Blood Groups, Blood Typing &

Blood Transfusions

Irina Datikashvili-David
History

In the year of 1901

Karl Land Steiner
discovered the
classical ABO
system and was
given Nobel Prize
in 1930.
* 1. The most important Blood
Group systems are:
1. ABO system
2. Rh system
3. MNS system
Less important blood group systems:
1. Lutheran
2. Kell
3. Lewis
4. Duffy
5. Bombay, etc…..
 The ABO blood group system is the most
important blood type system (or blood group
system) in human blood transfusion.
 The ABO blood group system wasdiscovered
by the Austrian scientist Karl Landsteiner,
who found three different blood types in
1900,he was awarded the Nobel Prize in
Physiology or Medicine in 1930 for his work.
 Blood has two main components: serum
and cells. Karl Landsteiner, a physician at
the University of Vienna, Austria, noted that
the sera of some individuals caused the red
cells of others to agglutinate.
 Two years later, two of his students
discovered the fourth and rarest type,
namely AB.
 Alleles at a locus independent of the ABO
blood group locus, known as the secretor
locus, determine an individual's ability to
secrete the ABO blood group substances in
saliva and other body fluids.
 There are two genes, Se and se, where Se is
dominant to se. In other words, an individual
with at least one Se gene is a secretor.
 The antigens expressed on the red blood cell
determine an individual's blood group. The
main blood groups are called ABO (with blood
types A, B, AB, and O) and Rh (with Rh D-
positive or Rh D-negative blood types).
 Blood type O is the most common worldwide,
followed by group A. Group B is less common,
and group AB is the least common.
 H(or O)

GalNAc transferase

 A substance
 H(or O)

Gal transferase

B substance
 In the case of the ABO blood groups, the
antigens are present on the surface of the
red blood cell, while the antibodies are in
the serum.
 Individuals with type A blood can receive
blood from donors of type A and type O
blood.
 Individuals with type B blood can receive
blood from donors of type B and type O
blood.
 Individuals with type AB blood can receive
blood from donors of type A, type B, type
AB, or type O blood.
 Individuals with type O blood can receive
blood from donors of only type O.
 Individuals of type A, B, AB and O blood can
receive blood from donors of type O blood.
Type O blood is called the universal donor.
*2. Land Steiner’s law
1. If an agglutinogen is present on red cells of
blood, the corresponding agglutinin must
be absent from the plasma.
2. If the particular antigen is absent, the
corresponding antibody must be present.
Note: The 2nd law is a fact, but not must .
Ex. Absence of Rh antigen is not accompanied by
the presence of anti-Rh antibody.
A. Classical ABO System
 Classical ABO System

Group A
Group B

Group AB
Group O
 Classical ABO System

Plasma Plasma Plasma

Plasma
 Classical ABO System
Blood Antigens (Agglutinogens) on Antibodies (Agglutinins)
Type Red Blood Cells in Plasma

A A Anti-B

B B Anti-A

AB A&B None

O Neither Anti-A & Anti-B

Note: A has 2 sub units: A1 and A2

Percentage of Distribution
of ABO Blood Groups
B. Inheritance of ABO System
[Formation of the A antigen]

RBC

Glucose

Galactose

N-acetyl glucosamine

Galactose

N-acetylgalactosamine
Fucose
 * 3. Basis of ABO Blood Group
ABO agglutinogens
1. The fructose containing ‘H ag” is the basic ag found
in all individuals

2. In case of ag A, N acetyl galactosamine as terminal

sugar on H ag

3. In ag B the terminal sugar is galactose

4. In AB persons both transferases are present while in

O group none of the enzymes present.
Formation of the B antigen
RBC

Glucose

Galactose

N-acetylglucosamine

Galactose

Galactose
Fucose
*4. How an individual gets his/her
Blood Group
Gene received from Group of of offspring Genotype
parents
A+A A AA

A+O A AO

B+B B BB

B+O B BO

A+B AB AB

O+O O OO
 ABO agglutinins
• These are natural antibodies and belongs
to Ig M and so do not cross the placental
barrier.

• These are called cold agglutinins because

they react better between 5-20˚c

• They appear after birth due to exposure

to A and B antigens, which may enter the
body along with food or bacteria
 Blood Typing/grouping/matching
Note : Typing is done on the basis of agglutination
Major and Minor Cross matching of blood

Donor’s Blood Patient’s blood

Mino
r Cro
s s ma
tchin
g
Plasma

at c hing
RBCs ros sm
o r C
Maj

Patient’s Plasma + Donor’s RBCs = Major Cross-Match

Donor’s Plasma + Patient’s RBCs = Minor Cross-Match

TASK: Mix and place a drop of plasma or RBC onto slide/test tube
Observe for Agglutination or Hemolysis.
31
Compatibility between the donors
cells and recipients serum
Anti- Donate Receive
Type Antigen Body To From
A A Anti - B A or AB A or O

B B Anti - A B or AB B or O
Universal
AB A+B Neither AB AB,A,B,O
Receiver

Universal
O None Both O,A,B,AB
Donor O
 The Rh System

• The second most important blood group in

humans is the Rhesus (Rh) system. Landsteiner
and Wiener discovered the Rh blood group in
1940. They found that when they injected
rabbits with Rhesus monkey blood; the rabbits
produced antibodies against the Rhesus red
cells.
• The Rh blood group system is the major cause
of hemolytic anemia in the newborn.
• A fetus who is Rh+ and whose mother is Rh− is
at high risk for this disorder, because the
mother will produce antibodies against the
fetal antigen.
• Anti-Rh+ antibody is injected into the mother
soon after her first delivery. This antibody
coats the fetal Rh+ cells in the mother's
circulation, which prevents them from causing
antibody production in the mother and,
therefore, her next child will not be at risk for
hemolytic anemia.
• Anti-Rh+ antibody is injected into the mother
soon after her first delivery. This antibody
coats the fetal Rh+ cells in the mother's
circulation, which prevents them from causing
antibody production in the mother and,
therefore, her next child will not be at risk for
hemolytic anemia.
 Examples of criteria for life-long donor exclusion
(permanent deferral).

• HCV, HIV, HTLV-I/II-positive, hepatitis of unknown origin

Homosexual and bisexual men, drug addicts, prostitutes,
prisoners, immigrants with a high rate of infection of HCVG,
HIV, HTLV-I/II in their home country, alcoholism History of
malaria, babesiosis, trypanosomiasis, leishmaniasis, syphilis,
brucellosis, rickettsiosis, leprosy, recurrent fever, tularemia,
osteomyelitis, malignant tumors (except cured basalioma and
similar), therapy with human hypophysis hormone, human
dura or cornea transplants, xenotransplants Suspicion of
Creutzfeldt–Jakob disease Current salmonellosis chronic
diseases when person endangers him-/herself or others by
the donation
Storage conditions of blood products. Maximum length
of Product Storage condition storage

• Cryoprecipitate and fresh frozen plasma −18

to −25◦C< 3 mo ≤25◦C 24 mo
• Granulocytes No storage possible
• Platelets 20–24◦C 5 days
• Red cells 2–6◦C 35–49 days, depending on
legislation and additive