BLOOD TYPING SYSTEMS OTHER THAN ABO
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	BLOOD TYPES AND LISTS OF 'OTHER' VALUABLE BLOOD TYPING SYSTEMS USED FOR BLOOD TYPES AND BLOOD TYPING REFERENCE AND BLOOD TEST TYPE RESEARCH - DIFFERENCES IN BLOOD TYPES.	TO HOME PAGE
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First A Word About ABO Incompatibility.
Transfusing a patient with the incorrect ABO group Blood may have fatal consequences. Donor red cells may be destroyed by an antibody in the recipient's plasma. The rapid intravascular hemolysis which occurs in ABO incompatible transfusions can precipitate severe disseminated coagulation (DIC), prolonged hypotension, acute uraemia and even death. It has also been recognized that a potent anti-A or anti-B in donor Blood of group O may destroy the A or B red cells of a non-O recipient. This, together with the discovery of other red cell group systems, has completely altered the significance of the term 'universal donor' which is often applied to Blood of group O.

The MNSs System
This system was discovered by injecting animals with human red cells. There are two loci: M/N and S/s. The antigens are M, N, S, and s. There are naturally occurring (IgM) antibodies to all these antigens. Anti-S and anti-s commonly develop immune characteristics (IgG class) as a result of pregnancy or transfusion.

The P System
This system was also discovered by injecting animals with human red cells. P1 is the most common antigen which has variable strength of expression. Anti-P1 may be naturally occurring. It is most often an IgM antibody.

The Lutheran (Lu) System
This system is a single locus system, with antigens Lua and Lub. The Lu(a) negative phenotype is very rare. Antibodies to Lutheran antigens are IgG. The genes of the Lutheran group are linked to the genes responsible for the secretion of ABH substances.

The Kell System
In this system there are four antigens at two loci: K (Kell) and k (cellano), and Kpa and Kpb. The Kp(a+) phenotype and the Kp(a-b-) phenotype are both rare. The Knull phenotype K- k- Kp(a-b-) is associated with chronic granulomatus disease (CGD), an inherited defect in the bacterial capacity of neutrophils. Antibodies to Kell system antigens are IgG. Named for the family of the antibody producer Mrs. Kellacher.

The Lewis System
This system was focuses on a single locus with two antigens, Le a and Le b. These antigens do not form an integral part of the red cell membrane, but are soluble antigens which may be present in body fluids and secretions. They are adsorbed on to the surface of red cells if they are present in the plasma in sufficient amounts. There are only three phenotypes: Le(a-b-); Le(a+b-); and Le(a-b+). Lewis phenotypes may change during pregnancy. Examples of Le(a+b+) are only transient. Lewis antibodies are only found in Le(a-b-) individuals, and are almost entirely IgM. They are the only Blood group antibodies which have never been implicated in HDN (hemolytic disease of the newborn.)

The Duffy System
The Duffy system is also a single locus with two antigens, Fy a and Fy b. The only rare phenotype is Fy(a-b-), which has a higher frequency in countries where there is a high incidence of Plasmodium falciparium malaria. This phenotype gives a degree of immunity to the disease because the malarial parasite requires Duffy antigens to enter the red cells. Duffy antibodies are almost exclusively IgG. This system is named after the family of the antibody producer, Duffy.

The Kidd (Jk) System
Another single locus system, two antigen system (Jka and Jkb). There are four possible phenotypes: Jk(a-b-); Jk(a+b-); Jk(a-b+); Jk(a+b+). Jk(a-b-) is a rare phenotype. Antibodies to the Kidd antigens are almost exclusively IgG.
Incompatible transfusion or pregnancy can lead to the formation of antibodies to all these Blood groups, if the recipient/mother lacks the relevant antigen. It is possible to detect all red cell antibodies using an antibody detection panel and different detection techniques. (Some antibodies, usually IgM class, react best at room temperature or cooler, and some work best at 37 degrees entigrade). If an antibody is detected in a serum the red cells from that patient are tested for the presence of the antigen. Antigen detection techniques also vary according to the nature of the antibody-antigen interaction. The presence of a particular antibody specifically excludes the patient from carrying that antigen.

The Rhesus (Rh) System
The Rhesus system is the most important of the other commonly utilized Blood grouping systems. It was discovered by Landsteiner and Weiner in 1940. Their experiment was to produce an antibody to the red cells of the Rhesus monkey in rabbits and guinea pigs, but they discovered that not only did the antibody in the rodents' serum agglutinate the Rhesus monkey red cells, it also agglutinated the red cells of 85% of the human population. If an individual's red cells were clumped together by this antiserum, they were said to have the Rhesus factor on their red cells (i. e. Rh positive). If an individual's cells were not agglutinated by the antiserum, they were said to lack the Rhesus factor (i. e. Rh negative).

The Fisher System
It is now known that the Rh system is very complex, and our present understanding is based on the Fisher system. There are three genes making up Rhesus antigens: C, D, and E, found on chromosome 1. There are two possible alleles at each locus: c or C; d or D; and e or E. One haplotype consisting of c/C, d/D, e/E is inherited from each parent, and the resulting Rhesus type of the individual depends on their inherited genotype. The haplotypes are given a code as follows in the table below.

If an individual's Rh genotype contains at least one of the C, D, E antigens, they are Rhesus positive. Only individuals with the genotype cde/cde (rr) are Rhesus negative. For Blood transfusion purposes, donors possessing C or E, even in Rh types r'r and r''r are classed as Rh positive. Recipients of Blood transfusions with Rh types r' and r'' should receive Rh negative (rr) Blood. This is to prevent sensitization to Rh antigens and subsequent Rh antibody formation. The most common Rh antibody is anti-D, but it is possible to form antibodies to c, C, e, and E as well, and to form combinations of antibodies. There is no anti-d  

http://www.umds.ac.uk/tissue/bludgrp.html

Blood Group Details Explained from SCARF

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   last updated 09/10/2005   bloodbook.com