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BLOOD BANK PROCEDURESABO Blood Group System
In 1900 Karl Landsteiner discovered the blood groups ABO and classifieds human blood into A,B andO Groups. A fourth blood Group AB was discovered by Landsteiner’s associates. Von Decastello andsturli in 1902.The four groups are determined by the presence or absence of blood group antigens(agglutinations) on the red cells and accordingly an individual’s group A,B,AB, or O (O is donates theabsence of A or B antigens). In addition, it has been shown that corresponding to antigens A and B,these are naturally occurring antibodies anti-A and B (agglutinations) in the plasma/serum of individually whose red cells lack the corresponding antigen.Group ‘A’ individually have anti-B, Group-B individually anti-A, Group ‘O’ Individually have both anti-A and anti-B and Group AB individually have no agglutination in the plasma/Serum.The A B O antigens and corresponding antibodies
Antigen on RBCAntibody in Plasma/SerumBlood Group
Aanti-BABanti-ABABNonAB Noneanti-A and anti-BOIn 1991 von lungern Hirszfeid showed that Group ‘A’ could be divided into two principal sub GroupsA1 and A2 on the basis of this the ABO system is classified into six main Groups A1,A2,B A1,B1, A2B and O.
ABH ANTIGENS:
A, B and H antigens are present not only on the red cells but are also widely distributed through out the body tissues except in the central nervous system.A,B and H antigen city is determined by specific sugars linked to the terminal portion of oligosaccharides (short chain sugars) these are present on glycoproteins or glycolipids.In the red cell membrane both glycolipids and glycoprotein’s with ABH activity are present. Inthe plasma only glycolipids in soluble form are found. Cell membranes of endothelial and epithelialcells have both glycolipids and glycoproteins.
Secretor Status
A, B and H Substances are also found in the Secretions of 80 % of the population the ability tosecrete B and H substances is determined by the presence of the secretor gene(se) in either thehomozygous se se or heterozygous se se state, which is inherited independently of the ABO and Hhgenes. Normally all secretors secrete H, in addition A and / or B sub stances.1
 
Showing Sector Status
Blood GroupSubstance secretedOHAA&HBB&HABA,B&HOhNilSUB GROUPS OF A and AB: A and AB have divided into Subgroup A1, A2, A, B and A2 Bdepending up on the reaction with the extract of a lactin Dolichos biflorus seeds or human Anti-A1serum. Anti-A sera very seldom differentiate between A1 and A2. both human anti-A1 and lactin anti-A1 agglutinate A1 and A1B cells but not A2 and A2 B cells. 20% of persons with A antigens in the A or AB group are A2 (or) A2 B.It is not necessary to classify group A patients or donors as A1 or A2 except when the individual serumcontains anti-A1, anti-A1, occurs in the serum of 1-8% of A2 group person and 22-35% of A2 B groups person. Anti-A1 courses discrepancies between ABO cells and serum test and may also causescrossmatch incompatibilities but is considered clinically significant if it reacts at 37°C.
Weak Subgroup of A:
Sub group weaker than A2 occurs in frequently they are characterized by the declining number of Aantigen sites or red cells and reciprocal increased in H reactivity. Weaker variants of A are mainly A3,Ag, Am and A. Intermediate.Classification of weak A subgroups based on.1.Degree of agglutination by anti-A, Anti-A1 and Anti-AB2.Degree of H reactivity on the red cells.3.Presence or absence of anti-A1 in the serum.4.Presence of A and H substance in saline of secretors.
Serological Reactions of A and B phenotypes
RBCPhenotypeReactions of cells withKnow Anti SerumReactions of serum againstRBCSaline of Secretors ContainsSaline of SecretorsContainsAB ABHA1A1A2BOA1+4-+4+,-+4--+4-A&HA2+4-+4+2--+4-A&HA1 and 2+4-+4+3+2--+4-A&HA3+2m-+2mg+3--+4-A&HAg-/w-+1/+2+4-+2-/w+4-HAm-/w--/w+4---+4-A&HB-+4+4--+4+4--B&HB2--/w-/++4-+4+4--HBm---/w+4-+4+4--B & H+ to + 4 means = agglutination of increasing strength2
 
W means = weak agglutination- no agglutinationMf means = mixed field agglutination.Means = occurrence of anti-A1 is variable.
Weak Subgroups of B
Sub groups of B are less common than subgroups of A and are only of theoretical value. They can beclassified on the basis of the reactions shown in Table.
Bombay Group or Oh Phenotype
The phenotype (Oh) is characterized by the absence of A,B and H antigens on the red cells. The serumof these persons contains anti-A1, anti-B and anti-H, which reacts with all O blood groups, All theseindividuals are non-secretors of ABH. The red cells and secretions in Bombay group individuals track Has well as A and B substances, irrespective of ABO genotype, i.e. individual of Oh phenotype may havenormal A/B genes but the corresponding antigens are not expressed on red cells. This type of blood wasfirst found in Bombay hence its name. the frequency in India is around 1:7600.
ANTIBODIES OF ABO SYSTEMAnti-A
The antibody anti-A is found in group B and group O individuals and reacts well with A1 and A2 cells but not as well with weaker subgroups of A.
Anti-B
The antibody anti-B is found in group A and O individuals, and reacts almost with all B group cells butless effectively with weaker variants of B group.
Anti-AB
An antibody anti-AB is found in group O individuals. Serum from O group individuals is particularlyuseful in detecting some weak A and B antigens.
Anti-A1
This is found in 1-8% of A2 and 22 to 35% of A2 B individuals. It is usually active at room temperatureor below and is rarely clinically significant, except when it reacts at 37°C.
Anti-H
Anti-H very rarely occurs as cold reactive agglutinin in individuals with very low levels of H antigenson their cells and have little clinical significance. However, anti-H found in Bombay blood group (Oh)is an alloantibody and is clinically significant. It occurs as a heamolysis and agglutinates cells at 37
A B O Grouping:PRACTICAL ASPECTS OF ABO GROUPING
(1)
Routine ABO
 
grouping must include both cells and serum testing as each test serves as check onthe other.
(2)
ABO grouping tests should be done at room temperature or lower; testing at 37°c weakensreaction.
(3)
Anti-sera used in the ABO grouping must be used as per the instruction of manufacturer.
(4)
Controls should always be run with respect to ABO grouping. Most laboratories have qualitycontrol of antisera once a day in order to eliminate the need to run individual controls every timethe reagents are used.3

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