Blood grouping and typing 1

For education purposes

1. Blood Grouping system And Types of Antibodies BY MBAH C HIMEZIE REGISTRAR DEPARTMENT OF HAEMATOLOGY BABCOCK UNIVERSTY TEACHING HOSPITAL ILISHAN REMO, OGUN STATE NIGERIA

2. O utlines INTRODUCTION COMPONENTS OF BLOOD DIFFERENT BLOOD GROUPS LANDSTEINER’S LAW AGGLUTINOGENS AGGLUTININS ABO BLOOD GROUPING SYSTEM RHESUS FACTOR BLOOD GROUPING SYSTEM BLOOD GROUP NOTATION BLOOD GROUP TYPING BLOOD TRANSFUSION-WHO CAN RECEIVE BLOOD FROM WHOM

3. INTRODUCTION: Experiments with blood transfusions, the transfer of blood or blood components into a person's blood stream, have been carried out for hundreds of years. Many patients have died and it was not until 1901, when the Austrian Karl Landsteiner discovered human blood groups, that blood transfusions became safer.

4. INTRODUCTION CONTD Mixing of blood from two individuals can lead to blood clumping or agglutination. The clumped red cells can crack and cause toxic reactions. This can have fatal consequences. Karl Landsteiner discovered that blood clumping was an immunological reaction which occurs when the receiver of a blood transfusion has antibodies against the donor blood cells.

5. Karl Landsteiner's work made it possible to determine blood groups and thus paved the way for blood transfusions to be carried out safely. For this discovery he was awarded the Nobel Prize in Physiology or Medicine in 1930.

6. COMPONENTS OF BLOOD An adult human has about 4–6 liters of blood circulating in the body. Among other things, blood transports oxygen to various parts of the body. Blood consists of several types of cells floating around in a fluid called plasma.

7. contd The red blood cells contain hemoglobin, a protein that binds oxygen. Red blood cells transport oxygen to, and remove carbon dioxide from, the body tissues. The white blood cells. The platelets . The plasma.

8. Different blood groups Differences in human blood GROUP are due to the presence or absence of certain molecules called antigens and antibodies. Antigens are located on the surface of the red blood cells and the antibodies are in the plasma. Individuals have variations in these molecules. The blood group of an individual depends on what he/she has inherited from both parents.

9. There are more than 20 genetically determined blood group systems known today, but the ABO and Rhesus systems are the most important ones used for blood transfusions. Not all blood groups are compatible with each other. Mixing incompatible blood groups results in agglutination reaction, which is hazardous and can even lead to death Nobel Laureate Karl Landsteiner was involved in the discovery of both the ABO and Rh blood groups.

10. Classification of blood group 1)Major blood grouping system: - ABO blood grouping system -Rhesus blood group system Because they cause major blood transfusion reaction 2) Minor blood grouping system -MNS blood group system -P blood group system Because they cause minor blood transfusion reaction 3 Familial blood group system - Kell,Duffy,Lutheran,Lewis,Deigo , Many

11. Landsteiner’s law In 1900, Karl Landsteiner framed this law which is divided into two major components: 1) if an agglutinogen is present in RBCs of individual, the corresponding agglutinin must be absent from plasma(for ABO or Rhesus system) 2)If the agglutinogen is absent in the individual RBC’s the corresponding agglutinin must be present in plasma(for ABO system)

12. Agglutinogens (Antigens) Antigen type A and B are present on cell membrane of RBCs in large proportion, called as agglutinogens They determine the type of blood group Agglutinogen A and B first appeared in the 6 th week of fetal life .Their concentration increases progressively during puberty and adolescence

13. Agglutinins(antibodies) Gamma globulins, produced by same cells that produce antibodies to any other antigens Mostly are IgM and develops in Plasma At birth, quantity of agglutinogen is almost zero At 2 to 8 months, agglutinins function starts

14. AB0 blood grouping system ABO system is based on agglutinogen present on RBC The ABO blood group antigen are all membrane glycolipids It mainly contain 3 agglutinogens A,B and H The antigen-H is common in all the blood groups According to the ABO blood group system there are four different kinds of blood groups: Blood group A Blood group B Blood group AB Blood group O

15. Blood group A If you belong to the blood group A, you have A antigens on the surface of your red blood cells and B antibodies in your blood plasma.

16. Blood group B If you belong to the blood group B, you have B antigens on the surface of your red blood cells and A antibodies in your blood plasma.

17. Blood group AB If you belong to the blood group AB, you have both A and B antigens on the surface of your red blood cells and no A or B antibodies at all in your blood plasma.

18. Blood group 0 If you belong to the blood group O (null), you have neither A or B antigens on the surface of your red blood cells but you have both A and B antibodies in your blood plasma.

19. The Rhesus(RH) blood grouping system Landsteiner and Weiner in 1940 discovered other antigen in human RBCs and named it Rhesus antigens because same antigens are present in Rhesus monkeys One of the basic difference between ABO and Rh systems is that the Rh-antibodies are not natural ie they are not present at birth but synthesized in Rh negative persons in response to presence of Rh positive antigen Rhesus antigens are transmembrane proteins with loops exposed at surface of red blood cells

20. Contd They appear to be used for the transport of Carbon dioxide and or Ammonia across the plasma membrane 85% of the population is RhD positive,the other 15% of the population has RhD negative

21. Cont. A person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh- blood without any problems.

22. Blood group notation According to above blood grouping systems, one can belong to either of following 8 blood groups: Rh+B (B+) Rh-B (B-) Rh+AB (AB+) Rh-AB (AB-) Rh+0 (O+) Rh-0 (O-) Rh+A (A+) Rh-A (A-)

23. Blood typing – how to find out to which blood group someone belongs to? 1. You mix the blood with three different reagents including either of the three different antibodies, A, B or Rh antibodies.

24. 2. Then you take a look at what has happened. In which mixtures has agglutination occurred? The agglutination indicates that the blood has reacted with a certain antibody and therefore is not compatible with blood containing that kind of antibody. If the blood does not agglutinate, it indicates that the blood does not have the antigens binding the special antibody in the reagent.

25. 3. If you know which antigens are in the person's blood, it's easy to figure out which blood group he or she belongs to!

26. What happens when blood clumps or agglutinates? Find out!

27. The A antigen and the A antibodies can bind to each other in the same way that the B antigens can bind to the B antibodies. This is what would happen if, for instance, a blood group B receives blood from a blood group A . The red blood cells will be linked together, like bunches of grapes, by the antibodies. As mentioned earlier, this clumping could lead to death.

28. Blood transfusions – who can receive blood from whom? Of course one can always give A blood to persons with blood group A, B blood to a person with blood group B and so on. But in some cases one can receive blood with another type of blood group, or donate blood to a person with another kind of blood group.

29. Cont. The transfusion will work if a person who is going to receive blood has a blood group that does not have any antibodies against the donor blood's antigens. But if a person who is going to receive blood has antibodies matching the donor blood's antigens, the red blood cells in the donated blood will clump.

30. Cont. Blood group O Rh - are called "universal donors" and people with blood group AB Rh + are called "universal receivers."

31. THANK YOU !