BMS 2135 Revision Notes

 Most important blood typing is ABO grouping

 A & B antigens are sugars carried on surface of RBCs. Type AB blood carries both antigens. Type
O has neither
 Simple Mendelian inheritance - A and B are co - dominant, O is recessive.
 Genes encode glycosyl transferases – NOT the Ag themselves
 Unusually, all individuals have antibodies to blood type antigens they do not possess
 Type A individuals - anti B; Type B anti A; Type AB no antibodies. Type O both anti A & anti B
 Donor blood must be matched or compatible with recipient or acute haemolytic transfusion
reaction can occur. --> “Shock” & often death of recipient
 Type O has no surface antigens
 Type AB individuals have no antibodies
 Forward grouping - Cells tested against standardised antibody reagents
 Reverse grouping - plasma tested against cells of known antigenic type
 Patient and donor should be cross matched - major: donor cells vs. recipient plasma. Minor:
Donor plasma vs. Recipient cells
 Bloods also generally typed for Rh status. 2nd most important blood group for transfusion. Rh
highly immunogenic.
 Rh has 2 major types Rh+ and Rh-
 About 85% of UK population are Rh+ (have the RhD antigen), 15% are Rh- (do not have the RhD
antigen)
 Inherited independently from ABO type - all ABO types can be either Rh+ or Rh-
 Does require prior exposure to RhD antigen to induce anti-RhD antibodies - only found in Rh-
individuals
 Incompatibilty between mother and fetus, most commonly at the RhD locus can cause HDFN
 Sensitisation of mother occurs at delivery
 Sensitisation leads to production of allo-antibody to RhD.
 Anti RhD is IgG -crosses placenta and attacks fetal RBCs - erythroblastosis fetalis
 Untreated -> post partum kernicterus –
 Treated with RAADP (Routine Antenatal Anti-D Prophylaxis) - in UK - injections of donor anti-D
to mother at 28 and 34 weeks gestation.
 Sufficient to prevent sentisation in >99% of cases
 Vol of FMH determined by Kleihauer-Betke test - count % fetal RBC in maternal blood
 Determination by flow cytometry
 ABO HDN occurs at low freq
 Usually mild - why?
 Minor Ag can also be the cause HDFN
 Some of these are serious