BLOOD PHYSIOLOGY Practical 1

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Presentation transcript:

BLOOD PHYSIOLOGY Practical 1 BLOOD GROUPS Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Objectives Describe the clinical significance of determination of blood groups. Name the blood groups of ABO & Rh system. Describe the principle of determination of blood groups. Determine blood groups by using anti-A and anti-B antisera. Mention the common indications of blood transfusion. List the common hazards of transfusion. Name the diseases transmitted by blood transfusion. Describe the concept of universal donor and universal recipient. Describe the cause of erythroblastosis fetalis. Phase II Medicine- Blood Module - May 2008

Clinical significance of determination of blood groups At least 30 commonly occurring antigens (Ag) have been found on the cell membrane of RBCs. These can cause Ag-Ab reaction if mixed with plasma that contain antibodies (Ab) against these Ag. 2 groups of Ag can cause transfusion reactions more than others: ABO and Rh systems. Phase II Medicine- Blood Module - May 2008

ABO Blood Groups A and B Antigens- Agglutinogens Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 ABO Blood Groups Relative frequency of different blood types: O 47% A 41% B 9% AB 3% Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Agglutinins Blood type Agglutinogen on RBC Agglutinin in plasma A Anti-B B Anti-A AB A and B None O Anti-A and Anti-B Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Rh Blood Type If type D antigen is present on RBC  Rh +ve Differences between ABO and Rh Ab? Anti-Rh antibodies are not naturally occurring Ab. Previous exposure to Rh antigen is required. Rh +ve blood transfusion. Rh –ve women pregnant with Rh +ve baby. Anti-Rh Ab can cross the placenta. Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Blood Grouping Phase II Medicine- Blood Module - May 2008

Blood grouping, showing agglutination of cells of the different blood types with anti-A or anti-B agglutinins in the sera Red blood cell types Anti-A serum Anti B serum O - A + B AB

Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 BLOOD TRANSFUSIONS Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Blood Transfusion Indications. Types: Heterologus Autologous Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Universal Donor. Most hospitals have available group O negative blood for use in extreme emergency situations. Group O negative is considered as universal donor. Phase II Medicine- Blood Module - May 2008

Transfusion Reactions resulting from mismatched blood types Agglutination and delayed hemolysis of donor’s RBC (or immediate intravascular hemolysis)→ Jaundice Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008

Common Hazards of Blood Transfusion Acute transfusion reactions occurring within 72 hours: Immunological reactions : Haemolytic transfusion reaction Allergic reactions eg. urticarial reaction Non immunological reaction: Circulatory overload Delayed transfusion reactions occurring after 72 hours: Iron overload Renal tubular blockage by haemoglobin Renal failure Phase II Medicine- Blood Module - May 2008 Phase II Medicine- Blood Module - May 2008 20

Diseases transmitted by blood transfusion Viral hepatitis HIV / AIDS Other transmissible diseases are syphilis, malaria, CMV etc., What do you do to prevent this? Phase II Medicine- Blood Module - May 2008 Phase II Medicine- Blood Module - May 2008 21

Pre-transfusion Tests For a safe blood transfusion, the following tests are done: Blood grouping Cross-matching Phase II Medicine- Blood Module - May 2008

X-matching Once patient’s blood group is known, donor blood of the same ABO and Rh type is selected. Possible donor RBC’s are mixed with the recipient’s serum. If no agglutination, no Ab in recipient blood will attack donor’s RBCs. Phase II Medicine- Blood Module - May 2008 Phase II Medicine- Blood Module - May 2008 23

Haemolytic Disease of the Newborn (HDN) Rh incompatibility  Erythroblastosis Fetalis (HDN). Rh –ve lady marrying Rh+ve man. If baby is Rh+ve, fetal RBC leaks to maternal circulation during placental separation (delivery or abortion). Mother starts to make anti-Rh Ab. Next pregnancy with Rh+ve baby  anti-Rh Ab pass to baby and cause agglutination and hemolysis of his RBC.

Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 HDN Clinical picture: Anemia→ Jaundice Hepatosplenomegaly Kernicterus (mental impairment due to precipitation of bilirubin in brain cells) Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008 Prevention Anti-D antibodies (RhoGam) injection given to Rh –ve mothers after delivery of Rh +ve baby. Phase II Medicine- Blood Module - May 2008

Phase II Medicine- Blood Module - May 2008