Human blood group systems

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Template:Short description Script error: No such module "For". The term human blood group systems is defined by the International Society of Blood Transfusion (ISBT) as systems in the human species where cell-surface antigens—in particular, those on blood cells—are "controlled at a single gene locus or by two or more very closely linked homologous genes with little or no observable recombination between them",[1] and include the common ABO and Rh (Rhesus) antigen systems, as well as many others; 48 human systems are identified since 31 May 2025Template:Dated maintenance category (articles)Script error: No such module "Check for unknown parameters"..[2]

Table of systems and classifications

ISBT No.[3] System name System symbol Structure / function Chromosome Antigens Notes
001 ABO ABO Carbohydrate (N-Acetylgalactosamine, galactose). 9q34.2 A, B, H Mainly elicit IgM antibody reactions, although anti-H is very rare, see the Hh antigen system (Bombay phenotype, ISBT #18).
002 MNS MNS GPA / GPB (glycophorins A and B). 4q31.21 M, N, S, s
003 P1PK P Glycolipid 22q13.2 P1, P, and Pk
004 Rh RH Protein and glucose. 1p36.11 C, c, D, E, e There is no "d" antigen; lowercase "d" indicates the absence of D.
005 Lutheran LU Protein (member of the immunoglobulin superfamily). 19q13.32 21 antigens
006 Kell KEL Glycoprotein. 7q34 K, k, Kpa, Kpb, Jsa and Jsb [4]
007 Lewis LE Carbohydrate (fucose residue). 19p13.3 Mainly Lea and Leb Associated with tissue ABH antigen secretion.
008 Duffy FY Protein (chemokine receptor). 1q23.2 Mainly Fya and Fyb Individuals lacking Duffy antigens altogether are immune to malaria caused by Plasmodium vivax and Plasmodium knowlesi.
009 Kidd JK Protein (urea transporter). 18q12.3 Jka and Jkb
010 Diego DI Glycoprotein (band 3, AE 1, or anion exchange). 17q21.31 Positive blood is found only among East Asians and Native Americans.
011 Yt YT Protein (AChE, acetylcholinesterase). 7q22.1
012 XG XG Glycoprotein. Xp22.33
013 Scianna SC Glycoprotein. 1p34.2
014 Dombrock DO Glycoprotein (fixed to cell membrane by GPI, or glycosyl-phosphatidyl-inositol). 12p12.3
015 Colton CO Aquaporin 1. 7p14.3 Mainly Co(a) and Co(b)
016 Landsteiner-Wiener LW Protein (member of the immunoglobulin superfamily). 19p13.2
017 Chido/Rodgers CH C4A C4B (complement fractions). 6p21.3
018 Hh H Carbohydrate (fucose residue). 19q13.33
019 XK XK Glycoprotein. Xp21.1
020 Gerbich GE GPC / GPD (Glycophorins C and D). 2q14.3
021 Cromer CROM Glycoprotein (DAF or CD55, regulates complement fractions C3 and C5, attached to the membrane by GPI). 1q32.2
022 Knops KN Glycoprotein (CR1 or CD35, immune complex receptor). 1q32.2
023 Indian IN Glycoprotein (CD44 adhesion function?). 11p13
024 Ok OK Glycoprotein (CD147). 19p13.3
025 Raph RAPH Transmembrane glycoprotein. 11p15.5
026 JMH JMH Protein (fixed to cell membrane by GPI). Also known as Semaphorin 7A or CD108. 15q24.1
027 Ii I Branched (I) / unbranched (i) polysaccharide. 6p24.2
028 Globoside GLOB Glycolipid. Antigen P. 3q26.1
029 GIL GIL Aquaporin 3.Script error: No such module "Unsubst". 9p13.3
030 Rh-associated glycoprotein RHAg Rh-associated glycoprotein.Script error: No such module "Unsubst". 6p21-qter
031 Forssman FORS Globoside alpha-1,3-N-acetylgalactosaminyltransferase 1 (GBGT1).Script error: No such module "Unsubst". 9q34.13
032 Langereis[5] LAN ABCB6, human ATP-binding cassette (ABC) transporter, mitochondrial porphyrin transporter.[5] 2q36
033 Junior JR ABCG2. Multi-drug transporter protein.Script error: No such module "Unsubst". 4q22
034 Vel Vel Human red cell antigens.Script error: No such module "Unsubst". 1p36.32
035 CD59 CD59 — 11p13
036 Augustine AUG Protein (transporter).[6] 6p21.1
037 KANNO[7][8] PRNP — 20p13
038 SID SID 17q21.32
039 CTL2 CTL2 19p13.2
040 PEL PEL 13q32.1
041 MAM MAM 19q13.33
042 EMM EMM 4p16.3
043 ABCC1 ABCC1 16p13.11
044 Er[9] Er Protein 16q24.3 Era, Erb, Er3, Er4, and Er5 Illustrates potential antigenicity of low abundance membrane proteins and contributes to understanding of in vivo characteristics of the Piezo1 protein in transfusion biology
045 CD36 CD36 7q21.11
046 ATP11C ATP11C Xq27.1
047 MAL MAL 2q11.1
048 PIGZ[10] PIGZ 3q29

Antibodies

Following is a comparison of clinically relevant characteristics of antibodies against the main human blood group systems:[11]

ABO Rh Kell Duffy Kidd Lutheran MNS Lewis P Ii
Most common in immediate hemolytic transfusion reactions A Yes Fya Jka
Most common in delayed hemolytic transfusion reactions E,D,C Jka
Most common in hemolytic disease of the newborn Yes D,C Yes
Commonly produce intravascular hemolysis Yes Yes Yes
Reactive at room temperature Yes M,N Lea, Leb P1
Nearly always clinically insignificant Yes M,N Yes P1
Naturally occurring Yes Yes M,N Yes Yes Yes
Enhanced by ficain[12] and papain[13] Yes Yes Yes Yes P1 Yes
Destroyed by ficain[12] and papain[13] Fya, Fyb Yes Yes
Displaying dosage Script error: No such module "labelled list hatnote". Cc, Ee Yes Yes Yes

Compatibility testing

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File:Serology interpretation of antibody panel for blood group antigens.jpg
Interpretation of antibody panel to detect patient antibodies towards the most relevant human blood group systems

Blood compatibility testing is performed before blood transfusion, including matching of the ABO blood group system and the Rh blood group system, as well as screening for recipient antibodies against other human blood group systems. Blood compatibility testing is also routinely performed on pregnant women and on the cord blood from newborn babies, because incompatibility puts the baby at risk for developing hemolytic disease of the newborn.[14][15] It is also used before hematopoietic stem cell transplantation, as it may be responsible for some cases of acute graft-versus-host disease.[16]

Other human blood group systems than ABO and Rh have a relatively small risk of complications when blood is mixed.[17] Therefore, in emergencies such as major hemorrhage, the urgency of transfusion can exceed the need for compatibility testing against other blood group systems (and potentially Rh as well).[17] Also, blood compatibility testing beyond ABO and Rh is generally limited to antibody detection (not necessarily including forward typing). Still, in Europe, females who require blood transfusions are often typed for the K and extended Rh antigens to prevent sensitization to these antigens, which could put them at risk for developing hemolytic disease of the newborn during pregnancy.[18]

When needing to give red blood cell transfusion to a patient, the presence of clinically significant antibodies produced by the patient can be detected by mixing patient serum with 2 to 4 "screening" or "control" red blood cells that together display essentially all relevant antigens. If any of these mixes display a reaction (evidence of patient antibodies binding to the screening red blood cells), a more extensive antibody panel is warranted (as imaged at right).[19]

See also

References

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  7. ↑ National Center for Global Health and Medicine, Japanese Red Cross Society, Fukushima Medical University and Japan Agency for Medical Research and Development (2019-08-05) 新たなヒト血液型「KANNO」の国際認定―国立国際医療研究センターなど、日本の研究グループとして初めての登録― (in Japanese)
  8. ↑ "Omae, Y.; Ito, S.; Takeuchi, M.; Isa, K.; Ogasawara, K.; Kawabata, K.; Oda, A.; Kaito, S.; Tsuneyama, H.; Uchikawa, M.; Wada, I.; Ohto, H.; Tokunaga, K. (2019). "Integrative genome analysis identified the KANNO blood group antigen as prion protein" Transfusion. 2019 Jul;59(7):2429-2435. DOI:10.1111/trf.15319. Epub 2019 Apr 24.
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Further reading

External links

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