Blood grouping & Rh factor

Blood grouping & Rh factor

A blood type (also known as a blood group) is a classification of blood, based on the presence and absence of antibodies and inherited antigenic substances on the surface of red blood cells (RBCs).

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  • These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system.
  • Some of these antigens are also present on the surface of other types of cells of various tissues.
  • Several of these red blood cell surface antigens can stem from one allele (or an alternative version of a gene) and collectively form a blood group system.

The blood’s composition varies between individuals. This difference in structure is what makes a person’s blood type.

An individual’s blood type depends on which genes they inherited from their parents.

As of 2019, a total of 41 human blood group systems are recognized by the International Society of Blood Transfusion (ISBT).

  • The two most important blood group systems are ABO and Rh; they determine someone’s blood type for suitability in blood transfusion.
  • ABO is the best-known system for grouping blood types, though there are other methods. There are four major categories within the ABO group: A, B, O, and AB. (A, B, AB, and O, with +, − or null denoting RhD status).
  • Each group can be either RhD positive or RhD negative, which means in total there are 8 blood groups.
  • Rh blood group system, system for classifying blood groups according to the presence or absence of the Rh antigen, often called the Rh factor, on the cell membranes of the red blood cells (erythrocytes). The designation Rh is derived from the use of the blood of rhesus monkeys in the basic test for determining the presence of the Rh antigen in human blood.

Each and every second, a person needs blood. When a person needs a transfusion, doctors must give them the right type. The wrong blood type can trigger an adverse reaction that could be life-threatening.

  • Antibodies and antigens

Blood is made up of red blood cells, white blood cells and platelets in a liquid called plasma. Your blood group is identified by antibodies and antigens in the blood.

  • Antibodies are proteins found in plasma. They’re part of your body’s natural defences. They recognise foreign substances, such as germs, and alert your immune system, which destroys them.
  • Antigens are protein molecules found on the surface of red blood cells.
  • The ABO system

There are 4 main blood groups defined by the ABO system:

  • Blood group A – has A antigens on the red blood cells with anti-B antibodies in the plasma
  • Blood group B – has B antigens with anti-A antibodies in the plasma
  • Blood group O – has no antigens, but both anti-A and anti-B antibodies in the plasma
  • Blood group AB – has both A and B antigens, but no antibodies
  • Blood group O is the most common blood group.

Receiving blood from the wrong ABO group can be life-threatening. For example, if someone with group B blood is given group A blood, their anti-A antibodies will attack the group A cells.

  • This is why group A blood must never be given to someone who has group B blood and vice versa.
  • As group O red blood cells do not have any A or B antigens, it can safely be given to any other group.
  • The Rh system

Red blood cells sometimes have another antigen, a protein known as the RhD antigen. If this is present, your blood group is RhD positive. If it’s absent, your blood group is RhD negative.

This means you can be 1 of 8 blood groups:

  • A RhD positive (A+)
  • A RhD negative (A-)
  • B RhD positive (B+)
  • B RhD negative (B-)
  • RhD positive (O+)
  • RhD negative (O-)
  • AB RhD positive (AB+)
  • AB RhD negative (AB-)
  • About 85% of the UK population is RhD positive (36% of the population has O+, the most common type).
  • In most cases, O RhD negative blood (O-) can safely be given to anyone. It’s often used in medical emergencies when the blood type is not immediately known.
  • It’s safe for most recipients because it does not have any A, B or RhD antigens on the surface of the cells, and is compatible with every other ABO and RhD blood group.
  • Blood group test

To work out your blood group, your red cells are mixed with different antibody solutions. If, for example, the solution contains anti-B antibodies and you have B antigens on your cells (you’re blood group B), it will clump together.

  • If the blood does not react to any of the anti-A or anti-B antibodies, it’s blood group O. A series of tests with different types of antibody can be used to identify your blood group.
  • If you have a blood transfusion – where blood is taken from one person and given to another – your blood will be tested against a sample of donor cells that contain ABO and RhD antigens. If there’s no reaction, donor blood with the same ABO and RhD type can be used.
  • Pregnancy

Pregnant women are always given a blood group test. This is because if the mother is RhD negative but the child has inherited RhD-positive blood from the father, it could cause complications if left untreated.

  • RhD-negative women of child-bearing age should always only receive RhD-negative blood.
  • Giving blood

Most people are able to give blood, but only 1 in 25 people actually do. You can donate blood if you:

  • are fit and healthy
  • weigh at least 50kg (7st 12lb)
  • are 17-66 years old (or 70 if you’ve given blood before)
  • are over 70 and have given blood in the last 2 years


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