The main antigens in the MNS system are M, N, S and s though there are more than 40 known antigens in the group. K and k are the most important antigens in this group. ![]() The Kell blood group is complex, contains 25 antigens and is the next most important in terms of immunogenicity after ABO and Rh. It is important to note that expression of blood group antigens is not restricted to red blood cells, as they may also be expressed elsewhere. Īlthough ABO and Rhesus D are the most important of the blood groups in terms of blood transfusion there are 38 blood group subtypes now recognised by the International Society of Blood Transfusion (ISBT) - some of which are outlined below. There are 5 main Rhesus (Rh) antigens on blood cells – C, c, D, E and e but Rhesus D is the most important for blood transfusions. ![]() There is a rare blood type called Bombay in which individuals do not express A, B or H antigens. Although type O individuals do not express A or B antigens, they do express the H antigen which is a precursor to A and B antigens. Blood transfusions fail if incompatible blood types are given due to the presence of anti-A or anti-B antibodies in the plasma. This is of great importance for blood transfusions as individuals who express the A antigen have anti-B antibodies in their plasma and vice versa. Individuals can express either A, B, AB or no A or B antigen (type O). (titer value more than 2 tubes difference in consecutive sample collected within a month is considered critical value here).The ABO blood group system involves expression of antigen A or B on the red blood cell surface. We also perform titer on the antibodies to predict potential HDFN, which is supervised by our Medical Director. Here in the US, we used MMA assay instead of CLT). (This test is a test that predict hemolytic potential, just like reminiscence assay performed in Europe as the journal that Malcolm has describe above. If mom cannot donate, you can also send out the sample for monocyte mono layer assay (MMA) to see if anti-Dib is clinically significant or if you can transfuse this patient Di(b+), had she bleed during her C section. Any thoughts or ideas for a different strategy?Ĭollect autologous unit if she can donate. If we can get units that are antigen negative for all 3 that's great, but the patient is not a scheduled C-section so the timing will be next to impossible. Therefore, my strategy is to have units that are at least antigen negative for Fya and Jka for the mom in case we cannot obtain units that are negative for all 3 antigens. From my reading the Diego antibodies are more commonly associated with HDFN than transfusion reactions, and anti-Dib typically causes mild HDFN. Most likely the units would be frozen and our local supplier would have them shipped in already thawed and deglycerolized, plus the time of flying them here is a challenge with flight schedules to our area. ![]() ![]() The prospect of getting blood is problematic. My concern is if we have to transfuse the mother. All 3 antibodies are capable of causing HDFN, although usually mild from what I have read. Our Reference Lab has informed us that a patient's sample we sent to them has anti-Dib (Diego b), anti-Fya, and anti-Jka! The patient is pregnant and due the end of July.
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