Introduction to the ABO Blood Group System

Catherine E. Newkirk, MS, MT(ASCP), Janet H. Coggins, MT(ASCP), SBB Reviewers: Aileen Hyde MS, MT(ASCP), Paul Fekete, MD

Introduction to ABO Blood Group System is an introductory-level course appropriate for MT and MLT students, pathology residents, or others who need a review of basic biochemistry, genetics, and reactions of the ABO system.

This course can also be used for CLS schools for academic instruction or could be used as a basic orientation for MT and MLT students who are beginning their blood bank rotation during internship.

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Continuing Education Credits

• P.A.C.E.® Contact Hours: 1 hour(s)
• Florida Board of Clinical Laboratory Science Credit Hours: General: 1 hour(s)

Objectives

• Outline the background and development of the ABO system.
• List antigens and antibodies of the system, including subgroups.
• Discuss the inheritance of the ABO antigens, including explanation of the genotype and phenotypes.
• Discuss development of serum antibodies with respect to "naturally" occurring antibodies and immune antibodies.
• Explain the procedure for routine ABO slide and tube typing and interpretation of results.
• Correctly perform routine ABO typing on ten patient blood samples.
• Determine the ABO blood group, given the forward and reverse typing results.

Course Outline

Click on a link in the outline to view a sample page from this course.

• Background and Introduction to the ABO System
• The History of the ABO System
• The History of the ABO System (cont.)
• Table 1: ABO Blood Group System
• Table 2: Testing the Patient Red Cells with Known Antisera (Forward Typing)
• Table 3: Testing the Serum with Known Red Cells (Reverse Typing)
• Importance of Understanding the ABO System
• Epitopes
• Why does agglutination (clumping) sometimes occur when red cells from one individual are mixed with serum from another?
• Match the blood types in the drop down boxes with the characteristics on the right.
• In order to determine the ABO type, known antisera are mixed  with patient RBCs and known red cells are mixed with patient serum.
• Genetic Basis for Cellular Antigens
• Galactose and ABO Antigen Precursor Substance
• Fucose
• "A" Antigenic Activity
• "B" Antigenic Activity
• The H gene
• The Bombay Blood Group
• A, B, and O Genes
• A, B, and O Genes - Diagram
• Bombay Blood Group Genes
• Inherited Genes
• Deducing the Gene
• Genotyping Through Genetics
• Determining Possible Offspring
• Punnett Squares
• Which specific terminal sugar causes a red cell to have A antigenic activity?
• Which specific terminal sugar causes a red cell to have B antigenic activity?
• What specific sugar configuration is necessary as a base for attachment of other sugars?
• How many gene loci regulate red cell ABO antigen development?
• O blood cell membranes contain which the following?
• Which of the following is true of Bombay cells?
• If an individual inherits an A gene from one parent and a B gene from the other, what ABO type will be exhibited?
• If an individual is type O, what is his/her ABO genotype?
• Which of the following genotypes would never result in a group A phenotype?
• Which of the following phenotypes is NOT possible in an offspring from an AB and BO mating? 
• Development of Serum Antibodies
• ABO Antibodies
• Anti-A and Anti-B Development
• ABO Antibodies and Aging
• "Immune" ABO Antibodies
• Immunoglobulin
• Anti-A and anti-B are stimulated by bacteria which have been shown to contain substances that are chemically similar to human A and B antigens.
• What is present in the blood of an individual with the Bombay phenotype which will cause it to agglutinate with any non-Bombay individu...
• There are some instances in which ABO reverse typing may be unreliable, such as in newborns, the elderly, or patients with hypogammaglobulinemia.
• Which of the following is NOT a way in which "immune" ABO antibodies may be formed?
• Subgroups of A
• Strength of the A Antigen
• A1 and A2
• Rare Subgroups of A
• Inherited Antigens
• Why Knowledge of A Subgroups Is Important For Laboratorians
• Reaction of Red Cell Subgroups With Known Antisera
• Which of the following is the most common subgroup of A?
• A1 and A2 individuals cannot be differentiated.
• Why may the presence of A subgroups cause ABO typing discrepancies?
• ABO Typing
• Agglutination Reactions
• Forward Typing
• Testing the Red Cells With Known Antisera
• Reverse Typing
• Testing Patient Serum With Known Reagent Red Cells (Reverse Grouping)
• Interpretation of ABO Group
• Example of an ABO discrepancy
• Automated Systems
• At what temperature range is the ABO antigen-antibody reaction best observed?
• Which of the following statements best describe forward typing?
• Which of the following best describes reverse typing?

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