Abo inkompatibilitas

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ABO Blood Grouping

Introduction

Terry Kotrla, MS, MT(ASCP)BB


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ABO Basics Blood group antigens are actually sugars

attached to the red blood cell.

Antigens are built onto the red cell. Individuals inherit a gene which codes

for specific sugar(s) to be added to thered cell.

The type of sugar added determines theblood group.


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This diagram illustrates the terminal

sugar for each blood group.


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ABO Type Frequencies In U.S.

ABO Type Per Cent

O 45%

A 40%

B 11%

AB 4%


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Landsteiners Rule

Individuals will form immune antibodies to

ABO blood group antigens they do not

possess.

Substances are present in nature which are so

similar to blood group antigens which result in

the constant production of antibodies to blood

group antigens they do not possess. Critical for understanding compatibility

between ABO blood groups.


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Inheritance

Blood group antigens are codominant,

if the gene is inherited, it will be

expressed. Some aberrant genotypes do occur but

due to the rarity will not be discussed.

Understanding of basic inheritanceimportant.


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Genetics

Two genes inherited, one from each parent.

Individual who is A or B may be homozygousor heterozygous for the antigen.

Heterozygous: AO or BO Homozygous: AA or BB

Phenotype is the actual expression of thegenotype, ie, group A

Genotype are the actual inherited genes whichcan only be determined by family studies, ie,

AO.


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Example of Determining

Genotype

Moms phenotype is group A, genotype AO

Dads phenotype is group B, genotype BO

B O

A AB 25% AO 25% (Group A)

O BO 25% (Group B) OO 25% (Group O)


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Other Examples

Mom Dad Offspring Blood

Group

AA BB 100% AB

BO OO 50% each of B

or O

OO OO 100% O

OO AO 50% each of A

or O


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Group O

Approximately 45% of the

population is group O.

No A or B antigens present,think of as 0 antigens present.

These individuals form potent

anti-A and anti-B antibodies

which circulate in the bloodplasma at all times.


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Group A


population is group A.

No B antigens present. These individuals form

potent anti-B antibodies

which circulate in the

blood plasma at all times.


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Group B


population is group B.

No A antigens present. These individuals form potent

anti-A antibodies which

circulate in the blood plasma

at all times.


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Group AB

Approximately 4% of thepopulation is group AB.

Both A and B antigens

present.

These individuals possessno ABO antibodies.

NOTE: This slide is inerror as it only illustratespresence of one antigennot 2.


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Hemolysis

If an individual is transfused with an

incompatible blood group destruction of the red

blood cells will occur.

This may result in the death of the recipient.


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Summary

Blood Group Antigens on cell Antibodies in

plasma

Transfuse with

group

A A Anti-B A or O

B B Anti-A B or O

AB A and B none AB, A, B or O

O None Anti-A & B O


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Rh (D) Antigen

Of next importance is the Rh type.

Term Rh is a misnomer.

Rh is a blood group system with manyantigens, one of which is D. Re-education of public is difficult.

Rh refers to the presence or absence of

the D antigen on the red blood cell.


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Rh (D) Antigen (continued)

The most important patient population to

consider is females of child-bearing age.

If immunized to Rh (D) antigen the antibodycan cross the placenta and destroy Rh (D)

positive fetal cells resulting in death.

This is why Rh negative women are given

Rhogam after birth of Rh positive baby.


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Blood Typing

There are 2 components to blood typing:

Test unknown cells with known antibodies

Test unknown serum/plasma with known rbcs The patterns are compared and the

blood group is determined.


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Slide Blood Typing

Very rudimentary method for determining bloodgroups.

CANNOT be used for transfusion purposes as

false positives and negatives do occur. A false positive is when agglutination occurs

not because the antigen is present, but cellsmay already be clumpled.

A false negative is one in which the cells arenot clumped because there are too many cellsor not enough reagent.


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Slide Blood Typing - continued

The slide is divided into halves.

On one side a drop of anti-A is added, this will attachto and cause clumping of rbcs possessing the A

antigen. On the other side a drop of anti-B is added which will

cause clumping of rbcs with the B antigen.

A drop of rbcs is added to each side and mixed wellwith the reagent.

The slide is tilted back and forth for one minute andobserved for agglutination (clumping) of the rbcs


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Interpretation of Slide Typing

Testing with Anti-A Anti-Serum

If an rbc contains the A

antigen the red blood cells will

be agglutinated by anti-A, a

positive reaction.

If an rbc does not have the A

antigen there will be no

clumping, a negative reaction.


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Interpretation of Slide Typing

Testing with Anti-B Anti-Serum

If an rbc contains the B antigen

the red blood cells will be

agglutinated by anti-B, a positive

reaction.

If an rbc does not have the B

antigen there will be no clumping

by anti-B, a negative reaction.


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Slide Blood Typing Group A

An unknown rbc suspension is added to known anti-sera.

The left hand of the slide contains anti-A which reactswith the unknown cell.

The right hand side contains anti-B which does notreact with the cell.


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Slide Blood Typing Group B

An unknown rbc suspension is added to known anti-sera.

The left hand of the slide contains anti-A does not reactwith the unknown cell.

The right hand side contains anti-B which reacts withthe cell.


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Slide Blood Typing Group O

The left hand of the slide contains anti-A does

not react with the unknown cell.

The right hand side contains anti-B does not

react with the unknown cell.


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Slide Blood Typing Group AB

The left hand of the slide contains anti-A which

reacts with the unknown cell.

The right hand side contains anti-B which

reacts with the unknown cell.


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Summary of Slide Typing

Anti-A Anti-B Blood Group

NEG NEG O

POS NEG A

NEG POS B

POS POS AB

Date post:	14-Apr-2018
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