03. Golongan Darah (E)
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GOLONGAN DARAH
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“ Golongan Darah “
Perbedaan golongan darah setiap orang disebabkan oleh
karena adanya Antigen (Ag) Aglutinogen pada dinding eritrosit dan adanya antibody spesifik (Ab) Aglutinin di dalam plasmanya
darah donor + resipien
Tidak cocok transfusi
oleh karena terjadi aglutinasi
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Golongan Darah “ ABO ”
Gol. Darah Ag. Ab.O - Anti A & anti BA A Anti BB B Anti AAB AB -
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Blood Types with their Genotypes and their constituent Agglutinogens and Agglutinins
Genotypes
Blood types Agglutinogens
Agglutinins
OO O - Anti A and Anti B
OA or AA A A Anti BOB or BB B B Anti A
AB AB A and B -
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Relative Frequencies of the Different Blood Types
The prevalence of the different Blood Types among one group of persons studied was approximately : O 47 % A 41 % B 9 % AB 3 %
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Blood typing, showing Agglutination of cells of the different blood types with Anti A or Anti B Agglutinins in the Sera
Red Blood Cells Types
SeraAnti A Anti B
O - -A + -B - +
AB + +
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“Reaksi silang“
Penting dikerjakan sebelum transfusi darah Eritrosit & serum antara donor & resipien direaksikan secara
silang invitro• r. s. mayor : erit. donor + serum resipien → ada /
tidaknya aglutinin resipien yg mungkin merusak erit. donor
• r. s. minor : serum donor + erit. resipien → ada / tidaknya aglutinin donor yg mempengaruhi erit. resipien.
Aglutinin donor dalam sirkulasi sangat diencerkan oleh plasma resipien < berbahaya r.s. minor dianggap kurang penting
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Contoh :Ag Ab
D → A : A anti BR → B : B anti A
m (+) M (+)
Sangat diencerkan dalam tubuh R → < penting
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“Golongan darah Rhesus“
Ag. golongan darah Rh, biasanya mempunyai antigenisitas lemah, kecuali Ag D disebut “Ag. Rh“
Ag Rh dalam erit golongan Rh (ada Ag Rh)Ag Rh dalam erit golongan Rh (tidak ada Rh)
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Anyone who has this type of antigen (D antigen) is said to be “Rh positive”, whereas a person who does not have type D antigen is called to be Rh negative
It can still cause transfusion reactions usually much milder
About 85 % of all white people are Rh positive and 15 % Rh negative
In American blacks the percentage of Rh positive is about 95, whereas in African blacks, it is virtually 100 percent
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Rh Blood Types
The major difference betweenAOB system Rh system
The plasma agglutinins responsible for causing transfusion reactions develop spontancously
Spontaneous agglutinins almost never occur
The person must first be massively exposed to an Rh antigen
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When RBC containing Rh factor Are injected
Blood does not contain Rh factor/Rh negative person
Anti Rh agglutinins develop slowly
Reaching maximum concentration of agglutinins about 2 to 4 months later
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If an Rh negative person has never before been exposed to Rh positive blood
Transfusion of Rh positiveNo Immediate reaction
Then it’s hemolyzed by the tissue macrophage system
A delayed transfusion reaction occurs, although it is usually mild
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N : Pada golongan darah Rh (–) → Tidak ada Ab anti Rh (–)
terpapar golongan darah Rh dari transfusi atau darah bayi waktu lahir
Reaksi pembentukan Ab. Anti Rhterpapar lagi Rh
Darah tsb akan dihancurkan oleh Ab. anti Rh
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Ibu Rh bayi Rh kehamilan baik oleh karena darah bayi placenta ibu. Waktu persalinan jaringan placenta rusak darah bayi ke ibu.
imunitas ibu membentuk Ab anti Rh. Beberapa tahun kemudian, ibu hamil II : bayi Rh anti Rh ibu ke bayi menghancurkan darah bayi anemia hemolitik “Erythroblastosis Fetalis”
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Erythroblastosis Fetalis
Is a disease of the fetus and new born child
Characterized by aglutination and phagocytosis of the fetus’s RBCs
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The mother is Rh (-)
The father Rh (+)
The baby hasInherited the Rh (+) antigen
The mother develops anti Rh agglutinins from exposure to the fetus’s Rh antigen
The mother’s agglutinins diffuse through the placenta into the fetus
Cause RBC agglutination
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Treatment of the Erythroblastosis Fetalis
To replace the neonate’s blood with Rh (–) blood by infused over period of 1,5 or more hours while the neonate’s own Rh (+) blood is being removed (during the first few weeks of life)