II. Definitions

  1. Blood Type (Blood Group)
    1. Classification systems referring to Red Blood Cell surface Antigens
    2. ABO is the major Blood Group Based on the H Antigens on RBC surface (Antigen A, Antigen B)
    3. Minor Antigens include Rh (xD), Kell, Duffy (Fy-a, Fy-b), MNS, Kidd (Jk-a, Jk-b, Jk-3)

III. Background

  1. Blood agglutinates (forms Antibody-Antigen clumps) if exposed to Antibody to Antigens on it's cell surface
    1. See Hemagglutination
    2. Antigens are known as Agglutinogens (e.g. Type A Antigen, Type B Antigen)
    3. Antibodies are known as Agglutinins (e.g. xA, xB, xRh)
    4. RBC with Blood Type O will agglutinate (Transfusion Reaction) if exposed to Antibody to Type A or Type B Blood

IV. Types: ABO Blood Types (H Antigen on RBC surface)

  1. Blood Type A
    1. Presence of Group A Antigen on RBC surface
  2. Blood Type B
    1. Presence of Group B Antigen on RBC surface
  3. Blood Type AB
    1. Presence of both Group A Antigen and Group B Antigen on RBC surface
    2. Universal Recipient (can receive any Blood Type)
  4. Blood Type O
    1. Absence of Blood Group A Antigen and Group B Antigen on RBC surface
    2. Universal Donor (can donate to any Blood Type on Blood Transfusion)
      1. Can only receive Blood Type 0 on Blood Transfusion

V. Types: Rhesus (Rh, D)

  1. Rhesus group (Rh) includes 50 Antigens of which only 5 are important
  2. Rh status (Rh+ or Rh-) refers to D Antigen which is the most important Antigen
  3. Rh (xD) is of critical importance in maternal and child health
    1. Mothers without Antibody to xD (Rh-) are at risk of sensitization to Rh if fetus is Rh+ (from father)
    2. Mother who forms Antibody to Rh during one pregnancy will react to future Rh Positive fetus
    3. Rh Sensitization results in future pregnancy Hemolytic Disease of the Newborn (Erythroblastosis Fetalis)
    4. RhoGAM is given during pregnancy to prevent Rh Sensitization

VI. Types: Other Important Minor Blood Groups

  1. Kell
    1. Group compromised of 25 specific Antigens
    2. Third most potent immunogenic Antigen (behind ABO, Rh)
      1. Risk of Hemolytic Disease of the Newborn (Erythroblastosis Fetalis)
      2. Risk of Hemolytic Transfusion Reactions
  2. Duffy
    1. Fy Glycoprotein on surface of Red Blood Cells has 2 main Antigens (Fy-a, Fy-b)
    2. Risk of Hemolytic Transfusion Reactions
  3. Kidd
    1. Kidd Antigen (Jk Antigen) is a Glycoprotein on RBC surface involved in urea transport
    2. Three immunogenic Antigens have been found (Jk-a, Jk-b, Jk-3)
    3. Rare, but risk of severe Hemolytic Transfusion Reactions and Hemolytic Disease of the Newborn

VII. Types: Other Minor Blood Groups

  1. MNS (xM, xN)
    1. Primarily used in paternity cases
    2. Rarely involved in Transfusion Reactions

VIII. Labs

  1. Blood Type and Screen
    1. Identifies Major Blood Type (ABO) and common minor Antibody groups (e.g. Rh, Kell, Duffy, Kidd)
  2. Blood Type and Cross Match
    1. Performs Blood Type and Screen (as above) AND
    2. Blood Bank reserves specified units of matching blood and re-screens for signficant Antibody incompatibility

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