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ABO Rh Typing: Difference between revisions

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|B, AB
|B, AB
|}
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Most to least H-antigen: O > A2 > B > A2B > A1 > A1B (subgroups used for organ donation)
* Most people are A1
ABO Antibodies
* Develop 'naturally' regardless of exposure to blood products (may be similar to structures found in bacteria, pollen, etc.)
** Non-red cell immunity
* Takes time to develop (3-6 months) in infants
{| class="wikitable"
|+
!Blood Group
!Antibodies Present
!Class
|-
|Group A
|Anti-B
|IgM
|-
|Group B
|Anti-A
|IgM
|-
|Group AB
| colspan="2" |None
|-
|Group O
|Anti-A
Anti-B
Anti-A,B
|IgM
IgM
IgG
|}
IgG antibodies can cross placenta, but IgM usually doesn't (except in trauma)
ABO Typing
ABO Typing
* Babies: perform forward testing ONLY
* Babies: perform forward testing ONLY

Revision as of 00:14, 13 February 2025

The ABO system is the most clinically significant blood group system in transfusion medicine.

  • Carbohydrate antigens
  • Non-RBC stimulated: individuals possess ABO antibodies to the antigens that they lack
  • IgM
  • Cause severe transfusion reactions
    • Cell lysis and hemolysis

ABO Genes

  • A and B genes present on chromosome 9
    • Code for transferase enzymes, which transfer sugar to a precursor on the RBC membrane
  • A and B co-dominant, O is recessive
  • One allele received from each parent
  • Cis-AB inheritance
    • Rare situation where A and B genes end up on same chromosome during crossover
    • Can result in AB mother and OO father having AB baby

H Gene

  • Present on chromosome 19
  • H gene codes for a fucosyl transferase (FUT 1) that produces H antigen
    • Precursor to A and B antigens
  • H allele frequency >99.99%
    • hh is Bombay phenotype
      • Produces anti-H antibodies

ABO Antigens

  • Carbohydrates attached to RBCs via gene-encoded transferase
  • A and B antigens are sugars attached to terminal end of oligosaccharides
  • O group has H terminal antigen instead of A or B
H A B
Gene Product (Enzyme) L-fucosyltransferase N-acetylgalactosaminyltransferase D-galactosyltransferase
Dominant/Terminal Sugar L-fucose N-acetyl-galactosamine D-galactose
Groups A, B, AB, O A, AB B, AB

Most to least H-antigen: O > A2 > B > A2B > A1 > A1B (subgroups used for organ donation)

  • Most people are A1

ABO Antibodies

  • Develop 'naturally' regardless of exposure to blood products (may be similar to structures found in bacteria, pollen, etc.)
    • Non-red cell immunity
  • Takes time to develop (3-6 months) in infants
Blood Group Antibodies Present Class
Group A Anti-B IgM
Group B Anti-A IgM
Group AB None
Group O Anti-A

Anti-B Anti-A,B

IgM

IgM IgG

IgG antibodies can cross placenta, but IgM usually doesn't (except in trauma) ABO Typing

  • Babies: perform forward testing ONLY
  • Babies: if baby appears Rh Negative and the mother is Rh Negative, perform weak D testing
  • AB Rh Positive patients require Rh Control to be performed
    • RHC should be a reaction of 0. This checks that the agglutination seen is not a result of autoagglutination in the patient.
  • Rh Control is also used for discrepancies (Rh testing results don't match, e.g. Anti-D1 is 2+ and Anti-D2 is 0)
  • Rh Control is also used for IAT Testing (e.g., Weak D testing)