Detty IryaniBagian Fisiologi

Fakultas Kedokteran UNand

� Sistem ABO

� Sistem Rhesus

� Dasar pembagian adalah : jenis aglutinogenyang terdapat pada membran eritrosit

� Terdapat 4 golongan darah :◦ Golongan darah A

◦ Golongan darah B◦ Golongan darah B

◦ Golongan darah AB

◦ Golongan darah O

� O 47%

� A 41%

� B 9%

� AB 3%

GOL.DARAH AGLUTINOGEN AGLUTININ

A A Beta

B B Alfa

AB A dan B -

O - Alfa dan beta

ABO Blood TypesABO Blood Types

Produces Produces antianti--B B

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ABO Blood TypesABO Blood Types

Produces Produces aaaa

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Produces Produces antianti--A A antibodieantibodiess

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ABO Blood TypesABO Blood Types

Produces Produces neither neither antianti--A nor A nor antianti--A nor A nor antianti--B B antibodiesantibodies

ABO Blood TypesABO Blood Types

Produces Produces both antiboth anti--A and A and

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A and A and antianti--B B antibodiesantibodies

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19-

10

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11

� Ada 6 tipe : C D E dan c d e.

� Yang paling kuat antigen D -� Rh ( + ), D (- ) –Rh(-).

� Orang kulit putih 85 % ( + ), 15 % ( - )

� Negro Amerika 95 % (+), Afrika 100 % (+).

� EBF ( Eritro Blastosis Fetalis ):

� Terjadi aglutinasi dan fagositosis eritrosit pada janin

Atau bayi baru lahir

� Terjadi bila ibu Rh (-) , ayah Rh (+) dan anak Rh (+).

RH- indicates no protein

RH+ indicates proteinRH+ indicates protein

Rh+ mother w/Rh- baby– no problemRh- mother w/Rh+ baby– problemRh- mother w/Rh- father– no problemRh- mother w/Rh- baby-- no problem

� Eritroblastosis fetalis

(hemolytic disease of the Newborn)

- Ibu Rh - ; Bapak Rh + → Anak Rh +

Anak I: tidak masalah, sebab titer aglutinin ibu rendah

Anak II: 3 % eritroblastosis fetalis

Anak III: 10 % eritroblastosis fetalis

- Aglutinin ibu tinggal dalam sirkulasi bayi sampai 1-2 - Aglutinin ibu tinggal dalam sirkulasi bayi sampai 1-2 bulan setelah lahir

↓aglutinasi → hemolisis → ikterus pada bayi

merusak sel tubuh yang lain

- Terapi: - exchange transfusion pada bayi

- sensitisasi pada ibu

Type ABType ABType ABType AB- universal recipients

Type OType OType OType O- universal donor

Rh factor:Rh factor:Rh factor:Rh factor:

Rh+ 85% dominant in pop

Rh- 15% recessive

Blood TypeBlood TypeBlood TypeBlood Type ClumpingClumpingClumpingClumping AntibodyAntibodyAntibodyAntibodyBlood TypeBlood TypeBlood TypeBlood Type ClumpingClumpingClumpingClumping AntibodyAntibodyAntibodyAntibody

A antigen A anti-A serum antibody anti-b

B antigen B anti-B serum antibody anti-a

AB antigen A & B anti A & B serum -

O neither A or B no clumping w/ either anti A or B anti-a, anti-b

SerumAnti-A

RBCsRBCsRBCsRBCs

Anti-B

Type AB (contains(contains(contains(containsagglutinogens A and B;agglutinogens A and B;agglutinogens A and B;agglutinogens A and B;agglutinates with bothagglutinates with bothagglutinates with bothagglutinates with bothsera)sera)sera)sera)

Blood being tested

Type A (contains(contains(contains(containsagglutinogen A;agglutinogen A;agglutinogen A;agglutinogen A;agglutinates with antiagglutinates with antiagglutinates with antiagglutinates with anti----A)A)A)A)

Figure 17.16Figure 17.16Figure 17.16Figure 17.16

agglutinates with antiagglutinates with antiagglutinates with antiagglutinates with anti----A)A)A)A)

Type B (contains(contains(contains(containsagglutinogen B;agglutinogen B;agglutinogen B;agglutinogen B;agglutinates with antiagglutinates with antiagglutinates with antiagglutinates with anti----B)B)B)B)

Type O (contains no(contains no(contains no(contains noagglutinogens; does notagglutinogens; does notagglutinogens; does notagglutinogens; does notagglutinate with eitheragglutinate with eitheragglutinate with eitheragglutinate with eitherserum)serum)serum)serum)

Blood Type & RhBlood Type & RhBlood Type & RhBlood Type & Rh How Many Have ItHow Many Have ItHow Many Have ItHow Many Have It FrequencyFrequencyFrequencyFrequency

O Rh Positive 1 person in 3 37.4%O Rh Positive 1 person in 3 37.4%

O Rh Negative 1 person in 15 6.6%

A Rh Positive 1 person in 3 35.7%

A Rh Negative 1 person in 16 6.3%

B Rh Positive 1 person in 12 8.5%

B Rh Negative 1 person in 67 1.5%

AB Rh Positive 1 person in 29 3.4%

AB Rh Negative 1 person in 167 .6%

PhenotypePhenotype GenotypeGenotypeOO ii iiAA I I A A I I AA or I or I A A iiAA I I I I or I or I iiBB I I B B I I BB or I or I B B ii

ABAB I I A A I I BB

� Untuk kepentingan transfusi darah

� Untuk mengetahui keturunan

� Menghindari terjadi kelainan tertentu, contoh :EBF

� Untuk kepentingan forensik/ penyelidikan � Untuk kepentingan forensik/ penyelidikan kasus kriminal

� Donor dan resipien

� Syarat menjadi donor :◦ Dewasa

◦ Sehat,tidak menderita penyakit menular

◦ Kadar Hb normal◦ Kadar Hb normal

� Indikasi transfusi◦ Perdarahan yang banyak

◦ Defisiensi pada salah satu komponen darah (ex.:trombosit, eritrosit, faktor pembekuan,dll)