BLOOD GROUPS

&
BLOOD
TRANSFUSION
Presented by:
Dr. Mujtaba Ashraf
MDS JR-1
Dept. of
Prosthodontics

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Contents
Introduction

Blood group systems

ABObloodgroupsystem
Rhbloodgroupsystem

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Blood transfusion
Introduction
Precautions
AdverseeffectOfBloodTransfusion
ExchangeTransfusion

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Introduction

AbloodgroupalsocalledaBloodType

Classificationofbloodisbasedonthepresenceor
absenceofinheritedantigenicsubstancesonthe
surfaceofredbloodcells(RBCs)

Theseantigensmaybeproteins,
carbohydrates,glycoproteins,orglycolipids,depending
onthebloodgroupsystem.
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ABO Blood Group System

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TheABO blood group systemisthemost

importantbloodtypesystem(orbloodgroup
system)inhumanbloodtransfusion.
ABObloodtypesarealsopresentinsome
otheranimals
forexamplerodentsandapessuchas
chimpanzees,bonobosandgorillas.

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Determination of ABO blood groups

depends upon the immunological reaction
between antigen and antibody.
Antigens are also called agglutinogens
because of their capacity to cause
agglutination of RBCs.

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History
KarlLandsteinerdiscovered

theABOBloodGroupSystem
in1901.
AdrianoSturliand
Karl Landsteiner
AlfredvonDecastello
whowereworkingunderLandsteinerdiscovered
typeABayearlaterin1902
Landsteinerwasawardedthe1930NobelPrizein
PhysiologyorMedicineforhiswork.
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Janskiscreditedwiththefirstclassificationofblood
intothefourtypes(A,B,AB,O)in1907,whichremainsin
usetoday.
ReubenOttenbergsuccessfullytransfusedbloodbetween
twopeopleatMountSinaiHospitalinNewYork.Hewas
thefirstpersontorecordpre-transfusiontestingforblood
compatibilityinaclinicalsetting.
Laterin1954hewasthefirsttobeawardedwithKarl
Landsteiner Award
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Landsteiner Rule
Ifanantigenispresentonapatientsredblood
cells(RBCs)thecorrespondingantibodywillNOT
bepresentinthepatientsplasma,undernormal
conditions.

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ABO BASICS
BasedonthepresenceorabsenceofantigenAand
antigenB,bloodisdividedintofourgroups:
A,B,ABandOgroup.
BloodhavingantigenAbelongstoAgroup.This
bloodhas-antibodyintheserum.

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BloodwithantigenBand-antibodybelongstoB
group.
Ifboththeantigensarepresent,bloodgroupiscalled
ABgroupandserumofthisgroupdoesnotcontain
anyantibody.
Ifbothantigensareabsent,thebloodgroupiscalled
Ogroupandbothandantibodiesarepresentin
theserum.

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Antigen and Antibody

Present in ABO Blood Group
ABO
Group

Antigen
Present

Antigen
Missing

Antibody
Present

A
B
O
AB

A
B
None
A and B

B
A
A and B
None

Anti-B
Anti-A
Anti-A&B
None

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PrincipleofBloodGrouping
oBloodgroupingisdoneonthebasisof
agglutination.
oAgglutinationmeansthecollectionof
separateparticleslikeRBCsintoclumpsor
masses.
oAgglutinationoccursifanantigenismixed
withitscorrespondingantibodywhichiscalled
isoagglutinin, i.e. occurswhenAantigenis
mixedwithanti-AorwhenBantigenismixed
withanti-B.

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IMPORTANCE OF ABO GROUPS

IN BLOOD TRANSFUSION
Duringbloodtransfusion,onlycompatiblebloodmust
beused.
Theonewhogivesbloodiscalledthedonor andthe
onewhoreceivesthebloodiscalledrecipient.
Whiletransfusingtheblood,antigenofthedonorand
theantibodyoftherecipientareconsidered.
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Theantibodyofthedonorandantigenofthe
recipientareignoredmostly.
Thus,RBCofOgrouphasnoantigenandso
agglutinationdoesnotoccurwithanyothergroup
ofblood.So,Ogroupbloodcanbegiventoany
bloodgrouppersonsandthepeoplewiththisblood
grouparecalleduniversal donors.

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PlasmaofABgroupbloodhasnoantibody.Thisdoes
notcauseagglutinationofRBCfromanyothergroup
ofblood.
PeoplewithABgroupcanreceivebloodfromany
bloodgrouppersons.So,peoplewiththisblood
grouparecalleduniversal recipients.

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Inmismatchedtransfusion,
thetransfusionreactionsoccurbetween
donorsRBCandrecipientsplasma.
So,ifthedonorsplasmacontains
agglutininsagainstrecipientsRBC,
agglutinationdoesnotoccurbecause
theseantibodiesaredilutedinthe
recipientsblood.
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Blood
Compatibility

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TRANSFUSION REACTIONS
DUE TO ABO INCOMPATIBILITY

Transfusionreactionsaretheadversereactionsinthe
body,whichoccurduetotransfusionerrorthat
involvestransfusionofincompatible(mismatched)
blood.
The reactionsmaybemildcausingonlyfeverand
hives(skindisordercharacterizedbyitching)ormay
besevereleadingtorenalfailure,shockanddeath.

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Rh Blood Group System

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TheRhbloodgroupsystemisoneofthirtyfivecurrenthumanbloodgroupsystems.
Itisthemostimportantbloodgroupsystem
afterABO.
Rhbloodgroupsystemconsistsof50defined
blood-groupantigens,amongthemtherearesix
commontypesofRhantigens.
EachofwhichiscalledanRh factor.
ThesetypesaredesignatedC,D, E, c, d,ande.
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ThetypeDantigeniswidelyprevalentinthe
populationandconsiderablymoreantigenicthan
theotherRhantigens.
Anyonewhohasthistypeofantigenissaidtobe
Rh positive, whereasapersonwhodoesnothave
typeDantigenissaidtobeRh negative.

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ThisantigenwasdiscoveredbyKarl
LandsteinerandAlexanderWienerin1940.
ItwasfirstdiscoveredinRhesus macaque and
hencethename'Rhfactor.

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Erythroblastosis Fetalis (Hemolytic Disease of the Newborn)

Erythroblastosisfetalisisadiseaseofthefetusand
newbornchildcharacterizedbyagglutinationand
phagocytosisofthefetussredbloodcells.
Inmostinstancesoferythroblastosisfetalis,the
motherisRhnegativeandthefatherRhpositive.
ThebabyhasinheritedtheRh-positiveantigenfromthe
father,andthemotherdevelopsanti-Rhagglutinins
fromexposuretothefetussRhantigen.
Inturn,themothersagglutininsdiffusethroughthe
placentaintothefetusandcauseredbloodcell
agglutination.
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Symptoms and signs in the fetus:

Enlargedliverspleen,orheart
fluidbuildupinthefetus'abdomenseenvia
ultrasound.

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Symptoms and signs in the newborn:

Anemiathatcreatesthenewborn'spallor
(paleappearance).
Jaundiceoryellowdiscolorationofthe
newborn'sskin,scleraormucous
membrane.
Enlargementofthenewborn'sliverand
spleen.
Severeedemaoftheentirebody.
Dyspneaordifficultybreathing.

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Other Blood Group System

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Thirty-fivemajorbloodgroupsystemswere
recognizedbytheInternational Society of Blood
Transfusion (ISBT)inOctober2012.
InadditiontotheABOantigensandRhesus
antigens,manyotherantigensareexpressedon
theredbloodcellsurfacemembrane.

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AnindividualcanbeABRhDpositive,andat
thesametimeMandNpositive(MNSsystem),
Kpositive(Kellsystem),andLeaor
Lebpositive(Lewissystem).Manyoftheblood
groupsystemswerenamedafterthepatientsin
whomthecorrespondingantibodieswere
initiallyencountered.

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Other blood groups include

Aubergergroups
Diegogroup
Bombaygroup
Duffygroup
Lutherangroup
Pgroup
Kellgroup
Igroup
Kiddgroup
SulterXggroup
Kiddgroup
Duffygroup
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Blood Transfusion

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Bloodtransfusionisgenerallytheprocessof
receivingbloodproductsinto
one'scirculationintravenously.
Transfusionsareusedforvariousmedical
conditionstoreplacelostcomponentsoftheblood.
Earlytransfusionsusedwholeblood,butmodern
medicalpracticecommonlyusesonlycomponents
oftheblood,suchasredbloodcells,whiteblood
cells,plasma,clottingfactors,andplatelets.

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Bloodtransfusionistheprocessoftransferring
bloodorbloodcomponentsfromoneperson(the
donor)intothebloodstreamofanotherperson(the
recipient).
Richard Lowerpioneeredthefirstblood
transfusionfromanimaltohumanin1665at
theRoyalSociety.
In1840Dr. Blundell,performedthefirst
successfulwholebloodtransfusionto
treathaemophilia.
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Beforeabloodtransfusionisgiven,therearemanysteps
takentoensurequalityofthebloodproducts,
compatibility,andsafetytotherecipient.
Bloodtransfusionstypicallyusesourcesofblood:one's
own(autologoustransfusion),orsomeoneelse's
(allogeneicorhomologoustransfusion).
Thelatterismuchmorecommonthantheformer.
Usinganother'sbloodmustfirststartwithdonationof
blood.
Bloodismostcommonlydonatedaswhole
bloodintravenouslyandcollectingitwith
ananticoagulant.
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Processing and Testing of Blood

Donatedbloodisusuallysubjectedtoprocessing
afteritiscollected,tomakeitsuitableforusein
specificpatientpopulations.
Collectedbloodisthenseparatedintoblood
componentsbycentrifugation:
redbloodcells,plasma,platelets,albuminprotein,
clottingfactor
concentrates,cryoprecipitate,fibrinogenconcentrate
andimmunoglobulins(antibodies)
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Alldonatedbloodistestedforinfections
likeHIVs,HepatitisB,HepatitisC,Syphilis
AlldonatedbloodisalsotestedforABO
andRhgroups,alongwiththepresenceof
anyredbloodcellantibodies.
PathogenReductiontreatmentdone.

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CONDITIONS WHEN BLOOD TRANSFUSION

IS NECESSARY

Anemia
Hemorrhage
Trauma
Burns
Surgery

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PRECAUTIONS TO BE TAKEN BEFORE

THE TRANSFUSION OF BLOOD
Donormustbehealthy,withoutanydiseaseslike:
a.Sexuallytransmitteddiseasessuchassyphilis
b.Diseasescausedbyviruslikehepatitis,AIDS,
etc.
Onlycompatiblebloodmustbetransfused
Bothmatchingandcross-matchingmustbedone
Rhcompatibilitymustbeconfirmed.

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PRECAUTIONS TO BE TAKEN WHILE

TRANSFUSING BLOOD
Apparatusfortransfusionmustbesterile

Temperatureofbloodtobetransfusedmustbe
sameasthebodytemperature
Transfusionofbloodmustbeslow.Thesudden
rapidinfusionofbloodintothebodyincreasesthe
loadontheheart,resultinginmanycomplications.

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Adverse effect of Blood

transfusion
Transfusionsofbloodproductsareassociatedwith
severalcomplications,manyofwhichcanbegroupedas
immunologicalorinfectioussuchas:
Acutehemolyticreaction
Delayedhemolyticreaction
Allergicreaction
Post-transfusionpurpura
Transfusionassociatedacutelunginjury
HIV
HepatitisC

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EXCHANGE TRANSFUSION
-istheprocedurewhichinvolves
removalofpatientsbloodcompletelyand
replacement
withfreshbloodorplasmaofthedonor.
Alsoknownasreplacement transfusion.
Itisanimportantinlife-savingprocedurecarried
outinconditionssuchas
severejaundice,sicklecellanemia,erythroblastosis
fetalis,etc.
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References
Guyton-Physiology-11th edition
Essentials of Medical Physiology, 6th Edition By
K Sembulingam

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