In modern medicine, the blood group procedure is still quite often used - this is the process of its implementation from a healthy donor to a patient with health problems (recipient). It requires compliance with certain rules, and is not without complications. Therefore, this operation is carried out with the utmost concentration of attention from medical personnel.

What is needed at the very beginning?

Before starting the transfusion procedure, the doctor will conduct a survey and the necessary studies. The donor or recipient must have a passport with them in order to correctly record all data. If they are present, a medical specialist will examine the patient or donor, measure blood pressure and identify possible contraindications.

Transfusion rules

Blood transfusions based on blood groups are carried out taking into account certain basics. Indications for the manipulation and the required dose of fluid transfused are prescribed by a medical specialist based on clinical data and tests performed. The rules for blood transfusion by group are created for the safety of both the donor and the recipient. The specialist must, regardless of previously received examinations, personally do the following:

1. Find out the group according to the ABO system and compare the data with the available indications.
2. Find out the characteristics of red blood cells, both donor and recipient.
3. Test for general compatibility.
4. Conduct a bioassay.

The process of determining blood identity

An important point in transfusion is to determine the identity of the biological fluid and the presence of infections in it. To do this, a blood sample is taken for a general analysis, the resulting amount is divided into two parts and sent for research. In the laboratory, the first one will be checked for the presence of infections, the amount of hemoglobin, etc. The second one is used to determine the blood type and its Rh factor.

Blood groups

Blood transfusion according to blood groups is necessary to prevent red blood cells from sticking together in the patient’s body due to an agglutination reaction upon receipt of the test sample. The blood groups of the human body according to the ABO classification system are divided into 4 main types. According to the ABO classification, separation occurs due to the presence of specific antigens - A and B. Each of them is attached to a specific agglutinin: A is attached to α and B to β, respectively. Depending on the combination of these components, the well-known blood groups are formed. Combining components of the same name is impossible, otherwise red blood cells will stick together in the body, and it simply will not be able to continue to exist. Due to this, only four known combinations are possible:

• Group 1: no antigens, there are two agglutinins α and β.
• Group 2: antigen A and agglutinin β.
• Group 3: antigen B and agglutinin α.
• Group 4: agglutinins are absent, antigens A and B are present.

Group Compatibility

Compatibility of blood groups for transfusion plays an important role during the operation. In medical practice, transfusions are performed only of identical types that are compatible with each other. Many people wonder what blood type they have but do not understand the process itself. And yet there are such suitable components. Which is a question that has a clear answer. People with the first blood group, due to the lack of antigens, are universal donors, and those with the fourth are considered. The blood group compatibility table is used to understand the process of blood transfusion.

Blood group	Who can transfuse (Donor)	Who can the transfusion be given to (recipient)
		All groups
	1st and 2nd groups	2 and 4 groups
	1st and 3rd groups	3 and 4 groups
	All groups

Despite the fact that in the modern world there are many ways to treat various diseases, it is still not possible to avoid the transfusion process. The blood group compatibility table helps medical specialists perform the operation correctly, which helps preserve the life and health of the patient. The ideal transfusion option will always be to use blood that is identical in both type and Rh. But there are cases when a transfusion is vitally necessary to carry out as soon as possible, then universal donors and recipients come to the rescue.

Rh factor

During scientific research in 1940, an antigen was found in the blood of macaques, which later received the name Rh factor. It is hereditary and depends on race. Those people who have this antigen in their blood are Rh positive, and if it is absent, they are Rh negative.

Transfusion compatibility:

• Rh negative is suitable for transfusion to people with Rh negative;
• Rh positive is compatible with any Rh blood.

If you use Rh-positive blood for a patient with a Rh-negative category, then special anti-Rhesus agglutinins will be produced in his blood, and with another manipulation, red blood cells will stick together. Accordingly, such a transfusion cannot be carried out.

Any transfusion is stressful for the human body. Whole blood is transfused only if the loss of this biological fluid reaches 25% or higher. If less volume is lost, blood substitutes are used. In other cases, transfusion of certain components, for example, only red blood cells, is indicated, depending on the type of lesion.

Sample methods

To conduct a compatibility test, the selected recipient serum is mixed with a sample from the donor on a sheet of white paper, tilting it in different directions. After five minutes, the results are compared, if the red blood cells do not stick together, the donor and recipient are compatible.

1. The donor's red blood cells, purified with saline, are loaded into a clean test tube, the mass is diluted with a warm gelatin solution and two drops of the recipient's serum. Place the mixture in a water bath for 10 minutes. After this time, it is diluted with saline in an amount of 7 milliliters and mixed thoroughly. If red blood cell adhesion is not detected, the donor and recipient are compatible.
2. 2 drops of recipient serum, 1 drop of polyglucin and 1 drop of donor blood are dripped into a centrifuge tube. The test tube is placed in a centrifuge for 5 minutes. Then, dilute the mixture with 5 ml of saline solution, place the test tube at an angle of 90° and check compatibility. If there is no adhesion or color change, the donor and recipient are compatible.

Bioassay

To reduce the risk of complications, a bioassay test is performed. To do this, a small amount of blood is transfused to the recipient, and his well-being is monitored for three minutes. In the absence of negative manifestations: increased heart rate, impaired breathing, the manipulation is repeated two more times, carefully monitoring the patient. Transfusion can be performed only when no negative manifestations have been detected, otherwise the operation is not performed.

Methodology

After all the necessary manipulations have been carried out to determine the blood group and compatibility, the transfusion itself begins. The injected blood should not be cold; only room temperature is allowed. If the operation is urgent, then the blood is heated in a water bath. The transfusion process is carried out drip-wise using a system, or directly using a syringe. The rate of administration is 50 drops in 60 seconds. During the transfusion, medical specialists measure the patient’s pulse and blood pressure every 15 minutes. After the manipulation, the patient is advised to rest and undergo medical observation.

Necessity and contraindications

Many people associate blood transfusion with a simple drip of medication. But this is a complex process in which foreign living cells enter the patient’s body. And even with perfectly selected compatibility, there is a risk that the blood may not take root. That is why it is extremely important for doctors to determine that such a procedure cannot be avoided. The specialist prescribing the operation must be firmly convinced that other treatment methods will not be effective. If there is doubt that a transfusion will be beneficial, it is better not to do it.

Consequences of incompatibility

If compatibility during blood transfusion and blood substitutes is not complete, the recipient may develop negative consequences from such a procedure.

Disturbances from such an operation can be different; they can be associated with problems in internal organs or systems.

Frequent malfunctions of the liver and kidneys appear, metabolism, activity and functioning of the hematopoietic organs are disrupted. Changes may also occur in the respiratory system and nervous system. Treatment, for any type of complications, should be carried out as early as possible, under the supervision of a doctor.

If incompatibility occurs during a bioassay, the person will also feel negative manifestations, but to a much lesser extent. The recipient may experience chills and pain in the chest and lumbar spine. The pulse will increase, and a feeling of anxiety will appear. If these signs are detected, a transfusion should not be given. Currently, incompatibility during blood transfusion by blood group practically does not occur.

If a person loses a large amount of blood, then the constancy of the volume of the internal environment of the body is disrupted. And therefore, since ancient times, in case of blood loss or illness, people have tried to transfuse sick people with the blood of animals or a healthy person.

The written monuments of the ancient Egyptians, the works of the Greek scientist and philosopher Pythagoras, the works of the Greek poet Homer and the Roman poet Ovid describe attempts to use blood for treatment. Patients were given the blood of animals or healthy people to drink. Naturally, this did not bring success.

In 1667 in France, J. Denis performed the first intravenous blood transfusion to a person in the history of mankind. The blood of a lamb was transfused into a bleeding, dying young man. Although the foreign blood caused a severe reaction, the patient tolerated it and recovered. The success inspired the doctors. However, subsequent attempts at blood transfusion were unsuccessful. Relatives of the victims filed a lawsuit against the doctors, and blood transfusions were prohibited by law.

At the end of the 18th century. It has been proven that the failures and serious complications that arose when transfusions of animal blood to humans are explained by the fact that the animal’s red blood cells stick together and are destroyed in the human bloodstream. At the same time, substances are released from them that act on the human body as poisons. They began to try to transfuse human blood.

The world's first human-to-human blood transfusion took place in 1819 in England. In Russia it was produced for the first time in 1832 by the St. Petersburg doctor Wolf. The success of this transfusion was brilliant: the life of a woman who was dying due to heavy blood loss was saved. And then everything went as before: first a brilliant success, then a serious complication until death. The complications were very reminiscent of the effect that was observed after transfusion of animal blood to a person. This means that in some cases the blood of one person may be foreign to another.

The scientific answer to this question was given almost simultaneously by two scientists - the Austrian Karl Landsteiner and the Czech Jan Jansky. They discovered 4 blood types in people.

Landsteiner drew attention to the fact that sometimes the blood serum of one person sticks together the red blood cells of another (Fig. 10). This phenomenon is called agglutination. The property of red blood cells to stick together when exposed to plasma or blood serum of another person became the basis for dividing the blood of all people into 4 groups (Table 4).

Why does gluing, or agglutination, of red blood cells occur?

Substances of a protein nature were discovered in red blood cells, which were called agglutinogens(adhesive substances). In humans there are two types. Conventionally, they were designated by letters of the Latin alphabet - A and B.

In people with blood group I, there are no agglutinogens in their erythrocytes, blood of group II contains agglutinogen A, erythrocytes of blood group III contain agglutinogen B, blood of group IV contains agglutinogens A and B.

Due to the fact that red blood cells of blood group I do not contain agglutinogens, this group is designated zero (0) group. Group II, due to the presence of agglutinogen A in erythrocytes, is designated A, group III - B, group IV - AB.

Found in blood plasma agglutinins(adhesives) of two types. They are designated by the letters of the Greek alphabet - α (alpha) and β (beta).

Agglutinin α glues erythrocytes with agglutinogen A, agglutinin β glues erythrocytes with agglutinogen B.

Blood serum of group I (0) contains agglutinins α and β, blood of group II (A) contains agglutinin β, blood of group III (B) contains agglutinin α, and blood of group IV (AB) contains no agglutinins.

You can determine your blood group if you have ready-made sera of blood groups II and III.

The principle of the method for determining blood group is as follows. Within the same blood group there is no agglutination (sticking together) of red blood cells. However, agglutination can occur and red blood cells clump together if they enter plasma or serum of another blood group. Consequently, by combining the test subject’s blood with a known (standard) serum, it is possible to use the agglutination reaction to resolve the issue of the group affiliation of the blood being tested. Standard serums in ampoules can be obtained at a blood transfusion station (or points).

Experience 10

Apply a drop of blood group II and III serum onto a glass slide with a stick. To avoid mistakes, write the corresponding serum group number on the glass next to each drop. Use a needle to pierce the skin of your finger and, using a glass rod, transfer a drop of the blood being tested into a drop of standard serum; thoroughly stir the blood in a drop of serum with a stick until the mixture becomes evenly colored pink. After 2 minutes, add 1-2 drops of saline to each drop and mix again. Make sure to use a clean glass rod for each manipulation. Place the slide on white paper and examine the results after 5 minutes. In the absence of agglutination, the drop is a uniform, cloudy suspension of red blood cells. In the case of agglutination, the formation of flakes of red blood cells in a clear liquid is visible to the naked eye. In this case, 4 options are possible, which allow the test blood to be classified into one of four groups. Figure 11 can help you solve this issue.

If agglutination is absent in all drops, this indicates that the blood being tested belongs to group I. If agglutination is absent in the serum of group III (B) and occurs in the serum of group II (A), then the blood being tested belongs to group III. If agglutination is absent in group II serum and is present in group III serum, then the blood belongs to group II. If agglutination occurs with both sera, we can say that the blood belongs to group IV (AB).

It must be remembered that the agglutination reaction is highly dependent on temperature. In the cold it does not occur, but at high temperatures agglutination of erythrocytes and nonspecific serum can occur. It is best to work at a temperature of 18-22°C.

On average, 40% of people have blood type I, 39% have group II, 15% have group III, and 6% have group IV.

The blood of all four groups is equally valuable in terms of quality and differs only in the described properties.

Belonging to one or another blood group does not depend on race or nationality. Blood type does not change throughout a person's life.

Under normal conditions, agglutinogens and agglutinins of the same name cannot occur in the blood of the same person (A cannot meet with α, B cannot meet with β). This can only happen with improper blood transfusion. Then an agglutination reaction occurs, the red blood cells stick together. Lumps of sticky red blood cells can clog capillaries, which is very dangerous for humans. Following the adhesion of red blood cells, their destruction occurs. Toxic breakdown products of red blood cells poison the body. This explains severe complications and even death from improperly performed blood transfusions.

Blood transfusion rules

The study of blood groups made it possible to establish the rules for blood transfusion.

People who give blood are called donors, and people who are given blood - recipients.

When transfusing, it is necessary to take into account the compatibility of blood groups. It is important that, as a result of blood transfusion, the donor’s red blood cells do not stick together with the recipient’s blood (Table 5).

In Table 5, agglutination is indicated by a plus sign (+), and the absence of agglutination is indicated by a minus sign (-).

The blood of people of group I can be transfused to all people, therefore people with blood group I are called universal donors. The blood of people of group II can be transfused to people with blood groups II and IV, the blood of people of group III - to people with blood groups III and IV.

From Table 5 it is also clear (see horizontally) that if the recipient has blood group I, then he can only be transfused with blood of group I, in all other cases agglutination will occur. People with blood group IV are called universal recipients, since they can be transfused with blood from all four groups, but their blood can only be transfused to people with blood group IV (Fig. 12).

Rh factor

During blood transfusion, even with careful consideration of the group affiliation of the donor and recipient, serious complications sometimes occurred. It turned out that the red blood cells of 85% of people contain the so-called Rh factor. It is so named because it was first discovered in the blood of the monkey Macacus rhesus. Rh factor is a protein. People whose red blood cells contain this protein are called Rh positive. In the red blood cells of 15% of people there is no Rh factor, this is - Rh negative People.

Unlike agglutinogens, there are no ready-made antibodies (agglutinins) for the Rh factor in human blood plasma. But antibodies against the Rh factor can form. If Rh-positive blood is transfused into the blood of Rh-negative people, then the destruction of red blood cells will not occur during the first transfusion, since there are no ready-made antibodies to the Rh factor in the recipient’s blood. But after the first transfusion, they form, since the Rh factor is a foreign protein for the blood of a Rh-negative person. When Rh-positive blood is re-transfused into the blood of an Rh-negative person, the previously formed antibodies will cause the destruction of the red blood cells of the transfused blood. Therefore, when transfusing blood, it is necessary to take into account compatibility with the Rh factor.

A long time ago, doctors paid attention to a more serious, often fatal disease of infants in the past - hemolytic jaundice. Moreover, several children in one family fell ill, which suggested the hereditary nature of the disease. The only thing that did not fit into this assumption was the absence of signs of the disease in the first child born and the increasing severity of the disease in the second, third and subsequent children.

It turned out that hemolytic disease of newborns is caused by incompatibility of the red blood cells of the mother and fetus according to the Rh factor. This occurs when the mother has Rh-negative blood and the fetus inherits Rh-positive blood from the father. During intrauterine development, the following occurs (Fig. 13). Erythrocytes of the fetus, which have the Rh factor, entering the blood of the mother, whose red blood cells do not contain it, are “foreign” antigens there, and antibodies are produced against them. But substances from the mother’s blood again enter the child’s body through the placenta, now having antibodies against the fetal red blood cells.

A Rh conflict occurs, which results in the destruction of the child’s red blood cells and the disease hemolytic jaundice.

With each new pregnancy, the concentration of antibodies in the mother's blood increases, which can even lead to the death of the fetus.

In the marriage of an Rh-negative man with an Rh-positive woman, children are born healthy. Only the combination of “Rh-negative mother and Rh-positive father” can lead to a child’s illness.

Knowledge of this phenomenon makes it possible to plan in advance preventive and therapeutic measures, with the help of which today it is possible to save 90-98% of newborns. For this purpose, all pregnant women with Rh-negative blood are specially registered, they are early hospitalized, and Rh-negative blood is prepared in case of a baby with signs of hemolytic jaundice. Exchange transfusions with the introduction of Rh-negative blood save such children.

Methods of blood transfusion

There are two ways of blood transfusion. At direct (immediate) transfusion blood is transfused directly from the donor to the recipient using special devices (Fig. 14). Direct blood transfusion is rarely used and only in special medical institutions.

For indirect transfusion The donor's blood is first collected in a vessel, where it is mixed with substances that prevent it from clotting (most often sodium citrate is added). In addition, preservative substances are added to the blood, which allow it to be stored in a form suitable for transfusion for a long time. Such blood can be transported in sealed ampoules over long distances.

When transfusing canned blood, a rubber tube with a needle is attached to the end of the ampoule, which is then inserted into the patient’s ulnar vein (Fig. 15). A clamp is placed on the rubber tube; with its help you can regulate the speed of blood injection - fast (“jet”) or slow (“drip”) method.

In some cases, it is not whole blood that is transfused, but its components: plasma or red blood cells, which are used in the treatment of anemia. Platelet mass is transfused in case of bleeding.

Despite the great medicinal value of canned blood, there is still a need for solutions that can replace blood. Many recipes for blood substitutes have been proposed. Their composition differs in greater or lesser complexity. All of them have certain properties of blood plasma, but do not have the properties of formed elements.

Recently, blood taken from a corpse has been used for medicinal purposes. Blood extracted in the first six hours after sudden death from an accident retains all its valuable biological properties.

Transfusion of blood or its substitutes has become widespread in our country and is one of the effective ways to save life in case of large blood losses.

Revitalization of the body

Blood transfusions have made it possible to bring back to life people who have suffered clinical death when cardiac activity stopped and breathing stopped; irreversible changes in the body have not yet occurred.

The first successful revival of a dog was carried out in 1913 in Russia. 3-12 minutes after the onset of clinical death, blood was injected under pressure into the dog’s carotid artery towards the heart, to which substances stimulating cardiac activity were added. The blood introduced in this way was directed into the vessels supplying blood to the heart muscle. After some time, the activity of the heart was restored, then breathing appeared, and the dog came to life.

During the Great Patriotic War, the experience of the first successful revivals in the clinic was transferred to front conditions. Infusion of blood under pressure into the arteries, combined with artificial respiration, brought back to life soldiers who were taken to the field operating room with cardiac activity that had just stopped and breathing had stopped.

The experience of Soviet scientists shows that with timely intervention it is possible to achieve revival after fatal blood loss, injuries and some poisonings.

Blood donors

Despite the fact that a large number of different blood substitutes have been proposed, natural human blood is still the most valuable for transfusion. It not only restores the constancy of the volume and composition of the internal environment, but also heals. Blood is needed to fill the heart-lung machines, which replace the patient's heart and lungs during some operations. The artificial kidney apparatus requires from 2 to 7 liters of blood to operate. A person with severe poisoning is sometimes transfused with up to 17 liters of blood to save them. Many people were saved thanks to timely blood transfusions.

People who voluntarily give their blood for transfusion - donors - enjoy deep respect and recognition of the people. Donation is an honorable social function of a citizen of the USSR.

Every healthy person over 18 years of age can become a donor, regardless of gender and type of activity. Taking a small amount of blood from a healthy person does not have a negative effect on the body. The hematopoietic organs easily replenish these small blood losses. About 200 ml of blood is taken from the donor at a time.

If you do a blood test from a donor before and after donating blood, it will turn out that immediately after taking the blood, the content of red blood cells and leukocytes in it will be even higher than before taking it. This is explained by the fact that in response to such a small blood loss, the body immediately mobilizes its strength and the blood in the form of a reserve (or depot) enters the bloodstream. Moreover, the body replenishes blood loss even with some excess. If a person regularly donates blood, then after some time the content of red blood cells, hemoglobin and other components in his blood becomes higher than before he became a donor.

Questions and tasks for the chapter "Internal environment of the body"

1. What is called the internal environment of the body?

2. How is the constancy of the internal environment of the body maintained?

3. How can you speed up, slow down or prevent blood clotting?

4. A drop of blood is placed in a 0.3% NaCl solution. What will happen to the red blood cells? Explain this phenomenon.

5. Why does the number of red blood cells in the blood increase in high mountains?

6. Which donor’s blood can be transfused to you if you have blood type III?

7. Calculate what percentage of students in your class have blood groups I, II, III and IV.

8. Compare the hemoglobin levels in the blood of several students in your class. For comparison, take the experimental data obtained when determining the hemoglobin content in the blood of boys and girls.

Blood is the internal environment of the body, formed by liquid connective tissue. Blood consists of plasma and formed elements: leukocytes, erythrocytes and platelets. Blood group is the composition of certain antigenic characteristics of red blood cells, which are determined by identifying specific groups of proteins and carbohydrates that make up the membranes of red blood cells. There are several classifications of human blood groups, the most significant of which are the ABO classification and the Rh factor. Human blood plasma contains agglutinins (α and β), human red blood cells contain agglutinogens (A and B). Moreover, only one of proteins A and α can be contained in the blood, as well as proteins B and β. Thus, only 4 combinations are possible that determine a person’s blood type:

• α and β determine blood group 1 (0);
• A and β determine blood group 2 (A);
• α and B determine blood group 3 (B);
• A and B determine blood group 4 (AB).

Rh factor is a specific antigen (D) located on the surface of red blood cells. The widely used terms “Rh”, “Rh-positive” and “Rh-negative” refer specifically to the D-antigen and explain its presence or absence in the human body. Blood group compatibility and Rh compatibility are key concepts that are individual identifiers of human blood.

Blood group compatibility

The theory of blood group compatibility arose in the mid-20th century. Hemotransfusion (blood transfusion) is used to restore the volume of circulating blood in the human body, replace its components (erythrocytes, leukocytes, plasma proteins), to restore osmotic pressure, in case of hematopoietic aplasia, infections, burns. The transfused blood must be compatible both by group and by Rh factor. The compatibility of blood groups is determined by the main rule: the donor’s red blood cells should not be agglutinated by the plasma of the receiving party. Thus, when agglutinins and agglutinogens of the same name (A and α or B and β) meet, the reaction of sedimentation and subsequent destruction (hemolysis) of red blood cells begins. Being the main mechanism of oxygen transport in the body, the blood stops performing its respiratory function.

It is believed that the first 0(I) blood group is universal, which can be transfused to recipients with any other blood group. The fourth blood group AB(IV) is a universal recipient, that is, its owners can be transfused with blood of any other groups. As a rule, in practice they are guided by the rule of exact compatibility of blood groups, transfusing blood of one group, taking into account the Rh factor of the recipient.

Blood type 1: compatibility with other groups

Holders of the first blood group 0(I) Rh– can become donors for all other blood groups 0(I) Rh+/–, A(II) Rh+/–, B(III) Rh+/–, AB(IV) Rh+/–. In medicine, it was customary to talk about a universal donor. In the case of 0(I) Rh+ donation, the following blood groups can become its recipients: 0(I) Rh+, A(II) Rh+, B(III) Rh+, AB(IV) Rh+.

Currently, blood group 1, whose compatibility with all other blood groups has been proven, is used for blood transfusion to recipients with a different blood group in extremely rare cases in volumes of no more than 500 ml. For recipients with blood group 1, compatibility will be as follows:

• with Rh+, both 0(I) Rh– and 0(I) Rh+ can become a donor;
• with Rh–, only 0(I) Rh– can become a donor.

Blood type 2: compatibility with other groups

Blood group 2, whose compatibility with other blood groups is very limited, can be transfused to recipients with A(II) Rh+/– and AB(IV) Rh+/– in case of negative Rh factor. In the case of a positive Rh factor Rh+ group A(II), it can only be transfused into A(II) Rh+ and AB(IV) Rh+ recipients. For those with blood type 2, compatibility is as follows:

• with its own A(II) Rh+, the recipient can receive the first 0(I) Rh+/– and the second A(II) Rh+/–;
• with its own A(II) Rh–, the recipient can only receive 0(I) Rh– and A(II) Rh–.

Blood group 3: transfusion compatibility with other groups

If the donor is the owner of blood group 3, the compatibility will be as follows:

• with Rh+, the recipients become B(III) Rh+ (third positive) and AB(IV) Rh+ (fourth positive);
• at Rh–, the recipients become B(III) Rh+/– and AB(IV) Rh+/–.

If the recipient is the owner of blood group 3, the compatibility will be as follows:

• for Rh+, donors can be 0(I) Rh+/–, as well as B(III) Rh+/–;
• in case of Rh–, holders of 0(I) Rh– and B(III) Rh– can become donors.

Blood type 4: compatibility with other groups

Holders of positive blood group AB(IV) Rh+ are called universal recipients. So, if the recipient has blood type 4, the compatibility will be as follows:

• for Rh+, donors can be 0(I) Rh+/–, A(II) Rh+/–, B(III) Rh+/–, AB(IV) Rh+/–;
• for Rh–, donors can be 0(I) Rh–, A(II) Rh–, B(III) Rh–, AB(IV) Rh–.

A slightly different situation is observed when the donor has blood type 4, the compatibility will be as follows:

• with Rh+ there can be only one recipient AB(IV) Rh+;
• with Rh–, recipients can become owners of AB(IV) Rh+ and AB(IV) Rh–.

Compatibility of blood groups for conceiving a child

One of the key meanings of compatibility of blood groups and Rh factors is conceiving a child and carrying a pregnancy. The compatibility of partners' blood groups does not affect the likelihood of conceiving a child. The compatibility of blood groups for conception is not as significant as the compatibility of Rh factors. This is explained by the fact that when an antigen (Rh factor) enters an organism that does not have it (Rh negative), an immunological reaction begins in which the recipient’s body begins to produce agglutinins (destructive proteins) to the Rh factor. When Rh-positive erythrocytes re-enter the blood of an Rh-negative recipient, agglutination (gluing) and hemolysis (destruction) reactions of the resulting erythrocytes occur.

Rh conflict is the incompatibility of the blood groups of the Rh-negative Rh– mother and the Rh+ fetus, which results in the breakdown of red blood cells in the child’s body. The baby's blood, as a rule, enters the mother's body only during childbirth. The production of agglutinins to the child's antigen during the first pregnancy occurs quite slowly, and by the end of pregnancy it does not reach a critical value that is dangerous for the fetus, which makes the first pregnancy safe for the child. Rh conflict conditions during the second pregnancy, when agglutinins are preserved in the Rh mother’s body, are manifested by the development of hemolytic disease. For Rh-negative women after their first pregnancy, it is recommended to administer anti-Rhesus globulin in order to break the immunological chain and stop the production of anti-Rhesus bodies.

Video from YouTube on the topic of the article:

All people are divided into 4 types according to blood composition, which are usually called 1, 2, 3 and 4 blood groups (BG). They are distinguished by the presence/absence of certain types of proteins on the cell membrane of red blood cells (blood cells). Such information is of greatest importance when a transfusion is necessary for the victim (recipient), blood is urgently needed for donation to family and friends, for conceiving a child and for the normal course of pregnancy.

Blood transfusion

Blood through mutations and crossings evolved from the first to the fourth, which was obtained by merging the second and third groups. The 4th GC is represented by only 5-7 percent of people, so it is important to know its compatibility with other groups.

Division of blood into groups

Blood is a liquid connective tissue that contains blood cells - red blood cells, platelets and leukocytes. It is the presence of certain antigens on the membranes (shells) of red blood cells that is the factor according to which the blood is divided into 4 groups. These are protein and carbohydrate compounds called agglutinogens and agglutinins.

The division of blood into groups is classified according to the AB0 system. To have an idea about the antigenic characteristics of erythrocyte membranes, you need to know that blood is characterized by the presence of α and β agglutinins, and erythrocytes - A and B agglutinogens. One red blood cell can contain only one of the α or A elements (β or B, respectively). Therefore, only 4 combinations are obtained:

1. 1st group (0) contains α and β;
2. Group 2 (A) contains A and β;
3. Group 3 (B) contains α and B;
4. Group 4 (AB) contains A and B.

Carriers of the 1st group make up the majority - 41% of humanity, and the 4th - a minority - 7%. Not only what kind of blood can be transfused depends on belonging to the group, but also the physiological characteristics of the body (in particular, the gastrointestinal tract), and psychological traits.

Important! You can inherit the fourth blood group from parents who have the second, third or fourth HA, that is, those whose erythrocyte cell membrane contains antigens A and B. Therefore, if one of the parents is a carrier of the first group, the child will never have AB (IV ).

Blood groups

Video on the topic:

History of the 4th group

The opinions of scientists regarding the relatively recent appearance (no earlier than the 11th century AD) of the 4th Civil Code are divided. But there are three main theories:

• Mutation of the 2nd and 3rd groups into the 4th as a result of the mixing of races: Indo-European and Mongoloid, which were characterized by individual characteristics that appeared during a long evolutionary process. This mixing began recently, which explains the youth of the fourth group.

Mixed marriage of Indo-European and Mongoloid races

• Another version: the emergence of the 4th group is associated with humanity’s opposition to viruses that threatened the complete destruction of the earth’s population. The response to such attacks was the development of appropriate antibodies that combine A and B.
• According to the third theory, the young fourth group formed as a defense for the body during the evolution of the food culture. As food processing methods became more complex, the need arose to combine antigens A and B, which should protect the body from unnatural food preferences.

Disagreements regarding the truth of the theory of the origin of the 4th group still exist in the scientific community. But there is unity regarding the rarity of this blood.

Interesting! Carriers of different HAs have characteristic agglomerations. The first and second groups are characteristic of the inhabitants of Africa and Europe, and the third - of Asia and Siberia. The 4th GC is characteristic of the inhabitants of Southeast Asia, Japan and Australia. Found traces of AB (IV) on the Shroud of Turin.

The importance of Rh for people with 4 BG

An equally important issue during blood transfusion or conception of offspring is the Rh factor, which divides each GC into two subgroups: negative and positive.

We will talk about additional antigen D, which is also a protein product and is located on the erythrocyte membrane. Its presence is recorded in Rh-positive people, and its absence in Rh-negative people. The indicator is of great importance in determining blood compatibility.

People who do not have the Rh antigen have more pronounced immune defense reactions, for example, implant rejection or allergies occur more often.

Prevalence of people by BG and Rh factor

4 positive and 4 negative blood groups: transfusion compatibility

Only in the middle of the 20th century was the theoretical basis for combining GCs formed. According to it, the need for transfusion (blood transfusion) arises when:

• restoration of blood volume to its original state due to heavy blood loss;
• renewal of blood composition - blood cells;
• restoration of osmotic pressure;
• replenishment of blood elements, the deficiency of which is caused by applasia of hematopoiesis;
• renewal of blood against the background of severe infectious lesions or burns.

The infused donor blood must match the group and Rh factor of the recipient. The recipient's blood should not agglutinate donor red blood cells: the same agglutinins and agglutinogens should not occur (A with α, as well as B with β). Otherwise, sedimentation and hemolysis (destruction) of red blood cells, which are the main transport of oxygen to tissues and organs, are provoked, so this situation is fraught with respiratory dysfunction of the body.

People with 4th GK are ideal recipients. More details:

• 4 positive blood group is ideally compatible with other groups - donors can be carriers of any group with any rhesus;
• blood group 4 negative - full compatibility, as with other groups that have negative Rh.

It is important who is suitable for the fourth blood group if a transfusion is necessary:

• compatibility of blood groups 4 and 4 is ensured only if the recipient and donor are Rhesus positive, that is, AB (IV) Rh (+) can only be transfused with AB (IV) Rh (+);
• 4 positive blood group and 4 negative compatibility occurs only if the donor is Rh negative, and the recipient is of the same group, but with any Rh factor, in other words: 4Rh (-) is allowed to be infused as 4 Rh (+) , and 4Rh (-).

To summarize: any blood is suitable for the owner of group 4, the only condition is that the donor has a negative Rh and the recipient has the same. And only holders of the same blood group can donate their blood for transfusion.

Before transfusion, a compatibility test is carried out. A negative result is fraught with agglutination (clotting) of blood, leading to transfusion shock and then death.

Read also: and features of inheritance

GK compatibility table

Blood type 4: compatibility with other groups during pregnancy

When planning a child for people with blood group 4, compatibility matters only if there is no Rh-determining protein (Rh (-)). This applies more to the female sex, but is also important for the male sex.

A woman with AB (IV) Rh (-) is at risk of pregnancy complications only when carrying an Rh-positive fetus that has inherited the blood from the father. In this case, the pregnant woman’s body perceives the embryo as a foreign body and tries to get rid of it. There is an occurrence of Rh conflict, or senbilization - a pronounced response of the immune system to foreign irritants (allergens), which involves the production of antibodies that inhibit the child's hematopoiesis. This is fraught with:

• the occurrence of difficulties (sometimes insurmountable) during conception;
• miscarriages;
• pathologies in the intrauterine development of the embryo up to stillbirth.

The difficulties described above arise towards the end of the first pregnancy, and with subsequent ones the negative manifestations intensify. This does not depend on the resolution of the “interesting situation” (childbirth or abortion), since after the first contact of the blood of mother and child and with each subsequent one, the concentration of antibodies in the female body increases, attacking the fetus and causing its rejection.

Modern medicine makes it possible to avoid such developments; for this purpose, a pregnant woman (for the first time) is given anti-Rhesus immunoglobulin a month before giving birth and within 72 hours after. The drug inhibits antibodies, facilitating the birth of a healthy baby and the passage of subsequent pregnancies without complications.

Interesting! In medical practice, there are cases when Rh-negative women carrying Rh-positive children have Rh protein appearing on their red blood cells (that is,Rh(-) changed toRh(+)), which is explained by fetal protection mechanisms.

Men with AB (IV) Rh (-) should be careful when planning children with Rh-positive women. If a child inherits the father’s Rh, a conflict may arise with the mother’s blood, which can lead to miscarriages and developmental pathologies.

For thousands of years, people were not aware of the true purpose of blood, but on a subconscious level they understood that the red liquid flowing through the veins was of particular value. It was used in various religious rituals, and bloodletting was performed on seriously ill patients. Today virtually everything is known about her. Modern knowledge has given doctors a unique world of red blood cells, platelets, leukocytes, antigen (Rh factor) and other substances flowing in the blood, by which the doctor can determine the state of health. However, why are they different among humanity and what blood group can be safely transfused to all people.

She is the source of life. A continuous flow of living energy supplies each cell of the body with all the necessary substances. The flow of the internal environment is a complex mechanism, which required humanity its entire history to study. A lot is known about her, but not enough to close this interesting question forever. In some Asian countries, for example, there is still a tradition where you must know the blood type of your passion before the wedding.

There is also a legend according to which only one flowed in the veins of the first people - the first group. And only later, with the development of civilization, the rest appeared. There are special diets, food for each blood group, and they use it to learn the fate and character of a person. In a word, blood is not only a source of energy for the body, but a broad, multifaceted concept.

Until the second half of the last century, enough was known about it, but the Rh factor was discovered only in 1940, by finding a new antigen in human red blood cells. Subsequently, it was found that the Rh factor and blood type do not change throughout life. It was also noted that according to the laws of genetics, the properties of blood are transmitted hereditarily. As already noted, people were treated with bloodletting, but not in every case such medical assistance resulted in recovery. Many people died, and the cause of death could not be determined until the beginning of the 20th century. Later, numerous studies provided a clue, and at the very beginning of the last century, the scientist K. Landsteiner substantiated the concept of groups.

Discovery of global significance

Using the method of scientific research, he proved what directions there are. People can only have 3 (subsequently, J. Jansky from the Czech Republic added a 4 group to the table). Blood plasma contains agglutinins (α and β), erythrocytes - (A and B). Of proteins A and α or B and β, only one of them can be contained. Accordingly, we can designate a diagram where:

• α and β - (0);
• A and β - (A);
• α and B - (B);
• A and B - (AB).

Antigen “D” is directly positioned with the concept of Rh factor. Its presence or absence is directly related to such medical terms as “positive or negative Rh factor.” The unique identifiers of human blood are: Rh compatibility and blood group compatibility.

For the discovery, K. Landsteiner received the Nobel Prize and read a report on what concept he developed. In his opinion, the discovery of new proteins in cells will continue until scientists are convinced that there are no two people on the planet that are antigenically similar, with the exception of twins. In the forties of the last century, the Rh factor was discovered. It was found in the red blood cells of rhesus monkeys. Almost a quarter of the world's population is negative. The rest are positive. It (Rh with any value) does not affect the blood group and the owner of, say, the 4th can live with a positive or negative Rh.

What you need to know about blood

However, when transfusing blood fluid, even if it fits the group and all the rules are followed, patients experienced complications. They could have been caused by various reasons, but the main one turned out to be a discrepancy in the signs of the Rh factor. If a fluid with Rh+ was transfused to someone with Rh-, antibodies to the antigen were formed in the patient’s blood and, during a secondary procedure, the same blood fluid reacted by destroying or “sticking together” the red blood cells of the donor person.

And then they came to the conclusion that not only she could be incompatible. It can only be transfused Rh+ to Rh+. This condition is mandatory both for negative Rh factor and plus what kind of blood flows from the donor and the patient. Today, a large number of other antigens have been discovered that are built into erythrocytes and form more than a dozen antigenic structures.

Transfusion is often the last step to save a person when they need urgent help. To comply with all the rules, a compatibility test was introduced. Risks during a therapeutic procedure can be minimized with the help of compatibility checks. The internal environment of the other group may turn out to be incompatible, and then a sad outcome is likely.

Before the procedure, a test is prescribed and performed to document the blood type and Rh factor.

Carrying out a mandatory test will allow us to determine: to confirm the ABO compatibility of the donor and the patient, to confirm antibodies in the patient’s serum, which will be positioned against the antibodies of the human donor’s erythrocytes. An identity test regarding the Rh factor can be carried out: a test with 33 percent polyglucin, a test with ten percent gelatin.

Serial data

More often than other methods, a test with polyglucin is used. It is practiced when assistance with transfusion is needed. To get the result, achieve the reaction in a centrifuge tube for five minutes without heating. In the second example, when using a sample with 10 percent gelatin, combine: a drop of donor red blood cells, two drops of a 10 percent gelatin solution heated to liquefaction, two drops of the patient’s serum and 8 ml of saline.

After short manipulations, the final result is obtained - whether the donor’s blood turned out to be incompatible with the patient’s blood. They also practice biological testing. In general, it is aimed at eliminating any force majeure circumstances due to the presence of a large number of secondary group systems. To minimize risks at the beginning of blood transfusion, another sample is tested - biological.

There are only four main groups. It can be assumed that they fall into the category of compatible and incompatible concepts, that is, one group can suit everyone. Blood can be transfused from one person to another, based on a set of medical rules.

• First group. Suitable for everyone. People with group 1 are considered universal donors.
• Second. Compatible with 2nd and 4th.
• Third. Suitable for persons with 3rd and 4th grade.
• Fourth. Can be used for transfusion to people with a similar group. It suits only them.

However, for such recipients, if they require help, any blood will do.

An important factor is heredity.

Basic rules, and what kind of blood the child will have relative to the group of the parents.

1. Will always remain constant: Rh factor, blood type.
2. Blood type does not depend on gender.
3. Taking into account the laws of genetics, blood type can be inherited.

Inheritance, or what kind of blood a baby may have, is indicated by the framework of genetic rules. If the father and mother are carriers of the first group, then the newborn will inherit it. If the second, we can confidently say that the offspring will have the first or second. If the third, the baby’s veins will begin to flow from the first or third group. A mother and father with AB (IV) will not have a baby with group zero.

In addition to blood fluid, human tissue also has specificity. From this we can conclude that tissue compatibility and blood transfusion are interconnected. To prevent tissue or organ rejection during transplantation, doctors first determine the biological compatibility of the donor and the patient, at the level of tissue compatibility of the organs.

As well as manipulating the internal environment, histocompatibility and blood transfusion play a large role in medicine. However, this meaning was important in the recent past. Today, universal ones have been developed: artificial leather, bones. They circumvent the problem of tissue rejection during transplantation. Therefore, tissue compatibility and blood transfusion are an issue that is gradually fading into the background in medicine.