15361 - BLOOD GROUPS- A REVIEW Human erythrocytes >300...

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BLOOD GROUPS- A REVIEW Human erythrocytes >300 antigenic determinants Only ABO and Rh important in the majority of blood transfusions Most severe transfusion reactions due to ABO incompatibility Alicia Gruber-Kalamas, MD, University of California San Francisco
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ABO INCOMPATIBILITY In tr a v a s c u la r H e m o ly s is H e m o g lo b in e m ia H e m o g lo b in u r ia D E A T H D IC P r o fu s e B le e d in g A c u te C ir c u la to r y C o lla p s e A n u r ia D o n o r b lo o d a n tig e n + R e c ip ie n t a n tib o d ie s ( Ig M ) A c tiv a te s C o m p le m e n t Alicia Gruber-Kalamas, MD, University of California San Francisco
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THE Rh SYSTEM - Rh gene 3 chromosomal loci with 6 alleles -D antigen is the most common and most immunogenic -Approximately 80-85% Caucasians have D antigen - Individuals lacking this allele are called “Rh- negative” -Only develop antibodies against the D antigen after exposure (transfusion/pregnancy)
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Rh ANTIBODIES IgG class of immunoglobulins Lack capacity to bind complement Elimination of red cells primarily in the spleen Clinical symptoms mild, generally limited to fever/chills
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Rh AND THE PREGNANT WOMAN Transplacental passage of D-positive fetal RBC’s into D-negative mother produces anti-D (IgG) Anti-D IgG traverses the placenta and coats fetal RBC’S leading to extravascular hemolysis Clinically manifest as hemolytic disease of the fetus and newborn- anemia, hepatosplenomegaly, hydrops fetalis, and death
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Rh PROPHYLAXIS- Rhlg 1968 RhIg first licensed for prophylactic administration via IM route (RhoGam)
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This note was uploaded on 02/23/2012 for the course PHARM 290 taught by Professor Staff during the Fall '10 term at Rutgers.

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15361 - BLOOD GROUPS- A REVIEW Human erythrocytes >300...

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