Abo Group.

Introduction:
● Discovered ABO Blood group system in

1901
● Discovered Rh factor in 1930 along with
Alexander S. Wiener
● Noble prize in Physiology or Medicine
in 1930
KARL LANDSTEINER (1886-1943)

What are the different blood
groups?
● The differences in human blood are due
to the presence or absence of certain
protein molecules called antigens and
antibodies.
● The antigens are located on the surface
of the RBCs and the antibodies are in
the blood plasma.
● Individuals have different types and
combinations of these molecules.
● The blood group you belong to depends
on what you have inherited from your
parents .
● There are more than 20 genetically
determined blood group systems known
today
● The ABO and Rhesus (Rh) systems are
the most important ones used for blood
transfusions.
● Not all blood groups are compatible

with each other. Mixing incompatible
blood groups leads to blood clumping or
agglutination, which is dangerous for
individuals.
● There are more than 20 genetically
determined blood group systems known
today
● The ABO and Rhesus (Rh) systems are
the most important ones used for blood
transfusions.
● Not all blood groups are compatible
with each other. Mixing incompatible
blood groups leads to blood clumping or
agglutination, which is dangerous for
individuals.
Landsteiner Law
● If an antigen/agglutinogen is present
on the red cell membrane of an
individual, the corresponding
antibody/agglutinin will be absent in
the plasma.
● If an antigen/agglutinogen is absent
on the red cell membrane of an
individual, the corresponding
antibody/agglutinin will be present
in the plasma.
Blood Group systems

● MAJOR
■ ABO
■ Rh (Rhesus)
● MINOR
• MN
• li
•P
• Lewis
• Duffy
• Kidd
• Kell
• Lutheran
Classical ABO Blood

Grouping System
● The most important in assuring a safe

blood transfusion.
● Is based on presence or absence of A &
B antigens on red cell membrane.
● There are 4 bloog groups according to
this system
● A, B, AB & O
Blood group A
If you belong to the blood group A, you
have A antigens on the surface of your
RBCs and B antibodies in your blood
plasma.
Blood Group B
If you belong to the blood group B, you
have B antigens on the surface of your
RBCs and A antibodies in your blood
plasma.
Blood group AB
If you belong to the blood group AB, you

have both A and B antigens on the surface
of your RBCs and no A or B antibodies at
all in your blood plasma.
Blood Group O:
If you belong to the blood group O (null),
you have neither A or B antigens on the
surface of your RBCs but you have both A
and B antibodies in your blood plasma.
•The table shows the four ABO

phenotypes ("blood groups")
present in the human population
and the genotypes that give rise to
them.
Why do individuals produce

antibodies to antigens they
do not have?
• The "A" and "B" antigens are
also produced by some other
plants and microorganisms.
Thus, individuals who do not
recognize one or more of these
antigens as "self" will produce
antibodies against the plant or
microbial antigens.
• These antibodies will also react

with human antigens of the same
kind whether introduced via a
blood transfusion or a tissue
graft.
Detremination of blood
groups:
Genetics & Inheritence of
ABO system:
● The ABO gene locus is located on the
chromosome 9
● A and B blood groups are dominant
over the O blood group
● A and B group genes are co-dominant
● Each person has two copies of genes
coding for their ABO blood group (one
maternal and one paternal in origin)
AUTOSOMAL
CHROMOSOME:
Possible Blood group
Genotypes:
Rhesus (Rh) Blood grouping
system:
● Rh antigen-C,D,E, c,d & e

● Some of us have it, some of us don't.
● If it is present, the blood is RhD
positive, if not it's RhD negative.
● So, for example, some people in group
A will have it, and will therefore be
classed as A+ (or A positive).
● While the ones that don't, are A- (or A
negative).
● And so it goes for groups B, AB and O.
Rh antibodies
● No natural antibodies
● But are produced only when Rh+
blood is given to a Rh- person
● Once produced they persist for years
& can produce serious reactions
during 2nd transfusion
● 85% of the population is Rh positive,
the other
● 15% of the population is Rh negative
Clinical Application of
Blood Grouping:
●In Blood transfusion
●In preventing hemolytic disease
●In paternity disputes
●In medicolegal cases In knowing
susceptibility to disease
●Group O-duodenal cancer
●Gropu A- Carcinoma of stomach,
pancreas & salivary glands
Bombay blood group

● H antigen/H substance is absent
● First discovered in Bombay, now
known as Mumbai by Dr. Y.M.
Bhende
● present in about 0.0004%
Formation of the H antigen

H antigen:
● The H antigen is the foundation upon
which A and B antigens are built
● A and B genes code for enzymes that
add a sugar to the H antigen
● Immunodominant sugars are present at
the terminal ends of the chains and
confer the ABO antigen specificity
Formation of the A
antigen:
Formation of the B
antigen:
Bombay:
●RBCs with no H, A, or B antigen
(patient types as O)
●Bombay RBCs are NOT agglutinated

with anti- A, anti-B, or anti-H (no
antigens present)
● Bombay serum has strong anti-A,

anti-B and anti-H, agglutinating
ALL ABO blood groups
●What blood group would you use to

transfuse this patient??
ANSWER:
● Another Bombay
Group O RBCs cannot be given
because they still have the H antigen
You have to transfuse the patient
with blood thatcontains NO H
antigen
HAEMOLYTIC DISEASE
OF NEWBORN
●Occurs due to Rh incompatibility

between mother & fetus
●anti-A or anti-B antibodies are of the

IgM class (large molecules) and these
do not cross the placenta
●Rh antibodies are IgG type & can
cross placenta
First pregnancy
Anti-Rh+ antibodies
Possible subsequent pregnancies

This happens when Rh- mother carries
an Rh+ baby
Manifestations of Haemolytic
disease:
●Erythroblastosis fetalis
●Icterus gravis neonatorum
Kernicterus
●Hydrops fetalis
Prevention & Treatment:
● Injecting single dose of Rh antibodies
(Anti-D) to the mother soon after
delivery
● Exchange transfusion
BLOOD
TRANSFUSION
Blood transfusions - who can receive
blood from whom?
People with blood group O are called

"universal donors" and people with
blood group AB are called "universal
receivers."
Indications
●Blood Loss
●For quick restoration of
haemoglobin
●Exchange transfusion
●Blood diseases
DONOR
RECIPIENT
Precautions
●Absolute indication
●Cross matching
●Rh+ blood should never be given to
Rh- person
●Donor's blood should always be
screened
●Bloodbg/bottle should be checked
●Should be given at slow rate
●Proper aseptic measures should be
followed
●Careful watch on recipient's
condition
Cross matching
Major Cross matching-
mixing of donor's cells with
recipient's plasma
Minor Cross matching
mixing of recipient's cells with
donor's plasma
Hazards of Blood Transfusion
1. Mismatch transfusion reactions
● Agglutination
● Tissue ischemia
● Haemolysis
● Haemolytic jaundice
● Circulatory shock
● Renal vasoconstriction
● Haemoglobinuria
● Renal tubular damage
● Acute renal shutdown
● Uremia
Transfusion Reaction
If a person is given blood of an
incompatible type, two different
antigen-antibody interactions take place.
By far the more serious consequences
arise from the effect of the antibodies in
the recipient's plasma on the incoming
donor erythrocytes. The effect of the
donor's antibodies on the recipient's
erythrocyte-bound antigens is less
important unless a large amount of blood
is transfused, because the donor's
antibodies are so diluted by the recipient's
plasma that little red blood cell damage
takes place in the recipient. Antibody
interaction with erythrocyte- bound
antigen may result in agglutination
(clumping) or hemolysis (rupture) of the
attacked RBCs. Agglutination and
hemolysis of donor red blood cells by
antibodies in the recipient's plasma can
lead to a sometimes fatal transfusion
reaction. Agglutinated clumps of
incoming donor cells can plug small blood
vessels. In addition, one of the most lethal
consequences of mismatched transfusions
is acute kidney failure caused by the
release of large amounts of hemoglobin
from ruptured donor erythrocytes. If the
free hemoglobin in the plasma rises above
a critical level, it will precipitate in the
kidneys and block the urine-forming
structures such as the glomeruli, leading
to complete acute kidney shutdown.
2. Circulatory overload
3. Transmission of blood-borne
infections
4. Pyrogenic reaction
5. Allergic reactions
6. Hyperkalemia
7. Hypocalcemia
8. Reduced tissue oxygenation
9. Haemosiderosis
10. Thrombophlebitis
11. Air embolism
CONCLUSION
Even though many studies have proven the
association between ABO blood types and
diseases by describing possible mechanisms,
others did not confirm it and making the
exact decision falls into uncertainty due to
inconsistent results. Nevertheless, evidences
were collected here to make this supposition
clear. ABO may influence the risk of
different diseases by different known and
unknown mechanisms. It is now clear that
ABO blood types are not the exact cause of
diseases, but they can be susceptible and
surrender to disease and health problems.
In general, non-O blood types are more
susceptible to diseases than O.It can be
useful to increase the knowledge of persons
in this aspect because individuals with high
risk blood types could be screened and
trained for modifying their lifestyles, health
behavior, and environment and other
attempts that may increase public health.
The importance of human blood types can
be seen more clearly in the context of
population movement and the persistent
combat between humans and infectious
disease. Evidence for selection by infectious
diseases at the level of the ABO and
secretor genes is persuasive, but for other
blood group antigens, founder effects
appear more likely to account for the
distribution of blood group polymorphisms
except for parts of the world in which
malaria is endemic. Available data suggests
that survivals from malaria have been the
most significant selective force acting on the
blood groups. Moreover, further
investigations have to be made particularly
on the molecular level of ABO blood groups
and their association with various diseases.

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Introduction:

● Discovered ABO Blood group system in

KARL LANDSTEINER (1886-1943)

● Not all blood groups are compatible

Blood Group systems

Classical ABO Blood

● The most important in assuring a safe

If you belong to the blood group AB, you

•The table shows the four ABO

Why do individuals produce

• These antibodies will also react

● Rh antigen-C,D,E, c,d & e

Bombay blood group

Formation of the H antigen

●Bombay RBCs are NOT agglutinated

● Bombay serum has strong anti-A,

●What blood group would you use to

●Occurs due to Rh incompatibility

●anti-A or anti-B antibodies are of the

Possible subsequent pregnancies

People with blood group O are called

1. Mismatch transfusion reactions

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