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

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

ABO & Rh(D)2 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)3 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)4 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)5 Antigens & Antibodies Blood Group Antigens on RBCs Antibodies in SerumGenotypes AAAnti-BAA or AO BBAnti-ABB or BO ABA and BNeitherAB ONeitherAnti-A and anti-BOO

ABO & Rh(D)6 Inheritance of ABO Groups Allele from the mother Allele from the father Genotype of offspring Blood types of offspring AAAAA ABAB AOAOA BAAB BBBBB BOBOB OOOOO

ABO & Rh(D)7 ABO Typing Cell 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 A 1 cells – Known B cells – Known O cells – ? Known A 2 cells Reactions may be weaker than cell group

ABO & Rh(D)8 Distribution of ABO Groups Population OABAB Aborigines Basques Blackfoot (N. Am. Indian) Bororo Chinese-Canton Chinese-Peking English Hawaiians Irish Mayas98111 Navajo (N. Am. Indian) Peru (Indians) United Kingdom (GB) USA (blacks) USA (whites)

ABO & Rh(D)9 Distribution of the A allele

ABO & Rh(D)10 Distribution of the B Allele

ABO & Rh(D)11 Distribution of the O Allele

ABO & Rh(D)12 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)13 Universal Donor and Recipient Universal Donor 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)14 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)15 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)16 Distribution of Rh(D) Types PopulationRh(D) posRh(D) neg Caucasian86%14% African- American 95%5% Oriental>99%<1%

ABO & Rh(D)17 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)18 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)19 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