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• KARL LANDSTEINER DISCOVERED ABO BLOOD
GROUP SYSTEM IN 1901
• DISCOVERED RH FACTOR IN 1930 ALONG
WITH ALEXANDER S. WIENER
• If an antigen /agglutinogen is present on the red cell membrane of
an individual, the corresponding antibody/agglutinin will be absent
in the plasma.
• If an antigen / agglutinogen is absent on the red cell membrane of
an individual, the corresponding antibody / agglutinin will be
present in the plasma.
ABO BLOOD GROUPING
• BLOOD GROUP A
If you belong to the blood group A, you
have A antigens on the surface of your
RBCs and B antibodies in your blood
• BLOOD GROUP B
If you belong to the blood group B,
you have B antigens on the surface
your RBCs and A antibodies in your
BLOOD GROUP AB
If you belong to the blood group AB, you
have both A and B antigens On the
surface of your RBCs and no A or B
antibodies at all in your blood plasma.
BLOOD GROUP O
If you belong to the blood group O (null),
You have neither A or B antigens on the
Surface of your RBCs but you have both A
and B antibodies in your blood plasma.
PRINCIPLE OF BLOOD GROUPING
• Blood grouping is done on the basis of agglutination. Agglutination
means the collection of separate particles like RBCs into clumps or
• Agglutination occurs if an antigen is mixed with its corresponding
antibody which is called isoagglutinin, i.e. Occurs when A antigen is
mixed with anti-A or when B antigen is mixed with anti-B.
• Almost all normal healthy individuals above 3-6 months of age have
“ naturally occurring antibodys” to the ABO antigens that they lack.
These antibodys termed naturally occurring because they were
thought to arise without antigenic stimulation
FORMATION OF H ANTIGEN
• The H antigen is the foundation upon
which A and B antigens are built
• A and B genes code for enzymes that
add a sugar to the H antigen
• Immunodominant sugars are present
at the terminal ends of the chains and
confer the ABO antigen.
BOMBAY BLOOD GROUP
• 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 group would you use to transfuse this patient??
• ANOTHER BOMBAY
• Group O RBCs cannot be given because they still have the H antigen
you have to transfuse the patient with blood that contains No H
• It is the most important blood group system after ABO.
• All Rh antigens are controlled by 2 genes – RHD gene– determines
expression of D , RHCE – encodes for C,c and E,e.
• RhD is a strong antigen (immunogenic) and other antigen are less
antigenic than D and are of less clinical significance.
• Therefore , in practice Rh negative and Rh positive depends on
presence of D antigen on the surface of red cells which is detected
by strong anti-D serum. Occasionally, anti – C,E,c,e may develop
in case of pregnancy or transfusion.
• Unlike ABO system there is no naturally occuring antibodies against
Rh antigens in Rh negative individuals. Immune ANTIBODYS develop
against Rh antigen after exposure to it following transfusion or
• It can be detected by enzyme treatment or coombs test(antiglobulin
• SIGNIFICANCE: Rh incompatibility results in haemolytic tranfusion
reaction. Haemolytic disease of newborn.
IMPORTANCE OF BLOOD GROUPING AND RH
• IN BLOOD TRANSFUSION
• HAEMOLYTIC DISEASE OF NEWBORN.
• PATERNITY DISPUTE
• MEDICOLEGAL ISSUES
• SUSCEPTIBILITY TO VARIOUS DISEASES (BLOOD GROUP O – PEPTIC ULCER, BLOOD
GROUP A – GASTRIC ULCER)
MINOR BLOOD GROUPS AND SIGNIFICANCE
1.Duffy blood group- lack glycoprotein DARC, which is receptor for
plasmodium vivax. So this blood group patients are not susceptible to
2. Kell blood group- very immunogenic . increased hemolytic disease
of new born.
3.Kidd blood group- increased hemolytic transfusion reaction.
UNIVERSAL DONOR AND RECIPIENT
NEITHER A OR B ANTIGENS
PATIENT HAS NO ANTI A/ANTI B
CANNOT LYSE ANY TRANSFUSED