BLOOD GROUPING
1. What is the principle of this experiment?
The surfaces of red cell membrane contain a variety of genetically determined
antigens is called agglutinogens, while the plasma contains antibodies (agglutinins).
To determine the blood group of a person, his/her red cells are made to react with
commercially available antisera containing known agglutinins.
The slide is then examined under the microscope to detect the presence or absence of
clumping and hemolysis (agglutination) of red cells which occurs as a result of
antigen-antibody reaction.
2. What is the ABO grouping system based on?
A group of related red cell antigens that show similar chemical, genetic, and reactivity
properties constitutes a “blood group system”.
Within a blood group (e.g. ABO system), there may be two or more different “blood
types” (e.g. A, B, O, AB).
3. What is the percentage of distribution of ABO blood grouping?
BLOOD PERCENTAGE
GROUP
A 20%
B 40%
AB 10%
O 30%
4. What is Land Steiner’s law?
The Landsteiner Law, which has 2 major components, states that:
1. If an agglutinogen is present on the red cells of an individual, the corresponding
agglutinins must be absent in the plasma.
2. If an agglutinogen is absent in the red cells, the corresponding agglutinins must be
present in the plasma.
The first part of the statement is a logical outcome of the situation because if both
agglutinogen and agglutinins were present, the red cells would be agglutinated. The
second part of the statement is a fact (for ABO system) but not a necessary outcome
because if the agglutinogen is absent from the red cells, the agglutinins might well be
absent.
5. What are the other systems of blood group classifications?
Other blood group systems are:
MN, Lutheran, Kell, Colton, Duffy, Kid, Diego, Lewis, Li, Yt, Xg, P, C, etc.
These groups are of little importance because they are not antigenic, though they are
of value in anthropological and genetic studies. Some of these function as cell
recognition molecules.
6. What is Bombay blood group?
This blood type is a rare phenomenon in which the H antigen is absent.
Since there is no H antigen, there is no antigen A or antigen B on the red cells.
However, the plasma contains anti-A, anti-B and anti-H antibodies. As a result, such a
person can receive blood only from a person having Bombay blood type.
7. What are the uses of blood grouping?
Blood grouping/typing is important in:
1. Blood transfusion for treatment purposes.
2. Determination of Rh incompatibility between the mother and child.
3. Paternity disputes.
4. Choice of a donor in tissue/organ transplantation.
5. Genetic studies.
6. Medico legal use.
7. Susceptibility to disease.
8. What is Erythroblastosis fetalis?
The most common problem due to Rh incompatibility may arise when an Rh –ve
mother carries an Rh +ve fetus.
Normally, no direct contact occurs between maternal and fetal bloods. However, if a
small amount of Rh +ve blood leaks from the fetus through the placenta into the
mother’s blood, the mother’s immune system will start to make anti-Rh antibodies.
This happens at the time of delivery when small amounts of fetal blood leak into the
mother as the placenta separates from the uterine wall. As a result, some mothers
develop high concentration of anti-Rh antibodies during the period following
delivery.
Therefore, the first-born baby will not be affected, unless the mother has previously
received Rh +ve blood transfusion. There are cases of fetal-placental bleeding during
pregnancy itself when fetal blood may enter the mother’s circulation. During the first
pregnancy, however, the anti-Rh antibody levels do not reach high enough levels to
cause complications.
However, during the second and subsequent pregnancies, the mother’s anti-Rh
antibodies cross the placental membrane into the fetus where they cause agglutination
and hemolysis. The clinical condition that develops in the fetus is called “Hemolytic
Disease of the Newborn (HDN)’ or “Erythroblastosis fetalis”
9. What are the indications of blood transfusion?
Acute hemorrhage.
Chronic anemias that cannot be treated with diet and drugs.
Exchange transfusion.
Bleeding disorders.
Granulocyte transfusion.
Bone marrow depression.
Autologous transfusion.
10. What is cross matching and when is it done?
The red cells and the plasma of the donor and recipient blood are separated by
centrifugation.
The donor red cells are then treated (tested) with the recipient plasma (major side
cross match), and the donor plasma is tested against the red cells of the recipient
(minor cross match).
The whole process is called “cross matching’. If there is no agglutination in either
case, the donor blood can safely be given to the recipient.
Cross matching must always be done before every blood transfusion.
11. What is blood banking?
With the modern surgical and medical procedures, the demand for blood has greatly
increased. It is for this reason that blood banks were started where blood from
voluntary donors could be stored, so that it was always available on demand.
Most blood banks have lists of would-be donors so that they may be contacted when
required.
Storage of blood- The blood bag is suitably sealed, labeled, and stored at 4ºC, where
it can be kept for about 20 days.Blood is stored at low temperatures for 2 reasons:
one, it decreases bacterial growth, and two, it decreases the rate of glycolysis and thus
prevents a quick fall in pH.
Changes in red cells during storage- Changes occur due to decreased metabolism,
and include increase in their Na+ and decrease in K+ concentration due to reduced
Na+-K+ pump activity, the result being a net increase in total base and water content
of the cells that swell and become more spherocytic. The ATP content decreases and
inorganic phosphate content increases.
Changes after transfusion- These changes occur within a day or so, the red cells lose
sodium and gain potassium, with the volume, shape and fragility returning to normal.
Their survival time increases if blood is given within a week of donation.
Fate of transfused citrate- The citrate that is used to store blood can safely be
injected intravenously. Within a few minutes, the liver removes citrate from blood and
polymerizes it into glucose, or metabolizes it directly for energy. But if the liver is
damaged, or if large amounts of citrate are injected too quickly, the citrate may lower
the calcium level in blood to result in tetany, or even death from convulsions.
Blood substitutes- Separate components of blood— packed RBCs, whole plasma to
provide clotting factors, platelets, leukocytes, plasma and plasma expanders are now
available.
12. How are A and B antigens inherited?
A and B antigens are inherited as Mendelian Dominant pattern.
13. What is a transfusion reaction? Differentiate between a major and minor
transfusion reaction.
The donor red cells are tested against recipient plasma to ensure that the recipient
plasma does not contain antibodies that would react with the antigens on the donor red
cells. it is called “major side cross match” or “major cross match”.
The donor plasma is tested against the recipient red cells to test the potency of donor
agglutinins. This reaction is not very important and usually does not occur even in a
mismatch, Thus, the donor agglutinins can usually be ignored, if their potency is not
too high is called “minor cross match”
14. Mention another important system of blood grouping. How does ABO system differ
from this system? Give the clinical importance of this system?
Rh Typing:
It Differs from other blood group systems. No naturally occurring antibodies to Rh
antigen. Only when immune system is exposed to antigens ,antibodies are formed.
Clinical importance- Rh typing to be done in Blood Transfusion to prevent transfusion
reactions.
15. Why is Blood Group ‘O’ is known as universal donor?
Type O persons do not have either A or B antigens on their red cells, they are called
“universal donors” because their blood can, theoretically, be given to all 4 blood
types.
16. What is the importance of MN Group?
This group is due to a glycoproteins present on the RBC membrane which serves as
receptor for cytokines and pathogens. Malarial Parasite Plasmodium falciparum attach
to this protein.
It required for paternity testing.
It is useful in anthropological and Genetic studies.
17. What is the composition of ACD mixture?
Composition of ACD mixture:
Acid Citrate- 0.48g
Trisodium Citrate- 1.32g
Dextrose- 1.47g
Distilled water- 100ml
18. Which preservative (anticoagulant) is used for storing blood?
ACD- Acid Citrate Dextrose
CPD- Citrate Phosphate Dextrose
19. What is the difference between Rouleaux formation and Agglutination.
Rouleaux Formation: RBCs are stacked up in long chain or one above the other due
to increase in Fibrogen or due to acute phase proteins of inflammation.
Agglutination: This is due to Antigen-Antibody reaction.
