ABO & Rh(D) Blood Groups

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Presentation transcript:

ABO & Rh(D) Blood Groups Anatomy & Physiology Unit 9 – Circulatory System

The ABO System Discovered in 1901 by Dr. Karl Landsteiner 4 Main Phenotypes (A, B, AB, O) ABO gene located on long arm of chromosome 9 ABO & Rh(D)

The ABO Antigens Added to Proteins or Lipids in Red Cells ABO & Rh(D) The ABO Antigens Added to Proteins or Lipids in Red Cells Substrate Molecule is H (fucose) A antigen is N-acetyl-galactosamine (GalNAc) B antigen is Galactose (Gal) A and B genes code for transferase enzymes ABO & Rh(D)

ABO Antibodies A and B substances very common Antibodies produced to “non-self” Produced after first few months of life A & B people have mainly IgM O people have IgG May fade in old age ABO & Rh(D)

Antigens & Antibodies Blood Group Antigens on RBCs Antibodies in Serum Genotypes A Anti-B AA or AO B Anti-A BB or BO AB A and B Neither O Anti-A and anti-B OO ABO & Rh(D)

Inheritance of ABO Groups Allele from the mother Allele from the father Genotype of offspring Blood types of offspring A AA B AB O AO BB BO OO ABO & Rh(D)

ABO Typing Cell Group Agglutination is a positive result Reverse Group Test Washed Cells With: Monoclonal Anti-A Monoclonal Anti-B Inert control Agglutination is a positive result Reverse Group Test plasma/serum with: Known A1 cells Known B cells Known O cells ? Known A2 cells Reactions may be weaker than cell group ABO & Rh(D)

Distribution of ABO Groups Population O A B AB Aborigines 61 39 Basques 51 44 4 1 Blackfoot (N. Am. Indian) 17 82 Bororo 100 Chinese-Canton 46 23 25 6 Chinese-Peking 29 27 32 13 English 47 42 8 3 Hawaiians 37 2 Irish 52 35 10 Mayas 98 Navajo (N. Am. Indian) 73 Peru (Indians) United Kingdom (GB) USA (blacks) 49 20 USA (whites) 45 40 11 ABO & Rh(D)

Distribution of the A allele ABO & Rh(D)

Distribution of the B Allele ABO & Rh(D)

Distribution of the O Allele ABO & Rh(D)

Significance of ABO Group ABO mismatched transfusions: Rare May be life threatening Can be caused by technical or clerical error Intravascular haemolysis More severe in group O patients ABO & Rh(D)

Universal Donor and Recipient Group O Carries no A or B antigens Packed and processed units have little antibody Universal Recipient Group AB Patient has no anti-A or anti-B present Cannot lyse any transfused cells Beware: other antibodies may be present Using the patient’s own group ASAP will conserve resources ABO & Rh(D)

The Rh(D) Antigen RH is the most complex system, with over 45 antigens Discovered in 1940 after work on Rhesus monkeys Subsequently discovered to be unrelated to monkeys RH gene located on short arm of chromosome 1 ABO & Rh(D)

Simple Genetics of Rh(D) 86% of caucasians are Rh(D) pos The antithetical antigen d has not been found The d gene is recessive: Dd, dD, DD, persons are Rh(D) pos Only dd persons are Rh(D) neg ABO & Rh(D)

Distribution of Rh(D) Types Population Rh(D) pos Rh(D) neg Caucasian 86% 14% African-American 95% 5% Oriental >99% <1% ABO & Rh(D)

Significance of Rh(D) 80% of Rh(D) neg persons exposed to Rh(D) pos blood will develop anti-D Anti-D can also be stimulated by pregnancy with an Rh(D) positive baby Sensitisation can be prevented by the use of anti-D immunoglobulin, antenatally and post natally Rh(D) neg females of childbearing potential should never be given Rh(D) positive blood products ABO & Rh(D)

Inheritance ABO & RH genes are not linked ABO & Rh(D) type are inherited independently For example: An A Rh(D) pos mother and a B Rh(D) pos father could have an O Rh(D) neg child ABO & Rh(D)

Inheritance of ABO and Rh(D) Mother Group A AO Rh(D) pos Dd Father Group B BO Rh(D) pos Dd Group A AO Rh(D) pos Dd Group B BO Rh(D) pos Dd Group O OO Rh(D) neg dd ABO & Rh(D)