BLOOD GROUPS
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Transcript BLOOD GROUPS
BLOOD GROUPS
Blood groups are classified according
to antigens on the membrane of RBCs
called “Agglutinogen”, which are
glycoprotein.
The plasma may contain antibodies
called agglutinins.
Two main systems of antigens and
hence grouping are the ABO and Rh
systems.
ABO system
1- Group (A): 40% of population,
RBCs has A Agglutinogens and the
plasma contains anti B antibodies. It
may be homozygous (AA) or
heterozygous (AO).
2- Group (B): 10% of population,
RBCs have B antigen and plasma
contain anti A it may be homozygous
(BB) or heterozygous (BO).
ABO system to be continued
3- Group (AB): 5% of population,
RBCs has both agglutinogens A + B,
the plasma does not contain
agglutinins.
4- Group (O): 45% of population,
RBCs has no agglutinogens, but the
plasma contains both agglutinins
Anti A + Anti B.
Rh System
People are classified according
to the presence or absence of
Rhesus antigens (most common
type D) into Rh+ve with D
antigen 85% and Rh-ve without
D antigen 15%.
Importance of Blood Groups:
1-Medicolegal importance:
Disputed parenthood.
Regarding blood group inheritance 2 antigens are
inherited from both father and mother.
These antigens determine the group.
The A + B antigens are dominant while the O one is
recessive.
In group A (phenotype A) the genotype may be AA
or AO.
In Group B may be (BB or BO).
In Group AB and O (AB or O).
Blood grouping is a good -ve test in disputed
parenthood
2- Blood Transfusion
If transfused blood is incompatible
usually
the
donor
RBCs
are
agglutinated
by recipient plasma as
the donor’s serum is diluted in recipient
blood.
- Group O: is the universal donor (no
agglutinogens).
- Group AB: is the universal recipient
(no agglutinins).
3-). Importance of Rh factor: (Erythroblastosis Fetalis)
The disease occurs when an Rhve mother carries an Rh+ve fetus,
small amounts of fetal blood leak
into the maternal circulation at
the time of delivery, thus the
mother will produce Anti D
agglutinins.
(Erythroblastosis Fetalis) to be cont.
During the next pregnancy the mother
agglutinins cross the placenta (IgG) to an
Rh+ve fetus causing hemolysis of fetal
RBCs and may lead to:
Anemia of fetus
Death of fetus.
Jaundice with deposition of bile pigment in the
basal ganglia (kernicterus syndrome) as the
blood brain barrier is not developed yet
(Erythroblastosis Fetalis).
(Erythroblastosis Fetalis) to be cont.
The first baby (Rh+ve) is affected in
case of maternal sensitization by:
-Previous Rh +ve blood transfusion.
- If the baby was born alive should
be treated by exchange blood
transfusion with Rh -ve group O
blood.
(Erythroblastosis Fetalis) to be cont.
Fetal-Maternal
hemorrhage
during
pregnancy.
This disease can be prevented by avoiding
Rh+ve blood transfusion to Rh-ve females,
and if pregnancy and labor happened an
anti-D antibodies are given to neutralize the
D antigens of the Rh +ve fetal cells and
prevent sensitization of the mother.
BLOOD TRANSFUSION
Indications
If the whole blood or any of its components is
deficient blood transfusion is indicated as in case of;
- Acute hemorrhage.
- Severe anemia.
- Agranulocytosis.
- Thrombocytopenia.
- Hemophilia.
However, if one element only is deficient it is
preferable to give this particular element e.g. packed
RBCs and human plasma transfusions.
Precautions
- Blood should be compatible (ABO and
Rh) assured by cross matching test.
- Blood should be free from contamination.
- Blood should be free from blood born
diseases.
- Blood should be fresh (less than 2 weeks
storage).
- High hemoglobin content.
Precautions to be cont.
Blood is stored at 4oC and added to:
- Sodium citrate as an anticoagulant.
- Dextrose as a nutrient for cells.
- Citric acid to reduce the pH.
- Storage lead to decrease in platelets,
coagulation factors VII, VIII, IX and
dextrose, while there is increase in lactic
acid content, K and haemoglobin released
from haemolysed RBCs.
Complications
The donor may suffer from anemia in repeated
donation and shock in excessive volume donation.
The recipient may suffer from:
1- Mechanical effect:
- Air or fat embolism.
- Dislodgement of a thrombus.
2- Infective complications:
E.g. infective hepatitis, AIDS or Malaria.
3- Physiological complications:
- Overloading in excessive transfusion leading to
heart failure.
- Pyrogenic reaction i.e. fevers.
4- Incompatibility complications
Agglutinated RBCs may block small vessels causing
severe pain, or haemolysis follows i.e., liberation of
hemoglobin, K+ and toxins into plasma.
a) Hemoglobin liberation will cause:
- increased blood viscosity leading to heart failure.
- conversion into bile causing jaundice.
- precipitate in renal tubules as acid haematin
causing renal
failure.
- hypoxia.
b) K+ causes arrhythmia.
c) Toxic substances cause powerful vasoconstriction
of renal vessels causing acute renal failure.