B (surface antigen B) ¾ AB (antigens A and B) ¾ O (neither A nor B) Agglutinogens ¾ Antigens on surface of RBCs ¾ Screened by immune system ¾ Plasma antibodies attack and agglutinate (clump) foreign antigens The Rh Factor ¾ Also called D antigen ¾ Either Rh positive (Rh + ) or Rh negative (Rh - ) Only sensitized Rh - blood has anti-Rh antibodies
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 1. 27 1. Blood Typing 1. Figure 19 – 6 Blood Types and Cross-Reactions
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 28 Blood Typing Cross-Reactions in Transfusions ¾ Also called transfusion reaction ¾ Plasma antibody meets its specific surface antigen ¾ Blood will agglutinate and hemolyze ¾ Occur if donor and recipient blood types not compatible Figure 19 – 6b Blood Types and Cross-Reactions
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 29 Blood Typing ¾ Performed on donor and recipient blood for compatibility ¾ Anti-A: sera containing antibodies against antigen-A ¾ Without cross-match, type O - is universal donor Figure 19 – 7 Blood Type Testing Cross-Match Testing for Transfusion Compatibility Antigen A clumping clumping clumping clumping clumping Antigen A and B No reaction No reaction No reaction No antigen
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 30 Blood Typing Hemolytic Disease of The Newborn During pregnancy mother and fetal blood circulatory systems are closely intertwined ad mothers antibodies can go and destroy fetal RBCs as foreign bodies. This condition is termed HDN. HDN also called erythroblastis fetalis, immature RBCs (erythroblasts) are the target of mothers anti-Rh antibodies. Quite dangerous, as Rh- antibodies can cross the placenta and enter fetal bloodstream, unlike the anti-A and anti-B antibodies. First pregnancy is not affected. Rh- mother becomes sensitized soon after carrying a Rh+ baby. Subsequent pregnancy with Rh+ baby is high risk and measures need to be taken. RhoGam, administration during 3 mths of 1 st pregnancy prevents maternal sensitization. RhoGam kills the fetal RBCs in maternal blood stream . A highly successful therapy to prevent HDN mortality.
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 31 Hemolytic Disease of The Newborn Figure 19 – 8 Rh Factors and Pregnancy
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 32 Hemolytic Disease of The Newborn Figure 19 – 8 Rh Factors and Pregnancy
Nov-3-2015 A & P Fall -2015 Ch-19 The Blood 33 Blood Typing Used to increase blood volume temporarily Isotonic electrolyte solution such as normal saline (0.9 % NaCl), approximates the normal osmotic pressure of extracellular fluids May have additive like dextran (carbohydrate) that can not freely move across the plasma membrane and maintain the osmotic pressure of blood Example lactacted Ringer’s solution containing lactate, potassium chloride and calcium chloride Easy to store and use in sterile conditions compared to donated plasma Provide an alternative to buy time while waiting for right blood type. Can not change the oxygen carrying capacity of the blood.
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