Blood Grouping Lecture (PDF)

‫بسم الله الرحمن‬ ‫الرحيم‬ BLOOD PHYSIOLOGY L9: Blood Groups & Blood Transfusion Dr.ABDULRHMAN MUSTAFA MB,BS –MSc-PhD-MHPE, MHAE FAIMER FELLOWSHIP Crt  Learning objectives Learning objectives Different types of Blood gro...

‫بسم الله الرحمن‬ ‫الرحيم‬ BLOOD PHYSIOLOGY L9: Blood Groups & Blood Transfusion Dr.ABDULRHMAN MUSTAFA MB,BS –MSc-PhD-MHPE, MHAE FAIMER FELLOWSHIP Crt  Learning objectives Learning objectives Different types of Blood group systems Explain blood typing and how it is used to avoid adverse reactions following blood transfusions.  Describe how blood reactions may occur between fetal and maternal tissues.  Blood Groups and transfusions Blood transfusions were not possible until Karl Landsteiner first identified the major human blood groups -- namely A, B, AB and O - in a series of experiments in 1901 that earned him the Nobel Prize. 3  Blood Group systems Today there are 31 different genes known to contribute to the surface features of RBCs determining compatibility between blood types Major systems ABO Rhesus system(Rh) 4  Importance of Blood Groups Transfusion of blood Association with disease Duodenal ulcers are more common in group O than in A or B Tumors of salivary glands, stomach and pancreas are more common in group A than in group O individuals. https://www.health.harvard.edu/blog/diet-n ot-working-maybe-its-not-your-type-20170 5  ABO blood groups Antigens – a chemical that stimulates cells to produce antibodies) Antibodies – a protein that reacts against a specific antigen) The ABO blood groups are defined by specific inherited molecules, or antigens, that are present on the surface of red blood cells 6  ABO Blood Group Based on the presence or absence of two major antigens on red blood cell membranes Antigen A Antigen B 7  Antibodies of the ABO blood group Antibodies in the ABO group appear usually in babies within the first six months following their birth  naturally occurring antibodies Blood Antigen Antibody Type A A Anti B B B Anti A AB A and B Neither Anti A nor Anti B O Neither A nor Both Anti A and Anti B B 8  Red blood cell Agglutinated red Antigen A blood cells Anti-B antibody Anti-A antibody (a) (b) (c) (d) 9  Genotype of ABO blood groups Blood Group Possible Genotype(s) A AA, AO B BB, BO AB AB O OO The genes A& B are co-dominant genes. The O gene is recessive 10  Landsteiner’s law 1. If an agglutinogen (antigen) is present on the RBCs the corresponding agglutinin (anti body) must be absent in the plasma 2. If an agglutinogen (antigen) is absent on the RBCs the corresponding agglutinin (anti body) must be present in the plasma The first law is applicable to all blood groups. But the second part is not necessary always, it is true for ABO blood groups. 11  Rh Blood group The Rh blood group was named for the rhesus monkey The group includes several Rh antigens or factors (Cc, Dd & Ee) Rh positive – presence of antigen D Rh negative – lack of D antigen 12 Genetic Inheritance of Rh- factors Rh+ is dominant over Rh- 13  Rh- Blood groups A person with Rh – ve blood does not have Rh antibodies naturally in the plasma A person with Rh-ve blood can develop Rh antibodies in the plasma if he or she receives blood from a person with Rh+ve blood. The seriousness of the Rh blood group is evident in a fetus that develops the condition erythroblastosis fetalis or hemolytic disease of the newborn 14  Erythroblstosis Fetalis –– – –– – ––– ––– – – – – – – – – –– – – –– – – – – – – – – – – – – – –– – –– – – – – – – – – – – – – – – –– – – –– – – – – – – – – – – –– – – –– – – – – – – – – – – – – – – –– – – – – –– – – – – – – –– – – – – – –– – – – – – – – – – – –– – – –– – –– – – –– – – – – – – ++ + – – – – – – – – – – – – ++ – – – – – – – – – – + – + – – + – + + – – – – + + – – – – – – + + + – + + + + – – – – – + + + – + – – + – + – – – + – + – – + – – – – + – – – – – – – – – Rh-negative Cells from Woman In the next woman with Rh-positive becomes Rh-positive Rh-positive fetus enter sensitized— pregnancy, fetus woman’s antibodies ( + ) maternal bloodstream form to fight antibodies Rh-positive attack fetal red blood cells blood cells 15  Erythroblastosis Fetalis (Hemolytic disease of the newborn-HDN) Clinical Features Edema (Hydrops) Jaundice Anemia Enlarged Liver & Spleen 16  Erythroblastosis Fetalis (Hemolytic disease of the newborn-HDN) Treatment Exchange blood transfusion Prevention Administer anti-D immunoglobulin to the mother This will destroy any fetus cells in mother circulation and stop any immunological reaction. 17 Blood groups in local population Blood Group Percentage of Population O+ 48 % A+ 24 % B+ 17 % AB + 4% Rh Positive are about 93% (90-95%) O- 4% A- 2% B- 1% AB- 0.23% Rh negative are about 7% (5-10%) 18  Blood transfusion Blood grouping and cross matching Donor’s RBCs + Recipient’s plasma (major cross matching) Recipients RBCs + Donor’s plasma (minor cross matching) 19  Considerations during Transfusion : Universal donor? Can give blood to any body? Universal recipient? Can receive blood from all others? has no antibodies against A or B? 20 Complications of Blood Transfusion Fatal hemolytic reactions in mismatched reactions. Rapid hemolysis Jaundice Renal tubular damage Circulatory overload – if rapid transfusion Hemosiderosis – with repeated blood transfusion Electrolyte disturbances Transmission of disease Hepatitis – B or C AIDS 21  References Human Physiology, Lauralee Sherwood, ninth edition Chapter 11, page no. 386- 388. Text book Physiology by Guyton &Hall,12th edition Chapter 32, page no. 420-421. Text book of Physiology by Linda S. Contanzo, third edition. Physiology by Berne and Levy, sixth edition.