Describes about the grouping and typing of blood groups. bombay blood group is explained in detail erythroblastosis fetalis is explained in detail.. mismatched transfusion reactions are well explained

1. BLOOD GROUPING AND
TRANSFUSION REACTIONS
DR.S.REKHA, MD,CCEBDM,
Assistant professor,
KMCHIHS&R

2. SYNOPSIS
• Blood group types
• ABO system
• Inheritance of blood groups
• Landsteiner’s law
• Bombay blood group
• Rh system
• Hemolytic disease of newborn
• Blood storage and transfusion

3. BLOOD GROUP TYPES
 ABO system
Rh system
MNS system
P
KELL
DUFFY
LUTHERAN
LEWIS and KIDD

4. KARL LANDSTEINER

5. CLASSICAL ABO SYSTEM
ABO GENES - LOCATED IN CHROMOSOME 9
IA ,IB ,i
4 blood groups
A,B,AB,O
A antigen has two subtypes A1 and A2
6 blood groups with subunits
• A1,A2,B,A1B,A2B,O

6. INHERITANCE OF BLOOD GROUPS
 Inherited as mendelian dominant
Six possible genotypes
Four phenotypes

9. ABO AGGLUTINOGENS(ANTIGEN)
Mainly Present on red cell
membrane
Also found in salivary
gland,testis,lung,kidney and
pancreas
Secretors --body fluids,
including saliva, semen, sweat,
and gastrointestinal juices.

10. ORIGIN OF ABO AGGLUTINOGENS
Appear at sixth week of
intrauterine life
Maximum at a age of 15-17
years
H antigen –precursor of A and
B
A-N-acetylgalactosamine
B-galactose
O-no sugar

11. ABO AGGLUTININS(ANTIBODIES)
Found in plasma
Naturally occurring antibodies
Second week of neonatal life
Peak in 10 years of life
Exact mechanism not known till yet..(research)

12. CHARACTERISTICS OF ABO
ANTIBODIES
Globulins of IgM type
Do not cross placenta
Cold antibodies (5 to 20 degree)

13. LANDSTEINER’S LAW
• 1ST LAW- If an agglutinogen is present on red cell membrane
of an individual , the corresponding agglutinin must be
absent in plasma
• 2ND LAW- If an agglutinogen is absent from the cell
membrane of RBC of an individual, the corresponding
agglutinin must be present in the plasma.
• Holds good for ABO system

14. LANDSTEINER’S LAW

16. BOMBAY BLOOD GROUP TYPE
H antigen –precursor of A and
B
Individuals lack H gene-no H
antigen-no A and B antigen
Routinely labelled as blood group O
But contains anti A,anti B and anti H
antibodies
Same blood group has to be
transfused

17. IMPORTANCE OF BLOOD
GROUPING
 Blood transfusion
Paternity disputes
Medicolegal cases eg: stain on clothes
Association with susceptibility to diseases
• O group- peptic ulcer
• A group- carcinoma of stomach

18. APPLIED PHYSIOLOGY
 ABO incompatibility
• Mismatched blood tranfusion
• Significant in organ transplantation
• Does not cause hemolytic disease of newborn
• Bombay blood group

19. Rh SYSTEM- WEINER-RHESUS
MONKEY
Gene located in chromosome 1.
 Six antigens C,D,E,c,d,e.
D antigen immunologically active.
Two blood groups: Rh positive and Rh negative.

20. INHERITANCE OF Rh GROUP

21. Rh ANTIBODIES
 Acquired antibodies
• Doesnot obey second part of Landsteiner,s law
Globulins of IgG type
 Crosses placenta
 Warm antibodies (37 degree)

22. APPLIED- Rh INCOMPATABILITY

23. HEMOLYTIC DISEASE OF
NEWBORN
Rh positive male marries Rh negative female
First pregnancy not affected
Subsequent pregnancies have problems

24. HEMOLYTIC DISEASE OF
NEWBORN

26. CLINICAL FEATURES

27. CLINICAL FEATURES

28. MANAGEMENT
Before birth
• Intrauterine fetal transfusion

29. MANAGEMENT
After birth
• Exchange transfusion (preferably
blood group AB negative)
• Plasmapheresis

30. MANAGEMENT
After birth
• Phototherapy

31. PREVENTION
 Marriage counselling
 Anti-D antibodies (Rhogam) after first delivery within 72
hours.
Rh negative people cannot be transfused with Rh positive
blood.

34. BLOOD TRANFUSION

35. INDICATION FOR BLOOD
TRANFUSION
Acute blood loss- accident and surgery
Chronic anaemia,thalassemia and sickle cell anemia
Bonemarrow failure
Purpura
Clotting factor deficiencies
Preparation for surgery
Burns

36. PROCEDURE OF BLOOD
TRANSFUSION
 Selection of appropriate donor
• 18-60 yrs
• Minimum Hb 12 g % in female and 13 g % in male
Cross matching
• Major
• Minor
 Universal donor and recipient

37. MAJOR CROSS MATCHING

38. MINOR CROSS MATCHING

39. UNIVERSAL DONOR AND RECIPIENT

40. PROCEDURE OF BLOOD
TRANSFUSION
 Collection of blood
• 350 ml of blood from antecubital vein
• Citrate-phosphate-Dextrose (CPD) coated bottle
 Autologous donor, Blood doping
Storage
• Stored at 4 degree Celsius
• Ideally stored for 2 weeks

41. RED CELL CHANGES DURING
METABOLISM AFTER 3 WEEKS
At low temperature,Decreased sodium potassium ATPase
activity
Cells swell and become spherocytic
Spontaneous hemolysis

42. COMPLICATIONS OF BLOOD
TRANSFUSIONS
Non-hemolytic reaction
Hemolytic reaction
 HEMOLYTIC REACTIONS
In incompatible transfusion as in ABO incompatible and Rh
incompatibility.

43. NON-HEMOLYTIC REACTIONS
 Pyrogenic reaction
 Allergic reactions like urticaria, anaphylaxis
 Transmission of diseases like AIDS, Hepatitis, malaria, syphilis.
 Circulatory overload
 Hyperkalemia can cause inhibition of heart.
 Hemochromatosis or iron overload.
 Air embolism
 Microembolism like pulmonary embolization leads to shock lung
syndrome

44. HAZARDS OF MISMATCHED
BLOOD TRANSFUSION
 Mild haemolytic reaction
Severe immediate hemolytic reaction
• Chills and rigor
• Fever headache, nausea and vomiting
• Joint pain,chest and abdominal pain
• Hemolytic anemia,jaundice
• Haemoglobinuria,acute renal failure
• Uremic coma
• Death
Delayed reaction

45. SUMMARY

46.  ABO genes are located in ……
 ABO antigens are mainly present in the……..
If an agglutinogen is present on red cell membrane of an
individual…
ABO antibodies are of type….
IgM antibodies are also called as…
IgM antibodies do not cross…..

47. Rh genes are located in ……
Immunologically active Rh antigen is…
Rh antibodies are of type….
IgG antibodies are also called as…
IgG antibodies cross…..

48. Rhogam is given within……hrs
Kernicterus is…..
Major cross matching is…
Universal donor is..
Universal recipient is..

49. Blood is Stored at ….degree Celsius
Blood is Ideally stored for … weeks
The anticoagulant used for storing blood is….
Diseases transmitted through blood transfusions are….

50. THANK YOU