presented by abhi raj....

1. BLOOD GROUP
AND
TRANSFUSION
PRESENTED BY ABHI RAJ
B.SC[OTT] STUDENT
DEPARTMENT OF ANESTHESIA
AIIMS NEW DELHI

2. OVERVIEW
1. CLASSICAL ‘ABO’ BLOOD GROUP
• KARL LANDSTEINER’S LAW
• INHERITANCE OF CLASSICAL BLOOD GROUP
2. RHESUS[RH] BLOOD GROUP
3. RH INCOMPATIBILITY [HEMOLYTIC DISEASE]
4. USE OF BLOOD GROUPING TESTS
• BLOOD TRANSFUSION,INVESTIGATION-A CASE OF PATERNITY DISPUTE
5. BLOOD STORAGE

3. Specific Learning Objectives
1. Distinguish between ABO and Rh blood group
2. Importance of matching of blood type before
administering a transfusion

4. CLASSICAL ‘ABO’ BLOOD GROUP
• 1901 Began studies of blood antigens, blood transfusion,
genetic inheritance of blood, use of blood type.
• Karl Landsteiner identified and named the blood group A, B,
AB, O in 1909.
• Received the Nobel prize in 1930.

5. LANDSTEINER’S LAW
If an antigen is present in the RBCs of an individual, the corresponding antibody
must be absent from the plasma.
If an antigen is absent in the RBCs of an individual, the corresponding antibody
must be present in the plasma.
BLOOD TYPES AGGLUTINOGENS AGGLUTININS
A A Anti – B
B B Anti – A
AB A and B -
O - Anti – A and Anti – B

6. INHERITANCE OF CLASSICAL BLOOD GROUP

7. Rhesus[Rh] blood group
• DISCOVERED BY LANDSTEINER AND WIENER IN 1940
KARL LANDSTEINER[1868-1943] A.S WIENER[1907-
1976]

8. How was the discovery done
• Animals Used in this process
1.Rhesus monkey with red Ischial Callosity
2.Rabbit

9. Methods Involved
• Firstly RBC of Rhesus monkey injected into rabbit’s body.
• Rabbit responded to antigen present on the RBC of monkey and formed
antibody against the antigen.
• Then the immunized Rabbit serum tested against human RBC then agglutination
occur in 85% of people and they were called as [Rh+].
• And no agglutination occur in 15% of people and they were called as [Rh-].
• Rh blood group system has not been detected in tissue other than RBC.

10. Distribution of Rh group Individual in india
STATE Rh+ Rh-
Jammu and Kashmir 90% 10%
Punjab 94% 6%
Delhi 95% 5%
South India 97.7% 2.3%

11. Rh Antigen[D] And Antibody[anti-d]
• Blood group are the result of action of gene which are present on 6 no
chromosome in case of D antigen.
• Gene of rh factor is called as D.
• DD=Homozygous
• Dd=heterozygous
• dd=homozygous
• As the gene of rh factor follows the LAW OF DOMINANCE given by Gregor
Johann Mendel;ie individual with [DD ,Dd] will be Rh+.

12. Rh Antibody
• Rh Antibody is of IgG Type.
• Rh antibody are also called warm antibody as agglutination reaction occur best
at body temperature.
• Rh antibody are not naturally present in the plasma of Rh- person, but
production Rh antibody can be evoked by…….
1. Transfusion with rh positive blood group in Rh negative
individual.
2.Entrance of D-positive RBC from Rh foetus into the maternal
circulatation of [Rh-]
mother [0.5 ml will be sufficient].

13. HOTS
• Which groups of individual will be affected, If we
inject anti-d in both rh+ and rh- group
individual???

14. Important Note
• C,D And E Are three types of Rh antigens ,The type D antigen is widely prevalent
in the population and is more antigenic than the other rh antigen .Due to more
antigenic nature of rh antigen so we just concider rh antigen during blood
examination.

15. Rh Factor and hemolytic disease
• As the name suggest that disease will be caused by break down of RBC.
• Break Down of RBC can take place by many ways, but in this ppt we will
learn about those breakdown that are cause by anti-d.
. Disease caused by anti-d
1.Hydrops foetalis
2.Erthroblastosis foetalis

16. Hydrops Foetalis

17. • Hydrops is a condition that occurs when large amount of fluid build up
in a baby’s tissue and organs causing extreme swelling.
• It either die in uterus or born prematurely and die within a few hours
• TYPES of hydrops fetalis
1.Immune
2. Non-immune

18. • IMMUNE
.occur when the mother’s immune system causes the baby’s red blood
cell to breakdown.
.most dangerous complication of hemolytic disease of newborn.
• Non Immune
.occur when disease or other complication interfere with the baby’s ability
to manage fluid.
.most common type.

19. Erythroblastosis Foetalis
• This complication occur only when-
.Mother is rh- and foetus is rh+
. This complication is mainly seen in 2nd child.
1.Infected child is born with jaundice or become so in 24 hour, due to excessive
destruction of RBC [hemolytic jaundice]
2.There may be no anaemia at birth but develops in few days. Because at
birth excessive blood loss is compensated by an intensive normoblastic response of
bone marrow, associated with high reticulocyte count and presence of many
nucleated RBCs

20. • Free anti-D [derived from mother] is present in infant’s blood for at least one
week after birth and continues to destroy the infant’s cells, till it get diminished.
3.There can be severe neurological disorder as blood brain barrier is not
completely developed in new born.
4.Liver may also be severely affected and death can occur due to liver failure.

21. BLOOD TRANSFUSION
• INDICATIONS : Alterations in blood either in quantity or quality that interferes with
the normal functions of the body.
1. Blood loss : accidents, surgical operations.
2. Blood disorders : hemophilia, sickle cell aneamia , clotting defects.
3. Blood diseases : severe anaemia, leukemia.
4. Poisoning : C0 poisoning.
5. Pre or post operatively in building up and making up the loss.
6. Shocks

22. USE OF BLOOD GROUPING TESTS
1. In blood transfusion.
2. In pregnancy(Rh incompatibility)
3. Investigate cases of paternity dispute.
4. Medicolegal value.
5. Blood group antigens help in cell recognition.

23. RULES FOLLOWED DURING BLOOD
TRANFUSION
• Group A And Group B Can Only Safely Receive Blood From There Own Group And
Group O.
• Person with blood group AB have no circulating agglutinins and can ,therefore ,be
given blood of any type without developing a transfusion reaction ,called universal
recipient.
• Persons with group O contain no agglutinogen and there blood can be given to any
one so called universal donor.
• But now these term are no longer valid as complication can occur due to existence of
rh and other factor .Therefore only safeguard against blood transfusion is Direct
cross matching. In direct matching there is direct matching of recipient serum with
• Very basic principle to be followed during blood transfusion is donor and receiver
blood group should be of same type.

24. Important note
• To eliminate the risk of transfusion reaction, patient’s
own blood can be withdrawn (1-1.5 L) 3-4 weeks in
advance of surgery and then reinfused during the
surgery ,a procedure called Autologous transfusion
• Anaemia resulting from withdrawal of blood can be made
good with appropriate iron therapy over the period of 3-
4 weeks.

25. BLOOD STORAGE
Characteristic features
1.For better long term preservation of blood cell and for transfusion purposes
citrate is used with dextrose in different form.
.Acid-citrate-dextrose solution
.citrate-phosphate-dextrose-adenine
under such condition blood can be stored for 14 days. 80% cell survive for 24
hours after transfusion and thereafter surviving cells are destroyed at a rate of 1%
per day.

26. 2.Stored blood is not a suitable medium for transfusing WBCs and platelets to a
recipient , because blood stored for longer than 24 hours contains virtually no
visible WBCs and platelets.
3.Cold storage decreases cell metabolism , thereby decreases active transport and
cation movesw with concentration gradient.

27. THANK YOU