BLOOD GROUPS

Blood groups. There are 4 main blood groups (types of blood) – A, B, AB and O. Your blood group is determined by the genes you inherit from your parents. Each group can be either RhD positive or RhD negative, which means in total there are 8 blood groups

1. Blood Groups, Blood Typing &
Blood Transfusions
By
Dr. K. AmbareeshaGoud.,PhD
Department of Physiology
Gandhi Medical College& Hospital, Secunderabad, TS

2. Contents
1.Blood Groups & Various types
2.Agglutinins and agglutinogens
3. Land Steiner’s law
4. Cross matching
5.Erythroblastsisfetalis
6.Blood transfusion and transfusion reactions
7. Importance of bloodGrouping

3. History
In the year of 1901
Karl Land Steiner
discovered the
classical ABO
system and was
given Nobel Prize
in 1930.

4. * 1. The most important Blood
Group systems are:
1. ABO system
2. Rh system
3. MNS system
Less important blood groupsystems:
1. Lutheran
2. Kell
3. Lewis
4. Duffy
5.Bombay,etc…..

5. *2. Land Steiner’s law
1.If an agglutinogen is present on red cells of
blood, the corresponding agglutinin must
be absent from the plasma.
2.If the particular antigen is absent, the
corresponding antibody must be present.
Note: The 2
nd
law is a fact, but not must .
Ex. Absence of Rh antigen is not accompanied by
the presence of anti-Rhantibody.

6. A. Classical ABO System

7. Group A
Classical ABO System
Group B
Group AB
Group O

8. Classical ABO System
Plasma Plasma
Plasma
Plasma

9. Classical ABO System
Blood
Type
Antigens (Agglutinogens) on
Red Blood Cells
Antibodies (Agglutinins)
in Plasma
A A Anti-B
B B Anti-A
AB A & B None
O Neither Anti-A & Anti-B
Note: A has 2 sub units: A1 and A2

10. Percentage of Distribution
of ABO Blood Groups

11. [Formation of the A antigen]
Glucose
Galactose
N-acetyl glucosamine
Galactose
RBC
Fucose
N-acetylgalactosamine
B. Inheritance of ABO System

12. * 3. Basis of ABO Blood Group
1.The fructose containing ‘H ag” is the basic ag found
in all individuals
2.In case of ag A, N acetyl galactosamineas terminal
sugar on H ag
3.In ag B the terminal sugar is galactose
4.In AB persons both transferases are present while in
O group none of the enzymes present.
ABO agglutinogens

13. Formation of the B antigen
Glucose
Galactose
N-acetylglucosamine
Galactose
RBC
Fucose
Galactose

14. *4. How an individual gets his/her
Blood Group
Gene received from
parents
Group of ofoffspring Genotype
A+A A AA
A+O A AO
B+B B BB
B+O B BO
A+B AB AB
O+O O OO

15. ABO agglutinins
•These are natural antibodies and belongs
to IgM and so do not cross the placental
barrier.
•These are called cold agglutinins because
they react better between 5-20˚c
•They appear after birth due to exposure
to A and B antigens, which may enter the
body along with food or bacteria

16. Blood Typing/grouping/matching
Note : Typing is done on the basis of agglutination

17. 17
Donor’s Blood
Patient’s blood
Major and Minor Cross matching of blood
TASK: Mix and place a drop of plasma or RBC onto slide/test tube
Observe for Agglutination or Hemolysis.
Patient’s Plasma + Donor’s RBCs = Major Cross-Match
Donor’s Plasma + Patient’s RBCs = Minor Cross-Match
Plasma
RBCs

18. Compatibility between the donors
cells and recipients serum
Type
Receive
From
Donate
To
Anti-
Body
Antigen
A
O
AB
B
A
B
A+B
None
AorO
Anti -A
Neither
Both
AB
O,A,B,AB
Anti -B
O
AorAB
B orABBorO
AB,A,B,O
Universal
Donor
Universal
Receiver

19. RBC Compatibility

20. *6. Effects of ABO Incompatible
blood transfusion
1.Immediate effects: Fever, chills
nausea, vomiting, chest pain, back pain
and rigor
2.Delayed effects: Jaundice, cardiac
shock and renal shut down

21. II. RhBlood group system
Landsteiner and Weiner discovered this group in
1940.
*7. Rhfactor
Rh factor is an ag present in RBC
First discovered in Rhesus monkey so
named as Rh factor
Theperson having D ag are called Rh +ve
and without D ag are called Rh-ve
Importance: Erythroblastosisfetalis is the
conditionoccur because of Rh incompatibility

22. Rh Blood group systemGroup
RhD positive
Ｄantigen
RhD negative
No Ｄantigen
Rh+ Rh-
O38.5%6.5%
A34.3%5.7%
B8.6%1.4%
AB4.3%0.7%

23. Rh agglutinins
1.These are called warm abs as they react better
at body temp [37˚c]
2. The Rh abs belongs to Ig G group and can
enter the fetal circulation through placenta.

24. Rh

29. Exercise-1

30. Rh group-applied aspect
Transfusion reactions:

32. About 1 in 10 pregnancies involve an Rh-
negative mother and an Rh-positive father
Haemolytic disease of new born [HDN]

33. Hemolytic Disease of Newborn
•Rh antibodies attack fetal blood
–causing severe anemia

34. 3. The HDN is associated with the
following features
a.Haemolytic anaemia
b. Erythro blastosis fetalis:
Due to excess destruction of RBSs there is an increased
production of RBS’s not only from the bone marrow
but also from liver and spleen
Due to rapid destruction, blast cells are released into
the circulation called EBF.

35. Blood film of a fetus affected by HDN showing
increased number of normaoblasts

37. C.Kernicterus:Due to
haemolysis excess bilirubin is
formed. This causes jaundice.
The excess bilirubin enters the
brain and causes permanent
damage
D. Hydrops fetalis: The fetus
may develop oedema of all the
organs leading to the intra uterine
death.

38. Prevention
•By marriage counseling
•Rh-ve mother with Rh +ve fetus should be
administered anti-D abs at 28
th
and 34
th
weeks
of gestation
•Rh-ve mother with Rh +ve fetus-anti D abs are
given immediately after 1
st
delivery within 48h.
to neutralize the ags that would have entered the
mothers blood

39. *8. Treatment of [HDN]
Erythroblastosisfetalis
Exchange transfusion:
1. Is replacement of newborn baby’s
blood with Rh-ve blood.
2. Baby’s Rh +ve blood is removed
slowly an about 400ml of Rh-ve is
infused is called exchange
transfusion

40. III. MNS System
•In 1921,Landsteinerand & Levine discovered this blood group
•They are used in medico legal cases like parent dispute etc.,
*9. Medico-legal Importance
1. Any red stain on a clotting may be claimed to be a supposed
victim
2. Therefore it is first confirmed that it is really a human blood
3. Blood Group of extracted sample can be then prove or disprove
the claim of the victim
4. In doubtful cases DNA finger printing would help.

41. IV. Bombay Blood Group
•This is the rare blood group in which H ag is absent,
Since there is no H ag there is no ag A or ag B on RBC.
•However, the plasma contains anti-A, anti-B and anti-
H abs.
•As a result , such a person can receive blood only from
person having Bombay blood group

42. Importance of Blood Groups
•To avoid transfusion reactions of blood
•Medico legal cases like disputed parented age and to
find out the criminals
•Research purposes as some blood groups are
associated with a high incidence of certain disease
•For matching the tissues during organ transplantation
•For preventing development of HDN

43. Blood Transfusion

44. Transfusion: The 1
st
blood transfusion was
made in 1667 by Dr. Jean Baptiste. Sheep blood
was transfused to a 15 yr old boy.
Transfusion is done to restore blood volume when there is
a decrease in blood volume.
Ex. Hemorrhage, burns ,dehydration, severe anaemia and
surgery

45. Blood Substitutes
When the required blood group is not available we give
blood substitutes
Ex:Packed RBCs, Platelet conc., plasma, saline, volume
expanders, Albumin and clotting factor concentrate
Collection of Blood:About 350-500ml of blood
depending on the Hb level

46. Effect of storage
Blood is stored in siliconized bottles in blood banks at 4˚c
An anticoagulant ACD / CPD is used for preventing
clotting
*10. Blood undergoes the following changes
during storage
Increases in Na
+
, decrease in K
+
with net increase in water
As a result the cell swells and is susceptible to
haemolysis, after 20 days most of RBC get lysed.

47. Precautions of transfusion
•Select healthy donor for transfusion
•Matching and typing should be done
•Before we use the blood, it should be warmed to
the normal body temp.
•Transfusion should be done at a slower rate
•Whole blood transfusion
•Autologous transfusion
•Blood doping

48. Treatment
1.Stop transfusion immediately on signs of incompatibility
2. To suppress reaction, corticosteroidsand Antihistamines
are also administered
3. If anuriais present, dialysis is given till the kidney
function is recovered
4. Anaemia may be treatedsuitably
5. Osmotic dieresis should be induced

49. Give Blood and Save lives !!
Thank
you

50. BLANKS
1.A new born with blood group B +ve is having Erythroblastosis
fetalis, Which is the most appropriate line of treatment exchange
transfusion with B+ve
2.The person is known as universal donor if he/she belongs to
blood group O
3.Major crossmatchingis tested betweendonors cells and
recipient plasma
4.The person is universal recipient if he or she belongs to blood
groupAB
5.One of the most lethal effects of transfusion reaction is acute
Kidney shutdown
6.Erythroblastosisfoetalis is the mother is Rh-ve and fetus is Rh
+ve

51. Essay
1.Name the various blood groups? Describe its
importance? Add a note on transfusion
reactions?
2. What is the physiological basis of blood
groups and how they determined? Give an
account of the significance of Rh factor?

52. Short notes
1.Transfusion reactions
2. Erythroblastosisfetalis
3. ABO system
4. Rh factor

53. Ultra short notes
1.Name the different blood groups and describe how
an individual gets his/ her blood group?
2. What is Rh factor? What is its importance?
3. What are the effects of incompatible blood
transfusion?
4. Explain the basis of ABO blood grouping?
5. Describe the medico legal importance of blood
groups?

54. 6. What is cross matching and mis-matching?
7. Mention the other types of blood grouping other
than ABO system?
8. What is treatment of Erythroblast sis fetalis?
9. What are the changes that occur in stored blood?
What is the significance of these changes?
10. What are the disadvantages of prolonged storage
of blood in blood banks?

56. Agglutination reactions

57. Crossmatch
Donor RBCs
(washed)
Patient serum
No agglutination ~ compatible
Agglutination ~ incompatible

58. Exercise-2

59. The genotype combination may be
Mom Dad Offspring Blood
Group
AA BB 100% AB
BO OO 50% each of B
or O
OO OO 100% O
OO AO 50% each of A
or O