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- Anatomy & Physiology
- Unit 9 – Circulatory System
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- Discovered in 1901 by Dr. Karl Landsteiner
- 4 Main Phenotypes (A, B, AB, O)
- ABO gene located on long arm of chromosome 9
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- Added to Proteins or Lipids in Red Cells
- Substrate Molecule is H (fucose)
- A antigen is N-acetyl-galactosamine (GalNAc)
- B antigen is Galactose (Gal)
- A and B genes code for transferase enzymes
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- A and B substances very common
- Antibodies produced to “non-self”
- Produced after first few months of life
- A & B people have mainly IgM
- O people have IgG
- May fade in old age
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- Cell Group
- Test Washed Cells With:
- Monoclonal Anti-A
- Monoclonal Anti-B
- Inert control
- Agglutination is a positive result
- Reverse Group
- Test plasma/serum with:
- Known A1 cells
- Known B cells
- Known O cells
- ? Known A2 cells
- Reactions may be weaker than cell group
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- ABO mismatched transfusions:
- Rare
- May be life threatening
- Can be caused by technical or clerical error
- Intravascular haemolysis
- More severe in group O patients
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- Universal Donor
- Group O
- Carries no A or B antigens
- Packed and processed units have little antibody
- Universal Recipient
- Group AB
- Patient has no anti-A or anti-B present
- Cannot lyse any transfused cells
- Beware: other
- antibodies may be present
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- RH is the most complex system, with over 45 antigens
- Discovered in 1940 after work on Rhesus monkeys
- Subsequently discovered to be unrelated to monkeys
- RH gene located on short arm of chromosome 1
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- 86% of caucasians are Rh(D) pos
- The antithetical antigen d has not been found
- The d gene is recessive:
- Dd, dD, DD, persons are Rh(D) pos
- Only dd persons are Rh(D) neg
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- 80% of Rh(D) neg persons exposed to Rh(D) pos blood will develop anti-D
- Anti-D can also be stimulated by pregnancy with an Rh(D) positive baby
- Sensitisation can be prevented by the use of anti-D immunoglobulin,
antenatally and post natally
- Rh(D) neg females of childbearing potential should never be given Rh(D)
positive blood products
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- ABO & RH genes are not linked
- ABO & Rh(D) type are inherited independently
- For example:
- An A Rh(D) pos mother
- and a B Rh(D) pos father
- could have an O Rh(D) neg child
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