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BLOOD GROUP SYSTEM

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BLOOD GROUP SYSTEM

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BLOOD GROUP SYSTEM

  1. 1. DR NILESH KATE MBBS,MD ASSOCIATE PROF DEPT. OF PHYSIOLOGY BLOOD GROUPS
  2. 2. OBJECTIVES.  BLOOD GROUPS  Introduction  Classical ABO blood grouping system  Rh blood grouping system  Clinical applications of blood groups.  BLOOD TRANSFUSION.  Indications  Donors & recipient.  Precautions during blood transfusion.  Hazards  Autologous BT.  Storage of blood for transfusion. Wednesday, November 9, 2016
  3. 3. INTRODUCTION  Agglutinogens – Antigens present on cell membrane of RBC  Agglutinins – antibodies against Agglutinogens present in plasma.  Agglutination – of RBC is reaction between these 2 Wednesday, November 9, 2016
  4. 4. BLOOD GROUPING SYSTEM.  Major blood group system – based on Agglutinogens on cell membrane, present widely & causes severe transfusion reaction  ABO  Rh system  Minor blood group system – based on Agglutinogens but present in few populations & causes mild transfusion reaction.  MNS  P  Familial blood group system – found in few families  KELL. DUFFY, LUTHERAN, BOMBAY LEWIS, DEIGO, KIDD Wednesday, November 9, 2016
  5. 5. LANDSTEINER’S LAW KARL LANDSTEINER 1900  If an Agglutinogens is present on surface of RBC corresponding agglutinins must be absent in plasma.  & if an Agglutinogens is absent on surface of RBC corresponding Agglutinins must be present in plasma. Wednesday, November 9, 2016
  6. 6. CLASSICAL ABO BLOOD GROUPING SYSTEM  A & B Agglutinogens- these are complex oligosaccharides differing in terminal sugar  In Antigen A – N-acetylgalactosamine & in Antigen B – galactose.  Other than RBC also present in salivary glands, pancreas, kidney, liver, lung, testes also in body fluids like saliva, semen & amniotic fluid Wednesday, November 9, 2016
  7. 7. CLASSICAL ABO BLOOD GROUPING SYSTEM  Anti-A (α)and anti-B (β) Agglutinins – IgM type & cannot cross placenta.  Absence of these are determined by Landsteiner’s law  Act best at low temperature so called Cold Antibodies. Wednesday, November 9, 2016
  8. 8. TYPES OF ABO BLOOD GROUPS. BLOOD GROUP ANTIGEN ANTIBODIES A A ANTI B OR β B B ANTI A OR α AB AB --------------------- O ----------- ANTI A (α) & ANTI B (β) Wednesday, November 9, 2016
  9. 9. POPULATION DISTRIBUTION OF ABO BLOOD GROUPS BLOOD GROUPS PERCENTAGE (%) A 20 B 40 AB 08 O 32 Wednesday, November 9, 2016
  10. 10. INHERITANCE OF ABO BLOOD GROUPS PHENOTYPE (BLOOD GROUP) GENOTYPE A AA,AO B BB,BO AB AB O OO Wednesday, November 9, 2016
  11. 11. APPERANCE OF ANTIGENS & ANTIBODIES  Antigens A & B appears in 6th week of fetal life, at birth 1/5th of adult level & rises during puberty & adolescence.  Antibodies are absent at birth, appear 10-15 days after birth, reach maximum at 10 yrs. Wednesday, November 9, 2016
  12. 12. MECHANISM  Antigens similar to A & B are present in intestinal bacteria & foods, when newborn exposed to these absorbed in blood, stimulate formation of antibodies against antigens recognized as non-self by immune system. Wednesday, November 9, 2016
  13. 13. DETERMINATION OF ABO BLOOD GROUPS  Covered in Practicals “ Determination of Blood Groups” Wednesday, November 9, 2016
  14. 14. Rh BLOOD GROUPING SYSTEM  Rh Antigens – called Rh as these were first discovered in RBC of rhesus monkey.  Discovered by Landsteiner & weiner in 1940.  3 types of Rh antigen, C,D & E,  D IS COMMONEST & causes severe transfusion reaction.  Rh antigens are integral membrane proteins & not found in other tissues. Wednesday, November 9, 2016
  15. 15. Rh Antibodies.  No natural antibodies like ABO blood groups system  Rh antibodies are produced when Rh -ve individual is transfused with Rh +ve blood.  These are IgG type & crosses placenta.  Warm Antibodies. Wednesday, November 9, 2016
  16. 16. INHERITANCE OF Rh BLOOD GROUPS Wednesday, November 9, 2016
  17. 17. Wednesday, November 9, 2016
  18. 18. HEMOLYTIC DISEASE OF NEWBORN.  Incompatibility of Rh blood groups between fetus & mother. Wednesday, November 9, 2016
  19. 19. MECHANISM OF HEMOLYTIC DISEASE OF NEWBORN IN RH INCOMPATIBILITY.  Entrance of Rh +ve fetal RBC into Rh –ve mother’s circulation during first pregnancy.  Production of Rh antibodies.  Rh incompatibility reaction during second pregnancy. Wednesday, November 9, 2016
  20. 20. MANIFESTATIONS OF HEMOLYTIC DISEASE OF NEWBORN.  Erythroblastosis fetalis.  Erythroblastosis  Anaemia.  Icterus gravis Neonatorum.  Jaundice  Enlarged liver & spleen.  Kernicterus – excess (<18mg%) bilirubin deposition in brain mainly basal ganglia  Hydrops fetalis – Grossly edematous fetus. Wednesday, November 9, 2016
  21. 21. PREVENTION OF HEMOLYTIC DISEASE OF NEWBORN.  Injecting single dose of Rh antibodies (anti-D) to mother soon after child birth.  So active antibodies will not be formed by mother. Wednesday, November 9, 2016
  22. 22. TREATMENT OF HEMOLYTIC DISEASE OF NEWBORN.  Replacement of baby’s Rh+ve blood by Rh –ve blood.  This is called Exchange Transfusion. Wednesday, November 9, 2016
  23. 23. CLINICAL APPLICATIONS OF BLOOD GROUPS.  In blood transfusion.  In Preventing Hemolytic Disease.  In Paternity Disputes.  In Medicolegal Cases.  In knowing Susceptibility to Diseases. Wednesday, November 9, 2016
  24. 24. BLOOD TRANSFUSION.  Life saving measure  Should be carried out when absolutely necessary. Wednesday, November 9, 2016
  25. 25. INDICATIONS  Blood loss – Accidents, major operations, rupture peptic ulcer, rupture aortic aneurysm & rupture ectopic pregnancy.  For Quick restoration of haemoglobin.  Exchange transfusion.  Blood diseases- Aplastic anaemia, agranulocytosis, leukemias, purpurae & clotting defects  Acute poisoning – carbon Monoxide poisoning. Wednesday, November 9, 2016
  26. 26. DONORS & RECIPIENT.  Donor – person who donate the blood  Recipient – person who receives the blood.  Universal donor – O Rh Negative.  Universal recipient – AB Rh positive Wednesday, November 9, 2016
  27. 27. PRECAUTIONS TO BE TAKEN WHILE SELECTING DONOR.  Should be Healthy  Age – 18- 60 yrs  Contraindicated in pregnant & lactating mothers  Screening for – AIDS, viral hepatitis, malaria, syphilis.  Hb & PCV should be normal Wednesday, November 9, 2016
  28. 28. PRECAUTIONS DURING BLOOD TRANSFUSION.  Absolute indication.  Cross matching  Major – Donor’s RBC + Recipient plasma  Minor -Donor’s plasma+ Recipient RBC  Rh +ve blood should never be transfused to Rh –ve person.  Donor’s blood should always be screened for diseases. Wednesday, November 9, 2016
  29. 29. PRECAUTIONS DURING BLOOD TRANSFUSION.  Blood bag/bottle should be checked.  Blood transfusion should be given at slow rate.  Proper Aseptic measures.  Careful watch on recipient condition – for first 10- 15min.  Should stop if any reaction Wednesday, November 9, 2016
  30. 30. HAZARDS OF BLOOD TRANSFUSION.  Mismatched transfusion reaction.  Agglutination of donor’s RBC  Tissue ischemia – chest pain or back pain  Haemolysis of agglutinated RBC- Haemoglobinemia  Haemolytic Jaundice  Renal vasoconstriction  Circulatory shock  Haemoglobinuria.  Renal tubular damage, acute renal shutdown & Uraemia. Wednesday, November 9, 2016
  31. 31. HAZARDS OF BLOOD TRANSFUSION.  Circulatory overload - Hypervolemia  Transmission of blood borne infections – AIDS, viral hepatitis  Pyrogenic reactions – fever with chills  Allergic reactions – skin rashes , asthma  Hyperkalemia – after excessive transfusion  Hypocalcaemia – Tetany due to chelation of Ca by citrate  Reduced tissue oxygenation – stored RBC has low 2,3-DPG  Haemosiderosis – Iron overload & deposition in liver, heart  Thrombophlebitis – at Venepuncture site  Air embolism – entry of air into blood. Wednesday, November 9, 2016
  32. 32. AUTOLOGOUS BT.  Transfusion of individual own blood withdrawl & stored  For elective surgery  During surgery  Sports persons Wednesday, November 9, 2016
  33. 33. STORAGE OF BLOOD FOR TRANSFUSION.  One unit 420 ml mixed with 120 ml ACD ( Acid citrate dextrose)  Contents –  Acid citrate 0.48 gm  Trisodium citrate – 1.32 gm  Dextrose – 1.47gm  Distilled water -100ml  Dextrose – provide energy for Na-K pump Wednesday, November 9, 2016
  34. 34. IMPORTANT FACTS ABOUT BLOOD TRANFUSION.  One can safely donate 1 unit of blood every 6 month.  Blood can be stored for 21 days with above conditions  WBC & platelet virtually absent after 24 hrs of storage.  After transfusion 80% RBC survive for 24 hrs & destroyed at a rate of 1% per day. Wednesday, November 9, 2016
  35. 35. Thank You
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BLOOD GROUP SYSTEM

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