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Blood type


Immunological effects of mismatched blood transfusions are much more likely to involve components of the ABO blood group system or the RhD antigen (also known as the Rhesus factor or Rhesus D antigen) of the Rhesus blood group system than components of any of the other blood group systems; hence, in the routine preparation of blood for transfusion in a blood bank, the presence or absence the immunogenic blood group antigens, the A antigen, the B antigen and the RhD antigen are always determined for all recipient and donor blood. This identifies the ABO blood group and the RhD antigen status, which are both stated in the common terminology A positive, O negative, etc., where a capital letter (A, B or O) refers to the ABO blood group, and positive or negative refers to the presence or absence of the RhD antigen of the Rhesus blood group system. In the routine preparation and selection of donor blood for blood transfusion, it is not necessary to determine the status of any other blood group antigens or antibodies, because antibody screening and cross-matching (or computer aided simulated cross-matching) prior to transfusion detects if there are any other blood group incompatibilities between potential donor blood and intended recipients.


Blood types are inherited and represent contributions from both parents. Often, pregnant women carry a fetus with a different blood type from their own, and sometimes the mother forms antibodies against the red blood cells of the fetus, which causes hemolysis of fetal RBCs, and which in turn can lead to low fetal blood counts, a condition known as hemolytic disease of the newborn. Some blood types are associated with inheritance of other diseases; for example, the Kell antigen is associated with McLeod syndrome.[1] Certain blood types may affect susceptibility to infections, an example being the resistance to specific malaria species seen in individuals lacking the Duffy antigen.[2] The Duffy antigen, presumedly as a result of natural selection, is less common in ethnic groups from areas with a high incidence of malaria.[3]

The two most significant blood group systems were discovered during early experiments with blood transfusion: the ABO group in 1901[4] and the Rhesus group in 1937.[5] Development of the Coombs test in 1945,[6] the advent of transfusion medicine, and the understanding of hemolytic disease of the newborn led to discovery of more blood groups. Today, a total of 29 human blood group systems are recognized by the International Society of Blood Transfusion (ISBT).[7] A complete blood type would describe a full set of 29 substances on the surface of RBCs, and an individual's blood type is one of the many possible combinations of blood group antigens. Across the 29 blood groups, over 600 different blood group antigens have been found,[8] but many of these are very rare or are mainly found in certain ethnic groups. Almost always, an individual has the same blood group for life; but very rarely, an individual's blood type changes through addition or suppression of an antigen in infection, malignancy or autoimmune disease.[9] Blood types have been used in forensic science and in paternity testing, but both of these uses are being replaced by DNA analysis, which provides greater certitude.

Additional recommended knowledge


Blood group systems


ABO blood group system


Phenotype Genotype
A AA or AO
B BB or BO

Rhesus blood group system


ABO and Rh distribution by nation

ABO and Rh blood type distribution by nation (averages for each population)
Argentina[11] 53.8% 34.7% 8.8% 2.7% 8.4% 0.44% 0.21% 0.06%
Austria[12] 30% 33% 12% 6% 7% 8% 3% 1%
Australia[13] 40% 31% 8% 2% 9% 7% 2% 1%
Belgium[14] 38.1% 34% 8.5% 4.1% 7% 6% 1.5% 0.8%
Canada[15] 39% 36% 7.6% 2.5% 7% 7% 1.4% 0.5%
Denmark[16] 35% 37% 8% 4% 6% 7% 2% 1%
Finland[17] 27% 38% 15% 7% 4% 6% 2% 1%
France[18] 36% 37% 9% 3% 6% 7% 1% 1%
Hong Kong, China[19] 40% 26% 27% 7% <0.3% <0.3% <0.3% <0.3%
Korea, South[20] 27.4% 34.4% 26.8% 11.2% 0.1% 0.1% 0.1% 0.05%
Netherlands[21] 39.5% 35% 6.7% 2.5% 7.5% 7% 1.3% 0.5%
Poland[22] 31% 32% 15% 7% 6% 6% 2% 1%
Sweden[23] 32% 37% 10% 5% 6% 7% 2% 1%
UK[24] 37% 35% 8% 3% 7% 7% 2% 1%
USA[25] 38% 34% 9% 3% 7% 6% 2% 1%

Other blood group systems

The International Society of Blood Transfusion currently recognizes 29 blood group systems (including the ABO and Rh systems).[7] Thus, in addition to the ABO antigens and Rhesus antigens, many other antigens are expressed on the RBC surface membrane. For example, an individual can be AB RhD positive, and at the same time M and N positive (MNS system), K positive (Kell system), Lea or Leb negative (Lewis system), and so on, being positive or negative for each blood group system antigen. Many of the blood group systems were named after the patients in whom the corresponding antibodies were initially encountered.

Clinical significance

Blood transfusion

Main article: Blood transfusion




The blood group may be included on identification tags or on tattoos worn by military personnel, in case they should need an emergency blood transfusion. Frontline German Waffen-SS had such tattoos during World War II. Ironically, this was an easy form of SS identification.[26]


Hemolytic disease of the newborn (HDN)



Blood products




Red blood cell compatibility



Red blood cell compatibility table[30][31]
Recipient[1] Donor[1]
O- O+ A- A+ B- B+ AB- AB+
O- O-
O+ O- O+
A- O- A-
A+ O- O+ A- A+
B- O- B-
B+ O- O+ B- B+
AB- O- A- B- AB-
AB+ O- O+ A- A+ B- B+ AB- AB+

Table note



Plasma compatibility

  Donor-recipient compatibility for blood plasma is the converse of that of RBCs. Plasma extracted from type AB blood can be transfused to individuals of any blood group, but type O plasma can be used only by type O recipients.

Plasma compatibility table
Recipient Donor[1]

Table note
1. Assumes absence of strong atypical antibodies in donor plasma


Universal donors and universal recipients

With regard to transfusions of whole blood or packed red blood cells, individuals with type O negative blood are often called universal donors, and those with type AB positive blood are called universal recipients (Strictly speaking this is not true and individuals with Bombay blood group or Hh antigen system are the universal donors). Although blood donors with particularly strong anti-A, anti-B or any atypical blood group antibody are excluded from blood donation, the terms universal donor and universal recipient are an over-simplification, because they only consider possible reactions of the recipient's anti-A and anti-B antibodies to transfused red blood cells, and also possible sensitisation to RhD antigens. The possible reactions of anti-A and anti-B antibodies present in the transfused blood to the recipients RBCs are not considered, because a relatively small volume of plasma containing antibodies is transfused.





In April 2007 a method was discovered to convert blood types A, B, and AB to O, using enzymes. This method is still experimental and the resulting blood has yet to undergo human trials.[32][33] The method specifically removes or converts antigens on the red blood cells, so other antigens and antibodies would remain. This does not help plasma compatibility, but that is a lesser concern since plasma has much more limited clinical utility in transfusion and is much easier to preserve.

Popular use

The Japanese blood type theory of personality is a popular belief that a person's ABO blood type is predictive of their personality, character, and compatibility with others, according to books by Masahiko Nomi. This belief has carried over to a certain extent in other parts of East Asia such as South Korea and Taiwan. In Japan, asking someone their blood type is considered as normal as asking their astrological sign. It is also common for Japanese-made video games (especially role-playing games) and manga series to include blood type with character descriptions.

The blood type diet is an American system whereby people seek improved health by modifying their food intake and lifestyle according to their ABO blood group and secretor status.[34] This system includes some reference to differences in personality, but not to the extent of the Japanese theory.

See also


  2. ^ Miller LH, Mason SJ, Clyde DF, McGinniss MH. "The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy." N Engl J Med. 1976 Aug 5;295(6):302-4 PMID 778616
  3. ^ Kwiatkowski, DP (Aug 2005). "How Malaria Has Affected the Human Genome and What Human Genetics Can Teach Us about Malaria". Am J Hum Genet. 77 (2): 171-192. Full text at PMC: 1224522. Retrieved on 2006-11-16."The different geographic distributions of α thalassemia, G6PD deficiency, ovalocytosis, and the Duffy-negative blood group are further examples of the general principle that different populations have evolved different genetic variants to protect against malaria".
  4. ^ Landsteiner K. Zur Kenntnis der antifermentativen, lytischen und agglutinierenden Wirkungen des Blutserums und der Lymphe. Zentralblatt Bakteriologie 1900;27:357-62.
  5. ^ Landsteiner K, Wiener AS. An agglutinable factor in human blood recognized by immune sera for rhesus blood. Proc Soc Exp Biol Med 1940;43:223-224.
  6. ^ Coombs RRA, Mourant AE, Race RR. A new test for the detection of weak and "incomplete" Rh agglutinins. Brit J Exp Path 1945;26:255-66.
  7. ^ a b Table of blood group systems. International Society of Blood Transfusion (October 2006). Retrieved on 2006-11-14.
  8. ^ American Red Cross Blood Services, New England Region, Maine, Massachusetts, New Hampshire, Vermont. American Red Cross Blood Services - New England Region (2001). Retrieved on 2006-11-14. “there are more than 600 known antigens besides A and B that characterize the proteins found on a person's red cells”
  9. ^ Dean, Laura. "The ABO blood group", Blood Groups and Red Cell Antigens. online: NCBI. “A number of illnesses may alter a person's ABO phenotype”  Stayboldt C, Rearden A, Lane T. "B antigen acquired by normal A1 red cells exposed to a patient's serum". Transfusion 27 (1): 41-4. PMID 3810822. Matsushita S, Imamura T, Mizuta T, Hanada M (1983). "Acquired B antigen and polyagglutination in a patient with gastric cancer". Jpn J Surg 13 (6): 540-2. PMID 6672386. Kremer Hovinga I, Koopmans M, de Heer E, Bruijn J, Bajema I (2007). "Change in blood group in systemic lupus erythematosus". Lancet 369 (9557): 186-7; author reply 187. doi:10.1016/S0140-6736(07)60099-3. PMID 17240276.
  10. ^ Your blood – a textbook about blood and blood donation (PDF) 63. Retrieved on 2006-11-21.
  11. ^ [1]
  12. ^ Austrian Red Cross - Blood Donor Information
  13. ^ Blood Types - What Are They?, Australian Red Cross
  14. ^ Rode Kruis Wielsbeke - Blood Donor information material[dead link – history]
  15. ^ Types & Rh System, Canadian Blood Services
  16. ^ Frequency of major blood groups in the Danish population.
  17. ^ Suomalaisten veriryhmäjakauma
  18. ^ Les groupes sanguins (système ABO) (French). Centre Hospitalier Princesse GRACE - Monaco. C.H.P.G. MONACO (2005). Retrieved on 2006-12-27.
  19. ^ Blood Donation, Hong Kong Red Cross
  20. ^ Statistics on annual blood donations 2002-2005, Gyung Nam Blood Center
  21. ^ Blood bank Sanquin - Blood Donor information material
  22. ^ Regionalne Centrum Krwiodawstwa i Krwiolecznictwa we Wrocławiu
  23. ^ Frequency of major blood groups in the Swedish population.
  24. ^ Frequency of major blood groups in the UK.
  25. ^ Census CounterParts.
  26. ^ German Intelligence Agents and Suspected Agents. Highlights of Freedom of Information releases in September 2005. The National Archives (September 2005). Retrieved on 2006-11-20. “... the trademark SS tattoo under his arm of his blood group”
  27. ^ Nickel, RG; Willadsen SA, Freidhoff LR, et. al (1999 Aug). "Determination of Duffy genotypes in three populations of African descent using PCR and sequence-specific oligonucleotides". Hum Immunol. 60 (8): 738-42. doi:10.1016/S0198-8859(99)00039-7. PMID 10439320.
  28. ^ Bruce, MG (May 2002). BCF - Members - Chairman's Annual Report. The Blood Care Foundation. Retrieved on 2006-11-16. “As Rhesus Negative blood is rare amongst local nationals, this Agreement will be of particular value to Rhesus Negative expatriates and travellers”
  29. ^ Daniels G, Finning K, Martin P, Summers J. "Fetal blood group genotyping: present and future.". Ann N Y Acad Sci 1075: 88-95. doi:10.1196/annals.1368.011. PMID 17108196.
  30. ^ RBC compatibility table. American National Red Cross (December 2006). Retrieved on 2006-12-24.
  31. ^ Blood types and compatibility
  32. ^ Blood groups 'can be converted'. BBC News (April 2007). Retrieved on 2007-10-10.
  33. ^ Liu Q, Sulzenbacher G, Yuan H, Bennett E, Pietz G, Saunders K, Spence J, Nudelman E, Levery S, White T, Neveu J, Lane W, Bourne Y, Olsson M, Henrissat B, Clausen H. "Bacterial glycosidases for the production of universal red blood cells". Nat Biotechnol. doi:10.1038/nbt1298. PMID 17401360.
  34. ^ D'Adamo, Dr. Peter J; Catherine Whitney (1996). Eat Right 4 Your Type: The Individualized Diet Solution to Staying Healthy, Living Longer and Achieving Your Ideal Weight. New York: Penguin Group (USA). ISBN 0-399-14255-X. 

Further reading

  • Dean, Laura. Blood Groups and Red Cell Antigens, a guide to the differences in our blood types that complicate blood transfusions and pregnancy. (HTML, also PDF, Flash and PRC versions). NCBI. Retrieved on September 15, 2006.
  • Mollison PL, Engelfriet CP and Contreras M. "Blood Transfusion in Clinical Medicine." 1997. 10th edition. Blackwell Science, Oxford, UK. ISBN 0-86542-881-6
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Blood_type". A list of authors is available in Wikipedia.