GOLONGAN DARAH 1
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 2
Golongan Darah ABO Gol. Darah Ag. Ab. O - Anti A & anti B A A Anti B B B Anti A AB AB - 3
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 B OB or BB B B Anti A AB AB A and B - 4
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 % 5
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 Anti A Sera Anti B O - - A + - B - + AB + + 6
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 7
Contoh : Ag Ab D A : A anti B R B : B anti A m (+) M (+) Sangat diencerkan dalam tubuh R < penting 8
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) 9
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 10
Rh Blood Types The major difference between AOB system The plasma agglutinins responsible for causing transfusion reactions develop spontancously Rh system Spontaneous agglutinins almost never occur The person must first be massively exposed to an Rh antigen 11
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 12
If an Rh negative person has never before been exposed to Rh positive blood Transfusion of Rh positive No Immediate reaction Then it s hemolyzed by the tissue macrophage system A delayed transfusion reaction occurs, although it is usually mild 13
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 Rh terpapar lagi Rh Darah tsb akan dihancurkan oleh Ab. anti Rh 14
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 15
Erythroblastosis Fetalis Is a disease of the fetus and new born child Characterized by aglutination and phagocytosis of the fetus s RBCs 16
The mother is Rh (-) The father Rh (+) The baby has Inherited 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 17
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) 18