Disusn Oleh:

dr. Husnil Kadri, M.Kes

ABO BLOOD GROUP

History
1. Landsteiners discovered the ABO Blood Group
System in 1901
2. He and five co-workers began mixing each
others red blood cells and serum together and
accidentally performed the ABO groupings.
3. Main Phenotypes (A, B, AB, O)
ABO gene located on long arm of chromosome
9

History of Blood Groups and Blood

Transfusions (Cont.)
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 types 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.

Inheritance of ABO Groups

Allele from
the mother

Allele from
the father

Genotype of
offspring

Blood types of
offspring

AA

AB

AB

AO

AB

AB

BB

BO

OO

O
4

http://learn.genetics.utah.edu/units/basics/blood/types.cfm

Blood Transfusions
A blood transfusion is a procedure in which blood is
given to a patient through an intravenous (IV) line in one
of the blood vessels. Blood transfusions are done to
replace blood lost during surgery or a serious injury. A
transfusion also may be done if a persons body can't make
blood properly because of an illness.

Rh + Can receive + or Rh - Can only receive -

Significance of ABO Group

ABO mismatched transfusions:
Rare
May be life threatening
Can be caused by technical or clerical error
Intravascular haemolysis
More severe in group O patients

The Rh(D) Antigen

RH is the most complex system, with
over 45 antigens
Discovered in 1940 after work on
Rhesus monkeys
Subsequently discovered to be unrelated
to monkeys
RH gene located on short arm of
chromosome 1
8

 Rh antigens are transmembrane proteins with

loops exposed at the surface of red blood cells.
They appear to be used for the transport of carbon
dioxide and/or ammonia across the plasma
membrane.
RBCs that are "Rh positive" express the antigen
designated D.

Simple Genetics of Rh(D)

86% of caucasians are Rh(D) pos
The antithetical antigen d has not been
found
The d gene is recessive:
Dd, dD, DD, persons are Rh(D) pos
Only dd persons are Rh(D) neg

10

Distribution of Rh(D) Types

11

Population

Rh(D) pos

Rh(D) neg

Caucasian

86%

14%

AfricanAmerican

95%

5%

Oriental

>99%

<1%

Significance of Rh(D)
80% of Rh(D) neg persons exposed to Rh(D)
pos blood will develop anti-D
Anti-D can also be stimulated by pregnancy with
an Rh(D) positive baby
Sensitisation can be prevented by the use of anti-D
immunoglobulin, antenatally and post natally

Rh(D) neg females of childbearing potential

should never be given Rh(D) positive blood
products
12

Inheritance of ABO and Rh(D)

Mother

Group A

Father

AO

Group B

Rh(D) pos Dd

BO

Rh(D) pos Dd

Group A AO

Group B BO

Group O OO

Rh(D) pos Dd

Rh(D) pos Dd

Rh(D) neg dd
13

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.

Why is an Rh incompatibility so dangerous

during pregnancy?
Most anti-A or anti-B antibodies are of the IgM class
(large molecules) and these do not cross the
placenta.
In fact, an Rh/type O mother carrying an
Rh+/type A, B, or AB foetus is resistant to
sensitisation to the Rh antigen.
Her anti-A and anti-B antibodies destroy any foetal
cells that enter her blood before they can elicit antiRh antibodies in her.

Rh incompatibility during pregnancy (cont.)

This phenomenon has led to an effective
preventive measure to avoid Rh sensitisation.
Shortly after each birth of an Rh+ baby, the
mother is given an injection of anti-Rh
antibodies (or Rhogam).
These passively acquired antibodies destroy
any foetal cells that got into her circulation
before they can elicit an active immune
response in her.

ABO antibodies

group A serum contains anti-B

group B serum contains anti-A
group AB serum contains no antibodies
group O serum contains anti-A, anti-B,
and anti-A,B

Anti-A1
Group O and B individuals contain anti-A
in their serum
However, the anti-A can be separated into
different components: anti-A and anti-A1
Anti-A1 only agglutinates the A1 antigen,
not the A2 antigen
There is no anti-A2.

Anti-A,B
Found in the serum of group O individuals
Reacts with A, B, and AB cells
Predominately IgG, with small portions
being IgM
Anti-A,B is one antibody, it is not a mixture
of anti-A and anti-B antibodies

ABO antibodies
IgM is the predominant antibody in Group
A and Group B individuals
Anti-A
Anti-B

IgG (with some IgM) is the predominant

antibody in Group O individuals
Anti-A,B (with some anti-A and anti-B)

ABO Antibodies
Usually present within the first 3-6 months
of life
Stable by ages 5-6 years
Decline in older age
Newborns may passively acquire maternal
antibodies (IgG crosses placenta)

Laboratory Testing:
ABO typing

ABO Blood Groups

ABO
Group

Antigen
Present

Antigen
Missing

Antibody
Present

anti-B

anti-A

None

A and B

anti-A, anti-B,
anti-A,B

AB

A and B

None

None

The ABO Blood Group System

Laboratory Determination of
the ABO System

Serology: This is a direct detection of the ABO

antigens. It is the main method used in blood
transfusion centres and hospital blood banks.
This form of testing involves two components:
a) Antibodies that are specific at detecting a
particular ABO antigen on RBCs.
b) Cells that are of a known ABO group that
are agglutinated by the naturally occurring
antibodies in the person's serum.

 Illustration of the forward and reverse

grouping reaction patterns of the ABO
groups using a blood group tile

http://www.bh.rmit.edu.au/mls/subjects/abo/resources/genetics1.htm

References
Aldahr MHS. ABO Blood Group. Faculty of Applied
Medical Sciences Blood Bank Medical Tecnology.
download 2011
Giacobbe. ABO & Rh(D) Blood Groups. Anatomy &
Physiology. Unit 9 Circulatory System.download 2011
Musani MI. Blood groups and Rhesus factor. Download
2011
Trimpe T. Blood Basics. Forensic Science.2006
Wilkins RN. ABO Blood Group System. University of
Mississippi Medical Center. Download 2011.