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Blood type

 
Sci-Tech Dictionary: ABO blood group
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(ā·bē′ō ′bləd ′grüp)

(immunology) An immunologically distinct, genetically determined group of human erythrocyte antigens represented by two blood factors (A and B) and four blood types (A, B, AB, and O).

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Genetics Encyclopedia: Blood Type
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Blood has two main components: serum and cells. In 1900 Karl Landsteiner, a physician at the University of Vienna, Austria, noted that the sera of some individuals caused the red cells of others to agglutinate. This observation led to the discovery of the ABO blood group system, for which Landsteiner received the Nobel Prize. Based on the reactions between the red blood cells and the sera, he was able to divide individuals into three groups: A, B, and O. Two years later, two of his students discovered the fourth and rarest type, namely AB.

Antigens and Antibodies

To understand blood typing, it is necessary to define antigen and antibody. An antigen is a substance, usually a protein or a glycoprotein, which, when injected into a human (or other organism) that does not have the antigen, will cause an antibody to be produced. Antibodies are a specific type of immune-system proteins known as immunoglobulins, whose role is to fight infections by binding themselves to antigens. In the case of the ABO blood groups, the antigens are present on the surface of the red blood cell, while the antibodies are in the serum. These antibodies are unique to the ABO system and are termed "naturally occurring antibodies." The table shows the relationships between blood types and antibodies.

Table 1

RELATIONSHIPS BETWEEN BLOOD TYPES AND ANTIBODIES
Blood TypeAntigens on Red Blood CellCan Donate Blood ToAntibodies in SerumCan Receive Blood From
AAA, ABAnti-BA, O
BBB, ABAnti-AB, O
ABA and BABNoneAB, O
ONoneA, B, AB, OAnti-A and anti-BO

This aspect of the ABO blood group system is very important in transfusion. Blood group O individuals are said to be universal donors, because their blood can be used for transfusion in individuals who have any one of the four blood types. On the other hand, individuals with blood type A can only donate to either type A or type AB, and individuals with blood type B can only donate to B or AB types. AB individuals can only donate to type AB. However, before any transfusions, donor blood is mixed with serum from the recipient (a process called cross matching) to ensure that no agglutination will occur after transfusion.

Multiple Alleles

The genetic basis of the ABO blood group system is an example of multiple alleles. There are three alleles, A, B, and O, at the ABO locus on chromosome 9. The expression of the O allele is recessive to that of A and B, which are said to be co-dominant. Thus, the genotypes AO and AA express blood type A, BO and BB express blood type B, AB expresses blood type AB, and OO expresses blood type O. In the past, ABO blood group typing was used extensively both in forensic cases as well as for paternity testing. More recently, DNA testing, which is much more informative, has superseded these tests.

The ABO blood group substances are glycoproteins, the basic molecule of which is known as the H substance. This H substance is present in unmodified form in individuals with blood type O. Adding extra sugar molecules to the H substance produces the A and B substances. The frequency of the ABO blood types varies widely across the globe. For example, blood group B has a frequency of 25 percent in Asians, 17 percent in Africans, but only 8 percent in Caucasians. The frequency of blood group O in Europe increases as one travels from southern to northern countries.

Alleles at a locus independent of the ABO blood group locus, known as the secretor locus, determine an individual's ability to secrete the ABO blood group substances in saliva and other body fluids. There are two genes, Se and se, where Se is dominant to se. In other words, an individual with at least one Se gene is a secretor. Approximately 77 percent of Europeans are secretors. This frequency is rarely less than 50 percent and sometimes as high as 100 percent in other populations.

An interesting aspect of the ABO blood groups is their association with disease. Among individuals with stomach and peptic ulcers, there is an excess of type O individuals, whereas among those with cancer of the stomach, there is an excess of type A individuals. Not all type O individuals have an increased risk for peptic or stomach ulcers, however. If type O individuals are secretors, they are protected against ulceration, whereas non-secretors have a two-fold increased risk. Thus the presence of ABO blood group substances act as a protective agent against the development of stomach and peptic ulcers.

The Rh System

The second most important blood group in humans is the Rhesus (Rh) system. Landsteiner and Wiener discovered the Rh blood group in 1940. They found that when they injected rabbits with Rhesus monkey blood; the rabbits produced antibodies against the Rhesus red cells. These antibodies reacted with red blood cells taken from 85 percent of Caucasians in New York City, who were thus said to be Rh positive, while the remaining 15 percent were Rh negative.

One year earlier (1939), Levine and Stetson published a paper describing the mother of a stillborn infant who had a severe reaction when transfused with her husband's blood. They tested the woman's serum and found that it reacted with 77 percent of blood donors. They postulated that the mother had been exposed to blood from her fetus and produced an antibody that reacted with it. The same antigen was present in the baby's father, explaining the woman's reaction to his blood. Their conclusion was correct, and later they realized that they had discovered the same antigen (Rh) that was discovered in the following year. The antibody found in the mother of the stillborn child was shown to be identical to the anti-Rh antibody produced in the rabbit by Landsteiner and Wiener.

The Rh blood group system is the major cause of hemolytic anemia in the newborn. A fetus who is Rh+ and whose mother is Rh− is at high risk for this disorder, because the mother will produce antibodies against the fetal antigen. The first such fetus is usually not at risk since the fetal cells do not enter the mother's circulation until the time of birth. Only at this time does the mother produce anti-Rh+ antibodies. This complicates future pregnancies, because her antibodies will enter the fetal circulation system and react with fetal blood, causing hemolysis.

A treatment for Rh− women at risk to have an Rh+ fetus is now widely used. Anti-Rh+ antibody is injected into the mother soon after her first delivery. This antibody coats the fetal Rh+ cells in the mother's circulation, which prevents them from causing antibody production in the mother and, therefore, her next child will not be at risk for hemolytic anemia.

The precise genetics of the complex Rh system has been in dispute since the early discoveries. The Rh blood group system is, in fact, much more complex than simply Rh+ and Rh−. There are two genes, one of which has four possible alleles, giving six antigens of which five are commonly tested. The first is D, which is the dominant gene that determines whether one is Rh+ or Rh−. Individuals with genotypes DD and Dd are Rh+ and those who are dd are Rh−. The DD and Dd genotypes cannot be distinguished from one another, since there is no "anti-d" antibody. The remaining four antigens are C, c, E, and e. The Rh locus is on the short arm of chromosome 1 and consists of two tandem genes. The first, RHCE, codes for non-RhD proteins while the second codes for the RhD protein. The Rh polypeptide has been sequenced. It contains 417 amino acids. Thus the molecular genetics conferring different antigenic Rh types is now clear.

Bibliography

Cavalli-Sforza, L. L., and W. F. Bodmer. The Genetics of Human Populations. San Francisco: W. H. Freeman and Company, 1971.

Huang, Cheng-Han, Philip Z. Liu, and Jeffrey G. Cheng. "Molecular Biology and Genetics of the Rh Blood Group System." Seminars in Hematology 37, no. 2 (2000): 150-165.

Race, R. R., and Ruth Sanger. Blood Groups in Man, 6th ed. Oxford, U.K.: Blackwell Scientific Publications, 1975.

Internet Resource

"Blood Types." Indiana State University. http://www.indstate.edu/thcme/mwking/abo-bloodgroups.gif.

—P. Michael Conneally

Health Dictionary: blood type
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One of many groups into which a person's blood can be categorized, based on the presence or absence of specific antigens in the blood. Blood type is inherited.

  • Blood transfusions can be given only between donors and recipients who have compatible types; if the types are not compatible, the blood of the recipient forms antibodies against the blood of the donor. There are four basic groupings — A, B, AB, and O — and within these groupings, the Rh factor may be present or absent.

    • Veterinary Dictionary: blood type
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    1. blood group.
    2. the phenotype of an individual with respect to a blood group system.

    Wikipedia: Blood type
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    Blood type (or blood group) is determined, in part, by the ABO blood group antigens present on red blood cells.

    A blood type (also called a blood group) is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system, and some of these antigens are also present on the surface of other types of cells of various tissues. Several of these red blood cell surface antigens, that stem from one allele (or very closely linked genes), collectively form a blood group system.[1]

    Blood types are inherited and represent contributions from both parents. A total of 30 human blood group systems are now recognized by the International Society of Blood Transfusion (ISBT).[2]

    Many pregnant women carry a fetus with a different blood type from their own, and the mother can form antibodies against fetal RBCs. Sometimes these maternal antibodies are IgG, a small immunoglobulin, which can cross the placenta and cause hemolysis of fetal RBCs, which in turn can lead to hemolytic disease of the newborn, an illness of low fetal blood counts which ranges from mild to severe.[3]

    Contents

    Serology

    If an individual is exposed to a blood group antigen that is not recognized as self, the immune system will produce antibodies that can specifically bind to that particular blood group antigen, and an immunological memory against that antigen is formed. The individual will have become sensitized to that blood group antigen. These antibodies can bind to antigens on the surface of transfused red blood cells (or other tissue cells), often leading to destruction of the cells by recruitment of other components of the immune system. When IgM antibodies bind to the transfused cells, the transfused cells can clump. It is vital that compatible blood is selected for transfusions and that compatible tissue is selected for organ transplantation. Transfusion reactions involving minor antigens or weak antibodies may lead to minor problems. However, more serious incompatibilities can lead to a more vigorous immune response with massive RBC destruction, low blood pressure, and even death.

    ABO and Rh blood grouping

    Agglutination of blood cells tested with antibodies for determination of blood type in the laboratory. The discovery of this type of agglutination was an important medical breakthrough.[4]

    Anti-A and Anti-B, the common IgM antibodies to the RBC surface antigens of the ABO blood group system, are sometimes described as being "naturally occurring"; however, this is a misnomer, because these antibodies are formed in infancy by sensitization in the same way as other antibodies. The theory that explains how these antibodies are developed states that antigens similar to the A and B antigens occur in nature, including in food, plants, and bacteria. After birth an infant's gut becomes colonized with normal flora that express these A-like and B-like antigens, causing the immune system to make antibodies to those antigens that the red blood cells do not possess. People who are blood type A will have Anti-B antibodies, blood type B will have Anti-A antibodies, blood type O will have both Anti-A and Anti-B antibodies, and blood type AB will have neither. Because of these so called "naturally occurring" and expected antibodies, it is important to correctly determine a patient's blood type prior to transfusion of any blood component. These naturally occurring antibodies are of the IgM class, which have the capability of agglutinating (clumping) and damaging red blood cells within the blood vessels, possibly leading to death. It is not necessary to determine any other blood groups because almost all other red blood cell antibodies can develop only through active immunization, which can occur only through either previous blood transfusion or pregnancy. A test called the Antibody Screen is always performed on patients who may require red blood cell transfusion, and this test will detect most clinically significant red blood cell antibodies.

    The RhD antigen is also important in determining a person's blood type. The terms "positive" or "negative" refer to either the presence or absence of the RhD antigen irrespective of the presence or absence of the other antigens of the Rhesus system. Anti-RhD is not usually a naturally occurring antibody as the Anti-A and Anti-B antibodies are. Cross-matching for the RhD antigen is extremely important, because the RhD antigen is immunogenic, meaning that a person who is RhD negative is very likely to make Anti-RhD when exposed to the RhD antigen (perhaps through either transfusion or pregnancy). Once an individual is sensitized to RhD antigens, his or her blood will contain RhD IgG antibodies, which can bind to RhD positive RBCs and may cross the placenta.[5]

    Blood group systems

    A total of 30 human blood group systems are now recognized by the International Society of Blood Transfusion (ISBT).[2] A complete blood type would describe a full set of 30 substances on the surface of RBCs, and an individual's blood type is one of the many possible combinations of blood-group antigens. Across the 30 blood groups, over 600 different blood-group antigens have been found,[6] but many of these are very rare or are mainly found in certain ethnic groups.

    Almost always, an individual has the same blood group for life, but very rarely an individual's blood type changes through addition or suppression of an antigen in infection, malignancy, or autoimmune disease.[7][8][9][10] An example of this rare phenomenon is the case of Demi-Lee Brennan, an Australian citizen, whose blood group changed after a liver transplant.[11][12] Another more common cause in blood-type change is a bone marrow transplant. Bone-marrow transplants are performed for many leukemias and lymphomas, among other diseases. If a person receives bone marrow from someone who is a different ABO type (eg, a type A patient receives a type O bone marrow), the patient's blood type will eventually convert to the donor's type.

    Some blood types are associated with inheritance of other diseases; for example, the Kell antigen is sometimes associated with McLeod syndrome.[13] Certain blood types may affect susceptibility to infections, an example being the resistance to specific malaria species seen in individuals lacking the Duffy antigen.[14] The Duffy antigen, presumably as a result of natural selection, is less common in ethnic groups from areas with a high incidence of malaria.[15]

    ABO blood group system

    ABO blood group system - diagram showing the carbohydrate chains that determine the ABO blood group
    Main article: ABO blood group system

    The ABO system is the most important blood-group system in human-blood transfusion. The associated anti-A antibodies and anti-B antibodies are usually "Immunoglobulin M", abbreviated IgM, antibodies. ABO IgM antibodies are produced in the first years of life by sensitization to environmental substances such as food, bacteria, and viruses. The "O" in ABO is often called "0" (zero/null) in other languages.[16]

    Phenotype Genotype
    A AA or AO
    B BB or BO
    AB AB
    O OO

    Rhesus blood group system

    Main article: Rhesus blood group system

    The Rhesus system is the second most significant blood-group system in human-blood transfusion. The most significant Rhesus antigen is the RhD antigen because it is the most immunogenic of the five main rhesus antigens. It is common for RhD-negative individuals not to have any anti-RhD IgG or IgM antibodies, because anti-RhD antibodies are not usually produced by sensitization against environmental substances. However, RhD-negative individuals can produce IgG anti-RhD antibodies following a sensitizing event: possibly a fetomaternal transfusion of blood from a fetus in pregnancy or occasionally a blood transfusion with RhD positive RBCs.[5] Rh disease can develop in these cases.[17]

    ABO and Rh distribution by country

    ABO and Rh blood type distribution by nation (population averages)
    Country Population[18]  O+  A+  B+ AB+  O-  A-  B- AB-
    Australia[19] 21262641 40% 31% 8% 2% 9% 7% 2% 1%
    Austria[20] 8210281 30% 33% 12% 6% 7% 8% 3% 1%
    Belgium[21] 10414336 38% 34% 8.5% 4.1% 7% 6% 1.5% 0.8%
    Brazil[22] 198739269 36% 34% 8% 2.5% 9% 8% 2% 0.5%
    Canada[23] 33487208 39% 36% 7.6% 2.5% 7% 6% 1.4% 0.5%
    Denmark[24] 5500510 35% 37% 8% 4% 6% 7% 2% 1%
    Estonia[25] 1299371 30% 31% 20% 6% 4.5% 4.5% 3% 1%
    Finland[26] 5250275 27% 38% 15% 7% 4% 6% 2% 1%
    France[27] 62150775 36% 37% 9% 3% 6% 7% 1% 1%
    Germany[28] 82329758 35% 37% 9% 4% 6% 6% 2% 1%
    Hong Kong SAR[29] 7055071 40% 26% 27% 7% 0.31% 0.19% 0.14% 0.05%
    Iceland[30] 306694 47.6% 26.4% 9.3% 1.6% 8.4% 4.6% 1.7% 0.4%
    India[31] 1166079217 36.5% 22.1% 30.9% 6.4% 2.0% 0.8% 1.1% 0.2%
    Ireland[32] 4203200 47% 26% 9% 2% 8% 5% 2% 1%
    Israel[33] 7233701 32% 34% 17% 7% 3% 4% 2% 1%
    New Zealand[34] 4213418 38% 32% 9% 3% 9% 6% 2% 1%
    Norway[35] 4660539 34% 42.5% 6.8% 3.4% 6% 7.5% 1.2% 0.6%
    Poland[36] 38482919 31% 32% 15% 7% 6% 6% 2% 1%
    Portugal[37] 10707924 36.2% 39.8% 6.6% 2.9% 6.0% 6.6% 1.1% 0.5%
    Saudi Arabia[38] 28686633 48% 24% 17% 4% 4% 2% 1% 0.23%
    South Africa[39] 49320000 39% 32% 12% 3% 7% 5% 2% 1%
    Spain[40] 40525002 36% 34% 8% 2.5% 9% 8% 2% 0.5%
    Sweden[41] 9059651 32% 37% 10% 5% 6% 7% 2% 1%
    Netherlands[42] 16715999 39.5% 35% 6.7% 2.5% 7.5% 7% 1.3% 0.5%
    Turkey[43] 76805524 29.8% 37.8% 14.2% 7.2% 3.9% 4.7% 1.6% 0.8%
    United Kingdom[44] 61113205 37% 35% 8% 3% 7% 7% 2% 1%
    United States[45] 307212123 37.4% 35.7% 8.5% 3.4% 6.6% 6.3% 1.5% 0.6%
    .
    Population-weighted mean (total population = 2261025244) 36.44% 28.27% 20.59% 5.06% 4.33% 3.52% 1.39% 0.45%

    Blood group B has its highest frequency in Northern India and neighboring Central Asia, and its incidence diminishes both towards the west and the east, falling to single digit percentages in Spain.[47][48] It is believed to have been entirely absent from Native American and Australian Aboriginal populations prior to the arrival of Europeans in those areas.[48][49]

    Blood group A is associated with high frequencies in Europe, especially in Scandinavia and Central Europe, although its highest frequencies occur in some Australian Aborigine populations and the Blackfoot Indians of Montana.[50][51]

    Other blood group systems

    Main article: Human blood group systems

    The International Society of Blood Transfusion currently recognizes 30 blood-group systems (including the ABO and Rh systems).[2] Thus, in addition to the ABO antigens and Rhesus antigens, many other antigens are expressed on the RBC surface membrane. For example, an individual can be AB RhD positive, and at the same time M and N positive (MNS system), K positive (Kell system), Lea or Leb negative (Lewis system), and so on, being positive or negative for each blood group system antigen. Many of the blood group systems were named after the patients in whom the corresponding antibodies were initially encountered.

    Clinical significance

    Blood transfusion

    Main article: Blood transfusion

    Transfusion medicine is a specialized branch of hematology that is concerned with the study of blood groups, along with the work of a blood bank to provide a transfusion service for blood and other blood products. Across the world, blood products must be prescribed by a medical doctor (licensed physician or surgeon) in a similar way as medicines. In the USA, blood products are tightly regulated by the U.S. Food and Drug Administration.

    Main symptoms of acute hemolytic reaction due to blood type mismatch.[52][53]

    Much of the routine work of a blood bank involves testing blood from both donors and recipients to ensure that every individual recipient is given blood that is compatible and is as safe as possible. If a unit of incompatible blood is transfused between a donor and recipient, a severe acute hemolytic reaction with hemolysis (RBC destruction), renal failure and shock is likely to occur, and death is a possibility. Antibodies can be highly active and can attack RBCs and bind components of the complement system to cause massive hemolysis of the transfused blood.

    Patients should ideally receive their own blood or type-specific blood products to minimize the chance of a transfusion reaction. Risks can be further reduced by cross-matching blood, but this may be skipped when blood is required for an emergency. Cross-matching involves mixing a sample of the recipient's serum with a sample of the donor's red blood cells and checking if the mixture agglutinates, or forms clumps. If agglutination is not obvious by direct vision, blood bank technicians usually check for agglutination with a microscope. If agglutination occurs, that particular donor's blood cannot be transfused to that particular recipient. In a blood bank it is vital that all blood specimens are correctly identified, so labeling has been standardized using a barcode system known as ISBT 128.

    The blood group may be included on identification tags or on tattoos worn by military personnel, in case they should need an emergency blood transfusion. Frontline German Waffen-SS had blood group tattoos during World War II.

    Rare blood types can cause supply problems for blood banks and hospitals. For example Duffy-negative blood occurs much more frequently in people of African origin,[54] and the rarity of this blood type in the rest of the population can result in a shortage of Duffy-negative blood for patients of African ethnicity. Similarly for RhD negative people, there is a risk associated with travelling to parts of the world where supplies of RhD negative blood are rare, particularly East Asia, where blood services may endeavor to encourage Westerners to donate blood.[55]

    Hemolytic disease of the newborn (HDN)

    Main article: Hemolytic disease of the newborn

    A pregnant woman can make IgG blood group antibodies if her fetus has a blood group antigen that she does not have. This can happen if some of the fetus' blood cells pass into the mother's blood circulation (e.g. a small fetomaternal hemorrhage at the time of childbirth or obstetric intervention), or sometimes after a therapeutic blood transfusion. This can cause Rh disease or other forms of hemolytic disease of the newborn (HDN) in the current pregnancy and/or subsequent pregnancies. If a pregnant woman is known to have anti-RhD antibodies, the RhD blood type of a fetus can be tested by analysis of fetal DNA in maternal plasma to assess the risk to the fetus of Rh disease.[56] One of the major advances of twentieth century medicine was to prevent this disease by stopping the formation of Anti-RhD antibodies by RhD negative mothers with an injectable medication called Rho(D) immune globulin.[57][58] Antibodies associated with some blood groups can cause severe HDN, others can only cause mild HDN and others are not known to cause HDN.[3]

    Compatibility

    Blood products

    In order to provide maximum benefit from each blood donation and to extend shelf-life, blood banks fractionate some whole blood into several products. The most common of these products are packed RBCs, plasma, platelets, cryoprecipitate, and fresh frozen plasma (FFP). FFP is quick-frozen to retain the labile clotting factors V and VIII, which are usually administered to patients who have a potentially fatal clotting problem caused by a condition such as advanced liver disease, overdose of anticoagulant, or disseminated intravascular coagulation (DIC).

    Units of packed red cells are made by removing as much of the plasma as possible from whole blood units.

    Clotting factors synthesized by modern recombinant methods are now in routine clinical use for hemophilia, as the risks of infection transmission that occur with pooled blood products are avoided.

    Red blood cell compatibility

    • Blood group AB individuals have both A and B antigens on the surface of their RBCs, and their blood serum does not contain any antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any group (with AB being preferable), but can donate blood only to another type AB individual.
    • Blood group A individuals have the A antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the B antigen. Therefore, a group A individual can receive blood only from individuals of groups A or O (with A being preferable), and can donate blood to individuals with type A or AB.
    • Blood group B individuals have the B antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the A antigen. Therefore, a group B individual can receive blood only from individuals of groups B or O (with B being preferable), and can donate blood to individuals with type B or AB.
    • Blood group O (or blood group zero in some countries) individuals do not have either A or B antigens on the surface of their RBCs, but their blood serum contains IgM anti-A antibodies and anti-B antibodies against the A and B blood group antigens. Therefore, a group O individual can receive blood only from a group O individual, but can donate blood to individuals of any ABO blood group (ie A, B, O or AB). If anyone needs a blood transfusion in a dire emergency, and if the time taken to process the recipient's blood would cause a detrimental delay, O Negative blood can be issued.
    RBC Compatibility chart
    In addition to donating to the same blood group; type O blood donors can give to A, B and AB; blood donors of types A and B can give to AB.
    Red blood cell compatibility table[59][60]
    Recipient[1] Donor[1]
    O− O+ A− A+ B− B+ AB− AB+
    O− Check markY
    O+ Check markY Check markY
    A− Check markY Check markY
    A+ Check markY Check markY Check markY Check markY
    B− Check markY Check markY
    B+ Check markY Check markY Check markY Check markY
    AB− Check markY Check markY Check markY Check markY
    AB+ Check markY Check markY Check markY Check markY Check markY Check markY Check markY Check markY

    Table note
    1. Assumes absence of atypical antibodies that would cause an incompatibility between donor and recipient blood, as is usual for blood selected by cross matching.

    A RhD-negative patient who does not have any anti-RhD antibodies (never being previously sensitized to RhD-positive RBCs) can receive a transfusion of RhD-positive blood once, but this would cause sensitization to the RhD antigen, and a female patient would become at risk for hemolytic disease of the newborn. If an RhD-negative patient has developed anti-RhD antibodies, a subsequent exposure to RhD-positive blood would lead to a potentially dangerous transfusion reaction. RhD-positive blood should never be given to RhD-negative women of child bearing age or to patients with RhD antibodies, so blood banks must conserve Rhesus-negative blood for these patients. In extreme circumstances, such as for a major bleed when stocks of RhD-negative blood units are very low at the blood bank, RhD-positive blood might be given to RhD-negative females above child-bearing age or to Rh-negative males, providing that they did not have anti-RhD antibodies, to conserve RhD-negative blood stock in the blood bank. The converse is not true; RhD-positive patients do not react to RhD negative blood.

    Plasma compatibility

    Plasma compatibility chart
    In addition to donating to the same blood group; plasma from type AB can be given to A, B and O; plasma from types A and B can be given to O.

    Recipients can receive plasma of the same blood group, but otherwise the donor-recipient compatibility for blood plasma is the converse of that of RBCs: plasma extracted from type AB blood can be transfused to individuals of any blood group; individuals of blood group O can receive plasma from any blood group; and type O plasma can be used only by type O recipients.

    Plasma compatibility table[60]
    Recipient Donor[1]
    O A B AB
    O Check markY Check markY Check markY Check markY
    A Check markY Check markY
    B Check markY Check markY
    AB Check markY

    Table note
    1. Assumes absence of strong atypical antibodies in donor plasma

    Rhesus D antibodies are uncommon, so generally neither RhD negative nor RhD positive blood contain anti-RhD antibodies. If a potential donor is found to have anti-RhD antibodies or any strong atypical blood group antibody by antibody screening in the blood bank, they would not be accepted as a donor (or in some blood banks the blood would be drawn but the product would need to be appropriately labeled); therefore, donor blood plasma issued by a blood bank can be selected to be free of RhD antibodies and free of other atypical antibodies, and such donor plasma issued from a blood bank would be suitable for a recipient who may be RhD positive or RhD negative, as long as blood plasma and the recipient are ABO compatible.

    Universal donors and universal recipients

    With regard to transfusions of whole blood or packed red blood cells, individuals with type O Rh(D) negative blood are often called universal donors, and those with type AB Rh(D) positive blood are called universal recipients; however, these terms are only generally true with respect to possible reactions of the recipient's anti-A and anti-B antibodies to transfused red blood cells, and also possible sensitization to RhD antigens. Exceptions include individuals with hh antigen system (also known as the Bombay blood group) who can only receive blood safely from other hh donors, because they form antibodies against the H substance.[61][62]

    Blood donors with particularly strong anti-A, anti-B or any atypical blood group antibody are excluded from blood donation. The possible reactions of anti-A and anti-B antibodies present in the transfused blood to the recipients RBCs need not be considered, because a relatively small volume of plasma containing antibodies is transfused.

    By way of example: considering the transfusion of O RhD negative blood (universal donor blood) into a recipient of blood group A RhD positive, an immune reaction between the recipient's anti-B antibodies and the transfused RBCs is not anticipated. However, the relatively small amount of plasma in the transfused blood contains anti-A antibodies, which could react with the A antigens on the surface of the recipients RBCs, but a significant reaction is unlikely because of the dilution factors. Rhesus D sensitization is not anticipated.

    Additionally, red blood cell surface antigens other than A, B and Rh D, might cause adverse reactions and sensitization, if they can bind to the corresponding antibodies to generate an immune response. Transfusions are further complicated because platelets and white blood cells (WBCs) have their own systems of surface antigens, and sensitization to platelet or WBC antigens can occur as a result of transfusion.

    With regard to transfusions of plasma, this situation is reversed. Type O plasma, containing both anti-A and anti-B antibodies, can only be given to O recipients. The antibodies will attack the antigens on any other blood type. Conversely, AB plasma can be given to patients of any ABO blood group due to not containing any anti-A or anti-B antibodies.

    Conversion

    In April 2007 a method was discovered to convert blood types A, B, and AB to O, using enzymes. This method is still experimental and the resulting blood has yet to undergo human trials.[63][64] The method specifically removes or converts antigens on the red blood cells, so other antigens and antibodies would remain. This does not help plasma compatibility, but that is a lesser concern since plasma has much more limited clinical utility in transfusion and is much easier to preserve.

    History

    The two most significant blood group systems were discovered by Karl Landsteiner during early experiments with blood transfusion: the ABO group in 1901[65] and in co-operation with Alexander S. Wiener the Rhesus group in 1937.[66] Development of the Coombs test in 1945,[67] the advent of transfusion medicine, and the understanding of hemolytic disease of the newborn led to discovery of more blood groups, and now 30 human blood group systems are recognized by the International Society of Blood Transfusion (ISBT),[2] and across the 30 blood groups, over 600 different blood group antigens have been found,[6] many of these are very rare or are mainly found in certain ethnic groups. Blood types have been used in forensic science and in paternity testing, but both of these uses are being replaced by genetic fingerprinting, which provides greater certainty [68].

    Cultural beliefs and pseudoscience

    The Japanese blood type theory of personality is a popular belief that a person's ABO blood type is predictive of their personality, character, and compatibility with others. This belief is also widespread in South Korea.[69] Deriving from ideas of historical scientific racism, the theory reached Japan in a 1927 psychologist's report, and the militarist government of the time commissioned a study aimed at breeding better soldiers.[69] The fad faded in the 1930s due to its unscientific basis. The theory has long since been rejected by the scientists[citation needed], but it was revived in the 1970s by Masahiko Nomi, a broadcaster who had no medical background.[69]

    The blood type diet is a diet advocated by Peter D'Adamo, a naturopathic physician, and outlined in his book Eat Right 4 Your Type. D'Adamo's claim is that ABO blood type is the most important factor in determining a healthy diet, and he promotes distinct diets for people with O, A, B, and AB blood types. This is viewed skeptically by most scientists and physicians (e.g.,http://www.earthsave.org/news/bloodtyp.htm).

    References

    1. ^ Maton, Anthea; Jean Hopkins, Charles William McLaughlin, Susan Johnson, Maryanna Quon Warner, David LaHart, Jill D. Wright (1993). Human Biology and Health. Englewood Cliffs, New Jersey, USA: Prentice Hall. ISBN 0-13-981176-1. 
    2. ^ a b c d "Table of blood group systems". International Society of Blood Transfusion. October 2008. http://ibgrl.blood.co.uk/isbt%20pages/isbt%20terminology%20pages/table%20of%20blood%20group%20systems.htm. Retrieved 2008-09-12. 
    3. ^ a b E.A. Letsky; I. Leck, J.M. Bowman (2000). "Chapter 12: Rhesus and other haemolytic diseases". Antenatal & neonatal screening (Second ed.). Oxford University Press. ISBN 0-19-262827-7. 
    4. ^ D'Adamo, Peter J; Catherine Whitney (2002). Complete blood type encyclopedia: the A-Z reference guide for the blood type. Riverhead Books. ISBN 1573229202. http://books.google.es/books?id=TgPtBGDaAzwC. Retrieved 2009-09-10. 
    5. ^ a b Talaro, Kathleen P. (2005). Foundations in microbiology (5th ed.). New York: McGraw-Hill. pp. 510–1. ISBN 0-07-111203-0. 
    6. ^ a b "American Red Cross Blood Services, New England Region, Maine, Massachusetts, New Hampshire, Vermont". American Red Cross Blood Services - New England Region. 2001. http://www.newenglandblood.org/medical/rare.htm. Retrieved 2008-07-15. "there are more than 600 known antigens besides A and B that characterize the proteins found on a person's red cells" 
    7. ^ Dean, Laura. "The ABO blood group". Blood Groups and Red Cell Antigens. online: NCBI. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen&part=ch05ABO. "A number of illnesses may alter a person's ABO phenotype" 
    8. ^ Stayboldt C, Rearden A, Lane T (1987). "B antigen acquired by normal A1 red cells exposed to a patient's serum". Transfusion 27 (1): 41–4. doi:10.1046/j.1537-2995.1987.27187121471.x. PMID 3810822. 
    9. ^ Matsushita S, Imamura T, Mizuta T, Hanada M (1983). "Acquired B antigen and polyagglutination in a patient with gastric cancer". Jpn J Surg 13 (6): 540–2. doi:10.1007/BF02469500. PMID 6672386. 
    10. ^ Kremer Hovinga I, Koopmans M, de Heer E, Bruijn J, Bajema I (2007). "Change in blood group in systemic lupus erythematosus". Lancet 369 (9557): 186–7; author reply 187. doi:10.1016/S0140-6736(07)60099-3. PMID 17240276. 
    11. ^ Demi-Lee Brennan has changed blood types and immune system Kate Sikora, The Daily Telegraph, January 25, 2008
    12. ^ Aust doctors hail teen's transplant 'miracle' Sean Rubinsztein-Dunlop, ABC News (Australia), January 24, 2008
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    14. ^ Miller LH, Mason SJ, Clyde DF, McGinniss MH. "The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy." N Engl J Med. 1976 Aug 5;295(6):302-4 PMID 778616
    15. ^ Kwiatkowski, DP (August 2005). "How Malaria Has Affected the Human Genome and What Human Genetics Can Teach Us about Malaria". Am J Hum Genet. 77 (2): 171–192. doi:10.1086/432519. Full text at PMC: 1224522. PMID 16001361. PMC 1224522. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1224522#N0x904fbd0.0x92f5ba8. Retrieved 2006-11-16. "The different geographic distributions of α thalassemia, G6PD deficiency, ovalocytosis, and the Duffy-negative blood group are further examples of the general principle that different populations have evolved different genetic variants to protect against malaria".
    16. ^ "Your blood – a textbook about blood and blood donation" (PDF). pp. 63. http://www.bloddonor.dk/fileadmin/Fil_Arkiv/PDF_filer/Andre/Your_Blood__June_2006.pdf. Retrieved 2008-07-15. 
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    18. ^ CIA World Factbook
    19. ^ Blood Types - What Are They?, Australian Red Cross
    20. ^ Austrian Red Cross - Blood Donor Information
    21. ^ Rode Kruis Wielsbeke - Blood Donor information material
    22. ^ Tipos Sanguíneos
    23. ^ Types & Rh System, Canadian Blood Services
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    25. ^ Veregruppide esinemissagedus Eestis
    26. ^ Suomalaisten veriryhmäjakauma
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    28. ^ de:Blutgruppe#Häufigkeit der Blutgruppen
    29. ^ Blood Donation, Hong Kong Red Cross
    30. ^ Blóðflokkar
    31. ^ Indian Journal for the Practising Doctor
    32. ^ Irish Blood Transfusion Service/Irish Blood Group Type Frequency Distribution
    33. ^ The national rescue service in Israel
    34. ^ What are Blood Groups? - NZ Blood
    35. ^ Norwegian Blood Donor Organization
    36. ^ Regionalne Centrum Krwiodawstwa i Krwiolecznictwa we Wroclawiu
    37. ^ Portuguese Blood Institute (assuming Rh and AB antigens are independent)
    38. ^ Fequency of ABO blood groups in the eastern region of Saudi Arabia
    39. ^ South African National Blood Service - What's Your Type?
    40. ^ Federación Nacional de Donantes de Sangre/La sangre/Grupos
    41. ^ Frequency of major blood groups in the Swedish population.
    42. ^ "Voorraad Erytrocytenconcentraten Bij Sanquin" (in Dutch). http://www.sanquin.nl/Sanquin-nl/erygrafiek.nsf/All/Voorraad-Erytrocytenconcentraten-Bij-Sanquin.html. Retrieved 2009-03-27. 
    43. ^ Turkey Blood Group Site.
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    45. ^ Blood Types in the U.S.
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    47. ^ Blood Transfusion Division, United States Army Medical Research Laboratory (1971). Selected contributions to the literature of blood groups and immunology. 1971 v. 4. United States Army Medical Research Laboratory, Fort Knox, Kentucky. http://books.google.com/books?id=ALilcA7Acd0C. "... In northern India, in Southern and Central China and in the neighboring Central Asiatic areas, we find the highest known frequencies of B. If we leave this center, the frequency of the B gene decreases almost everywhere ..." 
    48. ^ a b Encyclopaedia Britannica (2002). The New Encyclopaedia Britannica. Encyclopaedia Britannica, Inc.. ISBN 0852297874. http://books.google.com/books?id=fpdUAAAAMAAJ. "... The maximum frequency of the B gene occurs in Central Asia and northern India. The B gene was probably absent from American Indians and Australian Aborigines before racial admixture occurred with the coming of the white man ..." 
    49. ^ Carol R. Ember, Melvin Ember (1973). Anthropology. Appleton-Century-Crofts. http://books.google.com/books?id=fvpFAAAAMAAJ. "... Blood type B is completely absent in most North and South American Indians ..." 
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    52. ^ Possible Risks of Blood Product Transfusions from American Cancer Society. Last Medical Review: 03/08/2008. Last Revised: 01/13/2009
    53. ^ 7 ADVERSE REACTIONS TO TRANSFUSION Pathology Department at University of Michigan. Version July 2004, Revised 11/5/08
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    67. ^ Coombs RRA, Mourant AE, Race RR. A new test for the detection of weak and "incomplete" Rh agglutinins. Brit J Exp Path 1945;26:255-66.
    68. ^ http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1351151
    69. ^ a b c Associated Press (2005-05-06). "Myth about Japan blood types under attack". AOL Health. http://aol.mediresource.com/channel_health_news_details.asp?news_id=6661&news_channel_id=11&channel_id=11. Retrieved 2007-12-29. 

    Further reading

    External links

    v • d • e
    Human group differences
    Gender/Sex
    Race
    Other dynamics
    v • d • e
    Certain conditions originating in the perinatal period / fetal disease (P, 760-779)
    Maternal factors
    and complications
    Chorion/Amnion/Umbilical cord
    Length of gestation
    and fetal growth
    Birth trauma
    By system
    Other disorders
    v • d • e
    Transfusion medicine
    General concepts
    Blood group systems · Blood types
    ABO · Chido-Rodgers · Colton · Cromer · Diego · Dombrock · Duffy · Gerbich · GIL · Hh · Ii · Indian · JMH · Kell (Xk) · Kidd · Knops · LW · Lewis · Lutheran · MNS · OK · P · Raph · Rh · Scianna · T-Tn · Xg · Yt · Other
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