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Blood group systems
ABO blood group system
Rh blood group system
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„Adverse effect Of Blood Transfusion
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A 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, depending
on the blood group system.
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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
for example rodents and apes such as
chimpanzees, bonobos and gorillas.
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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.
Karl Landsteiner discovered
the ABO Blood Group System
Adriano Sturli and
Alfred von Decastello
who were working under Landsteiner discovered
type AB a year later in 1902
Landsteiner was awarded the 1930 Nobel Prize in
Physiology or Medicine for his work.
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Janský is credited with the first classification of blood
into the four types (A, B, AB, O) in 1907, which remains in
Reuben Ottenberg successfully transfused blood between
two people at Mount Sinai Hospital in New York. He was
the first person to record pre-transfusion testing for blood
compatibility in a clinical setting.
Later in 1954 he was the first to be awarded with Karl
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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
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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.
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Blood with antigen B and α-antibody belongs to ‘B’
If both the antigens are present, blood group is called
‘AB’ group and serum of this group does not contain
If both antigens are absent, the blood group is called
‘O’ group and both α and β antibodies are present in
A A B Anti-B
B B A Anti-A
O None A and B Anti-A&B
AB A and B None None
Antigen and Antibody
Present in ABO Blood Group
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Principle of Blood Grouping
o Blood grouping is done on the basis of
o Agglutination means the collection of
separate particles like RBCs into clumps or
o Agglutination occurs if an antigen is mixed
with its corresponding antibody which is called
isoagglutinin, i.e. occurs when A antigen is
mixed with anti-A or when B antigen is mixed
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IMPORTANCE OF ABO GROUPS
IN BLOOD TRANSFUSION
During blood transfusion, only compatible blood must
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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The antibody of the donor and antigen of the
recipient are ignored mostly.
Thus, RBC of ‘O’ group has no antigen and so
agglutination does not occur with any other group
of blood. So, ‘O’ group blood can be given to any
blood group persons and the people with this blood
group are called ‘universal donors’.
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Plasma of AB group blood has no antibody. This does
not cause agglutination of RBC from any other group
People with AB group can receive blood from any
blood group persons. So, people with this blood
group are called ‘universal recipients’.
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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
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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)
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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The Rh blood group system is one of thirty-
five current human blood group systems.
It is the most important blood group system
Rh blood group system consists of 50 defined
blood-group antigens, among them there are six
common types of Rh antigens.
Each of which is called an Rh factor.
These types are designated C,D, E, c, d, and e.
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The type D antigen is widely prevalent in the
population and considerably more antigenic than
the other Rh antigens.
Anyone who has this type of antigen is said to be
Rh positive, whereas a person who does not have
type D antigen is said to be Rh negative.
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This antigen was discovered by Karl
Landsteiner and Alexander Wiener in 1940.
It was first discovered in Rhesus macaque and
hence the name 'Rh factor’.
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Erythroblastosis Fetalis (“Hemolytic Disease of the Newborn”)
Erythroblastosis fetalis is a disease of the fetus and
newborn child characterized by agglutination and
phagocytosis of the fetus’s red blood cells.
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
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Symptoms and signs in the fetus:
Enlarged liver spleen, or heart
fluid buildup in the fetus' abdomen seen via
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Symptoms and signs in the newborn:
•Anemia that creates the newborn's pallor
•Jaundice or yellow discoloration of the
newborn's skin, sclera or mucous
•Enlargement of the newborn's liver and
•Severe edema of the entire body.
•Dyspnea or difficulty breathing.
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Thirty-five major blood group systems were
recognized by the International Society of Blood
Transfusion (ISBT) in October 2012.
In addition to the ABO antigens and Rhesus
antigens, many other antigens are expressed on
the red blood cell surface membrane.
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An individual can be AB Rh D positive, and at
the same time M and N positive (MNS system),
K positive (Kell system), and Lea or
Leb positive (Lewis system). Many of the blood
group systems were named after the patients in
whom the corresponding antibodies were
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Other blood groups include
Sulter Xg group
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Blood transfusion is generally the process of
receiving blood products into
one's circulation intravenously.
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, such as red blood cells, white blood
cells, plasma, clotting factors, and platelets.
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Blood transfusion is the process of transferring
blood or blood components from one person (the
donor) into the bloodstream of another person (the
Richard Lower pioneered the first blood
transfusion from animal to human in 1665 at
the Royal Society.
In 1840 Dr. Blundell, performed the first
successful whole blood transfusion to
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•Before a blood transfusion is given, there are many steps
taken to ensure quality of the blood products,
compatibility, and safety to the recipient.
•Blood transfusions typically use sources of blood: one's
own (autologous transfusion), or someone else's
(allogeneic or homologous transfusion).
•The latter is much more common than the former.
•Using another's blood must first start with donation of
•Blood is most commonly donated as whole
blood intravenously and collecting it with
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Processing and Testing of Blood
Donated blood is usually subjected to processing
after it is collected, to make it suitable for use in
specific patient populations.
Collected blood is then separated into blood
components by centrifugation:
red blood cells, plasma, platelets, albumin protein,
concentrates, cryoprecipitate, fibrinogen concentrate
and immunoglobulins (antibodies)
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All donated blood is tested for infections
like HIVs, Hepatitis B, Hepatitis C, Syphilis
All donated blood is also tested for ABO
and Rh groups, along with the presence of
any red blood cell antibodies.
Pathogen Reduction treatment done.
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CONDITIONS WHEN BLOOD TRANSFUSION
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PRECAUTIONS TO BE TAKEN BEFORE
THE TRANSFUSION OF BLOOD
Donor must be healthy, without any diseases like:
a. Sexually transmitted diseases such as syphilis
b. Diseases caused by virus like hepatitis, AIDS,
Only compatible blood must be transfused
Both matching and cross-matching must be done
Rh compatibility must be confirmed.
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PRECAUTIONS TO BE TAKEN WHILE
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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Adverse effect of Blood transfusion
Transfusions of blood products are associated with
several complications, many of which can be grouped as
immunological or infectious such as:
Acute hemolytic reaction
Delayed hemolytic reaction
Transfusion associated acute lung injury
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- is the procedure which involves
removal of patient’s blood completely and
with fresh blood or plasma of the donor.
Also known as replacement transfusion.
It is an important in life-saving procedure carried
out in conditions such as
severe jaundice, sickle cell anemia, erythroblastosis
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•Essentials of Medical Physiology, 6th Edition By K
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