Notes
Slide Show
Outline
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ABO & Rh(D) Blood Groups
  • Anatomy & Physiology
  • Unit 9 – Circulatory System
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The ABO System
  • 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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The ABO Antigens
  • 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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ABO Antibodies
  • 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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Antigens & Antibodies
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Inheritance of ABO Groups
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ABO Typing
  • 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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Distribution of ABO Groups
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Distribution of the A allele
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Distribution of the B Allele
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Distribution of the O Allele
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Significance of ABO Group
  • 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 and Recipient
  • 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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The Rh(D) Antigen
  • 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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Simple Genetics of Rh(D)
  • 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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Distribution of Rh(D) Types
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Significance of Rh(D)
  • 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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Inheritance
  • 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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Inheritance of ABO and Rh(D)