GENETIC BASIS OF BLOOD GROUPS

TRANSFUSION LAWS and Medico legal solutions

BY D.HARIHARAN hariharanhd@yahoo.co.in

BLOOD GROUPS A B AB O

ANTIGENS
y AGGLUTINOGENS ARE PRESENT ON RBC

SURFACE
y A-ANTIGEN y B-ANTIGEN B y AB BOTH A AND B ANTIGENS y O-NO ANTIGENS ON RBC

y PHENOTYPES y A GROUP y B GROUP y AB GROUP y O GROUP

GENOTYPES AA,AO,OA BB,BO,OB AB OO

y Rh System , y In rhesus monkeys y Experiment: y First, it was discovered that injection of red cells of

rhesus monkey into rabbit results in antibody formation against the rhesus cells, later based on this they found that the rabbit s serum contains an antirhesus antibody agglutinate the human red cells .this led to the discovery of the Rh system in humans

Disputed parentage /disputed maternity

When the blood group of a child and the mother is known ,it can be told that the man in suspicion is the father or not .However ,blood group can never prove that the person is himself culprit and father the same child ,This is because the blood group gene only helps to identify not confims but suggests he might be ..

y Rh System Antigens y This system is based on concept of y

D antigens

y Rh antigens are located on the chromosome number 1

Rh system

Rh positive

Rh negative

Group A POSITIVE A-NEGATIVE B-POSITIVE B-NEGATIVE O-POSITVE O-NEGATIVE

Antigen on RBC A A B B -

Antibody in plasma Anti-B Anti-A Anti-B Anti-A Anti-A,B Anti A,B -

D antigen PRESENT ABSENT PRESENT ABSENT PRESENT ABSENT PRESENT ABSENT

Rh positive/negatie Positive Negative Positive Negative Positive Negative Positive Negative

AB POSITIVE A,B AB-NEGATIVE A,B

Transfusion
y The transfer of blood from the vascular compartment

of one individual to other individual under needy circumstances to maintain the homeostasis by maintainance of blood volume .
y Transfusion of blood is not an simple issue. This

technique needs lots of sample testing and compatibility of person to particular group of blood. y It is done based on LANDSTEINER LAWS

LANDSTEINER LAWS
y The law states that if a particular agglutinogen is

present on the red cell membrane of an individual, the corresponding agglutinin must be absent in his plasma .Conversely, if the agglutinogen is absent on red cell agglutinin is present in the plasma

Rh incompatibility
y Erythroblastosis Foetalis :
This is a Hemolytic disease of the newborn which occurs due to Rh incompatibility when an Rh negative mother carries Rh positive fetus during pregnancy .usually, no reaction occurs in first pregnancy .However ,at the time of delivery during placental separation ,a small amount of fetal blood leaks into the maternal circulation .This includes formation of Anti-Rh agglutinin from mother ,which is predominantly IgG type causes hemolysis .In the third and subsequent pregnancies ,the degree of hemolysis becomes severe, mainly due to formation of AntiRh agglutinin

Clinical features of ERYTHROBLASTOSIS FETALIS

y ANEMIA y HEMOLYTIC JAUNDICE y GENERALIZED EDEMA y KERNICTERUS y EXTRAMEDULLARY HEMOPOIESIS

TREATMENT OF ERYTHROBLASTOSIS
y INTRAUTERINE FETAL TRANSFUSION y EXCHANGE TRANSFUSION y PHOTHERAPY(IN NEONATAL JAUNDICE)

PREVENTION BY PASSIVE IMMUNISATION

Hazards of blood transfusion

y Acute hemolytic transfusion reactions (ABO Incompatibility) 1.Shivering 2.Hemoglobinemia/hemoglobinuria 3.Jaundice 4.Renal failure(acute) Diseases transmitted : Hepatitis Malaria AIDS Syphylis

THANK YOU