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Blood Types; Transfusion; Tissue and Organ Transplantation



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Blood Types; Transfusion; Tissue and Organ Transplantation 
Antigenicity Causes 
Immune Reactions of Blood Multiplicity of Antigens in the Blood Cells. 
At least 30 
commonly occurring antigens and hundreds of other rare antigens, each of which can at times cause 
antigen-antibody reactions, have been found on the surfaces of the cell membranes of human blood 
cells. Most of the antigens are weak and therefore are of importance principally for studying the 
inheritance of genes to establish parentage. Two particular types of antigens are much more likely than 
the others to cause blood transfusion reactions. They are the 
O-A-B 
system of antigens and the 
Rh 
system. 
Agglutinins 
When type A agglutinogen 
is not present 
in a person‘s red blood cells, antibodies known as 
anti-A 
agglutinins 
develop in the plasma. Also, when type B agglutinogen
is not present 
in the red blood cells, 
antibodies known as 
anti-B agglutinins 
develop in the plasma. Thus, referring once again to Table 35-
1, note that type O blood, although containing no agglutinogens, does contain both 
anti-A 
and 
anti-B 
agglutinins; 
type A blood contains type A agglutinogens and 
anti-B agglutinins; 
type B blood contains 
type B agglutinogens and anti-A agglutinins. Finally, type AB blood contains both A and B 
agglutinogens but no agglutinins. 
Titer of the Agglutinins at Different Ages. 
 
Agglutination Process in Transfusion Reactions 
When bloods are mismatched so that anti-A or anti-B plasma agglutinins are mixed with red blood 
cells that contain A or B agglutinogens, respectively, the red cells agglutinate as a result of the 
agglutinins‘ attaching themselves to the red blood cells. Because the agglutinins have 2 binding sites 
(IgG type) or 10 binding sites (IgM type), a single agglutinin can attach to two or more red blood cells 
at the same time, thereby causing the cells to be bound together by the agglutinin. This causes the cells 
to clump, which is the process of ―agglutination.‖ Then these clumps plug small blood vessels 
throughout the circulatory system. During ensuing hours to days, either physical distortion of the cells 
or attack by phagocytic white blood cells destroys the membranes of the agglutinated cells, releasing 
hemoglobin into the plasma, which is called ―
hemolysis
‖ of the red blood cells. these antibodies are 
called 
hemolysins
.

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