ABO Incompatibility

Group 9 Saliba • Samonte • Samoy Segubre • Sese • Solana Sta. Ana • Tan Gana • Tee

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• Antigen: Any substance that when introduced in to, or present in, the tissues or blood causes the formation of antibodies and only reacts with its specific antibodies • Antibody: A protein produced by certain cells of the body in the presence of a specific antigen. The antibody combines with that antigen to inhibit, neutralize or destroy it • Agglutinogen: An antigen located on the surface plasma membrane of RBC which determines the blood group of the individual.

Definition of Terms

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• Agglutinin: A specific antibody in blood plasma capable of causing the clumping of RBC or bacteria or particles such as viruses • Agglutination: The clumping together of blood cells or microorganisms, usually due to an antigen-antibody reaction

• Blood group: The type or specification of an individual’s bloo according to the presence or absence of specific agglutinogens on the red cells

Definition of Terms

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Blood transfusion: The introductioof blood from one person into the circulation of another person

• Incompatibility: When the agglutinogens on the red cells in the donor react with the agglutinins in the recipient’s blood.

Definition of Terms

DISCOVERY OF ABO Next .

workers began mixing each others red cells and serum together and inadvertently performed the first forward and reverse ABO groupings. O . • Sturle and Von Descatello .AB Karl Landsteiner (1868-1943) A.Home • Discovered the ABO Blood Group System in 1901 • He and his five co . B.

Home • Delivers oxygen to the tissues • Helps in the disposal of carbon dioxide and protons formed by tissue metabolism. • life span -120 days Functions of The Red Blood Cell .

BLOOD GROUP SYSTEM .

 discovered by the Austrian scientist Karl Landsteiner. A and B. B. O) segregating at a single genetic locus . whose presence or absence is determined by three alleles (A. who found three different blood types in year 1900  ABO blood group system is the most important blood type system (or blood group system) in human blood transfusion  defined by two red blood cell antigens.

bacteria.• An unusual feature of this system is the presence of serum IgM antibodies in healthy adults  which are usually produced in the first years of life by sensitization to environmental substances such as food. and viruses • to whichever antigen (A or B) is absent from that individual's cells .

directed against whichever of the A and B antigens is not present on that person's red cells. The blood "type" is defined by the presence of two red blood cell antigens.  "Natural" antibodies called isoagglutinins exist in an individual's serum. "A" and "B. type AB red cells bear both antigens. those of type B have antigen B. Two basic rules: . while type O cells bear neither antigen." RBCs of type A have the A antigen on their surface.

• Glucosyltransferase – enzyme that facilitates the transfer of carbohydrate molecules onto carbohydrate precursor molecules • Immunodominant Sugar – sugar molecule that completes the antigenic determinant when combined with the precursor substance Definition of Terms .

• Amorph – a mutant allele that has little or no effect on the expression of trait • Allele – any alternate form of a gene that can occupy a given chromosomal location (locus) • Isoagglutins – defined as antibodies that agglutinate blood cells of some individuals of the same species .

following combination with the homologous antigen . such as an antibody. red blood cells. e.g..An antigen that stimulates the production of a particular agglutinin. bacteria.• Agglutinogen . (Agglutogen) • Agglutinin .antibody which aggregates a particulate antigen.

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ABO BLOOD GROUP .

• Individuals whose erythrocytes develop only Antigen A are said to have blood type A. who have erythrocytes which develop both agglutinogen A and B. are said to have blood group AB. .• Based on two agglutinogens referred to as A and B. • Those whose erythrocytes develop only agglutinogen B are said to have blood group B. • Those individuals who manufacture neither agglutinogen are said to have blood group O. • Some individuals.

a and b. are present in the plasma of the individuals • Blood group A plasma contains agglutinin b • Blood group B plasma contains agglutinin a • Blood group AB contains neither of the agglutinin • Blood group O contains both agglutinin a and b .• The blood group agglutinins.

• A locus termed H and the final product of the genes at the locus is H antigen. or O gene. ABH Antigens .• The inheritance of ABO blood group demonstrates that each individual inherits ABO gene from each parent and these two genes will determine the antigen present on RBC membrane • One position or locus on each chromosome 9 is occupied with A. It is necessary for the expression of normal ABO antigens. B.

• The biosynthesis of the H antigen and the A and B antigens involves a series of enzymes (glycosyltransferases) that transfer monosaccharides. Depending upon a person's ABO blood type. the H antigen remains unmodified. the H antigen is converted into either the A antigen. which are attached to lipids and proteins that are anchored in the RBC membrane. H Antigen . Therefore. If a person has blood group O. or both. The resulting antigens are oligosaccharide chains. • The H antigen is produced by a specific fucosyltransferase. the H antigen is present in the highest amounts in blood type O and in the least amounts in blood type AB. B antigen.

and because the H antigen is an essential precursor to the ABO blood group antigens. Therefore. their serum contains anti-A and anti-B. in addition to potent anti-H.• Individuals who are homozygous for null alleles at this locus (h/h) do not produce H antigen. they cannot produce A and B antigens. This rare phenotype of Hdeficient RBCs is called the "Bombay phenotype" (Oh) .

the antibodies in their serum would place them at a high risk of having an acute hemolytic transfusion reaction. This can be avoided by using only blood products from a donor who also has the Bombay phenotype (usually a relative). . but if they ever needed a blood transfusion.• Individuals with the Bombay phenotype are healthy.

• Blood group antigens are either sugars or proteins. specifically oligosaccharides RBC Antigens . • the antigens of the Rh blood group are proteins • the antigens of the ABO blood group are sugars.

• Oligosaccharides are synthesized through the action of specific enzymes: glycosyltransferases • oligosaccharide foundation called the O (or sometimes H) antigen • A and B antigens differ from the O antigen by the addition of one extra monosaccharide. either Nacetylgalactosamine (for A) or galactose (for B) through an α-1.3 linkage to the galactose terminal Glycosyltransferases .

A / B / O diagrams .

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• N-acetyl galactosamine transferase. • An A blood group individual possess this enzyme • Transfers N-acetyl galactosamine to the terminal sugar on the H Substance forming A antigen • IUPAC Name: • 2-(Acetylamino)-2-deoxy-D-galactose N-Acetylgalactosamine .

• D-galactose transferase. • The B blood group individual possesses this enzyme • Transfers the sugar D-galactose to the terminal sugar on the H substance forming B antigen Galactose .

• Consist of two different terminal sugars. • A and B antigens are formed only when terminal sugar L-fucose is added to the precursor substance. are transferred to different chains of the same RBC. N-acetyl galactosamine and D-galactose. • In the absence of the H antigen. there is no production of A or B antigen. AB Type .

• For A/B antigen synthesis to occur. • In RBCs. Antigen Genetics . the enzyme that synthesizes the H antigen is encoded by the H locus (FUT1).• The ABO locus encodes specific glycosyltransferases that synthesize A and B antigens on RBCs. • In saliva and other bodily secretions. a precursor called the H antigen must be present. the enzyme that synthesizes the H antigen is encoded by the Se locus (FUT2).

the antibodies in their serum would place them at a high risk of having an acute hemolytic transfusion reaction. • Therefore. they cannot produce A and B antigens. • it encodes a fucosyltransferase that produces the H antigen on RBCs. their serum contains anti-A and anti-B. but if they ever needed a blood transfusion. and because the H antigen is an essential precursor to the ABO blood group antigens. in addition to potent anti-H. • Individuals who are homozygous for null alleles at this locus (h/h) do not produce H antigen. This rare phenotype of H-deficient RBCs is called the "Bombay phenotype" • Individuals with the Bombay phenotype are healthy. • This can be avoided by using only blood products from a donor who also has the Bombay phenotype (usually a relative).3. Antigen Genetics .• The H locus is located on chromosome 19 at 19q13.

L266M.1-q34.2. • The O allele differs from the A allele by deletion of guanine at position 261.• The ABO locus is located on chromosome 9 at 9q34. • The A and B alleles differ from each other by seven nucleotide substitutions. G268A). • The residues at positions 266 and 268 determine the A or B specificity of the glycosyltransferase they encode. Antigen Genetics . G235S. four of which translate into different amino acids in the gene product (R176G. • The deletion causes a frameshift and results in translation of an almost entirely different protein that lacks enzymatic activity.

• Agglutination occurs if the antibodies match the epitopes of the blood cells. multivalent antigen interacts with a single antibody. Agglutination . • May occur when an undeterminate. AB and O. This eventually leads to clumping. resulting in crosslinking of the antigen particles by the antibody. the blood type of the individual can be determined. • Observing the agglutination patterns. • Blood typing is one common application for the agglutination test.B. There are different blood groups like A. univalent antigen interacts with at least two distinct antibodies.• Occurs when an antibody interacts with antigen. It may also occur if a multi determinate.

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• method to determine an individual’s specific blood type • blood types are differentiated according to the types of proteins or antigens on the surfaces of the red blood cells ABO Typing .

AB. B.• shows that people have one of four blood types: A. or O • Type A: has A antigen in the RBCs and type B antibodies in the plasma • Type B: has B antigen in the RBCs and type A blood antibodies in the plasma • Type O: neither has the A nor B antigen but has both type A and type B antibodies • Type AB: has both the A and B antigens but does not have antibodies against type A or type B blood .

or serum confirmation How the test is performed . back typing.• Antigen typing and antibody detection • Antigen typing – forward typing • Antibody detection – reverse.

Cells are tested with the antisera reagents anti-A and anti-B Forward typing .• determines antigens on the donor's cells a.

Serum tested with reagent A cells and B cells Reverse typing .• determines antibodies in patient's or donor's serum or plasma a.

Routine ABO Typing Reaction of Cells Tested Red Cell ABO Reaction of Serum Tested Reverse ABO With Group Against Group Anti-A 0 + 0 + Anti-B 0 0 + + O A B AB A1 Cells + 0 + 0 B Cells + + 0 0 O A B AB Expected results .

• The process of transferring whole blood or blood components from one person (donor) to another (recipient). Blood Transfusion . • Blood can be provided from two sources: Autologous or Donor blood.

RBC Compatibility .

• If a transfusion reaction is suspected during blood administration. and clinical management.• Transfusion reactions require immediate recognition. the safest practice is to stop the transfusion and keep the intravenous line open with 0. laboratory investigation. Blood Transfusion Reactions .9% sodium chloride (normal saline).

(Up to months following) Classification .• Acute (Immediate) reactions : Symptoms appear within minutes or up to 24 hrs post transfusion. • Delayed reactions : Reactions occurring more than 24 hours following transfusion.

Immediate Adverse Effects & Their Management .

Immediate Adverse Effects & Their Management .

Immediate Adverse Effects & Their Management .

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