GOLONGAN DARAH

Program Studi Ilmu Keperawatan B

Dr. dr. Endang Sriwahyuni, MS.

Maret 2008

 Golongan Darah

Perbedaan golongan darah setiap orang disebabkan oleh karena adanya Antigen (Ag) Aglutinogen pada dinding eritrosit dan adanya antibody spesifik (Ab) Aglutinin di dalam plasmanya
darah donor + resipien Tidak cocok transfusi oleh karena terjadi aglutinasi
2

Golongan Darah ABO

Gol. Darah O A B AB

Ag. A B AB

Ab. Anti A & anti B Anti B Anti A -

Blood Types with their Genotypes and their constituent Agglutinogens and Agglutinins
Genotypes OO OA or AA OB or BB AB Blood types O A B AB Agglutinogens A B A and B Agglutinins Anti A and Anti B Anti B Anti A 4

Relative Frequencies of the Different Blood Types

The prevalence of the different Blood

Types among one group of persons studied was approximately : O 47 % A 41 % B 9% AB 3%

Blood typing, showing Agglutination of cells of the different blood types with Anti A or Anti B Agglutinins in the Sera Red Blood Cells Types Sera Anti A Anti B + + + +

O A B AB

Reaksi silang
Penting dikerjakan sebelum transfusi darah Eritrosit & serum antara donor & resipien direaksikan secara silang invitro r. s. mayor : erit. donor + serum resipien ada / tidaknya aglutinin resipien yg mungkin merusak erit. donor r. s. minor : serum donor + erit. resipien ada / tidaknya aglutinin donor yg mempengaruhi erit. resipien. Aglutinin donor dalam sirkulasi sangat diencerkan oleh plasma resipien < berbahaya r.s. minor dianggap 7 kurang penting

 Contoh :

DA RB

: : m (+)

Ag A B

Ab anti B anti A M (+)

Sangat diencerkan dalam tubuh R < penting

Golongan darah Rhesus

Ag. golongan darah Rh, biasanya mempunyai

antigenisitas lemah, kecuali Ag D disebut Ag. Rh

Ag Rh dalam erit golongan Rh (ada Ag

Rh) Ag Rh dalam erit golongan Rh (tidak ada Rh)

9

 Anyone who has this type of antigen (D antigen) is

said to be Rh positive, whereas a person who does not have type D antigen is called to be Rh negative much milder

It can still cause transfusion reactions usually

About 85 % of all white people are Rh positive

and 15 % Rh negative

In American blacks the percentage of Rh positive

is about 95, whereas in African blacks, it is virtually 100 percent 10

Rh Blood Types
The major difference between

AOB system Rh system The plasma agglutinins Spontaneous agglutinins responsible for causing almost never occur transfusion reactions develop spontancously The person must first be massively exposed to an Rh antigen

11

 When RBC containing Rh factor

Are injected Blood does not contain Rh factor/Rh negative person Anti Rh agglutinins develop slowly Reaching maximum concentration of agglutinins about 2 to 4 months later
12

 If an Rh negative person has never before been

exposed to Rh positive blood Transfusion of Rh positive No Immediate reaction

Then its hemolyzed by the tissue macrophage system A delayed transfusion reaction occurs, although it is usually mild
13

 N : Pada golongan darah Rh () Tidak ada Ab anti Rh () terpapar golongan darah Rh dari transfusi atau darah bayi waktu lahir Reaksi pembentukan Ab. Anti Rh terpapar lagi Rh
Darah tsb akan dihancurkan oleh Ab. anti Rh

14

 Ibu Rh bayi Rh kehamilan baik oleh karena darah

bayi placenta ibu. Waktu persalinan jaringan placenta rusak darah bayi ke ibu. imunitas ibu membentuk Ab anti Rh. Beberapa tahun kemudian, ibu hamil II : bayi Rh anti Rh ibu ke bayi menghancurkan darah bayi anemia hemolitik Erythroblastosis Fetalis

15

Erythroblastosis Fetalis
Is a disease of the fetus and new

born child Characterized by aglutination and phagocytosis of the fetuss RBCs

16

The mother is Rh (-)

The baby has

The father Rh (+)

Inherited the Rh (+) antigen The mother develops anti Rh agglutinins from exposure to the fetuss Rh antigen

The mothers agglutinins diffuse through the placenta into the fetus Cause RBC agglutination
17

Treatment of the Erythroblastosis Fetalis

To replace the neonates blood with Rh ()

blood by infused over period of 1,5 or more hours while the neonates own Rh (+) blood is being removed (during the first few weeks of life)

18