There are 30 different groups of antigens present on the surface of our RBCs. 我們的紅細胞表面存在 30 種不同的抗原組。
Important in transfusion of blood 輸血中很重要
Agglutination or clumping takes place when antibodies in the serum reacts with antigens on RBCs. 當血清中的抗體與紅細胞上的抗原反應時，就會發生凝集或凝集。
ABO, most important ABO，最重要
Rh (Rhesus) Rh （恆河猴）
28 Others systems 28 其他系統
No antigens 無抗原
Blood type 0 0 型血
mADAM 夫人
Rhesus Antigen 恆河猴抗原
The Rh system is the second most significant blood-group system in human-blood transfusion with currently 50 antigens. Rh 系統是人類血液輸注中第二重要的血型系統，目前有 50 種抗原。
The most significant Rh antigen is the DD antigen (RhD) because it is the most likely to provoke an immune reaction. 最重要的 Rh 抗原是 DD 抗原 （RhD），因為它最有可能引發免疫反應。
There are Rhesus antigens D,E,C, and 47 others 有 Rh 抗原 D、E、C 和其他 47 種
Rh Blood Group System Rh 血型系統
Rh positive or Rh negative Rh 陽性或 Rh 陰性
Rh+ve people = have RhD antigen on RBC surface (& no RhD antibodies in the blood) Rh+ve 人=紅細胞表面有 RhD 抗原（血液中沒有 RhD 抗體）
(majority > 99%>99 \% of HK people are Rh+ve) （大多數 > 99%>99 \% 香港人是 Rh+ve）
Rh-ve people = don’t have RhD antigen on RBC surface , (& may have anti-D antibodies in the blood) Rh-ve 人=紅細胞表面沒有 RhD 抗原，（血液中可能有抗 D 抗體）
(minority of HK people are /Rh-ve) （少數香港人是 /Rh-ve） rarr\rightarrow Rh-ve person’s blood does not yet contain anti-D antibodies. But if they were exposed to Rh+ve blood somehow, 50-80% Rh-ve people will develop anti-D antibodies. rarr\rightarrow Rh-ve 人的血液中尚不含抗 D 抗體。但是，如果他們以某種方式接觸 Rh+ve 血液，50-80% 的 Rh-ve 人會產生抗 D 抗體。
Rhesus System consideration in Blood transfusion 輸血時對 Ror 系統的考慮
Rh+ve person : can receive both Rh+ve and Rhve blood Rh+ve 人 ： 可以同時接受 Rh+ve 和 Rhve 血液
Rh-ve person : can only receive Rh-ve blood (unless in emergency situation) Rh-ve 人 ： 只能接受 Rh-ve 血液（除非在緊急情況下）
AB 血型
Rh-ve mother with Rh+ve fetus, Rh-ve 母親與 Rh+ve 胎兒，
Mangement: 管理：
RhD immunoglobulin (RhIG) RhD 免疫球蛋白 （RhIG）
work by antibody feedback with T-cell suppression of the B-cell clone responsible for the formation of anti-D antibody. 通過抗體反饋與 T 細胞抑制負責形成抗 D 抗體的 B 細胞克隆起作用。
1 injection last 12 weeks, so, need several injections 1 次注射持續 12 周，因此需要多次注射
irradiated blood products (red blood cells and platelets concentrates)- after exposure 20 to 40 Gy
leukocyte (granulocyte) concentrates
BLOOD PRODUCTS(2)
Plasma products
fresh-frozen plasma (FFP)
cryoprecipitate
factor concentrates (VIII, IX)
albumin
immune globulins
BLOOD LOSS- signs, symptoms and indication for transfusion
Volume Lost
Clinical signs
mL
% of Total
Blood Volume (5 litres)
Volume Lost Clinical signs
mL % of Total
Blood Volume (5 litres) | Volume Lost | Clinical signs |
| :---: | :---: |
| mL | % of Total |
| Blood Volume (5 litres) | |
no transfusion or crystalloid solution
crystalloid solution or colloids or RBC if
necesssary| no transfusion or crystalloid solution |
| :---: |
| crystalloid solution or colloids or RBC if |
| necesssary |
1000
20
drop in BP
crystalloid solution plus colloids plus
RBC or blood if available
crystalloid solution plus colloids plus
RBC or blood if available| crystalloid solution plus colloids plus |
| :---: |
| RBC or blood if available |
1500
30
shock
crystalloid solution plus colloids
plus
crystalloid solution plus colloids
plus| crystalloid solution plus colloids |
| :--- |
| plus |
40
RBC or blood if available
500 10 "None;
tachycardia" "no transfusion or crystalloid solution
crystalloid solution or colloids or RBC if
necesssary"
1000 20 drop in BP "crystalloid solution plus colloids plus
RBC or blood if available"
1500 30 shock "crystalloid solution plus colloids
plus"
40 RBC or blood if available| 500 | 10 | None; <br> tachycardia | no transfusion or crystalloid solution <br> crystalloid solution or colloids or RBC if <br> necesssary |
| :--- | :---: | :---: | :---: |
| 1000 | 20 | drop in BP | crystalloid solution plus colloids plus <br> RBC or blood if available |
| 1500 | 30 | shock | crystalloid solution plus colloids <br> plus |
| | 40 | | RBC or blood if available |
crystalloid= salt solution eg normal sline
Indication for transfusion in anemic patients
The decision to transfuse is based on an assessment of the patient’s
clinical condition rather than a given level of hemoglobin
blood transfusion of patients with chronic stable anemia is probably unjustifiable if the hemoglobin level is above 7 g per 100ml
factors to consider include the symptomatic anemia(dizziness, weakness, shortness of breath), the patient’s age, the presence of underlying cardiac, pulmonary, or vascular disease.
Transfusion reactions
The ABO Blood System
Blood Type
(genotype)
Blood Type
(genotype)| Blood Type |
| :--- |
| (genotype) |
"Blood Type
(genotype)" "Type A
(AA, AO)" Type B (BB,BO) "Type AB
(AB)" Type 0 (00)
"Red Blood
Cell Surface
Proteins
(phenotype)" https://cdn.mathpix.com/cropped/2025_04_02_77e51ad293920ee03007g-17.jpg?height=470&width=512&top_left_y=557&top_left_x=522 https://cdn.mathpix.com/cropped/2025_04_02_77e51ad293920ee03007g-17.jpg?height=470&width=512&top_left_y=557&top_left_x=1054 https://cdn.mathpix.com/cropped/2025_04_02_77e51ad293920ee03007g-17.jpg?height=470&width=513&top_left_y=557&top_left_x=1565 No agglutinogens
Plasma Antibodies (phenotype) b agglutinin only https://cdn.mathpix.com/cropped/2025_04_02_77e51ad293920ee03007g-17.jpg?height=528&width=474&top_left_y=1143&top_left_x=1092 No agglutinin a and b agglutinin| Blood Type <br> (genotype) | Type A <br> (AA, AO) | Type B $(\mathrm{BB}, \mathrm{BO})$ | Type AB <br> (AB) | Type 0 (00) |
| :---: | :---: | :---: | :---: | :---: |
| Red Blood <br> Cell Surface <br> Proteins <br> (phenotype) |  |  |  | No agglutinogens |
| Plasma Antibodies (phenotype) | b agglutinin only |  | No agglutinin | a and b agglutinin |
-tFannsfusiporreactions:
Mild, in 1% of transfusions-- fever, chills and itch
. Severe transfusion reaction can result in death, rare (at <0.5 per 100, 000 transfusions.
Can result from ABO incompatibility, allergic reaction, bacterial contamination
Treatment: Stop transfusion and treat the cause Treat shock
Table-3: Number of transfusion reactions according to the type of blood component involved.
Father's Blood Type
A B AB 0
Mother'sBloodType A A or 0 A, B, AB, or O A,B or AB A or 0 Child's Blood type Must Be
B A,B,AB or O B or 0 A,B, or AB B or 0
AB A, B, or AB A, B, or AB A, B, or AB A or B
0 A or 0 B or O A or B 0 | | | Father's Blood Type | | | | |
| :---: | :---: | :---: | :---: | :---: | :---: | :---: |
| | | A | B | $A B$ | 0 | |
| Mother'sBloodType | A | A or 0 | A, B, AB, or O | $A, B$ or $A B$ | A or 0 | Child's Blood type Must Be |
| | B | $A, B, A B$ or $O$ | B or 0 | $A, B$, or $A B$ | $B$ or 0 | |
| | AB | A, B, or AB | A, B, or AB | A, B, or AB | A or B | |
| | 0 | A or 0 | B or O | $A$ or $B$ | 0 | |
Child's Blood Type
A
B
AB
0
Mother's
Blood 血
Type
A
A,B,AB\mathrm{A}, \mathrm{B}, \mathrm{AB} or O
BB or ABA B
BB or ABA B
A, B, or O
Father's Blood Type Must Be
B
AA or ABA B
A, B, AB or 0
AA or ABA B
A, B, or O
AB
A, B, AB or O
A, B, AB or 0
A,BA, B or ABA B
0
AA or ABA B
BB or ABA B
A, B, or O
Child's Blood Type
A B AB 0
Mother'sBloodType A A,B,AB or O B or AB B or AB A, B, or O Father's Blood Type Must Be
B A or AB A, B, AB or 0 A or AB A, B, or O
AB A, B, AB or O A, B, AB or 0 A,B or AB
0 A or AB B or AB A, B, or O | | | Child's Blood Type | | | | |
| :---: | :---: | :---: | :---: | :---: | :---: | :---: |
| | | A | B | AB | 0 | |
| Mother'sBloodType | A | $\mathrm{A}, \mathrm{B}, \mathrm{AB}$ or O | $B$ or $A B$ | $B$ or $A B$ | A, B, or O | Father's Blood Type Must Be |
| | B | $A$ or $A B$ | A, B, AB or 0 | $A$ or $A B$ | A, B, or O | |
| | AB | A, B, AB or O | A, B, AB or 0 | $A, B$ or $A B$ | | |
| | 0 | $A$ or $A B$ | $B$ or $A B$ | | A, B, or O | |
ABO Blood Group System
Phenotype
A
B
AB
O
Genotype
AA.or
AO
BB.or O
AB
OO
Genotype in the offspring
{:[" ABO genotype in the "],[" offspring "]:}\begin{array}{c}\text { ABO genotype in the } \\ \text { offspring }\end{array}
ABO alleles inherited from the
mother
" ABO genotype in the
offspring " ABO alleles inherited from the
mother | $\begin{array}{c}\text { ABO genotype in the } \\ \text { offspring }\end{array}$ | ABO alleles inherited from the | |
| :---: | :---: | :---: | :---: |
| mother | | |
