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Blood grouping
Introduction :
In 1900, Karl Landsteiner first reported A and B antigens on the surface of human red
blood cells
He divided human red cells into three groups A, B and O
In 1902 Decastell and Sturil recognized AB
Principle:
Human red blood cells has A &/or B antigen
They will agglutinate in presence of antibody directed to respective antigens
The antibodies used for testing are monoclonal IgM produced by murine hydridoma
cell lines grown in tissue culture
Each hybridoma cell produces single antibody
Agglutination of red cells with anti A monoclonal and anti B monoclonal is positive it
indicates presence of corresponding antigen
Absence of agglutination of red blood cell is negative result indicating absence of
corresponding antigen
HUMAN BLOOD GROUP
It is based on the antigenic characters of red cells
Presence or absence of antigen on red cells or the presence of antibodies in the plasma
indicates the persons blood group
There are nearly 300 blood group systed
The first to be discovered was ABO by Karl Landsteiner
There are two types of blood group
1. Natural – there is natural presence of antibodies from birth which lack the
corresponding antigen on the RBC e.g ABO, MNS, P, LEWIS (Le) LUTHERN (Lu)
2. Immune blood group- these antigens are bale to produce immune antibodies in
receipients blood when exposed to them as foreign antigens e.g. Rh, Kidd (JK), Duffy
(F), Kell (K) etc
Variation in blood group is due to different combination of antigens and
degree of dominance
ABO blood group system:
It is the basic blood group system
It is important because of the natural presence of A and B antibodies in persons
from birth who lack corresponding antigens on his red cells
Transfusion of incompatible ABO blood group causes serious problems in
persons
A,B antigens are detected on foetal red cells but receptor sites are not well
developed so the reactions are not strong
A antigen exists as A1 which is strong reacting and A2 which is weak
Infants have A2 at birth which becomes A1 later
The antibodies to antigen other than those present are present naturally i.e. anti A
and anti B
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They are IgM , a polyvalent antibodies
It cant cross placenta that protects fetus from mothers incompatible natural
antibodies
Antibodies A and B appear at the age of 3 to 4 months
It increases at adolescence and declines with aging
Anti a titer is higher than anti B
Anti a titer is higher in O than in B group persons
phenotypes of ABO blood group are of 6 types :- A1A2, B, A1B, A2B, and O
subgroups are important for blood transfusion
Variations in ABO:
Sometimes O has only anti B due to weak or abnormal A antigen on RBC or vice-
versa
A, AB, B, blood group develop weak anti H so O blood group which has H
antigen cannot be received
Bombay blood group Oh has anti H, anti A and anti B so cant accept O blood
group
Bombay blood group lacks A,B,H antigens
H antigen is present on RBC of all ABO blood groups
In autoimmune anemia disease antibodies corresponding to antigens on rbc are
present
Some plant products have properties like anti A, anti B and anti H
These are lectins e.g.Dolichous biflorus
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Rh blood group system
It is clinically important
Rh negative persons if transfused with Rh positive blood, they form Rh
antibodies
Haemolytic disease of newborn occurs due to Rh incompatibility of mothe –Rh
negative and fetus –Rh positive i.e. erythroblastofaetalis diseases
Rh antigens are inherited
anti Rh develop in Rh negative persons when he receive Rh positive RBC
Landsteiner and Weiner transfused the red cells of rhesus monkey (Rh) into rabbit
Rabbit produced anti Rh that could agglutinate rbc of rhesus monkey and of
human RBC
They were called as Rh positive persons
If RBC did not react with rabbit anti Rh sera then they are Rh negative
If Rh (D) antigen is present on RBC then he is Rh positive
So person of any ABO blood group can be Rh positive or Rh negative
Inheritance of Rh antigen is independent of ABO antigens
There are 110 antigen of Rh blood group of which 5 are important
2 types of nomenclatures are used:-
Fisher-Race (easy to follow so is used) Wiener
D Rho
C Rh’
E Rh”
d Hr’
c Hr”
Rh blood group has 5 linked allelic genes –Cc,D, Ee
If D is present then he is Rh positive if absent then Rh negative
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Rh antibodies
They are immune antibodies
It is IgG
Its molecular weight is 1,70,000
It is monovalent and incomplete and can cross placenta
So they cause heamolytic disease of new born in Rh negative mother bearing Rh
positive foetus
Optimum reaction is 37oC
Rh variant (Du)
These are weak D antigen
It can be detected by Coombs test by using antihuman globin
Same antigens are present on leukocytes, platelets and tissue cells e.g. human
leukocyte antigen (HLA) system
HLA are present on all nucleated body cells so are important for organ transplantation
Importance of blood grouping:
It is important for blood transfusion
Identical ABO blood group of donor is ideal
blood group is universal donor as they have no antigens on their RBC so they do not
react with corresponding antibodies
AB blood group is universal recipient and can accept A, B, AB ,O as anti A and anti
B are absent
Whole blood is given in case of heavy blood loss 9haenorrhage)
Whole blood is not given to anemic persons as volume of blood increases
(hypervolumic) causing congestive heart failure
They are given required packed red cells
How to detect your blood group…………….
Sample:
Blood collected with or without anticoagulant may be used
Test at the earliest
Store samples at 2-8 C if delayed
Blood got by finger puncture is tested by slide method
Avoid clotting
Store reagents at 2-8 C
Avoid contamination
Bring reagents to 25 C
Procedure:
Rapid slide test:
Prepare 10% suspension of RBC in normal slain (0.85% NaCl solution)
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Oxalatedd whole blood can be used
Mark three areas on glass slide as A and B
Add one drop of corresponding reagent to the above areas
Add one drop of cell suspension or whole blood to each of labeled areas
With separate applicator sticks mix each cell reagent well
Tilt slide back and forth
Within 2 minutes, Observe macroscopic or microscopic agglutination
Interpretation
1. agglutination of red blood cells by reagent indicates positive result
2. absence of agglutination of red blood cells by reagent indicates negative result
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