BLOOD TYPES, BLOOD TRANSFUSION AND TISSUE/ ORGAN TRANSPLANT

The ABO and Rh blood grouping systems were discovered by an Austrian Scientist Karl Landsteiner, in
1901. These are the two main important blood grouping systems when considered during blood
transfusion. There are currently over 20 different blood grouping systems known.

For the ABO blood groups, its determination depends on the reaction between antigen and antibody.

There are 2 antigens on the surface of RBC’s: A antigen and B antigen. These antigens are also known as
Agglutinogens since they can cause agglutination or clumping of RBC’s.

In the plasma however, there are corresponding antibodies which are also known as agglutinins. These
antibodies are named anti-A or α-antibody and anti-B or β-antibody.

NOTE: a particular antigen (agglutinogen) and its corresponding antibody (agglutinin) cannot be
present on the same RBC at the same time, else it leads to clumping of RBC’s

There are 4 blood groups according to the ABO system and this is grouped based on the presence or
absence of Antigen A or Antigen B, namely;

i. ‘A’ group (has antigen A on RBC and B antibody in serum)

ii. ‘B’ group (has antigen B on RBC and A antibody in serum)
iii. ‘AB’ group (has both A and B antigen on RBC bit no antibody in serum)
iv. ‘O’ group (has no antigen on RBC but has both A and B antibody in serum)

Determination of an individual’s ABO group is known as blood grouping, blood matching or blood typing.

Isoagglutination: this happens when an antigen is mixed with its corresponding antibody E.g A antigen
mixed with anti- A antibody.

How to determine blood group

You will need;

i. Blood sample from the individual mixed with saline solution

ii. Test sera (antisera A containing anti- A antibody and test sera B containing anti-B antibody)
iii. Glass Slide

The procedure is done by

i. Drop both test sera on both ends of the glass slide (ends should be labelled for
identification purposes). 1 drop is enough.
ii. Add 1 drop of blood suspension to the test sera
iii. Gently tilt slide back and forth for 2 minutes
iv. Check both mixtures for agglutination or not

Result interpretation

i. if there is clumping / agglutination with antiserum A, It means that A antigen is present on

the RBC of that individual. Which means that this blood is group A blood
 ii. if clumping/ agglutination occurs with antiserum B, it means that B antigen is present on the
RBC of that individual, which means the blood group is B
iii. if clumping/ agglutination occurs with both antisera it means that there is both A and B
antigen on the RBC of that individual, which means the blood is group AB.
iv. If clumping does not occur with either antisera, it means that there is no antigen on the RBC
of this individual and the person is group O.

Universal donor
O blood group has no antigen on its RBC and thus no agglutination occurs when “O” blood is
transfused to another type. This Is why they can donate to all blood types and are called
universal donors. It is the commonest type of Blood group

Universal recipient
AB blood group has no antibody in its serum so they can receive from all blood types
without any agglutination taking place. They are called universal recipients. It is the rarest
type of blood group.

Inheritance of ABO blood groups

The gene for A and B are dominant while the gene for O is recessive.

Rh blood group system and Rh Factor (rhesus factor)

The Rh blood group system is a human blood group system just like the ABO system. The Rh factor is a
protein/ antigen on the surface of red blood cells. After the ABO blood group system, it is the most likely
to be involved in transfusion reactions

It was first discovered in Rhesus monkeys. There are over 50 types of Rhesus antigens present, however,
the D antigen is the most immunogenic.

An individual can either be Rh D + or – depending on whether they have the antigen on their RBC or not.

Difference between Rh and ABO system

 I. I Rh D does not have a corresponding natural antibody. Anti D is only gotten if an Rh + blood
is transfused to and Rh – person, then the recipient (Rh -)develops anti D but no
complication occurs vice versa.

The inheritance for Rhesus factor is dominant. It can be either homozygous positive (DD) or
heterozygous positive (Dd). A negative rhesus means that neither parent is carrying the gene.

Other types of blood groups are ;

i. Lewis group
ii. MNS group
iii. Auberger groups
iv. Diego group
v. Bombay group
vi. Duffy group
vii. Lutheran group

Blood transfusion

Blood transfusion is the process of transferring blood or blood components from one person (the
donor) into the bloodstream of another person (the recipient). It is a life saving act.

Before blood transfusion

i. Group and cross match blood for ABO and Rh compatibility

ii. Screen blood for infections e. HIV, Hep. B and C, syphilis
iii. Sterile equipment only should be used
iv. Blood to be warmed to body temperature of recipient
v. Transfusion to go slowly

Hazards of blood transfusion

Hazards of blood transfusion are of four types:

1. Reactions due to incompatible blood transfusion – transfusion reactions (fever, chills, acute kidney
failure, hemolytic reaction, shock, death)

2. Reactions due to massive blood transfusion (circulatory shock, hyperkalemia (stored blood),
hypocalcemia, hemosiderosis (accumulation of hemosiderin, in this case due to repeated transfusions) )

3. Reactions due to faulty techniques during blood transfusion; thrombophlebitis and air embolism

4. Transmission of infections;

Types of blood transfusion

I. Autologous: A.K.A self donation. Blood is taken from and individual and then reinfused later
when needed. i.e recipient and donor are same person.
II. Heterologous or allogenic: from one individual to another i.e donor and recipient are
different people.

Organ/ tissue transplant

Similar reactions can occur during organ transplant too since the RBC are present in the organs as well.

There are different types of transplant

I. Autograft : A transplant of a tissue or whole organ from one part of the same animal to
another part. E.g collecting skin flap from Sarah’s thigh to cover an injury on Sarah’s arm.
II. Isograft: transplant from one identical twin to another (genetically identical individuals).
III. Allograft: from one person to another or from an animal to another animal of the same
species, E.g sarah kidney being transplanted to Ella.
IV. Xenograft: from a nonhuman animal to a human or from an animal of one species to one of
another species. E.g a pigs heart being transplanted to a human.