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TRANSFUSION MEDICINETRANSFUSION MEDICINE

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BLOOD GROUP:BLOOD GROUP:

HISTORYHISTORY

DEFINITIONDEFINITION COMMON TYPESCOMMON TYPES

IMPORTANCE OF ABO GROUPIMPORTANCE OF ABO GROUP

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HISTORYHISTORY

The idea of the blood transfusionThe idea of the blood transfusionappeared in15th and 16appeared in15th and 16thth centuries withcenturies with

the belief that transfusion of blood fromthe belief that transfusion of blood from

young and healthy person into an aged oryoung and healthy person into an aged ordebilitated individual would restore youthdebilitated individual would restore youth

and health.and health.

Pope innocent VII was given blood from 3Pope innocent VII was given blood from 3

unfortunate persons in 1542 and all theunfortunate persons in 1542 and all the

four died.four died.

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In middle of 17In middle of 17thth centurycentury-- experimentalexperimentalanimal blood transfusion was performed.animal blood transfusion was performed.

In 1704 Jean Denys tried to transfuseIn 1704 Jean Denys tried to transfuse

animal blood to human being. The personanimal blood to human being. The persondied and he was accused of murder.died and he was accused of murder.

In 18In 18thth centurycentury-- James Blundell along withJames Blundell along with

Dr. Leacock concluded that only humanDr. Leacock concluded that only humanshould serve as the source for humanshould serve as the source for human

blood transfusion.blood transfusion.

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Karl LandsteinerKarl Landsteinerdiscovered the ABOdiscovered the ABO

blood group systemblood group system 1901 and thus laid1901 and thus laid

the foundation of modern bloodthe foundation of modern blood

transfusion.transfusion.

Rous and TurnerRous and Turner Glucose is useful inGlucose is useful inextending the life of red blood cells underextending the life of red blood cells under

storage condition.storage condition.

J. Loutit and P. MollisonJ. Loutit and P. Mollison -- Acid CitrateAcid CitrateDextrose (ACD) solutions for storage.Dextrose (ACD) solutions for storage.

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In between 1960 and 1965In between 1960 and 1965 CitrateCitrate

Phosphate DextrosePhosphate Dextrose Adenin (CPDAdenin (CPD--A)A)

were introduced resulting in betterwere introduced resulting in betterpreservation and for the preparation ofpreservation and for the preparation of

blood components in closed system.blood components in closed system.

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COMMON TYPESCOMMON TYPES

ABO SystemABO System

Rh SystemRh System

Lewis SystemLewis System P SystemP System

Kell SystemKell System

MNS SystemMNS System Duffy (Fy) SystemDuffy (Fy) System

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IMPORTANCE OF ABO SYSTEMIMPORTANCE OF ABO SYSTEM

A and B antigens are inherited as per theA and B antigens are inherited as per theMendelian laws.Mendelian laws.

ABO group is determined by the presenceABO group is determined by the presenceof one (AA orBB) (homozygous) or theof one (AA orBB) (homozygous) or thepresence of two (AO or AB)presence of two (AO or AB)(heterozygous) of the three alleles.(heterozygous) of the three alleles.

A, B and H antigens are not fullyA, B and H antigens are not fullydeveloped at birth. Complete developmentdeveloped at birth. Complete developmentis attained by 1 year of age.is attained by 1 year of age.

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Antigens of ABO systemAntigens of ABO system

A and B antigens are located on the redA and B antigens are located on the red

cell membrane.cell membrane.

SUBTYPES OF ASUBTYPES OF A

80% of group A individuals are A1.80% of group A individuals are A1.

20% are A2.20% are A2.

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ABO AntibodiesABO Antibodies

Naturally occurring antiNaturally occurring anti--A and antiA and anti--BBantibodies are IgM type and react with theantibodies are IgM type and react with thered cells of the corresponding antigenred cells of the corresponding antigen

resulting in severe hemolytic transfusionresulting in severe hemolytic transfusionreaction.reaction.

Eg: Blood group A person possesses antiEg: Blood group A person possesses anti--B

antibodies in his serum; while O groupB

antibodies in his serum; while O groupperson has both antiperson has both anti--A and antiA and anti--BBantibodies in his serum.antibodies in his serum.

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Distribution of ABO antigens andDistribution of ABO antigens and

antibodiesantibodiesBlood groupBlood group Antigens onAntigens onred cellsred cells

Naturally occurringNaturally occurring

antibody in bloodantibody in blood

AA A and HA and H Anti BAnti B

BB B and HB and H Anti AAnti A

ABAB A,B and HA,B and H NoneNone

OO HH Anti A and BAnti A and B

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ABO System and DiseaseABO System and Disease

Group OGroup O 1.5 times the risk of developing1.5 times the risk of developing

peptic ulcer.peptic ulcer.

Group AGroup A 1.2 times the risk of developing1.2 times the risk of developinggastric carcinoma than blood group O andgastric carcinoma than blood group O and

B.B.

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ABO GROUPINGABO GROUPING

ABO grouping is carried out by makingABO grouping is carried out by making

2% saline suspension of red cells and2% saline suspension of red cells and

adding antiadding anti--A, antiA, anti--B and AntiB and Anti--AB sera.AB sera.

Two common methods are employed:Two common methods are employed:

1.1. Slide TechniqueSlide Technique

2.2. Tube TechniqueTube Technique

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Slide TechniqueSlide Technique

Take a slide and mark it antiTake a slide and mark it anti--A, antiA, anti--B and antiB and anti--AB.AB.

Put one drop of antiPut one drop of anti--A, antiA, anti--B and antiB and anti--AB sera onAB sera on

the marked slide.the marked slide.

AntiAnti--AA AntiAnti--BB AntiAnti--ABAB

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Add one drop of washed 20% red cell toAdd one drop of washed 20% red cell to

each antiserum.each antiserum.

Mix each cellMix each cell--serum mixture separatelyserum mixture separatelywith applicator stick and rock the slidewith applicator stick and rock the slide

gently.gently.

Read for the agglutination macroscopicallyRead for the agglutination macroscopically

within 5 minutes and identify the bloodwithin 5 minutes and identify the blood

group.group.

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AntibodyAntibody

addedadded

AntiAnti--AA AntiAnti--BB AntiAnti--ABAB ResultResult

groupgroup

AgglutinAgglutin

ationation

__ __ __ OO

"" ++ __ ++ AA

"" __ ++ ++ BB

"" ++ ++ ++ ABAB

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THANK YOUTHANK YOU