BLOOD GROUPS IN MAN
DR OCHOGWU O.L
CONSULTANT HAEMATOLOGIST
OUTLINE
• INTRODUCTION
• TYPES OF BLOOD GROUPS
• ABO BLOOD GROUP
• RHESUS BLOOD GROUP
INTRODUCTION
• The International society of Blood Transfusion(ISBT) Working party
recognizes 30 blood group systems.
• Red cell antigens that are produced by alleles( alternative forms of a
specified gene) at a single gene locus or very closely linked loci
constitute a blood group system.
• Common blood groups are ABO, Rhesus, Lutheran, Kell,Kidd, Duffy,
Lewis, MNS
INTRODUCTION
• ABO and Rh are the most important blood group types because they
are the most immunogenic(i.e capable of inducing a strong antibody
response on stimulation)
• Their alloantibodies can cause destruction of transfused red cells and
can cause haemolytic disease of the newborn(HDN)
• ABO antigens are also important in organ transplantation
• Blood group antigens are inherited in a mendelian manner and are
mostly located on autosomes
INTRODUCTION
• The particular alleles at a specific gene locus is the genotype.
• Phenotype is the outward expression of the genotype
• Note: A and B genes are dominant while O gene is recessive
BLOOD GROUPS
Question:Can a B+ man married to an A+ woman give birth to an O+ve
child?
ABO BLOOD GROUPS
• Identification of the four blood groups, A, B,AB and O is based on the
presence or absence of A and/or B antigens on the red cells.
• According to Landsteiner’s law, anti-A and/or anti-B antibodies are
always present in the plasma of individuals who lack corresponding
antigens in their red cells.
• In addition to red cells, they are also expressed on white cells,
platelets ,various body tissues and sometimes in secretions(in
secretors)
BLOOD GROUPS
Blood groups Frequency Genotype Antigen on red cells Antibody in plasma
A 27% AA or AO A Anti-B
B 31% BB or BO B Anti-A
AB 8% AB AB Nil
O 34% OO Nil Anti A and Anti-B
• Question:You are the HO on call. A woman in labour is rushed in bleeding
profusely and needs a transfusion urgently. The lab identifies her blood
group as AB and tells you that only blood group O is available. What will
you do?
PREVALENCE OF BLOOD GROUPS
Blood Group Prevalence Blood Rec.
O **** Only O
B *** O or B
A ** O or A
AB * All
ABO Blood Groups
Plasma Plasma Plasma
Plasma
ABO Blood Groups
ABO Blood Groups
• A person with blood type A can receive blood transfusion from a
donor with blood type A. The anti-B antibodies in the recipient do not
combine with the type A antigen on the red blood cells of the donor
ABO BLOOD GROUP SYSTEM
• They are called naturally occurring antibodies because they arise without
immune stimulation(i.e transfusion or pregnancy ) by relevant blood group
antigens.
• They are not usually detectable in the blood of infants due to their
undeveloped immune system and appear around 3-6 months of life.
• It is thought that they develop in response to A- and B- like antigens which
are present in the intestine and in certain foods.
• If anti-A and Anti-B are present at birth, they are of maternal origin(IgG
class)
• Anti-A and Anti-B antibodies are of IgM class and can fix complement
efficiently.
ABO Blood Groups
• Naturally occurring ABO antibodies can cause
• Haemolytic transfusion reaction in cases of ABO mismatched
transfusion.
• Acute graft rejection in cases of ABO incompatible solid organ
transplantation.
• Haemolysis of donor cells following ABO incompatible bone marrow
transplantation.
The Rhesus system
• The Rh system is next in importance to the ABO blood group system in
transfusion practice.
• The important antigens of the Rh system are C,D,E,c and e. D antigen
is the most immunogenic.
• A person is either grouped as Rh positive(when red cells express the D
antigen) or Rh negative( when red cells lack the D antigen)
• Frequency of D antigen varies in the population. In Nigeria, 95% of
people are positive for the D antigen while only 5% lack the D antigen.
Blood groups
Blood Groups
Blood Groups
Blood Groups
Rhesus Blood Groups
• Rh antibodies are of the immune type .They are the result of immunization
by transfusion or pregnancy
• Rh antibodies are of the IgG class and can cross the placenta unlike the ABO
antibodies.
• Rh antibodies can cause haemolytic transfusion reaction or haemolytic
disease of the newborn.
• Since Rh antibodies do not activate complement, haemolysis is
extravascular and predominantly occurs in the spleen.
• During pregnancy, IgG anti-D can cross the placenta and induce haemolytic
disease of the newborn by causing immune haemolysis of foetal red cells.
Rhesus Blood Group
• Rh haemolytic disease of the newborn can be prevented by
prophylactic administration of Rh immune globulin to all Rh negative
pregnant women within 72 hours of delivery
Haemolytic disease of the newborn(HDN)
• HDN is the most common problem with Rh incompatibility
COMPARISON OF ABO AND RhD GROUPS
PARAMETER ABO GROUP RhD GROUP
Location Chromosome 9 Chromosome 1
Antigens A,B,AB D
Distribution of antigens Red cells, platelets, many tissues, Red cells only
body fluids
Development of antigen Weak expression at birth Fully developed at birth
Dosage effect No Present
Nature of antibody Naturally Occuring Immune
Antibody Class IgM IgG
Whether antibodies fix Yes No
complement
Optimal reaction temperature of 4o C 37o C
antibody
Optimal reaction medium Saline Anti-Human globulin
ANY QUESTIONS?
