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Transcript of Blood Physiology- cont. 1432 Lecture # 5 Blood Groups Professor A M Abdel Gader MD, PhD, FRCP...
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Blood Physiology- cont. 1432
Lecture # 5
Blood Groups
Professor A M Abdel GaderMD, PhD, FRCP (Lond., Edin), FRSH (London)
Professor of Physiology, College of Medicine &King Khalid University Hospital
King Saud UniversityRiyadh
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Objectives
At the end of this lecture student should be able to:
1.Describe ABO blood groups types2.Recognize Agglutinin in plasma3.Describe genetic inheritance of
Blood groups.4.Recognize transfusion reaction
Dr Sitelbanat 20115
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5. Describe Rhesus blood groups.6. Describe causes of hemolytic
disease of the newborn.
Objectives-cont
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Group A
A
Group A B
Group O
Group BB
AB
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BLOOD GROUPS
Determined by:Antigens (glycoprotein) on the surface
RBC
The chief blood groups are:Clinically most significant– A-B-O System– Rh (Rhesus) System
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The ABO system:
• Depends on whether the red cells contain one, both or neither of the two blood antigens:
A and B.• Four main ABO groups:
A, B, AB, O
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GroupBlood
Agglutinogen
Agglutinin
A
B
AB
O
A
B
A & B
-
Anti-B
Anti-A
-
Anti A+B
The ABO Blood groups
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The ABO system- cont.
•Anti-A & Anti-B are: naturally occurring antibodies.
• Not present at birth, appear 2-8/12
• Triggered by A & B antigens in food and bacteria
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Inheritance of blood groups Blood group Genotypes
A AA, AO B BB, BOO OOAB AB
Uses of genotypes:• Sorting disputes in paternal
dispute• Frequency of ABO has ethnic
variation
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Rhesus (Rh) Blood GroupDetermined by:• Presence or absence of the Rhesus
antigen (D) on the surface of RBC:
– Presence of D (individual is Rh+ve)
– Absence of D ( ‘ ‘ ‘ Rh–ve)
• Rhesus antigens: Dd, Cc, Ee
Clinically most important is D
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Rhesus (Rh) Blood Group
Anti-D antibody (agglutinin):
-Is not naturally-occurring-Can be acquired by:
i-Transfusion of Rh-ve individual with Rh+ve blood
ii-Rh-ve pregnancy with Rh+ve faetus.
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Importance of blood groups
1.Blood Transfusion.2.Rh incompatibilty between
mother and fetus
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Blood Transfusion
D O N OR
Patient
A B AB O
A - + + -B + - + -
AB (-) (-) - (-)O + + + -
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Agglutination in transfusion reaction• If a patient of blood group A
transfused with blood of group B
• The anti-B in plasma will agglutinate the transfused group B cells:
Outcome:– The clumped cells plug small blood
vessels (kidney shut down)– Sometimes immediate hemolysis
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21
Transfusion reactions(Incompatible Blood transfusion)
• If a person with blood group A transfused with blood of group B (contains anti-A in plasma)
• The anti-A in plasma of recipient blood group B will agglutinate the transfused cell (A)
• The clumped cells plug small blood vessels
• Sometimes causes immediate hemolysis
Transfusion reaction
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Complications of blood transfusion
1. Immune reaction: Incompatible blood transfusion leading to immediate or delayed reaction, fever, haemolysis, allergic reaction
2. Transmission of diseases; malaria, syphilis, viral hepatitis & Aids
3. Iron overload due to multi-transfusion in case of sickle cell anemia and thalassemia
Dr Sitelbanat 2011
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BLOOD DONORS
BLOOD BANKScreening
Blood components PrepStorage
ISSUE
HOSPITAL PATIENTS
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Blood tests before transfusion
1. Blood group type of patient (recipient)
2. Cross-matching
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Blood tests before transfusion
1. Blood group type of patient (recipient)
2. Cross-matching
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Blood tests before transfusion
1. Blood group type of patient (recipient)
• Look for agglutination
A drop of patient
RBC
Anti-A Anti-B Anti-D
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Agglutination Reaction
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Blood tests before transfusion
RBC Anti A Anti-B
O - -
A + -
B - +
AB + +
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Blood tests before transfusion
1. Blood group type of patient (recipient)
2. Cross-matching
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Blood tests before transfusion
1. Blood group type of patient (recipient)
2. Cross-matching
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Blood tests before transfusion
2. Cross-matching:
donor cells +
recipients (patient)serum
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Rh incompatibilty between
mother and fetus
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Rh incompatibilty between mother and fetus
• Mother Rh-ve first Rh+ve baby:
• At delivery– Fetal Rh+ RBC cross to maternal
blood
• The mother will develop Anti-D after delivery.
• First child escapes & is safe
(If the mother is transfused with Rh+ve blood before, first child will be affected)
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Rh incompatibilty between mother and fetus-cont.
• Second fetus– If Rh+ve– Anti-D crosses placenta and
destroys fetal Rh+ RBC
– Outcome?
Hemolytic Disease of the newborn
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Hemolytic Disease of the newborn
1. Hemolytic anemia:– If severe:
treated with exchange transfusion:Replace baby blood with Rh-ve RBC (several times)
2. Hydrobs fetalis (death in utero)
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Hemolytic Disease of the newborn-cont.
Prevention:• Injecting the mother with anti-D
immediately after 1st childbirth
• Antenatal (during pregnancY) prophylaxis
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Anti-D
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