Blood groups

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By Dr. Chethan H. A.

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Blood groups:

Blood groups Dr. Chethan H. A.

Online physiology discussion forum:

Online physiology discussion forum www.facebook.com/physiologymbbs IA – 21 st onwards

Karl Landsteiner law:

Karl Landsteiner law Discovered the ABO Blood Group System in 1901 He and his five co-workers began mixing each others red cells and serum together and inadvertently performed the first forward and reverse ABO groupings http://www.nobelpreis.org/castellano/medizin/images/landsteiner.jpg

ABO:

ABO 400 antigens and 30 blood group systems Precursor antigen 19 th chromosome ABO antigens 9 th chromosome A Two types – A1 contains A and A1, A2 contans A only B – 4 types, but less important

Location:

Location The presence or absence of the ABH antigens on the red blood cell membrane is controlled by the H gene The presence or absence of the ABH antigens in secretions is indirectly controlled by the Se gene

B Subgroups:

B Subgroups B subgroups occur less than A subgroups B subgroups are differentiated by the type of reaction with anti-B, anti-AB, and anti-H B 3 , B x , B m , and B el

Bombay:

Bombay The hh causes NO H antigen to be produced Results in RBCs with no H, A, or B antigen (patient types as O) Bombay RBCs are NOT agglutinated with anti-A, anti-B, or anti-H (no antigens present) Bombay serum has strong anti-A, anti-B and anti-H, agglutinating ALL ABO blood groups What blood ABO blood group would you use to transfuse this patient??

Rh :

Rh Percentage of ABO Percentage of Rh No naturally occuring antibodies IgG type – cross placenta

Other blood groups:

Other blood groups MN – paternity test Lewis – Lea and Leb – antibodies are IgM Li - L and i antigens – neonates have more i than L.. in haemoglobinopathies i proportion increases Duffy – Fya,Fyb , Fyab – Fyab resistant to P.viax . Kell – K antigen – are susceptible to chronic granulomatous disease

HDN:

HDN Icterus gravid neonatorum Erythroblastosis fetalis Heamolytic disease of newborn Hydrops fetalis Kernicterus Cause Treatment

Applications of blood group:

Applications of blood group Blood transfusion Rh incompatibility Paternity disputes Ethnology Medico legal cases Knowing susceptibility to disease

Average Percents…:

Average Percents… Type O—46% Type A—40% Type B—10% Type AB—4%

Indications of blood transfusion:

Indications of blood transfusion Blood loss Anemia Bonemarrow failure Purpura Clotting diseases

Types of blood transfusion:

Types of blood transfusion Whole blood Packed cell transfusion Leucocyte transfusion Platelet transfusion Cyroprecipitate Fresh frozen plasma Conditioned plasma Artificial blood – perfluro compound Plasma expanders – dextran, mannitol Autologous transfusion Blood doping Exchange

Complicatiions of blood transfusion:

Complicatiions of blood transfusion Due to mismatch – shivering – fever, haemoglobinemia and haemoglobinuria , jaundice, renal failure, hyperkalemia Due to faulty technique – thrombophlebitis , air embolism Massive transfusion – cardiac arrhythmias – hyperkalemia Febrile reaction Citrate toxicity Allergic reaction Diseases – hepatitis, malaria, AIDS, syphilis

Signs and Symptoms of AHTR:

Signs and Symptoms of AHTR Chills , fever Facial flushing Hypotension Renal failure DIC Chest pain Dyspnea Generalized bleeding Hemoglobinemia Hemoglobinuria Shock Nausea Vomitting Back pain Pain along infusion vein

PowerPoint Presentation:

Treatment Antihistamines, corticosteroids Stop infusion, Fluid therapy and osmotic diuresis Alkalinization of urine (increase solubility of Hb degradation products) Correct bleeding, Rx. DIC

Care in blood transfusion:

Care in blood transfusion Typing Cross matching Major Minor Reverse Absolute indication Never transfuse Rh positive to Rh negative person especially females Bag should be cross checked Aseptic precaution Speed of transfusion Watching patients condition

Blood storage and blood transfusion :

Blood storage and blood transfusion 4degree centigrade, disodium hydrogen citrate reduce ph better. Should be used within two weeks . 14ml of CPD-A per 100ml CPD-A – 35 days Red cell changes – increase in sodium and reduced potassium in cell, cell swell, WBC and platelets are absent, hemolyse , reduced ATP ,

PowerPoint Presentation:

Converting A, B, AB into O blood group Coomb’s test

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