Team:Tuebingen

Background Information

The advent of modern medicine has also created a growing need for blood transfusions. Many modern treatments for various diseases are only possible due to advanced transfusion medicine. Especially emergency medicine is heavily dependent on a constant supply of donor blood in order to save lives.

There are many aspects of blood that need to be considered before a patient can receive a transfusion since erythrocytes (red blood cells) show various antigens on their surface that could be recognized by the receiver’s immune system and thereby cause complications. The ABO antigens are the most widely known antigens of erythrocytes and together with the Rhesus factor are the most relevant antigens for transfusions. When only considering the ABO system and Rhesus factor there are the blood types A, B, AB and O, either with or without the Rhesus factor antigen (Rhesus factor positive or negative). Generally, an individual always has antibodies against antigens that are not expressed on the surface of the own erythrocytes.

The ABO antigens consist of glycosilated proteins on the erythrocyte’s surface. Individuals with blood types A or B both have a distinct glycosilation that serves as an antigen. Individuals with blood type AB have a mix of proteins: some are glycosilated analogous to blood type A and some are glycosilated analogous to blood type B. The blood type O antigen (“H antigen”) is a primitive glycosilation that serves as a basis for the glycosilations that then form type A or B. It is important to note here that there are no antibodies against the H antigen and the anti-A and anti-B antibodies do not interact with this very basic glycosilation. Thus, it is possible to transfer type O to individuals with any other blood group – type O is the universal donor.

Often, the blood type of patients needing emergency transfusions is unknown and tests would take too long or are not possible in the given situation. Thus, patients of unknown blood type receive the universal donor blood type O. This, however, creates a huge demand for blood of type O and clinics usually have to plan ahead carefully in order to always keep a sufficient stock of type O blood. Especially in crisis regions the stockpiling of type O blood is a difficult task.

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