Blood group system

Contamination of blood products with lymphocytes can lead to transfusion-induced reactions ranging from a mild fever to severe reactions such as alloimmunization and graft versus host disease (GvHD), in which the transfused lymphocytes (graft) survive the defensive immune reaction of the patient (host) and start a reaction which destroys the cells of the host. The patient also may develop an immune response to the human leukocyte antigen (HLA) type of the graft s cells and reject all platelet transfusions that do not match their own HLA system. The HLA system, found on blood platelets and lymphocytes, is more compHcated than, but similar to, the ABO blood group system of red cells. 

Transfusion-induced autoimmune disease has been a significant complication in the treatment of patients who require multiple platelet transfusions. Platelets and lymphocytes carry their own blood group system, ie, the human leukocyte antigen (HLA) system, and it can be difficult to find an HLA matched donor. A mismatched platelet transfusion does not induce immediate adverse reactions, but may cause the patient to become refractory to the HLA type of the transfused platelets. The next time platelets with an HLA type similar to that of the transfused platelets are transfused, they are rejected by the patient and thus have no clinical efficacy. Exposure to platelets originating from different donors is minimized by the use of apheresis platelets. One transfusable dose (unit) of apheresis platelets contains 3-5 x 10 platelets. An equal dose of platelets from whole blood donation requires platelets from six to eight units of whole blood. Furthermore, platelets can be donated every 10 days, versus 10 weeks for whole blood donations. 

Biologicals. Figure 1 The ABO blood group system with immunochemical specificity due to terminal sugars and reciprocal antibodies in the serum. From Immunity Immune Response in Inflammatory Disease by DeFranco, Locksley and Robertson [2]. 

THE BIOCHEMICAL BASES OF THE ABO BLOOD GROUP SYSTEM HAVE BEEN ESTABLISHED... 

ABO Blood group system (A, AB, B, and O) ARD Acute respiratory disease adult respiratory... 

Karl Landstiener was the first to demonstrate the existence of different blood group antigens in 1900. We now recognize 29 different blood group systems comprising over 250 antigens, but the most well known are the ABO (also known as ABH) and rhesus (Rh) systems. 

During blood transfusions, immune reactions can occur that destroy the erythrocytes transfused from the donor. These reactions result from the formation of antibodies (see p. 300) directed to certain surface structures on the erythrocytes. Known as blood group antigens, these are proteins or oligosaccharides that can differ from individual to individual. More than 20 different blood group systems are now known. The ABO system and the Rh system are of particular clinical importance. 

The oligosaccharide structures responsible for the ABO blood-group system have been related by using the appropriate glycosyltransferases for interconversion, and the results have been reviewed.223,373 Blood-group H substance (91) was converted374 into an A-active substance (92) with... 

Marcus, D. M., The ABO and Lewis Blood-Group System. Immunochem-... 

Watkins WM (1995) Biosynthesis 5. Molecular basis of t antigenic specificity in the A, B, 0, H and Lewis blood group system. In Montreuil J, Vliegenthart JFG, Schachter H (eds) (1995) New Comprehensive Biochemistry Vol 29a, Glycoproteins. Elsevier, Amsterdam, p 313... 

Chaudhuri, A., Polyakova, J., Zbrzezna, V., Williams, K., Gulati, S., and Pogo, A. O. (1993) Cloning of the gpD protein cDNA, the major subunit of the Duffy blood group system and the receptor for the Plasmodium vivax malaria parasite. Proc. Natl. Acad. Sci. USA 90, 10,793-10,797. 

Glycoprotein blood group system, a family of red blood cell antigens. The Lutheran... 

Spitalnik P, Spitalnik S. The P blood group system Bio- 61. chemical, serological and clinical aspects. Transfus. Med. Rev. 1995 9 110-122. 

Interestingly, compatibility within the blood group system has proved to be the decisive factor in liver transplantation to date. Although the HLA system is usually determined (for retrospective evaluation), it is of minor importance according to present knowledge. This is also true of so-called "cross-matching between... 

Beside the ABO blood group system a number of additional carbohydrate-based antigenic determinants are known (O Table 2), which are, however, not only recognized by antibodies. Some of them are more highly expressed on tumor cells and therefore can be described as tumor-associated antigens [115]. Synthetic tumor-associated antigens such as Lewis y or Globo H have been used in the development of antitumor vaccines [116,117]. 

Avent ND. Molecular biology of the Rh blood group system. J Pediatr Hematol Oncol 2001 23 394-402. 

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