The document discusses the physiology and functions of blood, highlighting transport, protection, and regulation roles. It details blood composition, types of hemolysis, blood group systems, and the significance of ABO and Rh blood types in transfusions. It emphasizes the importance of matching donor and recipient blood types to prevent severe transfusion reactions.

1. Physiology of blood

2. Functions of blood
• Blood has three main functions: transport, protection, communication &
regulation.
• Transport
• Blood transports the following substances:
• Gases, namely oxygen (O2) and carbon dioxide (CO2), between the lungs and rest of the
body (respiration function)
• Nutrients from the digestive tract and storage sites to the rest of the body(nutritive
function)
• Waste products to be detoxified or removed by the liver and kidneys (excretory
function)
• Hormones from the glands in which they are produced to their target cells (humoral
function)
• Heat to the skin so as to help regulate body temperature (themoregulatory function)

3. Protection
Blood has several roles in inflammation:
Leukocytes, or white blood cells, destroy invading microorganisms and
cancer cells Antibodies and other proteins destroy pathogenic substances
(immune function)
Platelet factors initiate blood clotting and help minimise blood loss
(protection against loosing of blood)
Regulation
Blood helps regulate:
pH by interacting with acids and bases
Water balance by transferring water to and from tissues
Ionic balance (homeostatic function)
Communication
Blood carry information over all body (communicative function)

4. COMPOSITION OF BLOOD
Blood is that portion of the
extracellular fluid volume that is
confined to the blood vessels
Blood is a normally liquid
suspension of formed elements
(cells and cell fragments) in
plasma

5. Blood composition

6. Red blood cells
Red blood cells (RBCs), also called erythrocytes
are flexible and oval biconcave disks lack a cell
nucleus and most organelles, in order to
accommodate maximum space for hemoglobin

7. Hemoglobin
iron-containing oxygen-transport metalloprotein in the
red blood cells

8. Hemoglobin compounds
Physiological:
HbO2
– oxyhemoglobin
Hb – reduced hemoglobin
HbCO2
– carbhemoglobin
Pathological:
HbCO – carboxyhemoglobin
MetHb - methemoglobin

9. Hemolysis

10. Types of hemolysis
• 1. Mechanical (in vivo when diluting tissues, in vitro when shaking blood in
a test tube).
• 2. Thermal (in vivo for burns, in vitro for freezing and thawing or heating of
blood)
• 3. Chemical (in vivo under the influence of chemicals, when inhaling vapors
of volatile substances (acetone, benzene, ether, dichloroethane,
chloroform), dissolving the shell of red blood cells, in vitro under the
influence of acids, alkalis, heavy metals, etc.).
• 4. Biological. Under the influence of factors of biological origin (hemolysins,
snake venom, fungal venom, protozoa (molar plasmodium).
• 4a.Immune(biological) hemolysis-when transfusions of incompatible blood
or in the presence of immune antibodies to red blood cells.
• 5. Osmotic resistance of red blood cells (ORE) - their stability in hypotonic
solutions.
• 6. Physiological-hemolysis of red blood cells that have completed their life
span (in the liver, spleen, red bone marrow).

11. Osmotic resistance of red blood cells (ORE) -
their stability in hypotonic solutions.
• Distinguish between:
• The minimum ORE is the concentration of the NaCl
solution at which hemolysis begins (0.48-0.46%). Less
stable ones are hemolysed.
• The maximum ORE. - the concentration of the NaCl
solution in which all red blood cells are hemolysed (0.34—
0.32%).
• Osmotic resistance of red blood cells depends on the
degree of their maturity and shape. Young forms of red
blood cells, coming from the bone marrow into the blood,
are most resistant to hypotension.

12. White blood cells (WBCs), also called
leukocytes

13. Blood groups or blood types

14. Immunologic properties
of blood
• Presence of blood group systems were discovered by
Karl Landsteiner during early experiments with blood
transfusion in 1901 .
• Blood of all people we can divide for different groups(or
types) according to presence or absence definite
agglutinogens.
• The most important are erythrocite blood groups.

15. • . A total of 35 human blood group systems are
now recognized by the
International Society of Blood Transfusion
(ISBT).
• The two most important ones are ABO and
the Rh(D) antigen; they determine someone's
blood type
Erythrocite blood group systems

16. Blood group
• When red cells from an individual are mixed with plasma
from another individual, an immune response (transfusion
reaction) will occur, in which the red cells will clump together
(agglutinate) and hemolysis, releasing their hemoglobin.
• The antigens are called agglutinogens and are carried on the
red cells in the blood as well as on cells in many other
tissues. In red cells, they are glycosphingolipids that differ by
only the last sugar in the carbohydrate chain that is attached
to a membrane sphingolipid.
• There are more than 400 different blood group antigens that
have been identified.

17. • There are more than 400 different blood
group antigens that have been identified.
• There are no two people with identical
fingerprints so there are no two persons with
identical antigenic set in blood.

18. System Антигены % распределение
групп крови
АВО A1, A2, A3, A4, A5, Az
, A0
, B1, B2, B3, BW
,
BX
, H, O
0 - 40 А - 39 В - 15 АВ - 6
MNSs M, M1, M2, Ma
, Mc
, Mk
, Mv
, Mg
, Mia
, Mur,
Mta
, N, N2, Nya
, S, Sta
, Sul, Sj, S2, s, U,
Tm, Hu, He, Hil, Vw
, Vr
, Ria
, Cla
M - 33 N - 19 MN - 48
P P1, P2, Pk
P1 - 79 P2 - 21 Pk
p
Rh C, Cw
, Cu
, Ces
, Ce, ce, CE, D, Du
, Dw
,
E, Eu
, Ew
, Et
, c, cE, d, e, e , LW
Rh+ 85 Rh- 15
Lu Lua
, Lub
Lua
-0,1 Lub
-92,4 Luab
-7,5
Le Lea
, Leb
, Lec
, Led
Lea
Leb
Lec
Led
K K, k, Kpa
, Kpb
, Jsa
, Jsb
Kk-0,2 Kk-9,8 kk-90
Fy Fya
, Fyb
Fya
-17 Fyb
-34 Fyab
-49
Jk Jka
,Jkb
Jka
-25 Jkb
-25 Jkab
-50
Di Dia
, Dib
Dia
Dib
Yt Yta
, Ytb
Yta
-91,9 Ytb
-0,2 Ytab
-7,9
Ii I, i I-99,98 i-0,02
Au Aua
, Aub
Aua
-82 Aub
-8
Bx Bx Bx+ 0,03 Bx-99,97
Xg Xga
Xga
+ 63M, 89F Xgа
-37M, 11F
Bua
Bua
Bua
+ 0,1 Bua
–99,9
Do Doa
Doa
+ 66 Doa
- 34

19. • K. Landsteiner and Y. Yansky (1901)
• The A and B antigens are the most important of the
different blood group antigens;
• They are inherited and are the basis for dividing
individuals into the four blood groups: O, A, B, and
AB.
• In neonatal life, we quickly develop antibodies against
the antigens that are not present on our red cells, and
these antibodies, called agglutinins ( and ), are
carried in plasma.
ABO antigens

20. Antigens of the ABO group
Antigens are glycosphingolipids on the surface of erythrocytes.
The H antigen that is present in individuals with type O blood.
The A antigen (type A blood) has a terminal N-acetylgalactosamine (NAG).
The B antigen (type B blood) has a terminal galactose (Gal).
Cer = ceramide; Fuc = fucose; Gal = galatose; Glu = glucose.
H antigen A antigen B antigen

21. The ABO system

22. The distribution of people among the four groups:

27. • Agglutionation of the erythrocytes occurs when agglutinogens of the
donor (the individual who supplies the blood) are combined with the
same agglutinins of the recipient – A plus , or B plus .
•
• If a unit of incompatible blood is transfused between a donor and
recipient, a severe acute hemolytic reaction with hemolysis (RBC
destruction), renal failure and shock is likely to occur, and death is a
possibility. (Hemotrasfusion shock)
Hemagglutination

29. • The best transfusion of blood is the
transfusion of blood the same group
Main principles of blood transfusion
•Transfusion blood
should not contain
identical agglutinogens
of the donor to
identical agglutinins of
the recipient
Two main exceptions of blood transfusion:
•The donor agglutinins are
diluted when small volumes
of blood are transfused.
This is the so called the rule
of dilution. The small
volume is 200 to 500 ml of
blood.

30. Two main exceptions of blood transfusion:

31. Type O individuals are called “universal donors” because
their red cells carry neither A nor B antigens.
Their plasma will agglutinate recipient red cells of types A, B,
and AB, but in a transfusion, the donated plasma will
normally be diluted by the donor’s plasma
Blood group AB individuals have both A and B antigens on
the surface of their RBCs, and their blood plasma does not
contain any antibodies against either A or B antigen.
Therefore, an individual with type AB blood can receive
blood from any group (with AB being preferable), but
cannot donate blood to any group other than AB. They are
known as universal recipients.

32. Determination of blood group

34. Rh SYSTEM
• K. Landsteiner and A. Wiener (1937)
Rhesus factor (Rh factor)
Rh-positive group Rh-negative group of blood
Within the Rh system, the C,D, and E
antigens are most important. They
are found only in red cells.
D is the most antigenic component,
and the presence or absence of D is
designated as “Rh-positive” or “Rh-
negative,” respectively.

35. Rhesus system
• Under normal circumstances, human plasma
does not contain anti-Rh antibodies(agglutinins).
• However, if an Rh- person received Rh+ blood
the body starts to make anti-Rh anti-bodies that
will remain in the blood.
• If a second transfusion of Rh+ blood is given
later, the previously formed antibodies will react
against the donated blood and a severe reaction
may occur (rhesus conflict).

36. • This ( rhesus conflict) can occur also when Rh+
fetal blood mixes with the circulation of an
Rh– mother.
• When an Rh- mother carries an Rh+ fetus and
small amounts of fetal blood mix with
maternal blood during delivery, the mother
may develop significant levels of anti-Rh
antibodies in her plasma. During the next
pregnancy, the mother’s Rh agglutinins cross
the placenta into the fetus and can cause
severe hemolytic disease in the fetus.

38. Hemotransfusion

39. Rules for hemotransfusion
• 1. Determination blood group belonging
(donor & recepient) ABO & Rh systems
• 2. Cross test
• 3. Biological test
15ml of donors blood(streamly) (wait 3 min), 3 times
• 4. Hemotransfution

40. Good bye!