Blood Groups, Blood Typing and Blood Transfusions Blood Groups, Blood Typing and Blood Transfusions The discovery of blood groups Experiments with blood transfusions, the transfer of blood or blood components into a person's blood stream, have been carried out for hundreds of years. Many patients have died and it was not until 1901, when the Austrian Karl Landsteiner discovered human blood groups, that blood transfusions became safer. Mixing blood from two individuals can lead to blood clumping or agglutination. The clumped red cells can crack and cause toxic reactions. This can have fatal consequences. Karl Landsteiner discovered that blood clumping was an immunological reaction which occurs when the receiver of a blood transfusion has antibodies against the donor blood cells. Karl Landsteiner's work made it possible to determine blood groups and thus paved the way for blood transfusions to be carried out safely. For this discovery he was awarded the Nobel Prize in Physiology or Medicine in 1930. What is blood made up of? An adult human has about 4–6 liters of blood circulating in the body. Among other things, blood transports oxygen to various parts of the body.

Blood consists of several types of cells floating around in a fluid called plasma. The red blood cells contain hemoglobin, a protein that binds oxygen. Red blood cells transport oxygen to, and remove carbon dioxide from, the body tissues. The white blood cells fight infection. The platelets help the blood to clot, if you get a wound for example. The plasma contains salts and various kinds of proteins. What are the different blood groups? The differences in human blood are due to the presence or absence of certain protein molecules called antigens and antibodies. The antigens are located on the surface of the red blood cells and the antibodies are in the blood plasma. Individuals have different types and combinations of these molecules. The blood group you belong to depends on what you have inherited from your parents. There are more than 20 genetically determined blood group systems known today, but the AB0 and Rh systems are the most important ones used for blood transfusions. Not all blood groups are compatible with each other. Mixing incompatible blood groups leads to blood clumping or agglutination, which is dangerous for individuals.

Nobel Laureate Karl Landsteiner was involved in the discovery of both the AB0 blood group (in 1901) and Rh blood group (in 1937). AB0 blood grouping system According to the AB0 blood group system there are four different kinds of blood groups: A, B, AB or 0 (null). Blood group A If you belong to the blood group A, you have A antigens on the surface of your red blood cells and B antibodies in your blood plasma. Blood group B If you belong to the blood group B, you have B antigens on the surface of your red blood cells and A antibodies in your blood plasma. Blood group AB If you belong to the blood group AB, you have both A and B antigens on the surface of your red blood cells and no A or B antibodies at all in your blood plasma. Blood group 0 If you belong to the blood group 0 (null), you have neither A or B antigens on the surface of your red blood cells but you have both A and B antibodies in your blood plasma. Rh factor blood grouping system Many people also have a so called Rh factor on the red blood cell's surface.

This is also an antigen and those who have it are called Rh+. Those who haven't are called Rh-. A person with Rh- blood does not have Rh antibodies naturally in the blood plasma (as one can have A or B antibodies, for instance). But a person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh- blood without any problems. Blood group notation According to above blood grouping systems, you can belong to either of following 8 blood groups: A Rh+ Do you know which blood group you belong to? Blood typing – how do you find out to which blood group someone belongs? 1. You mix the blood with three different reagents including either of the three different antibodies, A, B or Rh antibodies. 2. Then you take a look at what has happened. In which mixtures has agglutination occurred? The agglutination indicates that the blood has reacted with a certain antibody and therefore is not compatible with blood containing that kind of antibody.

If the blood does not agglutinate, it indicates that the blood does not have the antigens binding the special antibody in the reagent. 3. If you know which antigens are in the person's blood, it's easy to figure out which blood group he or she belongs to! A person with A+ blood receives B+ blood. The B antibodies (yellow) in the A+ blood attack the foreign red blood cells by binding to them. The B antibodies in the A+ blood bind the antigens in the B+ blood and agglutination occurs. This is dangerous because the agglutinated red blood cells break after a while and their contents leak out and become toxic. What happens when blood clumps or agglutinates? For a blood transfusion to be successful, AB0 and Rh blood groups must be compatible between the donor blood and the patient blood. If they are not, the red blood cells from the donated blood will clump or agglutinate. The agglutinated red cells can clog blood vessels and stop the circulation of the blood to various parts of the body. The agglutinated red blood cells also crack and its contents leak out in the body.

The red blood cells contain hemoglobin which becomes toxic when outside the cell. This can have fatal consequences for the patient. The A antigen and the A antibodies can bind to each other in the same way that the B antigens can bind to the B antibodies. This is what would happen if, for instance, a B blood person receives blood from an A blood person. The red blood cells will be linked together, like bunches of grapes, by the antibodies. As mentioned earlier, this clumping could lead to death. Blood transfusions – who can receive blood from whom? Of course you can always give A blood to persons with blood group A, B blood to a person with blood group B and so on. But in some cases you can receive blood with another type of blood group, or donate blood to a person with another kind of blood group. The transfusion will work if a person who is going to receive blood has a blood group that doesn't have any antibodies against the donor blood's antigens. But if a person who is going to receive blood has antibodies matching the donor blood's antigens, the red blood cells in the donated blood will clump.

People with blood group 0 Rh - are called "universal donors" and people with blood group AB Rh+ are called "universal receivers." Rh+ blood can never be given to someone with Rh - blood, but the other way around works. For example, 0 Rh+ blood can not be given to someone with the blood type AB Rh -. Blood Types: ABO System, Rh System, and Minor Blood Types Credits Your blood is typed, or classified, according to the presence or absence of certain markers ( antigens ) found on red blood cells and in the plasma that allow your body to recognize blood as its own. If another blood type is introduced, your immune system recognizes it as foreign and attacks it, resulting in a transfusion reaction. ABO blood type system The ABO system consists of A, B, AB, and O blood types. People with type A have antibodies in the blood against type B. People with type B have antibodies in the blood against type A. People with AB have no anti-A or anti-B antibodies. People with type O have both anti-A and anti-B antibodies. People with type AB blood are called universal recipients, because they can receive any of the ABO types.

People with type O blood are called universal donors, because their blood can be given to people with any of the ABO types. Mismatches with the ABO and Rh blood types are responsible for the most serious, sometimes life-threatening, transfusion reactions. But these types of reactions are rare. For every 1 million units of blood transfused, getting the wrong blood type happens, at the most, 4 times. 1 Transfusion with the wrong blood type can cause a severe reaction that may be life-threatening. 2 Rh system The Rh system classifies blood as Rh-positive or Rh-negative, based on the presence or absence of Rh antibodies in the blood. People with Rh-positive blood can receive Rh-negative blood, but people with Rh-negative blood will have a transfusion reaction if they receive Rh-positive blood. Transfusion reactions caused by mismatched Rh blood types can be serious. Minor blood types There are over 100 other blood subtypes. Most have little or no effect on blood transfusions, but a few of them may be the main causes of mild transfusion reactions. Mild transfusion reactions are frightening, but they are rarely life-threatening when treated quickly.

WebMD Medical Reference from Healthwise This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.© 1995-2015 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Next Article Human Blood: ABO Blood Types (1868-1943) The most well-known and medically important blood types are in the ABO group. They were discovered in 1900 and 1901 at the University of Vienna by Karl Landsteiner in the process of trying to learn why blood transfusions sometimes cause death and at other times save a patient. In 1930, he belatedly received the Nobel Prize for his discovery of blood types. All humans and many other primates can be typed for the ABO blood group. There are four principal types: A, B, AB, and O. There are two antigens and two antibodies that are mostly responsible for the ABO types. The specific combination of these four components determines an individual's type in most cases.

The table below shows the possible permutations of antigens and antibodies with the corresponding ABO type ("yes" indicates the presence of a component and "no" indicates its absence in the blood of an individual). It is easy and inexpensive to determine an individual's ABO type from a few drops of blood. A serum containing anti-A antibodies is mixed with some of the blood. Another serum with anti-B antibodies is mixed with the remaining sample. Whether or not agglutination occurs in either sample indicates the ABO type. It is a simple process of elimination of the possibilities. For instance, if an individual's blood sample is agglutinated by the anti-A antibody, but not the anti-B antibody, it means that the A antigen is present but not the B antigen. Therefore, the blood type is A. Genetic Inheritance Patterns Research carried out in Heidelberg, Germany by Ludwik Hirszfeld and Emil von Dungern in 1910 and 1911 showed that the ABO blood types are inherited. We now know that they are determined by genes on chromosome 9, and they do not change as a result of environmental influences during life.

An individual's ABO type results from the inheritance of 1 of 3 alleles (A, B, or O) from each parent. The possible outcomes are shown below: The possible ABO alleles for one parent are in the top row and the alleles of the other are in the left column. Offspring genotypes OO (O) Both A and B alleles are dominant over O. As a result, individuals who have an AO genotype will have an A phenotype . People who are type O have OO genotypes. In other words, they inherited a recessive O allele from both parents. The A and B alleles are codominant. Therefore, if an A is inherited from one parent and a B from the other, the phenotype will be AB. Agglutination tests will show that these individuals have the characteristics of both type A and type B blood. CAUTION: the inheritance of ABO blood types does not always follow such straightforward rules of inheritance. If you wish to explore the reason why this is true, select the Bombay Phenotype button below. Bombay Phenotype ABO Blood type antigens are not only found on the surface of red cells.

They are also normally secreted by some people in their body fluids, including saliva, tears, and urine. Whether someone is able to secrete them is genetically controlled. Police agencies now routinely use this so-called secretor system data to identify potential victims and criminals when blood samples are not available. Despite the fact that the blood types of children are solely determined by inheritance from their parents, paternity in the U.S. and many other nations can no longer be legally established based on conventional blood typing. To do that, it is necessary to compare HLA types and/or DNA sequences. The use of DNA is more accurate in determining paternity, but it is also more expensive than HLA typing. Antibodies to alien antigens in the ABO group are usually present in our plasma prior to the first contact with blood of a different ABO type. This may be partly explained by the fact that these antigens are also produced by certain bacteria and possibly some plants. When we come in contact with them, our bodies may develop long-term active immunity to their antigens and subsequently to the same antigens on the surface of red blood cells. This usually occurs in babies within the first six months following their birth.

Environmental Factors While blood types are 100% genetically inherited, the environment potentially can determine which blood types in a population will be passed on more frequently to the next generation. It does this through natural selection . Specific ABO blood types are thought to be linked with increased or decreased susceptibility to particular diseases. For instance, individuals with type A blood are at a somewhat higher risk of contracting smallpox and developing cancer of the esophagus, pancreas, and stomach. People who are type O are at a higher risk for contracting cholera and plague as well as developing duodenal and peptic ulcers. Research suggests that they are also more tasty to mosquitoes. That could be a significant factor in contracting malaria. NOTE: A small number of people have two different ABO blood types. They are not simply AB codominant. Apparently, most of these blood chimera individuals shared a blood supply with their non-identical twin before birth. In some cases, people are unaware that they had a twin because he or she died early in gestation and was spontaneously aborted. As many as 8% of non-identical twins may have chimeric blood.

Some people are microchimeric--they have a small amount of blood of a different type in their system that has persisted from a blood transfusion or passed across the placental barrier from their mother before birth. Likewise, fetal blood can pass into a mother's system. This fact has led some researchers to suggest that the significantly higher frequency of autoimmune disorders in women is a result of the presence of foreign white blood cells that had come from their unborn children during pregnancy. NEWS: An international team of researchers led by Henrick Clausen of the University of Copenhagen, Denmark have discovered a bacterial enzyme that can convert red blood cells of types A, B, and AB into O by stripping away their identifying surface antigens. This has the potential for dramatically improving the safety of blood transfusions. Clinical trials of this technique are now underway. ("Bacterial Glycosidases for the Production of Universal Red Blood Cells", published online in Nature Biotechnology, April 1, 2007.) NEWS: A research team led by Peer Bork of the European Molecular Biology Laboratory in Heidleberg, Germany discovered that people can be classified into one of 3 distinct types based on the kinds of bacteria in their guts. They refer to them as enterotypes.

This type system is independent of blood types and may have equally important implications for peoples' health. How enterotypes are established is not known, but the authors suggest that babies may be randomly colonized by different species of bacteria and that they alter the gut so that only certain species of bacteria can live there. ("Enterotypes of the Human Gut Microbiome", published online in Nature, April 20, 2011.) ABO BLOOD GROUP SYSTEM by M. Schroeder and M. Jensen ABO BLOOD GROUP SYSTEM Definition: Blood group system A series of antigens exhibiting similar serological and physiological characteristics, and inherited according to a specific pattern. Importance of the ABO system: Most important (clinically significant) Blood Group System for transfusion practice Why? This is the only blood group system in which antibodies are consistently, predictably, and naturally present in the serum of people who lack the antigen. Therefore ABO compatibility between donor and recipient is crucial since these strong, naturally occurring A and B antibodies are IgM and can readily activate complement and cause agglutination. If ABO antibodies react with antigens in vivo, result is acute hemolysis and possibly death.

Indications for ABO grouping: ABO grouping is required for all of the following individuals: Blood Donors-since it can be life threatening to give the wrong ABO group to the patient. Transfusion recipients-since we need to know the donor blood is ABO compatible. Transplant Candidates and Donors-ABO antigens are found in other tissues as well. Therefore the transplant candidates and donors must be compatible. Prenatal Patients-To determine whether the mothers may have babies who are suffering from ABO-HDN. It is also beneficial to know the ABO group should she start hemorrhaging. Newborns (sometimes) If the baby is demonstrating symptoms of Hemolytic Disease of the Newborn, the ABO group needs to be determined along with Rh and others. Paternity testing Since the inheritance of the ABO Blood Group System is very specific, this serves as one of the first methods to determine the likelihood that the accused father is the father or not. Discovery of the ABO system: In 1900 Karl Landsteiner reported a series of tests, which identified the ABO Blood Group System. In 1910 he won Nobel prize for medicine for this discovery.

He mixed the serum and cells of all the researchers in his lab and found four different patterns of agglutination. From those studies he developed what we now know as Landsteiner's rules for the ABO Blood Group: A person does not have antibody to his own antigens Each person has antibody to the antigen he lacks (only in the ABO system) Below are the four blood groups and the antigens and the expected, naturally-occurring antibodies present. BLOOD GROUP Incidence (%) of ABO Blood Groups in the US Population ABO Group 4 ABO Typing ABO typing involves both antigen typing and antibody detection. The antigen typing is referred to as the forward typing and the antibody detection is the reverse typing The forward typing determines antigens on patient's or donor's cells a. Cells are tested with the antisera reagents anti-A, anti-B, (and in the case of donor cells anti-A,B) b. Reagents are either made from hyperimmunized human sources, or monoclonal antibodies. c. One advantages of the monoclonal antibodies are the antibody strength. d. Another advantage of monoclonals: human source reagents can transmit infectious disease (hepatitis).

Reverse typing determines antibodies in patient's or donor's serum or plasma a. Serum tested with reagent A1 cells and B cells b. Reverse grouping is also known as backtyping or serum confirmation Routine ABO Typing Reaction of Cells Tested With Red Cell ABO Group Reaction of Serum Tested Against Reverse ABO Group AB Discrepancies in ABO typing Results of forward and reverse typing must agree before reporting out blood type as seen in the about table. If forward and reverse do not agree, must identify cause of discrepancy. If cannot resolve discrepancy, must report out blood type as UNKNOWN and give group O blood Characteristics of ABO antigens: ABO antigens are glycolipid in nature, meaning they are oligosaccharides attached directly to lipids on red cell membrane. These antigens stick out from red cell membrane and there are many antigen sites per red blood cell (approximately 800,000) Besides their presence on red blood cells, soluble antigens can be present in plasma, saliva, and other secretions. These antigens are also expressed on tissues other than red cells. This last fact is important to consider in organ transplantation. ABO antigens are only moderately well developed at birth.

Therefore ABO-HDN not as severe as other kinds of Hemolytic Disease of the Newborn. . Characteristics of ABO antibodies: These are expected naturally occurring antibodies that occur without exposure to red cells containing the antigen. (There is some evidence that similar antigens found in certain bacteria, like E.coli, stimulate antibody production in individuals who lack the specific A and B antigens.) Immunoglobulin M antibodies, predominantly They react in saline and readily agglutinate. Due to the position of the antigen and the IgM antibodies it is not necessary to overcome the zeta potential. Their optimum temperature is less than 30oC, but reactions do take place at body temperature Not only are these antibodies expected and naturally occurring, they are also commonly present in high titer, 1/128 or 1/256. They are absent at birth and start to appear around 3-6 months as result of stimulus by bacterial polysaccharides. (For this reason, newborn blood is only forward typed.) ABO INHERITANCE actual genetic information for a trait carried on each chromosome (ex.

O/O or A/O) dominant: the expressed characteristic on one chromosome takes precedence over the characteristic determined on the other chromosome (ex. A/O types as A) co-dominant: the characteristics determined by the genes on both chromosomes are both expressed - neither is dominant over the other (ex. A/B types as AB) recessive: the characteristic determined by the allele will only be expressed if the same allele is on the other chromosome also (ex. can type as O only when genotype is O/O) ABO Genes The A and B genes found on chromosome #9. We inherit one gene (allele) from our father and one from our mother. The two co-dominant alleles are A or B. Anytime an individual inherits an A or B gene it will be expressed. The O gene signifies lack of A or B antigens. It is not expressed unless this gene is inherited from both parents (OO). Therefore the O gene is recessive. Below is the example of two individuals who are A. One inherited only one A gene along with an O gene and is therefore heterozygous. The other inherited 2 A genes and is homozygous for A.

1 = A/A Can Contribute Only an A Gene to Offspring Can Contribute A or O Gene to Offspring Inheritance Patterns We can't determine genotypes of A or B people unless family studies are done. Some basic rules of ABO inheritance are as follows: A/A parent can only pass along A gene A/O parent can pass along either A or O gene B/B parent can only pass along B gene B/O parent can pass along either B or O gene O/O parent can only pass along O gene AB parent can pass along either A or B gene ABO phenotypes and genotypes 1. Group A phenotype = A/A or A/O genotype 2. Group B phenotype = B/B or B/O genotype 3. Group O phenotype = O/O genotype 4. Group AB phenotype = A/B genotype Offspring possibilities Possibilities of an A/O mating with a B/O: (Children's genotypes in purple) Mother's Genes BO BIOCHEMISTRY OF THE ABO SYSTEM The ABO antigens are terminal sugars found at the end of long sugar chains (oligosaccharides) that are attached to lipids on the red cell membrane. The A and B antigens are the last sugar added to the chain.

The "O" antigen is the lack of A or B antigens but it does have the most amount of next to last terminal sugar that is called the H antigen. Production of A, B, and H antigens The production of A, B and H antigens are controlled by the action of transferases. These transferases are enzymes that catalyze (or control) addition of specific sugars to the oligosaccharide chain. The H, A, or B genes each produce a different transferase, which adds a different specific sugar to the oligosaccharide chain. To understand the process let's look at the sequence of events: Precursor chain of sugars is formed most frequently as either Type 1 or Type 2 depending on the linkage site between the N-acetylglucosamine (G1cNAc) and Galactose (Gal). H gene causes L-fucose to be added to the terminal sugar of precursor chain, producing H antigen (shown in this diagram of a Type 2 H antigen saccharide chaine).

Either A gene causes N-acetyl-galactosamine to be added to H substance, producing A antigen, (shown in this diagram) or B gene causes D-galactose to be added to H substance, producing B antigen. If both A and B genes present, some H-chains converted to A antigen, some converted to B antigen. If H gene absent (extremely rare), no H substance can be formed, and therefore no A or B antigen. Result is Bombay blood group. Bombay blood group: The Bombay blood group lacks H gene and therefore cannot make H antigen (H substance). Since the H substance is the precursor for the A and B antigens, these antigens also are not made. The cells type as O and the serum has anti-A, anti-B, and anti-H since the individual lacks all of these antigens. Anti-H agglutinates O cells. The only cells Bombay individuals do not agglutinate are from other Bombay blood people since they lack the H antigen, Subgroups of A and B The subgroups of A and B are caused by decreased amounts of antigen on the red blood cells. They are inherited conditions. The most common are subgroups of A.

Approximately 80% of the A's and AB's have a normal expression of A1. Most of the other 20% are either A2 or A2B. This subgroup has fewer H chains converted to A antigen ï¿½ result is more H chains on red cell, and fewer A antigens. A small percentage of the individuals There are other, weaker subgroups of A exist: A3; Aint; Am, Ax; Ael. Each has a different pattern of reacting with anti-A, anti-A, and various antibody-like substances called lectins. Lectins Lectins are extracts of seeds of plants that react specifically with certain antigens. The two most common lectins used in Blood Bank are: Ulex europaeus, or lectin H, which agglutinates cells that have H substance. Dolichos biflouros, or lectin A1, which agglutinates cells with A1. Lectin-H reacts strongest with O cells, which has a high concentration of H antigen, and weakest with A1 cells, which have a low concentration of H.

Lectin often in serum Problems with Ax: Because Ax cells initially type as O and serum usually has anti-A1, (along with anti-B), patient forwards and reverses as O. Unfortunately when Ax is transfused into an O individual, the naturally occurring anti-A,B will react with the donor cells causing a transfusion reaction. Therefore: To prevent Ax from being erroneously typed as O, confirm all group O donors with anti-A,B. OBJECTIVES ï¿½ ABO SYSTEM Explain why the ABO system is the most important for blood transfusion practice. List the situations in which an ABO type would be required. Describe 6 significant characteristics of ABO antigens. Describe 6 characteristics of ABO antibodies. Explain how the ABO system was discovered. State Landsteiner's rules. List the blood groups in the ABO system, the antigen(s) present on the e cell in each blood group and the antibody(ies) in the serum for each, for adults. State the differences in ABO antigens and antibodies in newborns.

State which ABO groups could safely receive a red cell transfusion from donors of each of the following blood types: A, B, AB, O State which ABO groups could safely receive a plasma transfusion from donors of each of the following blood types: A, B, AB, O Explain how ABO blood types are determined. Explain what is meant by forward and reverse grouping, backtyping, and serum confirmation. Explain what an ABO discrepancy is, and what must be done if the discrepancy cannot be resolved State the incidence of each ABO blood group in the Caucasian population, and how the percentages differ in the Black and Oriental populations. Define each of the following and give an example of each within the ABO system: a.gene Blood Transfusion : Blood Groups and Compatibilities Contact us Blood Groups and Compatibilities There are many blood groups in the human population including ABO, Rh, Kidd, Kell, Duffy, MNS and Lewis. The most important of these are ABO and RhD. Transfusion with ABO incompatible blood can lead to severe and potentially fatal transfusion reactions. RhD is highly immunogenic and can lead to red cell haemolysis in certain settings.

ABO antigens and antibodies The ABO blood group is the most important of all the blood group systems. There are four different ABO blood groups (see Table1), determined by whether or not an individual's red cells carry the A antigen, the B antigen, both A and B antigens or neither. Normal healthy individuals, from early in childhood, make red cell antibodies against A or B antigens that are not expressed on their own cells. These naturally occurring antibodies are mainly IgM immunoglobulins. They attack and rapidly destroy red cells carrying the corresponding antigen. For example, anti-A attacks red cells of Group A or AB. Anti-B attacks red cells of Group B or AB. Name of Blood Group A and B antigens nil If ABO incompatible red cells are transfused, red cell haemolysis can occur. For example if group A red cells are infused into a recipient who is group O, the recipient's anti-A antibodies bind to the transfused cells. An ABO incompatible transfusion reaction may result in overwhelming haemostatic and complement activation, resulting in shock, renal failure & death (for more information please click here ).

Rhesus D (RhD) antigen There are more than 40 different kinds of Rh antigens. The most significant Rh antigen is RhD. When RhD is present on the red cell surface, the red cells are called RhD positive. Approximately 80% of the Australian population are RhD positive. The remaining 20% of the population that lack the RhD antigen are called RhD negative. Antibodies to RhD develop only after an individual is exposed to RhD antigens via transfusion, pregnancy or organ transplantation. Anti RhD (or anti-D) antibodies destroy RhD positive red cells and can lead to haemolytic transfusion reactions. This is of particular importance in pregnancy where anti-D antibodies can cross the placenta from mother to unborn child and lead to haemolytic disease of the newborn. As a general rule, RhD negative individuals should not be transfused with RhD positive red cells, especially RhD negative girls and women of childbearing age. If transfusion of an RhD positive product to RhD negative recipient is unavoidable a haematologist should be consulted and administration of anti-D immunoglobulin considered. Are they compatible?

When a transfusion is given, it is preferable for patients to receive blood and plasma of the same ABO and RhD group. However if the required blood type is unavailable, a patient may be given a product of an alternative but compatible group as shown below. Blood Compatibility RhD Positive RhD Negative Note that Group O RhD negative (O negative) red cells have neither ABO nor RhD antigens on their surface. O RhD negative red cells are issued in emergency situations where life saving transfusion is required prior to completion of a crossmatch. Both RCH and RWH blood banks maintain a reserve of 5 emergency O RhD Negative red cells. (Click here for further information on emergency blood release). Group O is often referred to as the universal red cell donor. Group AB individuals have neither anti-A nor anti-B antibodies in their plasma. Group AB plasma can therefore be given to patients of any ABO blood group and is often referred to as the universal plasma donor. Avoiding ABO incompatible transfusions Most ABO incompatible transfusions occur as a result of improper patient identification at the time of collection of the pre-transfusion sample or administration of the blood product.

The pre-transfusion check is carried out at the bedside by 2 members of clinical staff to ensure the right blood is transfused to the right patient. Positive patient identification prior to blood sample collection and labelling the specimen tube at the bedside is critical for accurate sample collection. Other blood cell antigen-antibody systems There are many other antigen systems expressed on red cells, white cells and platelets. Transfusion can cause antibodies to develop in the recipient. Some of these antibodies can cause transfusion reactions or damage the foetus. The purpose of pretransfusion testing (or crossmatching) is to detect potentially harmful antibodies in a patient before transfusion and where possible select red cell units that will not react with them. Blood Type Chart: Facts & Information on Blood Group Types - Disabled World Blood Type Chart: Facts & Information on Blood Group Types Print Published: 2012-09-28 (Rev. 2016-05-30) - Contact: Ian Langtree at Disabled World Synopsis: Information regarding blood types including charts outlining donor compatibility and childs blood group from parents blood type.

About Blood Type (Group) A blood type (also called a blood group) is defined as the classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells (RBCs). A series of related blood types constitutes a blood group system, such as the Rh or ABO system. The frequencies of the ABO and Rh blood types vary from population to population. Main Document "While blood types are 100% genetically inherited, the environment potentially can determine which blood types in a population will be passed on more frequently to the next generation." When a person's blood is analyzed under a microscope distinct blood differences are visible. In the early 20th century, an Austrian scientist named Karl Landsteiner classified blood according to those differences. Landsteiner observed two distinct chemical molecules present on the surface of the red blood cells . He labeled one molecule "A" and the other molecule "B". Blood Type A - If the red blood cell has only "A" molecules on it. Blood Type B - If the red blood cell has only "B" molecules on it. Blood Type AB - If the red blood cell has a mixture of both "A" & "B" molecules.

Blood Type O - If the red blood cell has neither "A" or "B" molecule. Blood Type Facts: There are eight different common blood types, which are determined by the presence or absence of certain antigens, which are substances that can trigger an immune response if they are foreign to the human body. Since some antigens can trigger a patient's immune system to attack the transfused blood, safe blood transfusions depend on careful blood typing and cross-matching. There are 4 major blood groups determined by the presence or absence of two antigens (A and B) on the surface of red blood cells: Blood Group Has only B antigen on red cells (and A antibody in the plasma) AB Has both A and B antigens on red cells (but neither A nor B antibody in the plasma) O Has neither A nor B antigens on red cells (but both A and B antibody are in the plasma) In addition to the A and B antigens, there is a third antigen called the Rh factor, which can be either present (+) or absent ( - ). In general, Rh negative blood is given to Rh-negative patients, and Rh positive blood or Rh negative blood may be given to Rh positive patients.

The universal red cell donor has Type O negative blood type. The universal plasma donor has Type AB positive blood type. Donating Blood by Compatible Type: Blood types are very important when a blood transfusion is necessary. In a blood transfusion, a patient must receive a blood type compatible with his or her own blood type. If the blood types are not compatible, red blood cells will clump together, making clots that can block blood vessels and cause death. If two different blood types are mixed together, the blood cells may begin to clump together in the blood vessels, causing a potentially fatal situation. Therefore, it is important that blood types be matched before blood transfusions take place. In an emergency, type O blood can be given because it is most likely to be accepted by all blood types. However, there is still a risk involved. Blood Type AB- A- B- O- Finding Out Your Blood Type: It is easy and inexpensive to determine a person's ABO type from a few drops of blood. A serum containing anti-A antibodies is mixed with some of the blood. Another serum with anti-B antibodies is mixed with the remaining sample. Whether or not agglutination occurs in either sample indicates the ABO type.

It is a simple process of elimination of the possibilities. For instance, if an individual's blood sample is agglutinated by the anti-A antibody, but not the anti-B antibody, it means that the A antigen is present but not the B antigen. Therefore, the blood type is A. Blood type is inherited, just like eye color. This chart shows the possible blood type of a child according to their parents blood group: Parent 1 B AB Note: In most cases, blood typing is not conclusive when attempting to determine, include or exclude an individual as the parent of a child or children. While blood types are 100% genetically inherited, the environment potentially can determine which blood types in a population will be passed on more frequently to the next generation. It does this through natural selection. Specific ABO blood types are thought to be linked with increased or decreased susceptibility to particular diseases. What Does Blood Group RH Factor Mean RH factor in blood types stands for "Rhesus Factor". Blood tests were performed on Rhesus monkeys and the Rh+ and Rh- factors were isolated.

An antigen found in the red blood cells of most people: those who have Rh factor are said to be Rh positive (Rh+), while those who do not are Rh negative (Rh-). What about the meaning of RHD- Rh blood group, D antigen . The rhesus complex is not just one antigen, but several, when someone is told to be Rh+, it usually refers to the D antigen (one of the components of the Rh complex), because it's the most common, and the easiest to identify, however it's not the only one. What is the Rarest Blood Type According to the American Red Cross the rarest is AB(-), present in 1% of the Caucasians, in African Americans it is even rarer. B(-) and O(-) are also very rare, each accounting for less than 5% of the world's population. Some people with rare blood types bank their own blood in advance of surgical procedures to ensure that blood is available to them. Blood Type Diet: The Eat Right for Your Type diet encourages people to eat certain foods and avoid others based on their blood type A, B, AB, or O.

The Diet is Based on: Type A ("for agrarian") - Flourishes on vegetarian diets, "the inheritance of their more settled and less warlike farmer ancestors," says D'Adamo. The type A diet contains soy proteins, grains, and organic vegetables and encourages gentle exercise. Type B - The nomadic blood type B has a tolerant digestive system and can enjoy low-fat dairy, meat, and produce but, among other things, should avoid wheat, corn, and lentils, D'Adamo says. If you're type B, it's recommended you exercise moderately. Type O ("for old," as in humanity's oldest blood line) - Your digestive tract retains the memory of ancient times, says D'Adamo, so your metabolism will benefit from lean meats, poultry, and fish. You're advised to restrict grains, breads, and legumes, and to enjoy vigorous exercise. Type AB - Has a sensitive digestive tract and should avoid chicken, beef, and pork but enjoy seafood, tofu, dairy, and most produce. The fitness regimen for ABs is calming exercises. NOTE: Critics cite a lack of published evidence backing D'Adamo's blood type-based diet plan.

Blood Type and Your Personality: Legend has it that blood type tells about personality. In Japan, it's widely believed that blood groups predict personality traits - from temperament to compatibility, to what kind of lover you are to what type of foods you should be eating. For instance: Type A is calm and trustworthy; Type B is creative and excitable; Type AB is thoughtful and emotional; Type O is a confident leader. Printable Blood Group/Type Charts: Printable chart showing compatible blood types for receiving blood transfusions Printable chart showing possible blood type of a child according to their parents blood group Blood & Heart Awareness The red ribbon raises awareness of blood and heart diseases including Cardiovascular Disease, Congenital Heart Defects, Hemophilia, Hypertension, Lymphoma, and other conditions relating to the heart and human blood. Other awareness dates Facts: Blood Type A total of 35 human blood group systems are now recognized by the International Society of Blood Transfusion (ISBT). With regard to transfusions of packed red blood cells, individuals with type O Rh D negative blood are often called universal donors, and those with type AB Rh D positive blood are called universal recipients.

Many pregnant women carry a fetus with a blood type which is different from their own, which is not a problem A popular belief in Japan is that a person's ABO blood type is predictive of their personality, character, and compatibility with others. Rarest Blood Type: A blood type is considered rare if fewer than 1 in 1,000 people have them. One of the rarest blood types in the world is Rh-null, which lack any antigens in the Rh system. There are only 9 active donors in the community of rare blood donors that have Rh-null blood. Rh-null is considered a universal blood for anyone with a rare blood type within the Rh system. However, anyone who has Rh-null blood can only receive Rh-null blood in a transfusion. Statistics: Blood Group Your body carries around four to six liters (7 to 10.5 pints) of blood. About 5 million Americans need blood transfusions every year. Receiving blood from the wrong ABO group can be life threatening. Almost half (48%) of the UK population has blood group O, making this the most common blood group.

Blood Groups and Blood Types About Watch and Favorite Watch Watching this resources will notify you when proposed changes or new versions are created so you can keep track of improvements that have been made. Favorite Favoriting this resource allows you to save it in the “My Resources” tab of your account. There, you can easily access this resource later when you’re ready to customize it or assign it to your students. Blood Groups and Blood Types Red blood cells have surface-expressed proteins that define the self/not-self nature of the cells. Learning Objective Evaluate the ABO and Rhesus blood groups in terms of donors and recipients Key Points Surface-expressed proteins called antigens on red blood cells determine an individual's blood type. There are two types of antigen groups: the ABO system antigens and a Rhesus D antigen. Exposure to a blood group antigen that is not recognized as self will cause the immune system to make specific antibodies to the new blood group antigen, often leading to destruction of the cells. Knowing an individual's antigen type is important to ensure compatibility if a transfusion is needed. Blood type is inherited.

O type is the most common despite being a recessive gene because it is more highly expressed in the gene pool, while type A and type B are dominant (and type AB is codominant) but are less common because they are less expressed in the gene pool. Individuals may also be positive or negative for the rhesus D antigen in addition to their blood type. Rhesus D complications are common during fetal development if the parents differ in rhesus antigen expression. Terms Register for FREE to remove ads and unlock more features! Learn more Full Text Red blood cells have surface-expressed proteins that act as antigens, which are molecules that can illicit an immune system response. Red blood cells belong to different groups on the basis of the type of antigen that they express. Blood type determines compatibility for receiving blood transfusions from other people. The ABO Blood Group System If an individual is exposed to a blood group antigen (A or B) that is not recognized as self, the individual can become sensitized to that antigen. This will cause the immune system to make specific antibodies to a particular blood group antigen and form an immunological memory against that antigen.

These antibodies can bind to antigens on the surface of transfused red blood cells (or other foreign tissue cells), often leading to destruction of the cells by recruitment of other components of the immune system. Knowledge of an individual's blood type is important to identify appropriate blood for transfusion or tissue for organ transplantation . There are four blood types that differ based on the antigen expressed by the red blood cell and by the type of associated antibody found in the plasma . The type of antigen determines which blood types that blood type may safely be donated to, while the type of antibody determines which types of antigen (and types of blood) will be rejected by the body. This chart depicts blood type classification. Group A has a red blood cell type A, plasma antibody of anti-B, red blood cell antigen A. Group A has a red blood cell type B, plasma antibody of anti-A, red blood cell antigen B. Group AB has a red blood cell type AB, no plasma antibody, red blood cell antigens A and B. Group O has a red blood cell type ), plasma antibodies of anti-A and anti-B, no red blood cell antigen.

Blood group A individuals have the A antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the B antigen. Therefore, a group A individual can only receive blood from individuals of groups A or O types, and can donate blood to individuals of groups A or AB. Blood group B individuals have the B antigen on their surface of their RBCs, and blood serum containing IgM antibodies against the A antigen. Therefore, a group B individual can only receive blood from individuals of groups B or O, and can donate blood to individuals of groups B or AB. Blood Group AB individuals have both A and B antigens on the surface of their RBCs, and their blood serum does not contain any antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any group, but can only donate blood to another group AB individual. AB blood is also known as "universal receiver. " Blood group O individuals do not have either A or B antigens on the surface of their RBCs, but their blood serum contains IgM antibodies against both A and B antigens.

Therefore, a group O individual can only receive blood from a group O individual, but they can donate blood to individuals of any ABO blood group (i.e. A, B, O, or AB). O blood is also known as "universal donor. " Blood types are inherited and represent genetic contributions from both parents. The gene that codes for blood type contains three alelles: IA and IB which give type A and B blood and are dominant, and i, which is recessive and codes type O. Children will have blood types similar to their parents based on inheritance. The i allele is far more commonly expressed in the gene pool than IA and IB, which is why type O blood is the most common type despite being a recessive phenotype. Type AB is the rarest because it is the combination of less commonly expressed alleles, and is the result of codominance between IA and IB alelles. Rhesus Factor Many people also have the rhesus D (Rh) antigen expressed by their red blood cells. Those that are have Rh antigens are positive for Rh, while those that don't have it are Rh negative (ie. type O+ is type O with rhesus, type A- is type A without rhesus).

Rh positive individuals do not have the antibodies for the Rh factor, but can make them if exposed to Rh. Besides being a consideration for blood transfusion, parents who differ based on Rh status must be cautious to ensure that maternal antibodies do not destroy their child's red blood cells during fetal development, which can cause hemolytic anemia . Blood groups - NHS Choices Blood groups Blood groups Introduction There are four main blood groups (types of blood): A, B, AB and O. Your blood group is determined by the genes you inherit from your parents. Each group can be either RhD positive or RhD negative, which means your blood group can be one of the eight types shown below (see the Rh system ). What is blood? Your body carries around four to six litres (7 to 10.5 pints) of blood. Blood is made up of red blood cells, white blood cells and platelets in a liquid called plasma. Plasma is about 90% water, but also contains proteins, nutrients, hormones and waste products. Blood is made up of about 60% plasma and 40% blood cells.

Each type of blood cell has a specific role to play: red blood cells carry oxygen around the body and remove carbon dioxide and other waste products; they give blood its red colour white blood cells are part of the immune system (the body's natural defence mechanism) and help fight infection platelets help the blood clot (thicken) to stop bleeding Antigens and antibodies Your blood group is identified by antigens and antibodies in the blood. Antibodies are part of your body's natural defences against invading substances such as germs. Antigens are protein molecules found on the surface of red blood cells. Antibodies are proteins found in plasma. Antibodies recognise anything foreign in your body and alert your immune system to destroy it. The ABO system There are four main blood groups defined by the ABO system: blood group A has A antigens on the red blood cells with anti-B antibodies in the plasma blood group B has B antigens with anti-A antibodies in the plasma blood group O has no antigens, but both anti-A and anti-B antibodies in the plasma blood group AB has both A and B antigens, but no antibodies Almost half (48%) of the UK population has blood group O, making this the most common blood group.

Receiving blood from the wrong ABO group can be life threatening. For example, the anti-A antibodies in a recipient with group B blood will attack the group A cells if transfused to them. This is why group A blood must never be given to a group B person. As group O red blood cells don't have any A or B antigens, it can safely be given to any other group. Matching blood groups | Australian Red Cross Blood Service Resources Matching blood groups Before you receive a transfusion, compatibility testing is performed between the donated blood and a patient's blood sample. When a transfusion is given, it is preferable for patients to receive blood of the same ABO and RhD group. However, in an emergency or special circumstance, if the same blood group isn’t readily available, a patient may be given another group that their immune system will not react to. What are antigens? Antigens are proteins or carbohydrates which our immune system can recognise. Any antigen that is ‘foreign’ to our immune system is destroyed by an antibody. What are antibodies? Antibodies are attack molecules our immune system makes to protect ourselves against foreign things such as bacteria and viruses. Antibodies can also be formed in response to different blood groups.

Everyone is born with some antibodies. What is the ABO group? A and B are different antigens on the surface of the red cells. O cells do not have either antigen. The type of antigen on your red cells is genetically determined. If you have the A antigen, you have Group A red cells. It is also possible to have both A and B antigens meaning your blood group is AB. What is Rh? The Rh blood group system has around 50 different red blood cell antigens. D is the most important antigen of the Rh system. It is also known as RhD. In Australia, approximately 83% of people will have the D antigen on their red cells. Their blood type is called Rh positive. The other 17% do not have the D on their red cells and are called Rh negative. The percentage of Rh negative people varies in different countries (eg. less than 5% of India’s population are Rh negative). An RhD negative person, with an RhD antibody, will destroy any RhD positive red cells they come in contact with. This may occur with a transfusion or when pregnant with an RhD positive baby.

Rh is very important for women who are or may become pregnant as the antibodies can cause problems for mother and baby. Red cell compatibility It is a general principle that red cell components of identical ABO group and RhD type as the recipient should be used for transfusion. As shown in the table below, 0 Rh negative is the universal red cell donor blood that can be given to all patients. This is common practice when a patient’s blood group is unknown and in emergency situations especially for women of child-bearing age. Plasma compatibility Plasma contains anti-A and anti-B antibodies depending upon the blood group. Our body also has antibodies to A and/or B antigens according to our blood group. Patients should only receive plasma that does not contain an antibody which could attack the antigens present on their own red cells. Group A recipients have A antigen on their red cells, so they can’t receive group O or group B plasma as the anti-A will attack their red cells. Group B recipients have B antigen on their red cells, so they can’t receive group O or group A plasma as the anti-B will attack their red cells. Group AB recipients can only receive group AB plasma.

Group O recipients do not have either A or B antigen, so can safely receive plasma of any blood group type. Platelet Compatibility ABO identical platelets are usually preferred. However, in some circumstances, the need for other special requirements may be more important than providing the same ABO group. This will be determined by the health care team overseeing your care. For more information please consult with your health care team. Resources Blood Groups Blood Groups Blood Groups (Human Biology, Human Anatomy & Physiology) Reminder about antigens and antibodies: Antigens are chemicals located on (that is, attached to) the surface of cells such as the red blood cells mentioned on this page. Antibodies are proteins produced by the body's immune system. They attack antigens on certain cells such as those on harmful bacteria that invade the body. Antibodies are specific to particular types of cells (more accurately, to particular antigens). For example, an antibody that attacks the antigens on a particular bacterium would not attack bacteria in general i.e. it would attack the specific bacteria, not any bacteria. Blood groups are defined according to the antigens and antibodies present in blood .

There are many types of blood and several blood group systems used to classify blood types (the terms 'blood types' and blood groups' are widely used interchangeably). The best known and most widely used blood group systems include the ABO blood group system and the Rh blood group system. The ABO blood group system is easy to explain because it is based on just two antigens (A and B) being either present, i.e. attached to the red blood cells (RBCs), or absent. The Rh (Rhesus) blood group system is more complicated because it involves consideration of the presence or absence of 50 defined blood-group antigens, of which the five antigens D, P, c, E, and e are the most important. A simple combination of the ABO blood group system with the Rh blood group system is widely used. This provides more information than the ABO system alone, while retaining enough simplicity for ease of use and understanding by many people - see below. ABO blood group system According to the ABO blood group system, blood can be classified into one of the four major blood types, which are: A, B, AB and O.

The symbols A, B, AB and O used to represent the four major blood types indicate which antigens (just A, just B, both A and B or neither A nor B) are present on the red blood cells. Blood that contains red blood cells of a particular type e.g. group A blood contains red blood cells with antigen A attached, also has (or does not have) particular antibodies present in the blood plasma . ABO blood groups indicate the combinations of antigens and antibodies present in the blood as follows: Blood Group neither A nor B both anti-A and anti-B Table 1: Antigens in RBCs and Antibodies in plasma for each of the 4 main blood groups Antibodies are specific. That is why the antibodies to antigen B (labelled 'anti-B' in the table above) in the blood plasma of group A blood do not attack the A antigens on the red blood cells of group A blood. However, the anti-A antibodies in group B blood plasma would attack the A antigens on the red blood cells of of group A blood if group B blood were given to a person whose blood type was group A.

Using the information in the table summarizing the antigens and antibodies in each of the four main blood types (above) it is possible to work out which types of blood can be safely donated to or received from people who have each of the four main types of blood. Blood Group any of these groups Table 2: Blood Transfusion between each of the 4 main blood groups Note that the above only takes into consideration the two antigens A and B and (antibodies to them), according to the ABO blood group system. In reality, various safety checks would normally take place prior to the donation or receipt of blood. For example, other possible antigens and antibodies may be taken into consideration and donated blood screened for transfusion transmitted infections (TTIs), the most common diseases transmitted via blood being viral infections such as HIV (see HIV in the news ) and forms of hepatitis (see hepatitis in the news ). Rh (Rhesus) blood group system (simple version) Although there are many Rh system antigens, the simplest and most common use of the Rh blood group system is in combination with the ABO blood group system.

In this case each of the four ABO blood groups A, B, AB and O are divided into two groups because each can be either Rhesus 'positive' (indicated by '+'), or Rhesus 'negative' (indicated by '-'). The Rhesus positive groups A+, B+, AB+ and O+ have the D antigen of the Rh blood group system, which is also known as 'the Rhesus factor', attached to red blood cells (RBCs). Conversely, the Rhesus negative groups do not have the Rhesus factor attached to RBCs.

Therefore, according to the (simple version of) the Rh blood group system, there are the following eight (8) blood groups: A+ which also called "A, Rhesus positive" and may be written "A RhD positive" or "A RhD+" (to emphasize that it is the Rhesus D antigen that is present) A- which also called "A, Rhesus negative" and may be written "A RhD negative" or "A RhD-" (to emphasize that it is the Rhesus D antigen that is absent) B+ which also called "B, Rhesus positive" and may be written "B RhD positive" or "B RhD+" (to emphasize that it is the Rhesus D antigen that is present) B- which also called "B, Rhesus negative" and may be written "B RhD negative" or "B RhD-" (to emphasize that it is the Rhesus D antigen that is absent) AB+ which also called "AB, Rhesus positive" and may be written "AB RhD positive" or "AB RhD+" (to emphasize that it is the Rhesus D antigen that is present) AB- which also

 called "AB, Rhesus negative" and may be written "AB RhD negative" or "AB RhD-" (to emphasize that it is the Rhesus D antigen that is absent) O+ which also called "O, Rhesus positive" and may be written "O RhD positive" or "O RhD+" (to emphasize that it is the Rhesus D antigen that is present) O- which also called "O, Rhesus negative" and may be written "O RhD negative" or "O RhD-" (to emphasize that it is the Rhesus D antigen that is absent) In all cases the "positive" means that, in addition to any other antigens present in the case of the ABO group concerned, the Rhesus Factor, which is the most immunogenic D antigen of the Rh blood group system is also attached to the red blood cells.

The Rhesus Factor is sometimes referred to as Rhesus D, RhD antigen or (when the context of the Rh blood group system is obvious), simply the D antigen. Examples of importance of blood groups Blood groups matter when there is a possibility of a person (or other animal for which blood groups are important, e.g. equines, pigs, rodents) receiving antibodies to antigens attached to their red blood cells. The main situations in which this might apply - hence blood tests are commonly used to determine blood type (blood group) are: Re. Blood Transfusions: Blood banks store blood according to blood type (blood group) Patients should ideally be carefully checked for blood type, receive only their own blood or a type-specific match, and if possible have donated blood cross-matched before receipt to minimize the risk of a transfusion reaction. This is not always possible, especially e.g. in emergency situations in remote areas. Note: Jehovah's Witnesses (JWs) do not accept blood transfusions for religious reasons.

Their decision in this matter is increasingly respected and has lead to medical advancements - initially to accomodate JWs, but also of benefit to others: "many of the techniques developed for use in Jehovah's Witness patients will become standard practice in years to come" from 'Continuing Education in Anaesthesia', Critical Care & Pain, 2004, Volume 4, No. 2, page 39 - reference from Re. Pregnancy: There may be concern due to, and action(s) taken against, the risk of complications due to mis-match between a pregnant woman's blood type and that of a fetus she is carrying. Note: The ABO blood group system is easy to explain and is included in many school biology courses e.g. GCSE Biology (UK). The Rh blood group system is also important and widely used but may not be included in some first-level courses in biology and/or human anatomy and physiology.

Question: Under the ABO blood group system, what blood type can receive blood transfusions from all other groups?
Answer: AB