1. 1 BLOOD PHYSIOLOGY Practical 1 BLOOD GROUPS By: khulood Hussein

2. Phase II Medicine- Blood Module - March 2009 2 Clinical significance of determination of blood groups At least 30 blood group system contaning 400 (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 blood system can cause transfusion reactions more than others: ABO and Rh systems.

3. Phase II Medicine- Blood Module - March 2009 3 ABO Blood Groups A and B Antigens- Agglutinogens

4. Phase II Medicine- Blood Module - March 2009 4 ABO Blood Groups Relative frequency of different blood types: O47% A41% B9% AB3%

5. Phase II Medicine- Blood Module - March 2009 5 Agglutinins Blood typeAgglutinogen on RBC Agglutinin in plasma AAAnti-B BBAnti-A ABA and BNone O Anti-A and Anti-B

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7. 7 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.

8. Phase II Medicine- Blood Module - March 2009 8 Blood Grouping

9. 9 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 serumAnti B serum O-- A+- B-+ AB++

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14. Phase II Medicine- Blood Module - March 2009 14 BLOOD TRANSFUSIONS

15. Phase II Medicine- Blood Module - March 2009 15 Blood Transfusion Indications. Types: –Heterologus –Autologous

16. Phase II Medicine- Blood Module - March 2009 16 Universal Donor. Most hospitals have available group O negative blood for use in extreme emergency situations. Group O negative is considered as universal donor.

17. Phase II Medicine- Blood Module - March 2009 17 Transfusion Reactions resulting from mismatched blood types Agglutination and delayed hemolysis of donor’s RBC (or immediate intravascular hemolysis)→ Jaundice

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19. Phase II Medicine- Blood Module - March 2009 19 Diseases transmitted by blood transfusion Viral hepatitis HIV / AIDS Other transmissible diseases are syphilis, malaria. What do you do to prevent this?

20. Phase II Medicine- Blood Module - March 2009 20 Pre-transfusion Tests For a safe blood transfusion, the following tests are done: –Blood grouping –Cross-matching

21. Phase II Medicine- Blood Module - March 2009 21 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.

22. 22 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.

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24. Phase II Medicine- Blood Module - March 2009 24 HDN Clinical picture: Anemia→ Jaundice Kernicterus (mental impairment due to precipitation of bilirubin in brain cells)

25. Phase II Medicine- Blood Module - March 2009 25 Prevention Anti-Rh gamma globulin (RhoGam) injection given to Rh –ve mothers after delivery of Rh +ve baby.