Blood group is determined by the presence or absence of antigens on red blood cells. The ABO blood group system divides blood into four main groups based on antigens present: A, B, AB, and O. Blood type is important for blood transfusions, as incompatible blood can cause agglutination and other serious reactions. The Rh system further divides blood into Rh-positive or Rh-negative groups depending on the presence of the D antigen, and Rh incompatibility can cause hemolytic disease of the newborn. Determining blood type through antigen-antibody reactions is crucial for safe blood transfusions.

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By
Dr. Faraza Javaid

2.  Blood group also called a Blood Type
 Classification of blood is based on the
presence or absence of inherited
antigenic substances on the surface of
red blood cells (RBCs)
 These antigens may be proteins,
carbohydrates, glycoproteins, or
glycolipids.
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4. The ABO blood group system is
the most important blood type
system (or blood group system) in
human blood transfusion.
ABO blood types are also present
in some other animals
for example rodents and apes such
as chimpanzees, bonobos and
gorillas.
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5. Determination of ABO blood groups
depends upon the immunological
reaction between antigen and
antibody.
Antigens are also called
agglutinogens because of
their capacity to cause
agglutination of RBCs.
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6. Landsteiner Rule
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If an antigen is present on a
patients red blood cells (RBCs)
the corresponding antibody will
NOT be present in the patients
plasma, under ‘normal
conditions’.

7. ABO BASICS
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Based on the presence or absence
of antigen A and antigen B, blood is
divided into four groups:
‘A, B, AB and ‘O’ group.
Blood having antigen A belongs to ‘A’
group. This blood has β-antibody in
the serum.

8. Blood with antigen B and α-antibody belongs
to ‘B’ group.
If both the antigens are present, blood group
is called ‘AB’ group and serum of this group
does not contain any antibody.
If both antigens are absent, the blood group
is called ‘O’ group and both α and β antibodies
are present in the serum.
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9. ABO
Group
Antigen
Present
Antigen
Missing
Antibody
Present
A A B Anti-B
B B A Anti-A
O None A and B Anti-A&B
AB A and B None None
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Antigen and Antibody
Present in ABO Blood Group

11. Principle of Blood
Grouping
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 Blood grouping is done on the
basis of agglutination.
 Agglutination means the collection
of separate particles like RBCs
into clumps or masses.
 Agglutination occurs if an antigen is
mixed with its corresponding
antibody which is called isoagglutinin,
i.e. when A antigen is mixed with
anti-A or when B antigen is mixed
with anti-B.

12. IMPORTANCE OF ABO
GROUPS IN BLOOD
TRANSFUSION
During blood transfusion, only
compatible blood must be used.
The one who gives blood is called the
‘donor’ and the one who receives the
blood is called ‘recipient’.
While transfusing the blood, antigen of
the donor and the antibody of the
recipient are considered.
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13. In mismatched transfusion,
the transfusion reactions occur
between donor’s RBC and recipient’s
plasma.
So, if the donor’s plasma contains
agglutinins against recipient’s RBC,
agglutination does not occur because
these antibodies are diluted in the
recipient’s blood.
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14. Blood Compatibility
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15. TRANSFUSION
REACTIONS DUE TO ABO
INCOMPATIBILITY
Transfusion reactions are the adverse reactions
in the body, which occur due to transfusion
error that involves transfusion of incompatible
(mismatched) blood.
The reactions may be mild causing only fever
and hives (skin disorder characterized by
itching) or may be severe leading to renal
failure, shock and death.
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17. Rh factor is an antigen present in RBC.
There are many Rh antigens but only the
D antigen is more antigenic in human.
The persons having D antigen are called
‘Rh positive’ and those without D antigen
are called ‘Rh negative’.
Percentage of Rh positive people is
more among black people.
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18. Inheritance of Rh Antigen
Rhesus factor is an inherited dominant factor.
It may be homozygous Rhesus positive with DD
or heterozygous Rhesus positive with Dd
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19. Transfusion Reactions due to Rh
Incompatibility
HEMOLYTIC DISEASE OF FETUS AND
NEWBORN
(ERYTHROBLASTOSIS FETALIS)
Erythroblastosis fetalis is a disease of
the fetus and newborn child
characterized by agglutination and
phagocytosis of the fetus’s red blood
cells.
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20.  In most instances of erythroblastosis
fetalis, the mother is Rh negative and the
father Rh positive.
 The baby has inherited the Rh-positive antigen
from the father, and the mother develops anti-
Rh agglutinins from exposure to the fetus’s Rh
antigen.
 In turn, the mother’s agglutinins diffuse
through the placenta into the fetus and
cause red blood cell agglutination.
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21. Symptoms and signs in the fetus:
Enlarged liver spleen, or heart
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Severe complications develop, viz.
1. Severe anemia
2. Hydrops fetalis
3. Kernicterus.

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23. Other blood groups include
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 Auberger groups
 Diego group
 Bombay group
 Duffy group
 Lutheran group
 P group
 Kell group
 I group
 Kidd group
 Sulter Xg group
 Kidd group

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25.  Blood transfusion is the process of transferring
blood or blood components from one person (the
donor) into the bloodstream of another person
(the recipient).
 Transfusions are used for various medical
conditions to replace lost components of the
blood.
 Early transfusions used whole blood, but modern
medical practice commonly uses only
components of the blood.
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26. CONDITIONS WHEN BLOOD
TRANSFUSION IS NECESSARY
1. Anemia
2. Hemorrhage
3. Trauma
4. Burns
5. Surgery
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27. Precautions
 Donor must be healthy, without any diseases
 Only compatible blood must be transfused
 Both matching and cross-matching must be
done and Rh compatibility must be
confirmed.
 Apparatus for transfusion must be sterile
 Temperature of blood to be transfused must
be same as the body temperature
 Transfusion of blood must be slow. The
sudden rapid infusion of blood into the body
increases the load on the heart, resulting in
many complications.
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28. „
HAZARDS OF BLOOD
TRANSFUSION
Hazards of blood transfusion are of four types:
1. Reactions due to mismatched (incompatible)
blood transfusion – transfusion reactions
2. Reactions due to massive blood transfusion
3. Reactions due to faulty techniques during
blood transfusion
4. Transmission of infections.
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29. Reactions due to mismatched
(incompatible) blood transfusion
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30. Reactions due to massive blood
transfusion
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 Circulatory shock, particularly in patients
suffering from chronic anemia, cardiac
diseases or renal diseases
 Hemosiderosis (increased deposition of
ion in the form of hemosiderin, in organs
such as endocrine glands, heart and liver)
due to iron overload after repeated
transfusions.

31. REACTIONS DUE TO FAULTY TECHNIQUES
DURING BLOOD TRANSFUSION
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Faulty techniques adapted during blood
transfusion leads to:
i. Thrombophlebitis (inflammation of vein,
associated with formation of thrombus).
ii. Air embolism (obstruction of blood vessel
due to entrance of air into the bloodstream).

32. BLOOD SUBSTITUTES
Fluids infused into the body instead of whole
blood are known as blood substitutes.
1. Human plasma
2. 0.9% sodium chloride solution (saline) and
5% glucose
3. Clotting Factors
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33. EXCHANGE TRANSFUSION
 Affected person’s blood is slowly drawn out in
small quantities of 5 to 20 mL, depending upon
the age and size of the person and the severity
of the condition.
 Equal quantity of fresh, prewarmed blood or
plasma is infused through intravenous catheter.
This is carried out for few minutes.
 Catheter is left in place and the transfusion is
repeated within few hours.
 This procedure is continued till the whole or
predetermined volume of blood is exchanged.
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34. CONDITIONS WHICH NEED
EXCHANGE TRANSFUSION
 Hemolytic disease of the newborn
 Severe sickle cell anemia.
 Toxicity of certain drugs.
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35. AUTOLOGOUS BLOOD
TRANSFUSION
Autologous blood transfusion is the
collection and reinfusion of patient’s
own blood. It is also called self blood
donation.
The conventional transfusion of blood
that is collected from persons other
than the patient is called allogeneic or
heterologous blood transfusion.
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36. BLOOD VOLUME
Total amount of blood present in the
circulatory system, blood reservoirs,
organs and tissues together constitute
blood volume.
In a normal young healthy adult male
weighing about 70 kg, the blood volume
is about 5 L.
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37. VARIATIONS IN BLOOD VOLUME
PHYSIOLOGICAL VARIATIONS
1.Age
2.Gender
3.Surface Area of the Body
4.Body Weight
5.Atmospheric Temperature
6.High Altitude
7.Emotion
PATHOLOGICAL VARIATIONS
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38. MEASUREMENT OF BLOOD
VOLUME
 DIRECT METHOD
 INDIRECT METHOD
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39. DIRECT METHOD
Direct method is employed only in animals
because It involves sacrificing the life.
INDIRECT METHOD
Indirect method is advantageous because, it is
used to measure the blood volume in human
beings without causing any discomfort or any
difficulty to the subject.
Measurement of total blood volume involves
two steps:
1. Determination of plasma volume
2. Determination of blood cell volume.
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40. Determination of Plasma Volume
Plasma volume is determined by two methods:
i. Indicator or dye dilution technique
ii. Radioisotope method.
Determination of Blood Cell Volume
Blood cell volume is determined by two methods:
i. By hematocrit value
ii. By radioisotope method.
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41. REGULATION OF BLOOD VOLUME
Hypothalamus regulates the blood volume by
acting mainly through kidneys and sweat
glands and by inducing thirst. Hormones also
are involved in the regulation of blood volume
through the regulation of ECF volume.
Hormones which are involved in the
maintenance of ECF volume are:
1. Antidiuretic hormone
2. Aldosterone
3. Cortisol
4. Atrial natriuretic peptide
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42. BLOOD VOLUME PATHOLOGIES
HYPERVOLEMIA
Hyperthyroidism
Hyperaldosteronism
HYPOVOLEMIA
Hemorrhage or Blood Loss
Fluid Loss
Hemolysis
Anemia
Hypothyroidism
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