1. Blood Groups & Blood Transfusion
HMIM BLOCK 224
Dr. Shaikh Mujeeb Ahmed
Assistant Professor
AlMaarefa College

2. Objectives Different types of Blood groups blood group system
Explain blood typing and how it is used to avoid adverse reactions following blood transfusions.
Describe how blood reactions may occur between fetal and maternal tissues.

3. Blood Groups and Transfusions
In the year 1900, identification of the ABO blood antigen gene explained the observed blood type incompatibilities by Karl Landsteiner
Today there are 31 different genes known to contribute to the surface features of RBCs determining compatibility between blood types

4. Blood Group Systems Major systems Minor ABO Rhesus system(Rh) MN P
Familial blood groups

5. Importance of Blood Groups
Transfusion of blood
Association with disease
Duodenal ulcers are more common in group O than in A or B
Tumors of salivary glands, stomach and pancreas are more common in group A than in group O individuals.

6. Antigens and Antibodies
Terms to become familiar with:
Agglutination – clumping of red blood cells in response to a reaction between an antibody and an antigen
Antigens – a chemical that stimulates cells to produce antibodies
Antibodies – a protein that reacts against a specific antigen

7. Type A blood Type B blood Type AB blood Type O blood Red blood cell
Anti-B antibody
Red blood cell
Anti-A antibody
Antigen A
Antigen B
Type A blood
Type B blood
Red blood cell
Anti-A antibody
Anti-B antibody
Antigen A
Antigen B
Red blood cell
Type AB blood
Type O blood

8. Agglutinated red
blood cells
Red blood cell
Antigen A
Anti-B antibody
Anti-A antibody
(a)
(b)
(c)
(d)

9. ABO Blood Group
Based on the presence or absence of two major antigens on red blood cell membranes
Antigen A
Antigen B

10. Antigens and antibodies of the ABO blood group
Blood Type
Antigen
Antibody A
Anti B B
Anti A AB
A and B
Neither Anti A nor Anti B O
Neither A nor B
Both Anti A and Anti B

11. Genotype of ABO blood groups
Possible Genotype(s) A
AA, AO B
BB, BO AB O OO

12. Landsteiner’s law.
If an agglutinogen (antigen) is present on the RBCs the corresponding agglutinin (anti body) must be absent in the plasma
If an agglutinogen (antigen) is absent on the RBCs the corresponding agglutinin (anti body) must be present in the plasma
The first law is applicable to all blood groups. But the second part is not necessary always, its true for ABO blood groups.

13. Rh Blood Group The Rh blood group was named for the rhesus monkey
The group includes several Rh antigens or factors (Cc, Dd & Ee)
Rh positive – presence of antigen D or other Rh antigens on the red blood cell membranes
Rh negative – lack of these antigens
The seriousness of the Rh blood group is evident in a fetus that develops the condition erythroblastosis fetalis or hemolytic disease of the newborn

14. Erythroblstosis Fetalis+ –
Rh-negative
woman with
Rh-positive
fetus
Cells from
fetus enter
woman’s
bloodstream
In the next
pregnancy,
maternal
antibodies
attack fetal red
blood cells
Woman
becomes
sensitized—
antibodies ( + )
form to fight

15. Erythroblastosis Fetalis (Hemolytic disease of the newborn-HDN)
Clinical Features
Edema (Hydrops)
Jaundice
Anemia
Enlarged Liver & Spleen

16. Erythroblastosis Fetalis (Hemolytic disease of the newborn-HDN)
Treatment
Exchange blood transfusion
Prevention
Rh immune globulin (RhIG) injections to the Rh –negative mother during pregnancy

18. Blood groups in local population
Percentage of Population
O +
48 %
A +
24 %
B +
17 %
AB +
4 %
Rh Positive are about 93% (90-95%) O- A- 2% B-
1 %
AB-
0.23%
Rh negative are about 7% (5-10%)

19. Blood transfusion Autologus blood transfusion
Blood grouping and cross matching
Donor’s RBCs + Recipient’s plasma (major cross matching)
Recipients RBCs + Donor’s plasma (minor cross matching)

20. Proffered And Permissible Blood Types For Transfusion
Blood Type of Recipient
Preferred Blood Type of The Donor
Permissible Blood Type of The Donor (In Extreme Emergency) A O B AB
A B
A,B, O
No alternate type

21. Complications of Blood Transfusion
Fatal hemolytic reactions in mismatched reactions.
Rapid hemolysis
Jaundice
Renal tubular damage
Circulatory overload – if rapid transfusion
Hemosiderosis – repeated blood transfusion
Electrolyte disturbances
Transmission of disease
Hepatitis – B or C
AIDS