How Blood Type Is Determined and Why You Need To Know: A+, A-B+, B - O+, O - AB+, AB
How Blood Type Is Determined and Why You Need To Know: A+, A-B+, B - O+, O - AB+, AB
How Blood Type Is Determined and Why You Need To Know: A+, A-B+, B - O+, O - AB+, AB
When blood transfusions from one person to another were first attempted, immediate or delayed
agglutination and hemolysis of the red blood cells (RBCs) often occurred, resulting in typical transfusion
reactions that frequently led to death. Soon it was discovered that the bloods of different people have different
antigenic and immune properties so that antibodies in the plasma of one blood type will react with antigens on
the surfaces of the RBCs of another blood type. If proper precautions are taken, one can determine ahead of
time whether the antibodies and antigens present in the donor and recipient bloods will cause a transfusion
reaction.
Major O-A-B Blood Types. In transfusing blood from one person to another, the bloods of donors and recipients
are normally classified into four major O-A-B blood types, as shown in Table 36-1, depending on the presence
or absence of the two agglutinogens, the A and B agglutinogens. When neither A nor B agglutinogen is present,
the blood is type O. When only type A agglutinogen is present, the blood is type A. When only type B
agglutinogen is present, the blood is type B. When both A and B agglutinogens are present, the blood is type
AB.
Blood types are determined by the presence or absence of certain antigens – substances that can trigger an immune response if they are
foreign to the body. Since some antigens can trigger a patient's immune system to attack the transfused blood, safe blood transfusions
depend on careful blood typing and cross-matching. Do you know what blood type is safe for you if you need a transfusion?
There are four major blood groups determined by the presence or absence of two antigens – A
and B – on the surface of red blood cells. In addition to the A and B antigens, there is a protein
called the Rh factor, which can be either present (+) or absent (–), creating the 8 most common
blood types (A+, A-, B+, B-, O+, O-, AB+, AB-)
There are very specific ways in which blood types must be matched for a safe
transfusion. The right blood transfusion can mean the difference between life and
death.
Use the interactive graphic below to learn more about matching blood types for
transfusions.
Blood Transfusions
A blood transfusion is the transfer of blood from one person to another. Blood that is lost through an
injury, an illness or a surgery can be replaced through transfusion. Aside from transferring blood as a
whole, parts of blood, such as red blood cells, platelets or plasma can also be transferred to individuals.
Blood Types
Human blood is grouped into four types: A, B, AB, and O. Each letter refers to a kind of antigen, or
protein, on the surface of red blood cells. For example, the surface of red blood cells in Type A blood
has antigens known as A-antigens.
The Rh Factor
Each blood type is also grouped by its Rhesus factor, or Rh factor. Blood is either Rh positive (Rh+) or
Rh negative (Rh-). About 85% of Americans have Rh+ blood.
Rhesus refers to another type of antigen, or protein, on the surface of red blood cells. The name Rhesus
comes from Rhesus monkeys, in which the protein was first discovered
TRANSPLANTATION OF TISSUES AND ORGANS Most of the different antigens of RBCs that cause
transfusion reactions are also widely present in other cells of the body, and each bodily tissue has its
own additional complement of antigens. Consequently, foreign cells transplanted anywhere into the
body of a recipient can produce immune reactions. In other words, most recipients are just as able to
resist invasion by foreign tissue cells as to resist invasion by foreign bacteria or RBCs. Autografts,
Isografts, Allografts, and Xenografts. A transplant of a tissue or whole organ from one part of the same
animal to another part is called an autograft; from one identical twin to another, an isograft; from one
human being to another or from any animal to another animal of the same species, an allograft; and
from a non-human animal to a human being or from an animal of one species to one of another
species, a xenograft.
Transplantation of Cellular Tissues. In the case of autografts and isografts, cells in the transplant
contain virtually the same types of antigens as in the tissues of the recipient and will almost always
continue to live normally and indefinitely if an adequate blood supply is provided. At the other
extreme, immune reactions almost always occur in xenografts, causing death of the cells in the graft
within 1 day to 5 weeks after transplantation unless some specific therapy is used to prevent the
immune reactions. Some of the different cellular tissues and organs that have been transplanted as
allografts, either experimentally or for therapeutic purposes, from one person to another are skin,
kidney, heart, liver, glandular tissue, bone marrow, and lung. With proper “matching” of tissues
between persons, many kidney allografts have been successful for at least 5 to 15 years, and allograft
liver and heart transplants for 1 to 15 years.
Tissue Typing—The Human Leukocyte Antigen Complex of Antigens. The most important antigens for
causing graft rejection are a complex called the human leukocyte antigen (HLA) antigens. Six of these
antigens are present on the tissue cell membranes of each person, but there are about 150 different
HLA antigens to choose from, representing more than a trillion possible combinations. Consequently, it
is virtually impossible for two persons, except in the case of identical twins, to have the same six HLA
antigens. Development of significant immunity against any of these antigens can cause graft rejection.
The HLA antigens occur on the white blood cells, as well as on the tissue cells. Therefore, tissue typing
for these antigens is done on the membranes of lymphocytes that have been separated from the
person’s blood. The lymphocytes are mixed with appropriate antisera and complement; after
incubation, the cells are tested for membrane damage, usually by testing the rate of transmembrane
uptake by the lymphocytic cells of a special dye. Some of the HLA antigens are not severely antigenic.
Therefore, a precise match of some antigens between donor and recipient is not always essential to
allow allograft acceptance. By obtaining the best possible match between donor and recipient, the
grafting procedure has become far less hazardous. The best success has been with tissue-type matches
between siblings and between parent and child. The match in identical twins is exact, so transplants
between identical twins are almost never rejected because of immune reactions.
Prevention of Graft Rejection by Suppressing the Immune System If the immune system were
completely suppressed, graft rejection would not occur. In fact, in a person who has serious depression
of the immune system, grafts can be successful without the use of significant therapy to prevent
rejection. However, in the normal person, even with the best possible tissue typing, allografts seldom
resist rejection for more than a few days or weeks without use of specific therapy to suppress the
immune system. Furthermore, because the T cells are mainly the portion of the immune system
important for killing grafted cells, their suppression is much more important than suppression of
plasma antibodies. Some of the therapeutic agents that have been used for this purpose include the
following: 1. Glucocorticoid hormones from adrenal cortex glands (or drugs with glucocorticoid-like
activity), which inhibit genes that code for several cytokines, especially interleukin-2 (IL-2). IL-2 is an
essential factor that induces T-cell proliferation and antibody formation. 2. Various drugs that have a
toxic effect on the lymphoid system and, therefore, block formation of antibodies and T cells, especially
the drug azathioprine. 3. Cyclosporine and tacrolimus, which inhibit formation of T-helper cells and,
therefore, are especially efficacious in blocking the T-cell rejection reaction. These agents have proved
to be highly valuable drugs because they do not depress some other portions of the immune system. 4.
Immunosuppressive antibody therapy, including specific antilymphocyte or IL-2 receptor antibodies.
Use of these agents often leaves the person unprotected from infectious disease; therefore, sometimes
bacterial and viral infections become rampant. In addition, the incidence of cancer is several times
greater in an immunosuppressed person, presumably because the immune system is important in
destroying many early cancer cells before they can begin to proliferate. Transplantation of living tissues
in human beings has had important success mainly because of the development of drugs that suppress
the responses of the immune system. With the introduction of improved immunosuppressive agents,
successful organ transplantation has become much more common. The current approach to
immunosuppressive therapy attempts to balance acceptable rates of rejection with moderation in the
adverse effects of immunosuppressive drugs.
A transplant is an organ, tissue or a group of cells removed from one person (the donor) and
transplanted into another person (the recipient) or moved from one site to another in the same person.
A skin graft is a common example of a transplant from one part of a person’s body to another part.
A transplant between two people can cause a rejection process where the immune system of the
recipient or host attacks the foreign donor organ or tissue and destroys it.
To reduce the risk of rejection of the donated organ, the recipient will probably need to take
immunosuppressive medication for the rest of their life.
Many different types of organs, tissue, cells and limbs can be transplanted – even faces.
The approach to different types of transplantation varies greatly, so you should speak with your
medical team about surgical procedures, recovery and medications.
A transplant is an organ, tissue or a group of cells removed from one person (the donor) and
surgically transplanted into another person (the recipient or host) or moved from one site to
another site in the same person.
Transplants – such as a liver transplant – can save lives. They can also restore function to
improve quality of life. For example, transplanting the clear tissue that covers the eye (cornea)
is not necessary for life, but can restore sight.
Types of transplantation
Transplantation is a complex area of medicine because when organs or tissues are transplanted from
one person to another, the recipient’s immune system can reject and destroy the donor organ or
tissue, and medication is needed to supress this immune response.The treatments used vary
depending on the tissue or organ being transplanted, the level of compatibility between the donor and
the recipient, and other factors.
Transplants of tissues in the same person
A transplant from one part of your body to another part is called an autograft and the process
is called autotransplantation.
The advantage of an autograft is that the person’s body is unlikely to reject their own cells, so
long-term medication to suppress the immune system (immunosuppressants) is not needed.
However, the retrieval (collecting) of the tissue creates a new wound in addition to the
transplant site, from which the person will need to recover.
A transplant between two people who are not genetically identical is called an allotransplant
and the process is called allotransplantation. Donor organs and tissues can be from people
who are living, or people who have died because of a significant brain injury or lack of
circulation.
Allotransplantation can create a rejection process where the immunesystem of the recipient
attacks the foreign donor organ or tissue and destroys it. The recipient may need to take
immunosuppressive medication for the rest of their life to reduce the risk of rejection of the
donated organ. Speak to your doctor if you are concerned about the long-term health risks of
taking immunosuppressants.
For some transplants (especially bone marrow), there is also the possibility that immune cells
in the donated bone marrow will recognise the host’s body as foreign and attack the cells of
the host. This is known as graft-versus-host disease (GvHD). Doctors can take steps to try to
reduce the risk of GvHD.
A transplant between identical twins is called an isograft. The recipient will almost never reject
an isograft and so immunosuppressants are not needed.
Organs and tissues transplanted
Ongoing medical advances and research means new opportunities for innovation in
transplant are expanding to include face transplants.
Multi-organ transplants, while less common than single-organ transplants, occur each year.
Common multi-organ transplants include heart and lungs or pancreas and kidney.
The approach to transplantation varies greatly depending on the type of transplant. Talk to
your medical team about surgical procedures, recovery and medication.