip will allow exact matching of blood patterns of donor and recipient preventing antibody development and subsequent transfusion reactionspreventing antibody development and subsequent transfusion reactions Thus Blood chip test will literally be a life saver in these conditionsThus Blood chip test will literally be a life saver in these conditions www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. HOW IS IT DONE ?HOW IS IT DONE ?  The test extracts and replicates DNA fromThe test extracts and replicates DNA from blood .blood .  Fragments of the DNA are labelled with aFragments of the DNA are labelled with a flourescent marker and then exposed to aflourescent marker and then exposed to a slide to which is fixed an array of DNAslide to which is fixed an array of DNA fragments specific for the blood groupsfragments specific for the blood groups  Fragments that combine(hybridise) withFragments that combine(hybridise) with specific DNA on the slide allow the bloodspecific DNA on the slide allow the blood groups to be identified using a scanninggroups to be identified using a scanning flourimeter.flourimeter. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. Rh(RHESUS)BLOOD TYPES-Rh(RHESUS)BLOOD TYPES- 19371937  The major difference between OAB & Rh system is: InThe major difference between OAB & Rh system is: In OAB system the plasma agglutinins responsible forOAB system the plasma agglutinins responsible for causing transfusion reaction develop spontaneouslycausing transfusion reaction develop spontaneously whereas in the Rh system,spontaneous agglutininswhereas in the Rh system,spontaneous agglutinins almost never occur.Instead the person must first bealmost never occur.Instead the person must first be massively exposed to an Rh antigen.massively exposed to an Rh antigen.  There are 6 common types of Rh antigens called an RhThere are 6 common types of Rh antigens called an Rh factorfactor  These types are designated as C,D,E,c,d,eThese types are designated as C,D,E,c,d,e Type D is more prevalent & antigenic.Type D is more prevalent & antigenic. therfore anyone who has this type of antigen is said totherfore anyone who has this type of antigen is said to be Rh +ve, if not Rh-vebe Rh +ve, if not Rh-ve 85% white ppl-Rh+ve85% white ppl-Rh+ve www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. Formation of anti Rh agglutininsFormation of anti Rh agglutinins  When RBC containing Rh factor are injected intoWhen RBC containing Rh factor are injected into a person whose blood does not contain the Rha person whose blood does not contain the Rh factor (Rh-ve) –anti Rh agglutinins developfactor (Rh-ve) –anti Rh agglutinins develop slowly, the maximum concentration ofslowly, the maximum concentration of agglutinins occurring about 2 to 4 months later.agglutinins occurring about 2 to 4 months later.  With multiple exposure to the Rh factor, an Rh-With multiple exposure to the Rh factor, an Rh- ve person eventually becomes stronglyve person eventually becomes strongly “sensitized” to Rh factor.“sensitized” to Rh factor. www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. Other blood group systemsOther blood group systems  The MNSs SystemThe MNSs System This system was discovered by injecting animalsThis system was discovered by injecting animals with human red cells. The antigens are M, N, S,with human red cells. The antigens are M, N, S, and s. There are naturally occurring antibodies toand s. There are naturally occurring antibodies to all these antigens.all these antigens.  The P SystemThe P System This system was also discovered by injectingThis system was also discovered by injecting animals with human red cells. P1 is the mostanimals with human red cells. P1 is the most common antigen which has variable strength ofcommon antigen which has variable strength of expression. Anti-P1 may be naturally occurring.expression. Anti-P1 may be naturally occurring.  The Lutheran (Lu) SystemThe Lutheran (Lu) System This system is a single locus system, with antigensThis system is a single locus system, with antigens Lua and Lub. The Lu(a) negative phenotype is veryLua and Lub. The Lu(a) negative phenotype is very rare. Antibodies to Lutheran antigens are IgGrare. Antibodies to Lutheran antigens are IgGwww.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14.  The Lewis SystemThe Lewis System This system focuses on a single locus with twoThis system focuses on a single locus with two antigens, Le a and Le b. These antigens do notantigens, Le a and Le b. These antigens do not form an integral part of the red cell membrane,form an integral part of the red cell membrane, but are soluble antigens which may be presentbut are soluble antigens which may be present in body fluids and secretions. They arein body fluids and secretions. They are adsorbed on to the surface of red cells if theyadsorbed on to the surface of red cells if they are present in the plasma in sufficient amounts.are present in the plasma in sufficient amounts. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15.  The Duffy SystemThe Duffy System The Duffy system is also a single locus with two antigens, Fy aThe Duffy system is also a single locus with two antigens, Fy a and Fy b. The only rare phenotype is Fy(a-b-), which has aand Fy b. The only rare phenotype is Fy(a-b-), which has a higher frequency in countries where there is a high incidence ofhigher frequency in countries where there is a high incidence of Plasmodium falcipariumPlasmodium falciparium malaria. This phenotype gives amalaria. This phenotype gives a degree of immunity to the disease because the malarialdegree of immunity to the disease because the malarial parasite requires Duffy antigens to enter the red cells. Duffyparasite requires Duffy antigens to enter the red cells. Duffy antibodies are almost exclusively IgG. This system is namedantibodies are almost exclusively IgG. This system is named after the family of the antibody producer, Duffy.after the family of the antibody producer, Duffy.  The Kidd (Jk) SystemThe Kidd (Jk) System Another single locus system, two antigen system (Jka and Jkb).Another single locus system, two antigen system (Jka and Jkb). There are four possible phenotypes: Jk(a-b-); Jk(a+b-); Jk(a-There are four possible phenotypes: Jk(a-b-); Jk(a+b-); Jk(a- b+); Jk(a+b+). Jk(a-b-) is a rare phenotype. Antibodies to theb+); Jk(a+b+). Jk(a-b-) is a rare phenotype. Antibodies to the Kidd antigens are almost exclusively IgG.Kidd antigens are almost exclusively IgG.  Incompatible transfusion or pregnancy can lead to theIncompatible transfusion or pregnancy can lead to the formation of antibodies to all these Blood groups, if theformation of antibodies to all these Blood groups, if the recipient/mother lacks the relevant antigen.recipient/mother lacks the relevant antigen. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. Clinical significanceClinical significance  Blood transfusionBlood transfusion  If a unit of incompatible blood isIf a unit of incompatible blood is transfusedtransfused between abetween a donordonor and recipient,and recipient, a severe acute immunological reaction,a severe acute immunological reaction, hemolysishemolysis (RBC destruction),(RBC destruction), renal failurerenal failure andand shockshock are likely to occur, and death is a possibility.are likely to occur, and death is a possibility. Antibodies can be highly active and can attack RBCs and bind componentsAntibodies can be highly active and can attack RBCs and bind components of theof the complement systemcomplement system to cause massive hemolysis of the transfusedto cause massive hemolysis of the transfused blood.blood.  Patients should ideally receive their own blood or type-specific bloodPatients should ideally receive their own blood or type-specific blood products to minimize the chance of aproducts to minimize the chance of a transfusion reactiontransfusion reaction. Risks can be. Risks can be further reduced byfurther reduced by cross-matchingcross-matching blood, but this may be skipped whenblood, but this may be skipped when blood is required for an emergency. Cross-matching involves mixing ablood is required for an emergency. Cross-matching involves mixing a sample of the recipient's serum with a sample of the donor's red blood cellssample of the recipient's serum with a sample of the donor's red blood cells and checking if the mixtureand checking if the mixture agglutinatesagglutinates, or forms clumps. If agglutination, or forms clumps. If agglutination occurs, that particular donor's blood cannot be transfused to that particularoccurs, that particular donor's blood cannot be transfused to that particular recipient.recipient.  In a blood bank it is vital that all blood specimens are correctly identified, soIn a blood bank it is vital that all blood specimens are correctly identified, so labeling has been standardized using alabeling has been standardized using a barcodebarcode system known assystem known as ISBT 128ISBT 128 ..  Rare blood types can cause supply problems forRare blood types can cause supply problems for blood banksblood banks and hospitals.and hospitals. For exampleFor example DuffyDuffy-negative blood occurs much more frequently in people of-negative blood occurs much more frequently in people ofwww.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. Hemolytic disease ofHemolytic disease of newborn(HDN)newborn(HDN)  AA pregnantpregnant woman can makewoman can make IgGIgG blood group antibodies if her fetusblood group antibodies if her fetus has a blood group antigen that she does not have. This can happen ifhas a blood group antigen that she does not have. This can happen if some of the fetus' blood cells pass into the mother's blood circulationsome of the fetus' blood cells pass into the mother's blood circulation (e.g. a small fetomaternal(e.g. a small fetomaternal hemorrhagehemorrhage at the time of childbirth orat the time of childbirth or obstetric intervention), or sometimes after a therapeuticobstetric intervention), or sometimes after a therapeutic blood transfusionblood transfusion. This can cause. This can cause Rh diseaseRh disease or other forms ofor other forms of hemolytic disease of the newbornhemolytic disease of the newborn (HDN) in subsequent pregnancies.(HDN) in subsequent pregnancies.  If a pregnant woman is known to have anti-RhD antibodies, the RhDIf a pregnant woman is known to have anti-RhD antibodies, the RhD blood type of ablood type of a fetusfetus can be tested by analysis of fetal DNA in maternalcan be tested by analysis of fetal DNA in maternal plasma to assess the risk to the fetus of Rh disease.plasma to assess the risk to the fetus of Rh disease.  One of the major advances of twentieth century medicine was toOne of the major advances of twentieth century medicine was to prevent this disease by stopping the formation of Anti-RhD antibodies byprevent this disease by stopping the formation of Anti-RhD antibodies by RhD negative mothers with an injectable medication calledRhD negative mothers with an injectable medication called Rho(D) immune globulinRho(D) immune globulin.. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. COMPATABILITYCOMPATABILITY  Blood productSBlood productS In order to provide maximum benefit from each blood donation and to extendIn order to provide maximum benefit from each blood donation and to extend shelf-life,shelf-life, blood banksblood banks fractionatefractionate some whole blood into several products.some whole blood into several products. The most common of these products are packed RBCs,The most common of these products are packed RBCs, plasmaplasma,, plateletsplatelets,, cryoprecipitatecryoprecipitate, and, and fresh frozen plasmafresh frozen plasma (FFP). FFP is quick-frozen to retain(FFP). FFP is quick-frozen to retain the labilethe labile clotting factorsclotting factors VV andand VIIIVIII, which are usually administered to, which are usually administered to patients who have a potentially fatal clotting problem caused by a conditionpatients who have a potentially fatal clotting problem caused by a condition such as advancedsuch as advanced liverliver disease, overdose ofdisease, overdose of anticoagulantanticoagulant, or, or disseminated intravascular coagulationdisseminated intravascular coagulation (DIC).(DIC).  Units of packed red cells are made by removing as much of the plasma asUnits of packed red cells are made by removing as much of the plasma as possible from whole blood units.possible from whole blood units.  Clotting factors synthesized by modern recombinant methods are now inClotting factors synthesized by modern recombinant methods are now in routine clinical use for hemophilia, as the risks of infection transmission thatroutine clinical use for hemophilia, as the risks of infection transmission that occur with pooled blood products are avoided.occur with pooled blood products are avoided. www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. Red Blood CellRed Blood Cell CompatibilityCompatibility Blood group ABBlood group AB individuals have both A and B antigens on theindividuals have both A and B antigens on the surface of their RBCs, and their blood serum does not containsurface of their RBCs, and their blood serum does not contain any antibodies against either A or B antigen. Therefore, anany antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any groupindividual with type AB blood can receive blood from any group (with AB being preferable), but can donate blood only to another(with AB being preferable), but can donate blood only to another type AB individual.type AB individual.  Blood group ABlood group A individuals have the A antigen on the surface ofindividuals have the A antigen on the surface of their RBCs, and blood serum containing IgM antibodies againsttheir RBCs, and blood serum containing IgM antibodies against the B antigen. Therefore, a group A individual can receive bloodthe B antigen. Therefore, a group A individual can receive blood only from individuals of groups A or O (with A being preferable),only from individuals of groups A or O (with A being preferable), and can donate blood to individuals with type A or AB.and can donate blood to individuals with type A or AB.  Blood group BBlood group B individuals have the B antigen on the surface ofindividuals have the B antigen on the surface of their RBCs, and blood serum containing IgM antibodies againsttheir RBCs, and blood serum containing IgM antibodies against the A antigen. Therefore, a group B individual can receive bloodthe A antigen. Therefore, a group B individual can receive blood only from individuals of groups B or O (with B being preferable),only from individuals of groups B or O (with B being preferable), and can donate blood to individuals with type B or AB.and can donate blood to individuals with type B or AB.  Blood group OBlood group O (or blood group zero in some countries)(or blood group zero in some countries) individuals do not have either A or B antigens on the surface ofindividuals do not have either A or B antigens on the surface of their RBCs, but their blood serum contains IgM anti-A antibodiestheir RBCs, but their blood serum contains IgM anti-A antibodies and anti-B antibodies against the A and B blood group antigens.and anti-B antibodies against the A and B blood group antigens. Therefore, a group O individual can receive blood only from aTherefore, a group O individual can receive blood only from a group O individual, but can donate blood to individuals of anygroup O individual, but can donate blood to individuals of any ABO blood group (ie A, B, O or AB). If anyone needs a bloodABO blood group (ie A, B, O or AB). If anyone needs a blood transfusion in a dire emergency, and if the time taken to processtransfusion in a dire emergency, and if the time taken to process the recipient's blood would cause a detrimental delay, Othe recipient's blood would cause a detrimental delay, O Negative blood can be issued.Negative blood can be issued. www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. Plasma CompatibilityPlasma Compatibility  Recipients can receive plasmaRecipients can receive plasma of the same blood group, butof the same blood group, but otherwise the donor-recipientotherwise the donor-recipient compatibility for blood plasmacompatibility for blood plasma is the converse of that ofis the converse of that of RBCs: plasma extracted fromRBCs: plasma extracted from type AB blood can betype AB blood can be transfused to individuals of anytransfused to individuals of any blood group; individuals ofblood group; individuals of blood group O can receiveblood group O can receive plasma from any blood group;plasma from any blood group; and type O plasma can beand type O plasma can be used only by type O recipients.used only by type O recipients. www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. Universal donors and recipientsUniversal donors and recipients  With regard to transfusions of whole blood or packed red blood cells,With regard to transfusions of whole blood or packed red blood cells, individuals with type O negative blood are often calledindividuals with type O negative blood are often called universaluniversal donorsdonors, and those with type AB positive blood are called, and those with type AB positive blood are called universaluniversal recipientsrecipients ; however, these terms are only generally true with respect; however, these terms are only generally true with respect to possible reactions of the recipient's anti-A and anti-B antibodies toto possible reactions of the recipient's anti-A and anti-B antibodies to transfused red blood cells, and also possible sensitization to RhDtransfused red blood cells, and also possible sensitization to RhD antigens. Exceptions include individuals with hh antigen system (alsoantigens. Exceptions include individuals with hh antigen system (also known as theknown as the Bombay blood groupBombay blood group ) who can only receive blood) who can only receive blood safely from other hh donors, because they form antibodies against the Hsafely from other hh donors, because they form antibodies against the H substance.substance.  Association of blood groups and maxillofacialAssociation of blood groups and maxillofacial deformitiesdeformities genetics plays an important role in many deformitiesgenetics plays an important role in many deformities blood grp B & AB have an increased incidence of association withblood grp B & AB have an increased incidence of association with maxillofacial deformities(B>AB)maxillofacial deformities(B>AB) www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. ConversionConversion  In April 2007 a method was discovered to convert bloodIn April 2007 a method was discovered to convert blood types A, B, and AB to O, using enzymes. This method istypes A, B, and AB to O, using enzymes. This method is still experimental and the resulting blood has yet tostill experimental and the resulting blood has yet to undergo human trials.undergo human trials.  The method specifically removes or converts antigensThe method specifically removes or converts antigens on the red blood cells, so other antigens and antibodieson the red blood cells, so other antigens and antibodies would remain. This does not help plasma compatibility,would remain. This does not help plasma compatibility, but that is a lesser concern since plasma has much morebut that is a lesser concern since plasma has much more limited clinical utility in transfusion and is much easier tolimited clinical utility in transfusion and is much easier to preserve.preserve. www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. CONCLUSIONCONCLUSION  The main reasons to know your bloodThe main reasons to know your blood group are if you need to have a bloodgroup are if you need to have a blood transfusion or if you are pregnant.transfusion or if you are pregnant. www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. THANK UTHANK U For more details please visit www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com

×