Running Head: THE CIRCULATORY SYSTEM 1

The Circulatory System: Blood Elements, Clotting, and the ABO and Rh Blood Groups

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The Circulatory System: Blood Elements, Clotting, and the ABO and Rh Blood Groups

1. Which of the formed elements would increase after the donation of a pint of blood

and why?

Following a transfusion of a pint of blood, the formed elements that are more likely to

increase in number are erythrocytes (red blood cells or RBCs). The reason is that RBCs are the

most abundant created elements in blood [approximately 4-6 million per mm3 (μl) of blood].

This represents approximately 45 percent of the total blood content, while plasma accounts for

55 percent, and the rest 1 percent consists of leucocytes (white blood cells or WBCs) and

thrombocytes (platelets). RBCs are abundant because they perform the critical function of

transporting oxygen from the lungs to the rest of the body and carbon dioxide from these other

parts of the body back to the lungs for exhalation (Marieb & Smith, 2016).

2. Describe the three phases of the normal blood-clotting process.

Blood coagulation or clotting is purposely intended to reduce excessive blood loss when

blood vessels rupture. Interaction of several plasma elements (procoagulants or clotting factors)

and others ingredients produced by injured tissues and platelets is required for this process to

proceed effectively (Periayah, Halim, & Saad, 2016). The process of clotting takes place in the

following three steps. In the first phase, the damaged platelets and tissues release platelet factor

(PF) 3 and tissue factor (TF), respectively. These elements activate the clotting cascade or

mechanism. In the second phase, PF3 and TF interact with other calcium ion and other clotting

factors, and in the process forming prothrombin factor – which transforms plasma prothrombin

into thrombin. The last step is the enzymatic polymerization of plasma fibrinogen proteins by

thrombin into an insoluble material known as fibrin. The fibrin is responsible for forming the

mesh-like strands that trap RBCs. This lays the groundwork for clots (Marieb & Smith, 2016).
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3. Describe the ABO and Rh blood groups.

Blood typing refers to the process of classifying blood depending on the specific

glycoproteins present on the external surfaces (plasma membrane) of red blood cells. These

proteins are usually known as agglutinogens or antigens, and are determined genetically.

Typically, blood types are classified based on the presence of antigens A, B, or both and the

presence of the rhesus factor. In the ABO blood types, the agglutinogens (antigens) occur

together with plasma proteins known as agglutinins or antibodies. Today, several blood typing

methods exist, depending on many potential antigens, but the elements commonly typed for

include the antigens for Rh blood groups and ABO blood groups. There are four types of ABO

blood groups: A, B, AB, and O. People with blood group A carry the "A" antigen on their RBC

plasma membranes, whereas their plasma contains Anti-B. In the U.S., it is estimated that nearly

40 percent of whites, 27 percent of Blacks, and 28 percent of Asians have blood type A. On the

other hand, people with blood type B carry the "B" antigen while their plasma contain Anti-A

antibodies. Estimates suggests that 11 percent of Whites, 20 percent of Blacks, and 27 percent of

Asians in the U.S. are blood group B. The AB blood group individuals have antigens A and B

but no antibodies. This makes them universal recipients. Approximately 4 percent of Whites, 4

percent of Blacks, and 5 percent of Asians are blood group AB. Finally, blood group 'O' people

lack antigens on their RBC membranes but carry anti-B and Anti-A proteins in their plasma.

These individuals are universal donors. Roughly 45 percent of White, 49 percent of Black, and

40 percent of Asian Americans carry this blood type.

For the Rh blood types, people whose RBCs contain the Rh antigen are described as

being Rh-positive (roughly 85 percent of people in the United States), while those without the Rh

antigen are Rh-negative. Contrary to ABO blood types, neither Rhesus negative or Rhesus
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positive people carry preformed anti-Rhesus agglutinins (antibodies). However, people who are

Rhesus negative can develop these antibodies when transfused for the first time with Rhesus

positive blood. These antibodies can react with Rhesus antigen when such people receive Rh-

positive blood in the future. This would result in clumping or agglutination and eventually cell

hemolysis.

4. Explain the antigen-antibody response as it relates to blood groups.

As mentioned above, blood types are classified based on the presence of antigens A, B, or

both and the presence of the rhesus factor. In the ABO blood types, the agglutinogens (antigens)

occur together with plasma proteins known as agglutinins or antibodies. Typically, these plasma

proteins react with antigens absent on the individual's "own" red blood cells. It means that if the

blood group does not fit with that of the recipient, the antibodies in the recipient's plasma are

more likely to react with the antigens on the surface of the RBCs. This results in a process

known as agglutination or clumping and subsequently hemolysis. This is the primary reason why

blood typing is necessary before any transfusion is performed. For example, agglutination and

hemolysis is likely to occur when a recipient who is blood group A gets transfused blood type B.

In this case, the clumping occurs because the recipient is carrying Anti-B antibodies in his/her

plasma, which automatically reacts with antigen B found on the plasma membrane of the donor

blood (Marieb & Smith, 2016).

However, there is no agglutination when blood group O is transfused to all other blood

types because there are no antigens in the RBC cell membranes in these blood groups. Blood

group individuals are often known as universal donors. On the other hand, no clumping occurs

when other types of blood are donated to AB blood group recipients because they lack

antibodies. These individuals are known as universal recipients. Finally, the same antibody-
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antigen interaction is expressed in rhesus blood groups. However, as mentioned above, both Rh-

negative and Rh-positive people do not have preformed antibodies. Rh-negative people are the

ones that can only develop anti-Rh antibodies once exposed to Rh-positive blood, and they

would react to subsequent exposures to Rh-positive blood, causing clumping and hemolysis

(Alhabbab, 2018).
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References

Alhabbab, R. Y. (2018). Basic serological testing. Springer International Publishing.

Marieb, E. N., & Smith, L. A. (2016). Human anatomy & physiology laboratory manual (12th

ed.). Pearson.

Periayah, M. H., Halim, A. S., & Saad, A. Z. (2016). Mechanism action of platelets and crucial

blood coagulation pathways in hemostasis. International Journal of Hematology-

Oncology and Stem Cell Research, 11(4), 319-327.