Blood Groups Book

Abbreviations     ix
An introduction to blood groups     1
What is a blood group?     1
Blood group antibodies     2
Clinical importance of blood groups     3
Biological importance of blood groups     3
Blood group systems     4
Blood group terminology and classification     5
Techniques used in blood grouping     7
Factors affecting antigen-antibody reactions     7
Temperature     7
Time and ionic strength     8
pH     8
Antigen density     8
Stages of haemagglutination reactions     9
Direct agglutination     10
Indirect agglutination     11
Enzyme techniques     11
Antiglobulin tests     12
Elution techniques     17
Automation of test procedures     17
Flow cytometry     18
Molecular blood group genotyping     19
The ABO blood groups     20
Introduction     20
ABO antigens, antibodies, and inheritance     20
A[subscript 1] and A[subscript 2]     21
Antigen, phenotype, and gene frequencies     22
ABO antibodies     23
The importance of the ABO system to transfusion and transplantation medicine     24
The biochemical nature of the ABO antigens     25
Biosynthesis of the ABO antigens and ABO molecular genetics     26
H, the precursor of A and B     27
ABH secretion     28
H-deficient red cells     29
Further complexities     30
Acquired changes     31
Associations with disease and functional aspects     31
The Rh blood group system     33
Introduction - Rh, not rhesus     33
Haplotypes, genotypes, and phenotypes     34
Biochemistry and molecular genetics     35
D antigen (RH1)     36
Molecular basis of the D polymorphism     37
D variants     37
Clinical significance of anti-D     39
D testing     40
Prediction of RhD phenotype from fetal DNA     40
C, c, E, and e antigens (RH2, RH4, RH3, RH5)     41
Clinical significance of CcEe antibodies     41
Molecular basis of the C/c and E/e polymorphisms     41
Other Rh antigens     42
Compound antigens: ce, Ce, CE, cE (RH6, RH7, RH22, RH27) and G (RH12)     42
C[superscript w], C[superscript x], MAR (RH8, RH9, RH51)     42
VS, V (RH20, RH10)     43
Rh-deficient phenotypes - Rh[subscript null] and Rh[subscript mod]     43
Putative function of the Rh proteins and RhAG     43
Other blood groups     45
The Kell system     45
The Kell glycoprotein and the Kel gene     46
Kell-system antigens     46
Kell-system antibodies     47
K[subscript 0] phenotype     47
McLeod syndrome, McLeod phenotype, and Kx (XK1) antigen     47
The Duffy system     48
Fy[superscript a] (FY1) and Fy[superscript b] (FY2)     48
Anti-Fy[superscript a] and -Fy[superscript b]     49
Fy3 and Fy5     49
The Duffy glycoprotein, a receptor for chemokines     49
Duffy and malaria     49
The Kidd system     50
Jk[superscript a] (JK1) and Jk[superscript b] (JK2); anti-Jk[superscript a] and -Jk[superscript b]     50
Jk(a-b-) and Jk3     50
The Kidd glycoprotein is a urea transporter     51
The MNS system     51
M (MNS1) and N (MNS2); anti-M and -N     52
S (MNS3) and s (MNS4); anti-S and -s     52
S- s- U- phenotype and anti-U      52
Other MNS antigens and antibodies     53
The Diego system     53
Band 3, the red cell anion exchanger     53
Di[superscript a] (DI1) and Di[superscript b] (DI2); anti-Di[superscript a] and -Di[superscript b]     53
Wr[superscript a] (DI3) and Wr[superscript b] (DI4); anti-Wr[superscript a] and -Wr[superscript b]     54
Other Diego-system antigens     54
The Lewis system     55
Some other blood group systems     56
P     56
Lutheran     56
Yt     57
Xg     57
Scianna     57
Dombrock     57
Colton     57
Landsteiner-Wiener (LW)     57
Chido/Rodgers     57
Gerbich     58
Cromer     58
Knops     58
Indian     58
I     58
Antigens that do not belong to a blood group system     59
Clinical significance of blood group antibodies     60
Antibody production and structure     61
Factors affecting the clinical significance of antibodies     63
Antibody specificity     64
Haemolytic transfusion reactions     65
Intravascular red cell destruction     65
Extravascular red cell destruction     65
Haemolytic disease of the fetus and newborn     66
Cross-matching for infants under 4 months old     68
Autoantibodies     70
Tests to assess the potential significance of an antibody     70
Decision-making for transfusion     71
Quality assurance in immunohaematology     73
Achieving total quality     73
Frequency and specificity of control material     73
Quality requirements for safe transfusion practice     76
Checklist of critical control points     76
QC for molecular blood group testing     77
Trouble-shooting and problem-solving in the reference laboratory     78
ABO grouping     78
Rh grouping     78
Problems in antibody screening, identification, and cross-matching     78
Frequently asked questions     88
Recommended reading     95
Index     97