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Blood Groups and Transfusion (Transfusion Reaction (Adverse Transfusion…
Blood Groups and Transfusion
ABO
Antigens
Molecular basis and Glycosyltransferases
Group A = enzyme N-acetylglucosamine
Group B = enzyme transfers D-galactose
Group 0 = enzyme is a non-functional variant
H Antigen
Framework of all three blood groups (oligosaccharide)
ABO Group
Inheritance
O is Recessive
A and B are Co-dominant
Phenotype
A
AA
AO
B
BB
BO
AB
AB
0
OO
Principle
ABO Forward Typing
Used to detect the presence or absence of A or B Antigens in red cells
ABO Reverse Typing
Used to detect ABO antibodies in serum
D Typing
D Antigen of Rh system
ABO Antibodies
Anti-B antibodies are produced by Group A individuals
Anti-A antibodies are produced by B individuals
Anti-A and Anti-B antibodies are produced by Group O individuals
Group A and B antibodies are IgM
Group O antibodies are IgG
All ABO antibodies are able to active complement - haemolysis and destruction of red cells
Compatibility
Red Cell Compatibility
Identical ABO group and RhD type as the recipient
0 RhD negative is universal red cell donor
Patent's Blood type
AB+
O- 0+ B- B+ A- A+ AB- AB+
AB-
0- B- A- AB-
A+
0- 0+ A- A+
A-
0- A-
B+
0- 0+ B- B+
B-
0- B-
0+
0- 0+
0-
0-
Plasma compatibility
Group A recipients have A antigen on their red cells, so they can't receive group O or group B plasma as the anti-A will attack their red cells. Group B recipients have B antigens on their red cells, so they can't receive group O or group A plasma as the anti-B will attack their red cells.
Group AB recipients can only receive group AB plasma. Group O recipients do not have either A or B antigen, so safely receive plasma of any blood group type
Patent's Blood type
A
A AB
B
B AB
AB
AB
O
O AB A B
Crossmatching
Compatible
No agglutination or haemolysis
Incompatible
Agglutination or haemolysis present
Transfusion Reaction
Adverse Transfusion Reaction
Haemolytic and Non-Haemolytic
Acute and Delayed
Immune-mediated and non-immune
Infectious and non-infectious
Acute Transfusion Reaction
Immune mediated
Haemolytic
Febrile non-haemolytic
Urticarial
Anaphylactic
Transfusion related lung injury
Non-immune
Bacterial contammination
Physical RBC damage
Citrate toxicity
Circulatory overload
Signs
Hypotension irreversible 'shock'
Disseminated intravascular coagulation (DIC) and renal failure
Acute HTR
Intravascular haemolysis
Haemoglobinaemia
Haemoglobinuria
cause
Antibody binding to RBC
Activation of complement
Activation of PMNs and cytokines
Activation of coagulation
Renal failure
Rh Blood Group System
System for classifying blood groups according to the presence or absence of the Rh antigen, on the cell membranes of the red blood cells (erythrocytes).
D antigen on the red cell gives you the positive + and lacking it gives you the negative – after the letter A, B, AB or O.
The D antigen is the most immunogenic, meaning it provokes an immune response that makes it most likely to cause a transfusion reaction in the recipient
Pregnancy
During labour, a small amount of the fetus’s blood may enter the mother’s bloodstream. The mother will then produce anti-Rh antibodies, which will attack any RH-incompatible fetus in subsequent pregnancies.
