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2350 Part XIII: Transfusion Medicine Chapter 136: Erythrocyte Antigens and Antibodies 2351
3. Cartron JP, Bailly P, Le Van Kim C, et al: Insights into the structure and function of
TABLE 136–7. ABO-Rh Compatibility Guidelines membrane polypeptides carrying blood group antigens. Vox Sang 74(Suppl 2):29, 1998.
Compatible Blood Groups 4. Daniels G: Human Blood Groups, 3rd ed. Blackwell Science, Oxford, 2013.
5. Issitt PD, Anstee DJ: Applied Blood Group Serology, 4th ed. Montgomery Scientific,
Antigen on Antibody Donor Red Donor Durham, NC, 1998.
Red Cells in Serum Cells Plasma 6. Reid ME, Lomas-Francis C, Olsson ML: Blood Group Antigen FactsBook, 3rd ed.
Academic Press, San Diego, 2012.
If recipient blood group is 7. Telen MJ: Erythrocyte blood group antigens: Not so simple after all. Blood 85:299, 1995.
8. Cartron JP, Colin Y: Structural and functional diversity of blood group antigens. Trans-
A A Anti-B A, O A, AB fus Clin Biol 8:163, 2001.
9. Bruce LJ, Ghosh S, King MJ, et al: Absence of CD47 in protein 4.2-deficient hereditary
B B Anti-A B, O B, AB
spherocytosis in man: An interaction between the Rh complex and the band 3 complex.
O O Anti-A, O O, A, B, AB Blood 100:1878, 2002.
anti-B 10. Reid ME, Mohandas N: Red blood cell blood group antigens: Structure and function.
Semin Hematol 41:93, 2004.
AB A, B None AB, A, B, O AB 11. Fung MK, Grossman BJ, Hillyer C, et al, editors: Technical Manual, 18th ed. American
Association of Blood Banks, Bethesda, MD, 2014.
Rh- D None Rh-positive, Rh not 12. Storry JR, Castilho L, Daniels G, et al: International Society of Blood Transfusion
positive Rh-negative considered Working Party on Red Cell Immunogenetics and Terminology: Cancun report (2012).
Vox Sang 107:90, 2014.
Rh- None Anti-D Rh-negative Rh not 13. Daniels GL, Anstee DJ, Cartron J-P, et al: Blood group terminology 1995. ISBT working
negative only if considered party on terminology for red cell surface antigens. Vox Sang 69:265, 1995.
immunized 14. Garratty G, Dzik WH, Issitt PD, et al: Terminology for blood group antigens and genes:
Historical origins and guidelines in the new millennium. Transfusion 40:477, 2000.
Whole blood must be identical to recipient’s blood group. Red blood 15. Reid ME, Lomas-Francis C: Blood Group Antigens & Antibodies: A Guide to Clinical
Relevance & Technical Tips. Star Bright Books, New York, 2007.
cell (RBC) products must be compatible with recipient’s serum. 16. Klein HG, Anstee DJ: Mollison’s Blood Transfusion in Clinical Medicine, 11th ed.
Plasma products should be compatible with recipient’s RBCs. Platelet Wiley-Blackwell, Oxford, 2006.
and cryoprecipitate products should be compatible with recipient’s 17. Clausen H, White T, Takio K, et al: Isolation to homogeneity and partial characteri-
RBCs, but any ABO group can be given if compatible products are zation of a histo-blood group A defined Fuca1—>2Gala1—>3-N-acetylglucosaminyl-
not available. transferase from human lung tissue. J Biol Chem 265:1139, 1990.
18. Yamamoto F, Marken J, Tsuji T, et al: Cloning and characterization of DNA comple-
mentary to human UDP-GalNAc: Fuca1—>2Gala1—>3GalNAc transferase (histo-
blood group A transferase) mRNA. J Biol Chem 265:1146, 1990.
Repeat donor testing and crossmatching are not performed 19. Yamamoto F, Hakomori S: Sugar-nucleotide donor specificity of histo-blood group A
for plasma and platelet components, but the recipient’s ABO and Rh and B transferases is based on amino acid substitutions. J Biol Chem 265:19257, 1990.
phenotypes must be known for appropriate selection of components. 20. Yamamoto F, Clausen H, White T, et al: Molecular genetic basis of the histo-blood
group ABO system. Nature 345:229, 1990.
Table 136–7 gives general ABO-D compatibility guidelines. 21. Chester MA, Olsson ML: The ABO blood group gene: A locus of considerable genetic
diversity. Transfus Med Rev 15:177, 2001.
22. Olsson ML, Chester MA: Polymorphism and recombination events at the ABO locus: A
ANTIBODY IDENTIFICATION major challenge for genomic ABO blood grouping strategies. Transfus Med 11:295, 2001.
23. Garratty G: Association of blood groups and disease: Do blood group antigens and
All unexpected antibodies should be investigated. Those detected in antibodies have a biological role? Hist Philos Life Sci 18:321, 1996.
serum or plasma as an ABO discrepancy, a positive antibody screen- 24. Avent ND, Reid ME: The Rh blood group system: A review. Blood 95:375, 2000.
ing result, or an incompatible crossmatch are identified using a panel of 25. Tippett P, Lomas-Francis C, Wallace M: The Rh antigen D: Partial D antigens and asso-
ciated low incidence antigens. Vox Sang 70:123, 1996.
eight to 16 different group O red cells that have been typed for antigens 26. Huang C-H, Liu PZ, Cheng JG: Molecular biology and genetics of the Rh blood group
corresponding to clinically significant antibodies. Serum reactions with system. Semin Hematol 37:150, 2000.
these RBCs are compared to their antigen typing to determine specific- 27. Reid ME: Applications of DNA-based assays in blood group antigen and antibody iden-
tification. Transfusion 43:1748, 2003.
11
ity. For example, an antibody that reacts with all K+ RBCs but not with 28. Giblett ER: A critique of the theoretical hazard of inter vs. intra-racial transfusion.
K– cells most likely is anti-K. Transfusion 1:233, 1961.
A control of autologous RBCs and serum is tested concurrently 29. Tippett P: Regulator genes affecting red cell antigens [review]. Transfus Med Rev 4:56,
with panel RBCs. Absence of reactivity with autologous cells implies the 1990.
antibody is an alloantibody, whereas a positive result suggests autoan- 30. Singleton BK, Burton NM, Green C, et al: Mutations in EKLF/KLF1 form the molecular
basis of the rare blood group In(Lu) phenotype. Blood 112:2081, 2008.
tibody or a positive direct antiglobulin test result. Once antibody spec- 31. Okubo Y, Yamaguchi H, Nagao N, et al: Heterogeneity of the phenotype Jk(a–b–) found
ificity is identified, the patient’s RBCs are tested for the corresponding in Japanese. Transfusion 26:237, 1986.
antigen. If the alloantibody is anti-K, the cells should type K–. Such 32. Hakomori S: Blood group ABH and Ii antigens of human erythrocytes: Chemistry,
polymorphism, and their developmental change. Semin Hematol 18:39, 1981.
antigen typing helps to confirm serum findings. 33. Spitalnik PF, Spitalnik SL: The P blood group system: Biochemical, serological, and
When antibody is detected both on red cells (a positive direct anti- clinical aspects. Transfus Med Rev 9:110, 1995.
globulin test result) and in serum, only the antibody in serum is identi- 34. Pogo AO, Chaudhuri A: The Duffy protein: A malarial and chemokine receptor. Semin
Hematol 37:122, 2000.
fied unless a review of the medical, pregnancy and transfusion history 35. Araten DJ, Swirsky D, Karadimitris A, et al: Cytogenetic and morphological abnormal-
offers evidence that the antibodies might be different. When antibody is ities in paroxysmal nocturnal haemoglobinuria. Br J Haematol 115:360, 2001.
detected only on RBCs and in vivo hemolysis is suspected, the antibody 36. Tippett P, Ellis NA: The Xg blood group system: A review. Transfus Med Rev 12:233,
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can be eluted from the patient’s RBCs and tested against panel RBCs to 37. Cartron J-P, Rahuel C: Human erythrocyte glycophorins: Protein and gene structure
identify the specificity. analyses. Transfus Med Rev 6:63, 1992.
38. Tournamille C, Colin Y, Cartron JP, Le Van Kim C: Disruption of a GATA motif in the
Duffy gene promoter abolishes erythroid gene expression in Duffy-negative individu-
als. Nat Genet 10:224, 1995.
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