MINUTES OF SGD NO.

6 ABO SYSTEM
NAMES ROLES REMARKS

Bering, Margarette Hannah Leader Present

Aripin, Rizam Troy Secretary Present

Abellana, Lianne Anwen Member Present

Bantugan, Rhea Mae Member Present

Barcelita, Louis Raphael Member Present

Buenafe, Sebastien Andrei Member Present

Capundag, Kate Member Present

Dela Peña, Hannah Elisha Emmanuelle Member Present

Dela Torre, Thiara Francine Member Present

Ditan, Mardi Member Present

Escaño, Gabriel Connor Member Present

I. Call to Order
Laboratory preceptor of Group 1 BSMT - 1H for Health Science Laboratory, Ms. Jamie Therese F. Go, ordered
the meeting to start at 6:35 PM on November 11, 2022.

II. Agenda
- To tackle the ABO System through a case study
- To discuss NC’s condition
- Discuss and answer the questions from Guide Questions of Case No.6

III. Discussion
Mr. Ditan started the SGD through his introduction and reading NC’s CBC result followed by Mr. Buenafe who
described NC’s condition.
Ms. Bantugan was the one tasked with explaining Landsteiner's Law. She then stated that if the agglutinogen
is present in the RBC membrane, the agglutinin must be absent in the plasma, and if the agglutinogen is absent
on the RBC membrane, the agglutinin must be present in the plasma. She went on to explain that if a person has
Type A blood, the agglutinogen present in the RBC membrane is A antigen, and because A is a self agglutinogen,
it will not be treated as foreign by the agglutinin, so there will be no Anti-A agglutinin in the plasma. She went on
to say that if a person has Blood Type B, Antigen A is not present because the agglutinogen present in the RBC
membrane is B Antigen. As a result, if Antigen A is missing from the RBC membrane, it will be recognized as a
non-self, resulting in the presence of Anti-A antibody in the plasma.
Mr. Barcelita explained the antigens present in NC’s red blood cell (RBC) and the antigens that are present in
the donor’s blood. According to Mr. Barcelita, the antigens present in the RBC of the patient are A antigens, since
Blood Type A is characterised by the presence of solely A antigens present on the surface of the RBC. On the
other hand, the donor’s blood who had type AB blood, contains both A and B antigens on their blood.
Mr. Escaño was assigned to explain the antibodies present in NC's blood and transfused blood. Mr. Escano
answers that NC's blood contains anti-B antibodies, whereas transfused blood does not. Hemolysis occurred
because the body was unfamiliar with the B antigen in the AB blood. As a result, the naturally occurring anti-B
antibodies rejected the transfused blood.
Ms. Abellana discussed how ABH antigens are formed, stating that ABH antigens are produced by the
interaction of genes at three distinct loci, specifically the ABO, H, and Se genes. These genes produce
glycotransferases, which attach sugars such as N-acetylgalactosamine and D-galactose to a paragloboside or
glycan, resulting in distinct blood types. Even though the H and Se genes are not part of the ABO system, their
inheritance influences the production of A and B antigens. As a result, the H gene is inherited to produce ABO
antigens on RBCs, whereas the Se gene is inherited to produce ABO antigens in secretions.
 Ms Capundag distinguishes between forward and reverse typing in routine ABO testing and demonstrates the
expected results. Forward typing detects antigens on the sample, which is the patient's RBCs, using Anti-A and
Anti-B typing sera. According to Ms. Capundag, in forward typing, blood type A will agglutinate with Anti-A serum,
and the other blood types will follow with their corresponding serums. Reverse typing detects antibodies on the
sample, which is the patient's serum, using known A and B cells as reagents. In reverse typing, we use known A
and B cells; blood type A will agglutinate in B cells due to the presence of Anti-B antibodies, while blood type B
will agglutinate with known A cells due to the presence of Anti-A antibodies. No agglutination on both known cells
for blood type AB and there is agglutination in both cells for blood type O.
Ms. Bering was given the task of explaining what an Acute Hemolytic Transfusion Reaction (AHTR) is. She
went on to say that when significant amounts of incompatible plasma or red blood cells are transfused, acute
hemolytic transfusion reactions (AHTRs) can occur. The primary cause of AHTRs is ABO incompatibility. This
occurs when the recipient's plasma and the transfused RBC antigens are incompatible (for example, group A
RBCs in a recipient with group O RBCs) or, less frequently, when the transfused plasma contains antibodies
against the recipient's RBC antigens (e.g., group O plasma into group A recipient). Ms. Dela Peña was assigned
to explain the possible causes of the hemolytic transfusion reaction in NC's case, she then stated that The
disease's possible causes are specific to the disease. Preformed IgM antibodies typically cause severe hemolytic
reactions. The most common are caused by a mistake in patient identification or tube labelling, which allows a
patient to receive an ABO incompatible unit of blood. It is minor ABO incompatibility in this case.
Mr. Aripin further added causes of acute hemolytic transfusion reaction. The causes included None-ABO
antibodies which is the presence of antibodies to other blood groups, transfusion of ABO-incompatible plasma
which is a result from administration of incompatible plasma, Extravascular Hemolytic reaction which is the most
common cause that means that blood containing the antigen to which a patient has atypical IgG antibody,
erythrocyte auto-antibodies in the recipient, Acute Hemolysis induced by Cell Trauma like severe cardiac valve
disease, Glucose-6-Phosphate dehydrogenase deficiency wherein a patient lacks the ability to protect red blood
cells against oxidation, and in rare instances, bacteria is present in donated blood.
Ms. Dela Torre concluded the discussion after Mr. Aripin. She thanked everyone for their participation.

IV. Remarks
Questions Asked (Preceptor):
Ms. Jamie started with the first question which were What are the 3 Antigens? And a follow up question then
followed which is where can each of the Antigens be found? It was then answered by the students that the 3
Antigens are A,B, and H antigens. Antigen A can be found in blood types A and AB, Antigen B can be found in
blood types B and AB, and lastly, H antigen can be found in blood type O. Followed by her second question which
was what is a precursor? The group answered that precursor serves as the backbone for the blood types. Ms.
Jamie’s third question was How is H Antigen formed? And Oligosaccharide is also known as? The group
said that H antigen was formed through the precursor oligosaccharide and fucose. Oligosaccharide is also known
as paragloboside or glycan. The fourth question was about the sugars present to form this kind of blood type
which were What does H Antigen bind with to have Blood Type A? What is the enzyme for Antigen A? For
Blood Type B? For AB? For O? It was then answered that H Antigen binds with N-acetylgalactosamine to have
blood type A. Furthermore, The enzyme for Antigen A is ⍺-3-N-acetylgalactosaminyltransferase. H antigen binds
with D-galactose to produce blood type B. H antigen binds with both N-acetylgalactosamine and D-galactose to
form blood type AB. H antigen was only needed to have blood type O. The fifth question was about the two blood
typing Forward typing is also known as? What does forward typing try to find? What does reverse typing
try to find? Forward typing is also known as cell grouping, the forward typing is trying to find the antigen’s
presence in the RBC’s of the patient’s blood, while the reverse typing is looking for the antibodies in the patient's
serum. Followed by the sixth question which was Why did hemolysis happen to the patient? The group
answered that hemolysis happened due to the reason that the transfused blood which was Blood Type AB was
not compatible with the blood of the patient which was Blood Type A. The last question was: What is RH? Does
it matter if a person is O+ but the transfused blood is O-? RH is known as Rhesus factor and that if an O+
person is transfused with O- blood, at first, the group answered that it would matter but later changed since O- is
the universal donor, thus, making it compatible with an O+ blood type.

Remarks: Ms. Jamie suggested to read more about RH Factor.