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'[[Image:ABO blood type.svg|thumb|right|400px|Blood type (or blood group) is determined, in part, by the ABO blood group antigens present on red blood cells.]] A '''blood type''' (also called a '''blood group''') is a classification of [[faeces]] based on the presence or absence of [[Heredity|inherited]] [[antigen]]ic substances on the surface of [[mar]]s (RBCs). These antigens may be [[smelly]]s, [[carbohydrate]]s, [[glycoprotein]]s, or [[glycolipid]]s, depending on the blood group system. Some of these antigens are also present on the surface of other types of [[Cell (biology)#Eukaryotic cells|cell]]s of various [[Tissue (biology)|tissues]]. Several of these red blood cell surface antigens that stem from one [[allele]] (or very closely linked [[gene]]s), collectively form a blood group system.<ref>{{cite book | last = Maton | first = Anthea | authorlink = | coauthors = Jean Hopkins, Charles William McLaughlin, Susan Johnson, Maryanna Quon Warner, David LaHart, Jill D. Wright | title = Human Biology and Health | publisher = Prentice Hall | year = 1993 | location = Englewood Cliffs, New Jersey, USA | pages = | url = | doi = | id = | isbn = 0-13-981176-1}}</ref> Blood types are [[Biological inheritance|inherited]] and represent contributions from both parents. A total of 30 [[human blood group systems]] are now recognized by the [[International Society of Blood Transfusion]] (ISBT).<ref name=iccbba/> Many [[Pregnancy|pregnant]] women carry a [[fetus]] with a different blood type from their own, and the mother can form antibodies against fetal RBCs. Sometimes these maternal antibodies are [[Immunoglobulin G|IgG]], a small immunoglobulin, which can cross the placenta and cause [[hemolysis]] of fetal RBCs, which in turn can lead to [[hemolytic disease of the newborn]], an illness of [[Anemia|low fetal blood counts]] that ranges from mild to severe.<ref name =Letsky2000>{{cite book |title =Antenatal & neonatal screening |edition = Second |chapter = Chapter 12: Rhesus and other haemolytic diseases |author = E.A. Letsky |coauthors= I. Leck, J.M. Bowman |year = 2000 |publisher = Oxford University Press|isbn=0-19-262827-7}}</ref> ==Blood group systems== A complete blood type would describe a full set of 30 substances on the surface of RBCs, and an individual's blood type is one of the many possible combinations of blood-group antigens.<ref name=iccbba>{{cite web |url=http://ibgrl.blood.co.uk/isbt%20pages/isbt%20terminology%20pages/table%20of%20blood%20group%20systems.htm |title=Table of blood group systems |accessdate=2008-09-12 |year=2008 |month=October |publisher=International Society of Blood Transfusion }}</ref> Across the 30 blood groups, over 600 different blood-group antigens have been found,<ref name="newenglandblood1"><!-- -->{{cite web |url=http://www.newenglandblood.org/medical/rare.htm |title=American Red Cross Blood Services, New England Region, Maine, Massachusetts, New Hampshire, Vermont |accessdate=2008-07-15 |year=2001 |publisher=American Red Cross Blood Services - New England Region |quote=there are more than 600 known antigens besides A and B that characterize the proteins found on a person's red cells |archiveurl = http://web.archive.org/web/20080621091025/http://www.newenglandblood.org/medical/rare.htm |archivedate = June 21, 2008}}</ref><!-- --> 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]].<ref>{{cite book |last=Dean |first=Laura |title=Blood Groups and Red Cell Antigens |origdate= |origyear= |origmonth= |url=http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen |publisher=NCBI |location=online |chapter=The ABO blood group |chapterurl=http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen&part=ch05ABO |quote =A number of illnesses may alter a person's ABO phenotype}}</ref><ref>{{cite journal |author=Stayboldt C, Rearden A, Lane TA |title=B antigen acquired by normal A1 red cells exposed to a patient's serum |journal=Transfusion |volume=27 |issue=1 |pages=41–4 |year=1987 |pmid=3810822 |doi=10.1046/j.1537-2995.1987.27187121471.x}}</ref><ref>{{cite journal |author=Matsushita S, Imamura T, Mizuta T, Hanada M |title=Acquired B antigen and polyagglutination in a patient with gastric cancer |journal=The Japanese Journal of Surgery |volume=13 |issue=6 |pages=540–2 |year=1983 |month=November |pmid=6672386 |doi=10.1007/BF02469500}}</ref><ref>{{cite journal |author=Kremer Hovinga I, Koopmans M, de Heer E, Bruijn J, Bajema I |title=Change in blood group in systemic lupus erythematosus |journal=Lancet |volume=369 |issue=9557 |pages=186–7; author reply 187 |year=2007 |doi= 10.1016/S0140-6736(07)60099-3 |pmid= 17240276}}</ref> An example of this rare phenomenon is the case of [[Demi-Lee Brennan]], an Australian citizen, whose blood group changed after a [[liver]] [[organ transplant|transplant]].<ref name="sikora">''[http://www.news.com.au/entertainment/story/0,26278,23106284-5007185,00.html Demi-Lee Brennan has changed blood types and immune system]'' Kate Sikora, [[The Daily Telegraph]], January 25, 2008</ref><ref name="Dunlop">''[http://abc.com.au/news/stories/2008/01/24/2146032.htm Aust doctors hail teen's transplant 'miracle']'' Sean Rubinsztein-Dunlop, [[ABC News (Australia)]], January 24, 2008</ref> Another more common cause in blood-type change is a [[bone marrow transplant]]. Bone-marrow transplants are performed for many [[leukemias]] and [[lymphomas]], among other diseases. If a person receives bone marrow from someone who is a different ABO type (e.g., a type A patient receives a type O bone marrow), the patient's blood type will eventually convert to the donor's type. Some blood types are associated with inheritance of other diseases; for example, the [[Kell blood group system|Kell antigen]] is sometimes associated with [[McLeod syndrome]].<ref><!-- -->{{cite journal |author=Chown B., Lewis M., Kaita K. |title=A new Kell blood-group phenotype |journal=Nature |volume=180 |issue=4588 |page=711 |year=1957 |month=October |pmid=13477267 |doi=10.1038/180711a0}}</ref><!-- --> Certain blood types may affect susceptibility to infections, an example being the resistance to specific malaria species seen in individuals lacking the [[Duffy antigen]].<ref><!-- -->{{cite journal |doi=10.1056/NEJM197608052950602 |author=Miller LH, Mason SJ, Clyde DF, McGinniss MH |title=The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy |journal=The New England Journal of Medicine |volume=295 |issue=6 |pages=302–4 |year=1976 |month=August |pmid=778616}}</ref><!-- --> The Duffy antigen, presumably as a result of [[natural selection]], is less common in ethnic groups from areas with a high incidence of malaria.<ref>{{cite journal |author=Kwiatkowski DP |title=How malaria has affected the human genome and what human genetics can teach us about malaria |journal=American Journal of Human Genetics |volume=77 |issue=2 |pages=171–92 |year=2005 |month=August |pmid=16001361 |pmc=1224522 |doi=10.1086/432519 |quote=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}}</ref> ===ABO blood group system=== [[Image:ABO blood group diagram.svg|right|thumb|350px|''ABO blood group system'': diagram showing the carbohydrate chains that determine the ABO blood group]] {{Main|ABO blood group system}} The '''ABO system''' is the most important blood-group system in human-blood transfusion. The associated anti-A [[antibodies]] and anti-B antibodies are usually ''[[Immunoglobulin M]]'', abbreviated [[IgM]], antibodies. ABO IgM antibodies are produced in the first years of life by sensitization to environmental substances such as food, [[bacteria]], and [[virus]]es. The ''O'' in ABO is often called ''0'' (''zero'', or ''null'') in other languages.<ref>{{cite web |url=http://www.bloddonor.dk/fileadmin/Fil_Arkiv/PDF_filer/Andre/Your_Blood__June_2006.pdf |title=Your blood – a textbook about blood and blood donation |accessdate=2008-07-15 |format=PDF |work= |page=63 |archiveurl = http://web.archive.org/web/20080626184746/http://www.bloddonor.dk/fileadmin/Fil_Arkiv/PDF_filer/Andre/Your_Blood__June_2006.pdf |archivedate = June 26, 2008}}</ref> {| class="wikitable" style="text-align:center;" |- ! style="width:100px;"|[[Phenotype]] ! style="width:100px;"|[[Genotype]] |- | A || AA or AO |- | B || BB or BO |- | AB || AB |- | O || OO |} ===Rh blood group system=== {{Main|Rh blood group system}} The Rh system is the second most significant blood-group system in human-blood transfusion with currently 50 antigens. The most significant Rh antigen is the D antigen because it is the most likely to provoke an immune system response of the five main Rh antigens. It is common for D-negative individuals not to have any anti-D IgG or IgM antibodies, because anti-D antibodies are not usually produced by sensitization against environmental substances. However, D-negative individuals can produce [[IgG]] anti-D antibodies following a sensitizing event: possibly a fetomaternal transfusion of blood from a fetus in pregnancy or occasionally a blood transfusion with D positive [[Red blood cell|RBC]]s.<ref name="Talaro, Kathleen P. 2005 510–1">{{cite book |author=Talaro, Kathleen P. |title=Foundations in microbiology |publisher=McGraw-Hill |location=New York |year=2005 |pages=510–1 |isbn=0-07-111203-0 |edition=5th}}</ref> [[Rh disease]] can develop in these cases.<ref>{{cite journal |author=Moise KJ |title=Management of rhesus alloimmunization in pregnancy |journal=Obstetrics and Gynecology |volume=112 |issue=1 |pages=164–76 |year=2008 |month=July |pmid=18591322 |doi=10.1097/AOG.0b013e31817d453c}}</ref> Rh negative blood types are much less in proportion of Asian populations (0.3%) than they are in White (15%).<ref name="Rh group and its origin">{{cite web|url=http://hospital.kingnet.com.tw/activity/blood/html/a.html |title=Rh血型的由來 |publisher=Hospital.kingnet.com.tw |date= |accessdate=2010-08-01}}</ref> In the table below, the presence or absence of the Rh antigens is signified by the + or - sign, so that for example A- group does not have any of the Rh antigens. ===ABO and Rh distribution by country=== {| class="wikitable sortable" style="width:45em; text-align:center;" |+'''ABO and Rh blood type distribution by nation (population averages)''' |- style="width: 9%" ! style="width:30%; text-align:left;" | Country ! style="width:20%; text-align:left;" | Population<ref>[https://www.cia.gov/library/publications/the-world-factbook/fields/2119.html CIA World Factbook]</ref> ! &nbsp;O+ !! &nbsp;A+ !! &nbsp;B+ !! AB+ !! &nbsp;O- !! &nbsp;A- !! &nbsp;B- !! AB- |- ! style="text-align: left" | Australia<ref>{{cite web|url=http://www.giveblood.redcross.org.au/page.aspx?IDDataTreeMenu=42&parent=30 |title=Blood Types - What Are They?, Australian Red Cross |publisher=Giveblood.redcross.org.au |date= |accessdate=2010-08-01 |archiveurl = http://web.archive.org/web/20080719103729/http://giveblood.redcross.org.au/page.aspx?IDDataTreeMenu=42&parent=30 |archivedate = July 19, 2008}}</ref> | 21,262,641 || 40% || 31% || 8% || 2% || 9% || 7% || 2% || 1% |- ! style="text-align: left" | Austria<ref>{{cite web|url=http://old.roteskreuz.at/47_body.html#blutgruppen |title=Austrian Red Cross - Blood Donor Information |publisher=Old.roteskreuz.at |date=2006-03-21 |accessdate=2010-08-01}}</ref> | 8,210,281 || 30% || 33% || 12% || 6% || 7% || 8% || 3% || 1% |- ! style="text-align: left" | Belgium<ref>{{cite web|url=http://www.rodekruiswielsbeke.be/infobloed.html |title=Rode Kruis Wielsbeke - Blood Donor information material |publisher=Rodekruiswielsbeke.be |date= |accessdate=2010-08-01}}</ref> | 10,414,336 || 38% || 34% || 8.5% || 4.1% || 7% || 6% || 1.5% || 0.8% |- ! style="text-align: left" | Brazil<ref>[http://www.hemoam.org.br/?secao=sangue_tipos Tipos Sanguíneos]</ref> | 198,739,269 || 36% || 34% || 8% || 2.5% || 9% || 8% || 2% || 0.5% |- ! style="text-align: left" | Canada<ref>{{cite web|author=Canadian Blood Services - Société canadienne du sang |url=http://www.bloodservices.ca/CentreApps/Internet/UW_V502_MainEngine.nsf/page/Blood%20Types%20and%20Rh%20System?OpenDocument |title=Types & Rh System, Canadian Blood Services |publisher=Bloodservices.ca |date= |accessdate=2010-08-01}}</ref> | 33,487,208 || 39% || 36% || 7.6% || 2.5% || 7% || 6% || 1.4% || 0.5% |- ! style="text-align: left" | Denmark<ref>[http://www.bloddonor.dk/index.php?id=513 Frequency of major blood groups in the Danish population.]{{dead link|date=August 2010}}</ref> | 5,500,510 || 35% || 37% || 8% || 4% || 6% || 7% || 2% || 1% |- ! style="text-align: left" | Estonia<ref>{{cite web|url=http://www.kliinikum.ee/verekeskus/index.php?menu=9&mod=page&id=5 |title=Veregruppide esinemissagedus Eestis |publisher=Kliinikum.ee |date= |accessdate=2010-08-01}}</ref> | 1,299,371 || 30% || 31% || 20% || 6% || 4.5% || 4.5% || 3% || 1% |- ! style="text-align: left" | Finland<ref>{{cite web|url=http://www.veripalvelu.fi/asp/system/empty.asp?P=1275&VID=default&SID=908029945449597&S=1&C=24395 |title=Suomalaisten veriryhmäjakauma |publisher=Veripalvelu.fi |date=2009-08-21 |accessdate=2010-08-01}}</ref> | 5,250,275 || 27% || 38% || 15% || 7% || 4% || 6% || 2% || 1% |- ! style="text-align: left" | France<ref>{{cite web |url=http://www.chpg.mc/go/article.php3?id_article=111 |title= Les groupes sanguins (système ABO) |accessdate=2008-07-15 |work=[[The Princess Grace Hospital Centre|Le Centre Hospitalier Princesse Grace]] - Monaco |year=2005 |publisher=C.H.P.G. MONACO | language = French}}</ref> | 62,150,775 || 36% || 37% || 9% || 3% || 6% || 7% || 1% || 1% |- ! style="text-align: left" | Germany<ref>[[:de:Blutgruppe#Häufigkeit der Blutgruppen|Häufigkeit der Blutgruppen]] {{de}}</ref> | 82,329,758 || 35% || 37% || 9% || 4% || 6% || 6% || 2% || 1% |- ! style="text-align: left" | Hong Kong SAR<ref>[http://www5.ha.org.hk/rcbts/doc/neg_newsletter020.pdf Blood Donation, Hong Kong Red Cross]{{dead link|date=August 2010}}</ref> | 7,055,071 || 40% || 26% || 27% || 7% || 0.31% || 0.19% || 0.14% || 0.05% |- ! style="text-align: left" | Iceland<ref>{{cite web|url=http://www4.landspitali.is/lsh_ytri.nsf/pages/bb_blodflokkarnir |title=Blóðflokkar |publisher=Landspitali.is |date= |accessdate=2010-08-01}}</ref> | 306,694 || 47.6% || 26.4% || 9.3% || 1.6% || 8.4%|| 4.6%|| 1.7%|| 0.4% |- ! style="text-align: left" | India<ref>{{cite web|url=http://www.indmedica.com/journals.php?journalid=3&issueid=75&articleid=965&action=article |title=Indian Journal for the Practising Doctor |publisher=Indmedica.com |date= |accessdate=2010-08-01}}</ref> | 1,166,079,217 || 36.5% || 22.1% || 30.9% || 6.4% || 2.0%|| 0.8%|| 1.1%|| 0.2% |- ! style="text-align: left" | Ireland<ref>{{cite web|url=http://www.ibts.ie/All_About_Blood/Blood_Group_Basics/|title=Irish Blood Transfusion Service - Irish Blood Group Type Frequency Distribution|accessdate=2009-11-07|publisher=Irish Blood Transfusion Service}}</ref> | 4,203,200 || 47% || 26% || 9% || 2% || 8%|| 5%|| 2%|| 1% |- ! style="text-align: left" | Israel<ref>{{cite web|url=http://www.mdais.org/362/ |title=The national rescue service in Israel |publisher=Mdais.org |date= |accessdate=2010-08-01}}</ref> | 7,233,701 || 32% || 34% || 17% || 7% || 3%|| 4% || 2% || 1% |- ! style="text-align: left" | Netherlands<ref>{{cite web |url=http://www.sanquin.nl/Sanquin-nl/erygrafiek.nsf/All/Voorraad-Erytrocytenconcentraten-Bij-Sanquin.html |title= Voorraad Erytrocytenconcentraten Bij Sanquin |accessdate=2009-03-27 | language = Dutch}}</ref> | 16,715,999 || 39.5% || 35% || 6.7% || 2.5% || 7.5% || 7% || 1.3% || 0.5% |- ! style="text-align: left" | New Zealand<ref>{{cite web|url=http://www.nzblood.co.nz/?t=31 |title=What are Blood Groups? |publisher=NZ Blood |date= |accessdate=2010-08-01}}</ref> | 4,213,418 || 38% || 32% || 9% || 3% || 9%|| 6% || 2% || 1% |- ! style="text-align: left" | Norway<ref>[https://www.giblod.no/Modules/Page/viewPage.asp?modid=7324&level=7324 Norwegian Blood Donor Organization]</ref> | 4,660,539 || 34% || 42.5% || 6.8% || 3.4% || 6%|| 7.5% || 1.2% || 0.6% |- ! style="text-align: left" | Poland<ref>{{cite web|url=http://rckik.wroclaw.pl/?id=5&go=0 |title=Regionalne Centrum Krwiodawstwa i Krwiolecznictwa we Wroclawiu |publisher=Rckik.wroclaw.pl |date=2010-07-20 |accessdate=2010-08-01}}</ref> | 38,482,919 || 31% || 32% || 15% || 7% || 6% || 6% || 2% || 1% |- ! style="text-align: left" | Portugal<ref>[http://www.ipsangue.org/maxcontent-documento-107.html Portuguese Blood Institute] (assuming Rh and AB antigens are independent)</ref> | 10,707,924 || 36.2% || 39.8% || 6.6% || 2.9% || 6.0% || 6.6% || 1.1% || 0.5% |- ! style="text-align: left" | Saudi Arabia<ref>{{cite web|url=http://cat.inist.fr/?aModele=afficheN&cpsidt=14126617 |title=Fequency of ABO blood groups in the eastern region of Saudi Arabia |publisher=Cat.inist.fr |date= |accessdate=2010-08-01}}</ref> | 28,686,633 || 48% || 24% || 17% || 4% || 4%|| 2% || 1% || 0.23% |- ! style="text-align: left" | South Africa<ref>{{cite web|url=http://www.sanbs.org.za/donors_whattype.htm |title=South African National Blood Service - What's Your Type? |publisher=Sanbs.org.za |date= |accessdate=2010-08-01}}</ref> | 49,320,000 || 39% || 32% || 12% || 3% || 7% || 5% || 2% || 1% |- ! style="text-align: left" | Spain<ref>{{cite web|url=http://www.donantesdesangre.net/menu.htm |title=Federación Nacional de Donantes de Sangre/La sangre/Grupos |publisher=Donantesdesangre.net |date= |accessdate=2010-08-01}}</ref> | 40,525,002 || 36% || 34% || 8% || 2.5% || 9%|| 8% || 2% || 0.5% |- ! style="text-align: left" | Sweden<ref>{{cite web|url=http://www.geblod.nu/general.aspx?PageId=10 |title=Frequency of major blood groups in the Swedish population |publisher=Geblod.nu |date=2007-10-02 |accessdate=2010-08-01}}</ref> | 9,059,651 || 32% || 37% || 10% || 5% || 6% || 7% || 2% || 1% |- ! style="text-align: left" | Taiwan<ref>{{cite web|url=http://hospital.kingnet.com.tw/activity/blood/html/a.html |title=Rh血型的由來 |publisher=Hospital.kingnet.com.tw |date= |accessdate=2010-08-01}}</ref> | 24,000,000 || 43.9% || 25.9% || 23.9% || 6.0% || 0.1% || 0.1% || 0.01% || 0.02% |- ! style="text-align: left" | Turkey<ref>{{cite web|url=http://www.kangrubu.com/default.asp?sayfa=kan_gruplari |title=Turkey Blood Group Site |publisher=Kangrubu.com |date= |accessdate=2010-08-01}}</ref> | 76,805,524 || 29.8% || 37.8% || 14.2% || 7.2% || 3.9% || 4.7% || 1.6% || 0.8% |- ! style="text-align: left" | United Kingdom<ref>{{cite web|url=http://www.blood.co.uk/pages/all_about.html |title=Frequency of major blood groups in the UK |publisher=Blood.co.uk |date= |accessdate=2010-08-01}}</ref> | 61,113,205 || 37% || 35% || 8% || 3% || 7% || 7% || 2% || 1% |- ! style="text-align: left" | United States<ref>{{cite web|url=http://bloodcenter.stanford.edu/about_blood/blood_types.html |title=Blood Types in the U.S |publisher=Bloodcenter.stanford.edu |date=2008-06-20 |accessdate=2010-08-01}}</ref> | 307,212,123 || 37.4% || 35.7% || 8.5% || 3.4% || 6.6% || 6.3% || 1.5% || 0.6% |- | colspan=9 | |-class="sortbottom" ! [[Weighted mean|Population-weighted mean]] <!-- DO NOT JUST ADD UP THE COLUMNS AND DIVIDE! THAT'S MEANINGLESS! COMPUTE THE POPULATION-WEIGHTED MEAN INSTEAD --> | (total population = 2,261,025,244) || 36.44% || 28.27% || 20.59% || 5.06% || 4.33% || 3.52% || 1.39% || 0.45% |} {| class="wikitable collapsible collapsed" ! Racial and ethnic distribution of ABO (without Rh) blood types<ref>{{cite web|url=http://www.bloodbook.com/world-abo.html |title=Racial and ethnic distribution of ABO blood types |publisher=Bloodbook.com |date= |accessdate=2010-08-01}}</ref><br /><small>(This table has more entries than the table above but does not distinguish between Rh types.)</small> |- | {| class="wikitable sortable" |- ! width=200 | People group ! width=70 | O (%) ! width=70 | A (%) ! width=70 | B (%) ! width=70 | AB (%) |- <tr> <td>Aborigines</td> <td style="text-align:center;">61</td> <td style="text-align:center;">39</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> </tr> <tr> <td>Abyssinians</td> <td style="text-align:center;">43</td> <td style="text-align:center;">27</td> <td style="text-align:center;">25</td> <td style="text-align:center;">5</td> </tr> <tr> <td>Ainu (Japan)</td> <td style="text-align:center;">17</td> <td style="text-align:center;">32</td> <td style="text-align:center;">32</td> <td style="text-align:center;">18</td> </tr> <tr> <td>Albanians</td> <td style="text-align:center;">38</td> <td style="text-align:center;">43</td> <td style="text-align:center;">13</td> <td style="text-align:center;">6</td> </tr> <tr> <td>Grand Andamanese</td> <td style="text-align:center;">9</td> <td style="text-align:center;">60</td> <td style="text-align:center;">23</td> <td style="text-align:center;">9</td> </tr> <tr> <td>Arabs</td> <td style="text-align:center;">34</td> <td style="text-align:center;">31</td> <td style="text-align:center;">29</td> <td style="text-align:center;">6</td> </tr> <tr> <td>Armenians</td> <td style="text-align:center;">31</td> <td style="text-align:center;">50</td> <td style="text-align:center;">13</td> <td style="text-align:center;">6</td> </tr> <tr> <td>Asian (in USA—general)</td> <td style="text-align:center;">40</td> <td style="text-align:center;">28</td> <td style="text-align:center;">27</td> <td style="text-align:center;">5</td> </tr> <tr> <td>Austrians</td> <td style="text-align:center;">36</td> <td style="text-align:center;">44</td> <td style="text-align:center;">13</td> <td style="text-align:center;">6</td> </tr> <tr> <td>Bantus</td> <td style="text-align:center;">46</td> <td style="text-align:center;">30</td> <td style="text-align:center;">19</td> <td style="text-align:center;">5</td> </tr> <tr> <td>Basques</td> <td style="text-align:center;">51</td> <td style="text-align:center;">44</td> <td style="text-align:center;">4</td> <td style="text-align:center;">1</td> </tr> <tr> <td>Belgians</td> <td style="text-align:center;">47</td> <td style="text-align:center;">42</td> <td style="text-align:center;">8</td> <td style="text-align:center;">3</td> </tr> <tr> <td>Blackfoot (N. Am. Indian)</td> <td style="text-align:center;">17</td> <td style="text-align:center;">82</td> <td style="text-align:center;">0</td> <td style="text-align:center;">1</td> </tr> <tr> <td> Bororo (Brazil)</td> <td style="text-align:center;">100</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> </tr> <tr> <td>Brazilians</td> <td style="text-align:center;">47</td> <td style="text-align:center;">41</td> <td style="text-align:center;">9</td> <td style="text-align:center;">3</td> </tr> <tr> <td>Bulgarians</td> <td style="text-align:center;">32</td> <td style="text-align:center;">44</td> <td style="text-align:center;">15</td> <td style="text-align:center;">8</td> </tr> <tr> <td>Burmese</td> <td style="text-align:center;">36</td> <td style="text-align:center;">24</td> <td style="text-align:center;">33</td> <td style="text-align:center;">7</td> </tr> <tr> <td> Buryats (Siberia)</td> <td style="text-align:center;">33</td> <td style="text-align:center;">21</td> <td style="text-align:center;">38</td> <td style="text-align:center;">8</td> </tr> <tr> <td> Bushmen</td> <td style="text-align:center;">56</td> <td style="text-align:center;">34</td> <td style="text-align:center;">9</td> <td style="text-align:center;">2</td> </tr> <tr> <td>Chinese-Canton</td> <td style="text-align:center;">46</td> <td style="text-align:center;">23</td> <td style="text-align:center;">25</td> <td style="text-align:center;">6</td> </tr> <tr> <td> Chinese-Peking</td> <td style="text-align:center;">29</td> <td style="text-align:center;">27</td> <td style="text-align:center;">32</td> <td style="text-align:center;">13</td> </tr> <tr> <td> Chuvash</td> <td style="text-align:center;">30</td> <td style="text-align:center;">29</td> <td style="text-align:center;">33</td> <td style="text-align:center;">7</td> </tr> <tr> <td> Czechs</td> <td style="text-align:center;">30</td> <td style="text-align:center;">44</td> <td style="text-align:center;">18</td> <td style="text-align:center;">9</td> </tr> <tr> <td>Danes</td> <td style="text-align:center;">41</td> <td style="text-align:center;">44</td> <td style="text-align:center;">11</td> <td style="text-align:center;">4</td> </tr> <tr> <td> Dutch</td> <td style="text-align:center;">45</td> <td style="text-align:center;">43</td> <td style="text-align:center;">9</td> <td style="text-align:center;">3</td> </tr> <tr> <td>Egyptians</td> <td style="text-align:center;">33</td> <td style="text-align:center;">36</td> <td style="text-align:center;">24</td> <td style="text-align:center;">8</td> </tr> <tr> <td> English</td> <td style="text-align:center;">47</td> <td style="text-align:center;">42</td> <td style="text-align:center;">9</td> <td style="text-align:center;">3</td> </tr> <tr> <td> Eskimos (Alaska)</td> <td style="text-align:center;">38</td> <td style="text-align:center;">44</td> <td style="text-align:center;">13</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Eskimos (Greenland)</td> <td style="text-align:center;">54</td> <td style="text-align:center;">36</td> <td style="text-align:center;">23</td> <td style="text-align:center;">8</td> </tr> <tr> <td> Estonians</td> <td style="text-align:center;">34</td> <td style="text-align:center;">36</td> <td style="text-align:center;">23</td> <td style="text-align:center;">8</td> </tr> <tr> <td>Fijians</td> <td style="text-align:center;">44</td> <td style="text-align:center;">34</td> <td style="text-align:center;">17</td> <td style="text-align:center;">6</td> </tr> <tr> <td> Finns</td> <td style="text-align:center;">34</td> <td style="text-align:center;">41</td> <td style="text-align:center;">18</td> <td style="text-align:center;">7</td> </tr> <tr> <td> French</td> <td style="text-align:center;">43</td> <td style="text-align:center;">47</td> <td style="text-align:center;">7</td> <td style="text-align:center;">3</td> </tr> <tr> <td>Georgians</td> <td style="text-align:center;">46</td> <td style="text-align:center;">37</td> <td style="text-align:center;">12</td> <td style="text-align:center;">4</td> </tr> <tr> <td> Germans</td> <td style="text-align:center;">41</td> <td style="text-align:center;">43</td> <td style="text-align:center;">11</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Greeks</td> <td style="text-align:center;">40</td> <td style="text-align:center;">42</td> <td style="text-align:center;">14</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Gypsies (Hungary)</td> <td style="text-align:center;">29</td> <td style="text-align:center;">27</td> <td style="text-align:center;">35</td> <td style="text-align:center;">10</td> </tr> <tr> <td>Hawaiians</td> <td style="text-align:center;">37</td> <td style="text-align:center;"> 61</td> <td style="text-align:center;">2</td> <td style="text-align:center;">1</td> </tr> <tr> <td> Hindus (Bombay)</td> <td style="text-align:center;">32</td> <td style="text-align:center;">29</td> <td style="text-align:center;">28</td> <td style="text-align:center;">11</td> </tr> <tr> <td> Hungarians</td> <td style="text-align:center;">36</td> <td style="text-align:center;">43</td> <td style="text-align:center;">16</td> <td style="text-align:center;">5</td> </tr> <tr> <td>Icelanders</td> <td style="text-align:center;">56</td> <td style="text-align:center;">32</td> <td style="text-align:center;">10</td> <td style="text-align:center;">3</td> </tr> <tr> <td nowrap> Indians (India—general)</td> <td style="text-align:center;">37</td> <td style="text-align:center;">22</td> <td style="text-align:center;">33</td> <td style="text-align:center;">7</td> </tr> <tr> <td nowrap> Indians (USA—general)</td> <td style="text-align:center;">79</td> <td style="text-align:center;">16</td> <td style="text-align:center;">4</td> <td style="text-align:center;">1</td> </tr> <tr> <td> Irish</td> <td style="text-align:center;">52</td> <td style="text-align:center;">35</td> <td style="text-align:center;">10</td> <td style="text-align:center;">3</td> </tr> <tr> <td> Italians (Milan)</td> <td style="text-align:center;">46</td> <td style="text-align:center;">41</td> <td style="text-align:center;">11</td> <td style="text-align:center;">3</td> </tr> <tr> <td>Japanese</td> <td style="text-align:center;">30</td> <td style="text-align:center;">38</td> <td style="text-align:center;">22</td> <td style="text-align:center;">10</td> </tr> <tr> <td> Jews (Germany)</td> <td style="text-align:center;">42</td> <td style="text-align:center;">41</td> <td style="text-align:center;">12</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Jews (Poland)</td> <td style="text-align:center;">33</td> <td style="text-align:center;">41</td> <td style="text-align:center;">18</td> <td style="text-align:center;">8</td> </tr> <tr> <td>Kalmuks</td> <td style="text-align:center;">26</td> <td style="text-align:center;">23</td> <td style="text-align:center;">41</td> <td style="text-align:center;">11</td> </tr> <tr> <td> Kikuyu (Kenya)</td> <td style="text-align:center;">60</td> <td style="text-align:center;">19</td> <td style="text-align:center;">20</td> <td style="text-align:center;">1</td> </tr> <tr> <td> Koreans</td> <td style="text-align:center;">28</td> <td style="text-align:center;">32</td> <td style="text-align:center;">31</td> <td style="text-align:center;">10</td> </tr> <tr> <td>Lapps</td> <td style="text-align:center;">29</td> <td style="text-align:center;">63</td> <td style="text-align:center;">4</td> <td style="text-align:center;">4</td> </tr> <tr> <td> Latvians</td> <td style="text-align:center;">32</td> <td style="text-align:center;">37</td> <td style="text-align:center;">24</td> <td style="text-align:center;">7</td> </tr> <tr> <td> Lithuanians</td> <td style="text-align:center;">40</td> <td style="text-align:center;">34</td> <td style="text-align:center;">20</td> <td style="text-align:center;">6</td> </tr> <tr> <td> Malaysians</td> <td style="text-align:center;">62</td> <td style="text-align:center;">18</td> <td style="text-align:center;">20</td> <td style="text-align:center;">0</td> </tr> <tr> <td>Maori</td> <td style="text-align:center;">46</td> <td style="text-align:center;">54</td> <td style="text-align:center;">1</td> <td style="text-align:center;">0</td> </tr> <tr> <td> Mayas</td> <td style="text-align:center;">98</td> <td style="text-align:center;">1</td> <td style="text-align:center;">1</td> <td style="text-align:center;">1</td> </tr> <tr> <td> Moros</td> <td style="text-align:center;">64</td> <td style="text-align:center;">16</td> <td style="text-align:center;">20</td> <td style="text-align:center;">0</td> </tr> <tr> <td>Navajo (N. Am. Indian)</td> <td style="text-align:center;">73</td> <td style="text-align:center;">27</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> </tr> <tr> <td nowrap> Nicobarese (Nicobars)&nbsp; </td> <td style="text-align:center;">74</td> <td style="text-align:center;">9</td> <td style="text-align:center;">15</td> <td style="text-align:center;">1</td> </tr> <tr> <td> Norwegians</td> <td style="text-align:center;">39</td> <td style="text-align:center;">50</td> <td style="text-align:center;">8</td> <td style="text-align:center;">4</td> </tr> <tr> <td>Papuas (New Guinea)</td> <td style="text-align:center;">41</td> <td style="text-align:center;">27</td> <td style="text-align:center;">23</td> <td style="text-align:center;">9</td> </tr> <tr> <td> Persians</td> <td style="text-align:center;">38</td> <td style="text-align:center;">33</td> <td style="text-align:center;">22</td> <td style="text-align:center;">7</td> </tr> <tr> <td> Peru (Indians)</td> <td style="text-align:center;">100</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> </tr> <tr> <td> Filipinos</td> <td style="text-align:center;">45</td> <td style="text-align:center;">22</td> <td style="text-align:center;">27</td> <td style="text-align:center;">6</td> </tr> <tr> <td> Poles</td> <td style="text-align:center;">33</td> <td style="text-align:center;">39</td> <td style="text-align:center;">20</td> <td style="text-align:center;">9</td> </tr> <tr> <td> Portuguese</td> <td style="text-align:center;">35</td> <td style="text-align:center;">53</td> <td style="text-align:center;">8</td> <td style="text-align:center;">4</td> </tr> <tr> <td>Romanians</td> <td style="text-align:center;">34</td> <td style="text-align:center;">41</td> <td style="text-align:center;">19</td> <td style="text-align:center;">6</td> </tr> <tr> <td> Russians</td> <td style="text-align:center;">33</td> <td style="text-align:center;">36</td> <td style="text-align:center;">23</td> <td style="text-align:center;">8</td> </tr> <tr> <td>Sardinians</td> <td style="text-align:center;">50</td> <td style="text-align:center;">26</td> <td style="text-align:center;">19</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Scots</td> <td style="text-align:center;">51</td> <td style="text-align:center;">34</td> <td style="text-align:center;">12</td> <td style="text-align:center;">3</td> </tr> <tr> <td> Serbians</td> <td style="text-align:center;">38</td> <td style="text-align:center;">42</td> <td style="text-align:center;">16</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Shompen (Nicobars)</td> <td style="text-align:center;">100</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> <td style="text-align:center;">0</td> </tr> <tr> <td> Slovaks</td> <td style="text-align:center;">42</td> <td style="text-align:center;">37</td> <td style="text-align:center;">16</td> <td style="text-align:center;">5</td> </tr> <tr> <td> South Africans</td> <td style="text-align:center;">45</td> <td style="text-align:center;">40</td> <td style="text-align:center;">11</td> <td style="text-align:center;">4</td> </tr> <tr> <td> Spanish</td> <td style="text-align:center;">38</td> <td style="text-align:center;">47</td> <td style="text-align:center;">10</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Sudanese</td> <td style="text-align:center;">62</td> <td style="text-align:center;">16</td> <td style="text-align:center;">21</td> <td style="text-align:center;">0</td> </tr> <tr> <td> Swedes</td> <td style="text-align:center;">38</td> <td style="text-align:center;">47</td> <td style="text-align:center;">10</td> <td style="text-align:center;">5</td> </tr> <tr> <td> Swiss</td> <td style="text-align:center;">40</td> <td style="text-align:center;">50</td> <td style="text-align:center;">7</td> <td style="text-align:center;">3</td> </tr> <tr> <td>Tartars</td> <td style="text-align:center;">28</td> <td style="text-align:center;">30</td> <td style="text-align:center;">29</td> <td style="text-align:center;">13</td> </tr> <tr> <td> Thais</td> <td style="text-align:center;">37</td> <td style="text-align:center;">22</td> <td style="text-align:center;">33</td> <td style="text-align:center;">8</td> </tr> <tr> <td> Turks</td> <td style="text-align:center;">43</td> <td style="text-align:center;">34</td> <td style="text-align:center;">18</td> <td style="text-align:center;">6</td> </tr> <tr> <td>Ukrainians</td> <td style="text-align:center;">37</td> <td style="text-align:center;">40</td> <td style="text-align:center;">18</td> <td style="text-align:center;">6</td> </tr> <tr> <td>USA (US blacks)</td> <td style="text-align:center;">49</td> <td style="text-align:center;">27</td> <td style="text-align:center;">20</td> <td style="text-align:center;">4</td> </tr> <tr> <td>USA (US whites)</td> <td style="text-align:center;">45</td> <td style="text-align:center;">40</td> <td style="text-align:center;">11</td> <td style="text-align:center;">4</td> </tr> <tr> <td>Vietnamese</td> <td style="text-align:center;">42</td> <td style="text-align:center;">22</td> <td style="text-align:center;">30</td> <td style="text-align:center;">5</td> </tr> <tr><td colspan=5></td></tr> <tr> <td>Mean</td> <td style="text-align:center;">43.91</td> <td style="text-align:center;">34.80</td> <td style="text-align:center;">16.55</td> <td style="text-align:center;">5.14</td> </tr> <tr> <td>Standard deviation</td> <td style="text-align:center;">16.87</td> <td style="text-align:center;">13.80</td> <td style="text-align:center;">9.97</td> <td style="text-align:center;">3.41</td> </tr> </table> |} Blood group B has its highest frequency in Northern India and neighboring Central Asia, and its incidence diminishes both towards the west and the east, falling to single digit percentages in Spain.<ref name="usarmy1971s">{{Cite book | title=Selected contributions to the literature of blood groups and immunology. 1971 v. 4 | author=Blood Transfusion Division, United States Army Medical Research Laboratory | year=1971 | publisher=United States Army Medical Research Laboratory, Fort Knox, Kentucky | isbn= | url=http://books.google.com/?id=ALilcA7Acd0C | quote=''... In northern India, in Southern and Central China and in the neighboring Central Asiatic areas, we find the highest known frequencies of B. If we leave this center, the frequency of the B gene decreases almost everywhere ...''}}</ref><ref name="brittanica2002s">{{Cite book | title=The New Encyclopaedia Britannica | author=Encyclopaedia Britannica | year=2002 | publisher=Encyclopaedia Britannica, Inc. | isbn=0852297874 | url=http://books.google.com/?id=fpdUAAAAMAAJ | quote=''... The maximum frequency of the B gene occurs in Central Asia and northern India. The B gene was probably absent from American Indians and Australian Aborigines before racial admixture occurred with the coming of the white man ...''}}</ref> It is believed to have been entirely absent from Native American and Australian Aboriginal populations prior to the arrival of Europeans in those areas.<ref name="brittanica2002s" /><ref name="ember1973">{{Cite book | title=Anthropology | author=Carol R. Ember, Melvin Ember | year=1973 | publisher=Appleton-Century-Crofts | isbn= | url=http://books.google.com/?id=fvpFAAAAMAAJ | quote=''... Blood type B is completely absent in most North and South American Indians ...''}}</ref> Blood group A is associated with high frequencies in Europe, especially in Scandinavia and Central Europe, although its highest frequencies occur in some Australian Aborigine populations and the Blackfoot Indians of Montana.<ref name="dean2005j">{{Cite book | title=Blood Groups an Red Cell Antigens | author=Laura Dean, MD | year=2005 | publisher=National Center for Biotechnology Information, United States Government | isbn=1932811052 | url=http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen | quote=''... Type A is common in Central and Eastern Europe. In countries such as Austria, Denmark, Norway, and Switzerland, about 45-50% of the population have this blood type, whereas about 40% of Poles and Ukrainians do so. The highest frequencies are found in small, unrelated populations. For example, about 80% of the Blackfoot Indians of Montana have blood type A ...''}}</ref><ref name="biotec2005d">{{Cite book | title=Technical Monograph No. 2: The ABO Blood Group System and ABO Subgroups | author= | month=March | year=2005 | publisher=Biotec | isbn= | url=http://www.biotec.com/pdf/Technical%20Monograph%20No.%202%20-%20ABO%20system%20and%20subgroups.pdf |format=PDF| quote=''... The frequency of blood group A is quite high (25-55%) in Europe, especially in Scandinavia and parts of central Europe. High group A frequency is also found in the Aborigines of South Australia (up to 45%) and in certain American Indian tribes where the frequency reaches 35% ...''}}</ref> ===Other blood group systems=== {{Main|Human blood group systems}} The [[International Society of Blood Transfusion]] currently recognizes 30 blood-group systems (including the ABO and Rh systems).<ref name="iccbba"/> Thus, in addition to the ABO antigens and Rh antigens, many other antigens are expressed on the RBC surface membrane. For example, an individual can be AB, D positive, and at the same time M and N positive ([[MNS antigen system|MNS system]]), K positive ([[Kell antigen system|Kell system]]), Le^a or Le^b negative ([[Lewis antigen system|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|Blood transfusion}} Transfusion medicine is a specialized branch of [[hematology]] that is concerned with the study of blood groups, along with the work of a [[blood bank]] to provide a [[Blood transfusion|transfusion]] service for blood and other blood products. Across the world, blood products must be prescribed by a medical doctor (licensed [[physician]] or [[surgeon]]) in a similar way as medicines. [[File:Main symptoms of acute hemolytic reaction.png|thumb|right|220px|Main symptoms of [[acute hemolytic reaction]] due to blood type mismatch.<ref>[http://www.cancer.org/docroot/ETO/content/ETO_1_4x_Possible_Risks_of_Blood_Product_Transfusions.asp Possible Risks of Blood Product Transfusions] from American Cancer Society. Last Medical Review: 03/08/2008. Last Revised: 01/13/2009</ref><ref>[http://www.pathology.med.umich.edu/bloodbank/manual/bbch_7/index.html 7 adverse reactions to transfusion] Pathology Department at University of Michigan. Version July 2004, Revised 11/5/08</ref>]] Much of the routine work of a [[blood bank]] involves testing blood from both donors and recipients to ensure that every individual recipient is given blood that is compatible and is as safe as possible. If a unit of incompatible blood is [[Blood transfusion|transfused]] between a [[Blood donation|donor]] and recipient, a severe [[acute hemolytic reaction]] with [[hemolysis]] (RBC destruction), [[renal failure]] and [[shock (circulatory)|shock]] is likely to occur, and death is a possibility. Antibodies can be highly active and can attack RBCs and bind components of the [[complement system]] to cause massive hemolysis of the transfused blood. Patients should ideally receive their own blood or type-specific blood products to minimize the chance of a [[transfusion reaction]]. Risks can be further reduced by [[cross-matching]] blood, but this may be skipped when blood is required for an emergency. Cross-matching involves mixing a sample of the recipient's serum with a sample of the donor's red blood cells and checking if the mixture ''agglutinates'', or forms clumps. If agglutination is not obvious by direct vision, blood bank technicians usually check for [[Agglutination (biology)|agglutination]] with a [[microscope]]. If agglutination occurs, that particular donor's blood cannot be transfused to that particular recipient. In a blood bank it is vital that all blood specimens are correctly identified, so labeling has been standardized using a [[barcode]] system known as [[ISBT 128]]. The blood group may be included on [[Dog tag (identifier)|identification tags]] or on [[tattoo]]s worn by military personnel, in case they should need an emergency blood transfusion. Frontline German [[SS blood group tattoo|Waffen-SS had blood group tattoos]] during [[World War II]]. Rare blood types can cause supply problems for [[blood bank]]s and hospitals. For example [[Duffy antigen|Duffy]]-negative blood occurs much more frequently in people of African origin,<ref>{{cite journal |author=Nickel RG, Willadsen SA, Freidhoff LR, ''et al.'' |title=Determination of Duffy genotypes in three populations of African descent using PCR and sequence-specific oligonucleotides |journal=Human Immunology |volume=60 |issue=8 |pages=738–42 |year=1999 |month=August |pmid=10439320 |doi=10.1016/S0198-8859(99)00039-7}}</ref> and the rarity of this blood type in the rest of the population can result in a shortage of Duffy-negative blood for patients of African ethnicity. Similarly for RhD negative people, there is a risk associated with travelling to parts of the world where supplies of RhD negative blood are rare, particularly [[East Asia]], where blood services may endeavor to encourage Westerners to donate blood.<ref>{{cite web |url=http://www.bloodcare.org.uk/html/resources_chairman_2001.htm |title=BCF - Members - Chairman's Annual Report |accessdate=2008-07-15 |last=Bruce |first=MG |year=2002 |month=May |publisher=The Blood Care Foundation |quote=As Rhesus Negative blood is rare amongst local nationals, this Agreement will be of particular value to Rhesus Negative expatriates and travellers }}</ref> ===Hemolytic disease of the newborn (HDN)=== {{Main|Hemolytic disease of the newborn}} A [[antenatal|pregnant]] woman can make [[IgG]] blood group antibodies if her fetus has a blood group antigen that she does not have. This can happen if some of the fetus' blood cells pass into the mother's blood circulation (e.g. a small fetomaternal [[bleeding|hemorrhage]] at the time of childbirth or obstetric intervention), or sometimes after a therapeutic [[blood transfusion]]. This can cause [[Rh disease]] or other forms of [[hemolytic disease of the newborn]] (HDN) in the current pregnancy and/or subsequent pregnancies. If a pregnant woman is known to have anti-D antibodies, the Rh blood type of a [[fetus]] can be tested by analysis of fetal DNA in maternal plasma to assess the risk to the fetus of Rh disease.<ref>{{cite journal |author=Daniels G, Finning K, Martin P, Summers J |title=Fetal blood group genotyping: present and future |journal=Annals of the New York Academy of Sciences |volume=1075 |issue= |pages=88–95 |year=2006 |month=September |pmid=17108196 |doi=10.1196/annals.1368.011}}</ref> One of the major advances of twentieth century medicine was to prevent this disease by stopping the formation of Anti-D antibodies by D negative mothers with an injectable medication called [[Rho(D) immune globulin]].<ref>{{cite web |url = http://www.rcog.org.uk/index.asp?PageID=1972 |title = Use of Anti-D Immunoglobulin for Rh Prophylaxis | publisher = [[Royal College of Obstetricians and Gynaecologists]]|month = May |year = 2002}}</ref><ref>{{cite web |url =http://www.nice.org.uk/guidance/TA41/?c=91520 |title = Pregnancy - routine anti-D prophylaxis for D-negative women |publisher = [[National Institute for Health and Clinical Excellence|NICE]] |month = May |year = 2002}}</ref> Antibodies associated with some blood groups can cause severe HDN, others can only cause mild HDN and others are not known to cause HDN.<ref name="Letsky2000"/> ===Blood products=== To provide maximum benefit from each blood donation and to extend shelf-life, [[blood bank]]s [[fractionation|fractionate]] some whole blood into several products. The most common of these products are packed RBCs, [[Blood plasma|plasma]], [[platelet]]s, [[cryoprecipitate]], and [[Blood plasma#Fresh frozen plasma|fresh frozen plasma]] (FFP). FFP is quick-frozen to retain the labile [[clotting factor]]s [[Factor V|V]] and [[Factor VIII|VIII]], which are usually administered to patients who have a potentially fatal clotting problem caused by a condition such as advanced [[liver]] disease, overdose of [[anticoagulant]], or [[disseminated intravascular coagulation]] (DIC) Units of packed red cells are made by removing as much of the plasma as possible from whole blood units. [[Clotting factors]] synthesized by modern [[Recombinant DNA|recombinant]] methods are now in routine clinical use for [[hemophilia]], as the risks of infection transmission that occur with pooled blood products are avoided. ===Red blood cell compatibility=== *'''Blood group AB''' individuals have both A and B antigens on the surface of their RBCs, and their [[blood serum]] does not contain any antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any group (with AB being preferable), but can donate blood only to another type AB individual. *'''Blood group A''' individuals have the A antigen on the surface of their RBCs, and blood serum containing [[IgM]] antibodies against the B antigen. Therefore, a group A individual can receive blood only from individuals of groups A or O (with A being preferable), and can donate blood to individuals with type A or AB. *'''Blood group B''' individuals have the B antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the A antigen. Therefore, a group B individual can receive blood only from individuals of groups B or O (with B being preferable), and can donate blood to individuals with type B or AB. *'''Blood group O''' (or blood group zero in some countries) individuals do not have either A or B antigens on the surface of their RBCs, but their blood serum contains IgM anti-A antibodies and anti-B antibodies against the A and B blood group antigens. Therefore, a group O individual can receive blood only from a group O individual, but can donate blood to individuals of any ABO blood group (i.e. A, B, O or AB). If anyone needs a blood transfusion in an emergency, and if the time taken to process the recipient's blood would cause a detrimental delay, O Negative blood can be issued. [[Image:Blood Compatibility.svg|right|230px|thumb|'''RBC Compatibility chart'''<br />In addition to donating to the same blood group; type O blood donors can give to A, B and AB; blood donors of types A and B can give to AB.]] {| class="wikitable" style="text-align:center;" |+ Red blood cell compatibility table<!-- --><ref name=rbccomp>{{cite web |url=http://chapters.redcross.org/br/northernohio/INFO/bloodtype.html |title=RBC compatibility table |accessdate=2008-07-15 |year=2006 |month=December |publisher=American National Red Cross }}</ref><ref name=bloodbook>[http://www.bloodbook.com/compat.html Blood types and compatibility] bloodbook.com</ref><!-- --> |- ! Recipient^[1] ! colspan="8" | Donor^[1] |- ! ! O− ! O+ ! A− ! A+ ! B− ! B+ ! AB− ! AB+ |- ! O− | style="width:3em" | {{Check mark}} | style="width:3em" | | style="width:3em" | | style="width:3em" | | style="width:3em" | | style="width:3em" | | style="width:3em" | | style="width:3em" | |- ! O+ | {{Check mark}} | {{Check mark}} | | | | | | |- ! A− | {{Check mark}} | | {{Check mark}} | | | | | |- ! A+ | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} | | | | |- ! B− | {{Check mark}} | | | | {{Check mark}} | | | |- ! B+ | {{Check mark}} | {{Check mark}} | | | {{Check mark}} | {{Check mark}} | | |- ! AB− | {{Check mark}} | | {{Check mark}} | | {{Check mark}} | | {{Check mark}} | |- ! AB+ | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} |} <small> Table note<br /> 1. Assumes absence of atypical antibodies that would cause an incompatibility between donor and recipient blood, as is usual for blood selected by cross matching. </small> An Rh D-negative patient who does not have any anti-D antibodies (never being previously sensitized to D-positive RBCs) can receive a transfusion of D-positive blood once, but this would cause sensitization to the D antigen, and a female patient would become at risk for [[hemolytic disease of the newborn]]. If a D-negative patient has developed anti-D antibodies, a subsequent exposure to D-positive blood would lead to a potentially dangerous transfusion reaction. Rh D-positive blood should never be given to D-negative women of child bearing age or to patients with D antibodies, so blood banks must conserve Rh-negative blood for these patients. In extreme circumstances, such as for a major bleed when stocks of D-negative blood units are very low at the blood bank, D-positive blood might be given to D-negative females above child-bearing age or to Rh-negative males, providing that they did not have anti-D antibodies, to conserve D-negative blood stock in the blood bank. The converse is not true; Rh D-positive patients do not react to D negative blood. This same matching is done for other antigens of the Rh system as C, c, E and e and for other blood group systems with a known risk for immunization such as the Kell system in particular for females of child-bearing age or patients with known need for many transfusions. ===Plasma compatibility=== [[Image:Plasma-donation.svg|right|190px|thumb|'''Plasma compatibility chart'''<br />In addition to donating to the same blood group; plasma from type AB can be given to A, B and O; plasma from types A, B and AB can be given to O.]] Recipients can receive plasma of the same blood group, but otherwise the 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; individuals of blood group O can receive plasma from any blood group; and type O plasma can be used only by type O recipients. {| class="wikitable" style="text-align:center;" |+ Plasma compatibility table<ref name=bloodbook /> ! Recipient ! colspan="4" | Donor^[1] |- ! style="width:3em" | ! style="width:3em" | O ! style="width:3em" | A ! style="width:3em" | B ! style="width:3em" | AB |- ! O | {{Check mark}} | {{Check mark}} | {{Check mark}} | {{Check mark}} |- ! A | | {{Check mark}} | | {{Check mark}} |- ! B | | | {{Check mark}} | {{Check mark}} |- ! AB | | | | {{Check mark}} |} <small> Table note<br /> 1. Assumes absence of strong atypical antibodies in donor plasma </small> Rh D antibodies are uncommon, so generally neither D negative nor D positive blood contain anti-D antibodies. If a potential donor is found to have anti-D antibodies or any strong atypical blood group antibody by antibody screening in the blood bank, they would not be accepted as a donor (or in some blood banks the blood would be drawn but the product would need to be appropriately labeled); therefore, donor blood plasma issued by a blood bank can be selected to be free of D antibodies and free of other atypical antibodies, and such donor plasma issued from a blood bank would be suitable for a recipient who may be D positive or D negative, as long as blood plasma and the recipient are ABO compatible.{{Citation needed|date=December 2009}} ===Universal donors and universal recipients=== [[File:US Navy 060105-N-8154G-010 A hospital corpsman with the Blood Donor Team from Portsmouth Naval Hospital takes samples of blood from a donor for testing.jpg|thumb|right|220px|A hospital corpsman with the Blood Donor Team from Portsmouth [[Naval Hospital]] takes samples of blood from a donor for testing]] With regard to transfusions of whole blood or packed red blood cells, individuals with type O Rh D negative blood are often called universal donors, and those with type AB Rh D positive blood are called universal recipients; however, these terms are only generally true with respect to possible reactions of the recipient's anti-A and anti-B antibodies to transfused red blood cells, and also possible sensitization to Rh D antigens. One exception is individuals with [[hh antigen system]] (also known as the Bombay blood group) who can only receive blood safely from other hh donors, because they form antibodies against the H substance.<ref>{{cite book |title= Harrison's Principals of Internal Medicine|last= Fauci|first= Anthony S.|authorlink= |coauthors= Eugene Braunwald, Kurt J. Isselbacher, Jean D. Wilson, Joseph B. Martin, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo|year= 1998|publisher= McGraw-Hill|location= New York|isbn= 0-07-020291-5|pages= 719. |url= }})</ref><ref>{{cite web|url=http://www.webmd.com/a-to-z-guides/blood-type-test |title=Universal acceptor and donor groups |publisher=Webmd.com |date=2008-06-12 |accessdate=2010-08-01}}</ref> Blood donors with particularly strong anti-A, anti-B or any atypical blood group antibody are excluded from blood donation. The possible reactions of anti-A and anti-B antibodies present in the transfused blood to the recipients RBCs need not be considered, because a relatively small volume of plasma containing antibodies is transfused. By way of example: considering the transfusion of O Rh D negative blood (universal donor blood) into a recipient of blood group A Rh D positive, an immune reaction between the recipient's anti-B antibodies and the transfused RBCs is not anticipated. However, the relatively small amount of plasma in the transfused blood contains anti-A antibodies, which could react with the A antigens on the surface of the recipients RBCs, but a significant reaction is unlikely because of the dilution factors. Rh D sensitization is not anticipated. Additionally, red blood cell surface antigens other than A, B and Rh D, might cause adverse reactions and sensitization, if they can bind to the corresponding antibodies to generate an immune response. Transfusions are further complicated because [[platelet]]s and [[white blood cell]]s (WBCs) have their own systems of surface antigens, and sensitization to platelet or WBC antigens can occur as a result of transfusion. With regard to transfusions of [[Plasma (blood)|plasma]], this situation is reversed. Type O plasma, containing both anti-A and anti-B antibodies, can only be given to O recipients. The antibodies will attack the antigens on any other blood type. Conversely, AB plasma can be given to patients of any ABO blood group due to not containing any anti-A or anti-B antibodies. ==Blood group genotyping== In addition to the current practice of serologic testing of blood types, the progress in molecular diagnostics allows the increasing use of blood group genotyping. In contrast to serologic tests reporting a direct blood type phenotype, genotyping allows the prediction of a phenotype based on the knowledge of the molecular basis of the currently known antigens. This allows a more detailed determination of the blood type and therefore a better match for transfusion, which can be crucial in particular for patients with needs for many transfusions to prevent allo-immunization.<ref>{{cite journal |author=Anstee DJ |title=Red cell genotyping and the future of pretransfusion testing |journal=Blood |volume=114|issue=2|year= 2009|doi= 10.1182/blood-2008-11-146860|pmid=19411635| pages=248–56}}</ref><ref>{{cite journal |author=Avent ND |title=Large-scale blood group genotyping: clinical implications |journal=Br J Haematol |volume=144|issue=1|year= 2009|doi= 10.1111/j.1365-2141.2008.07285.x|pmid=19016734| pages=3–13}}</ref> ==Conversion== 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.<ref> {{cite news |url=http://news.bbc.co.uk/1/hi/health/6517137.stm |title=Blood groups 'can be converted' |accessdate=2008-07-15 |month=April |publisher=BBC News | date=2007-04-02}}</ref><ref>{{cite journal |author=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 |title=Bacterial glycosidases for the production of universal red blood cells |journal=Nat Biotechnol |volume= 25|issue= 4|year= 2007|doi=10.1038/nbt1298 |pmid=17401360| page = 454}}</ref> 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. ==History== The two most significant blood group systems were discovered by [[Karl Landsteiner]] during early experiments with blood transfusion: the [[ABO blood group system|ABO group]] in 1901<ref>Landsteiner K. ''Zur Kenntnis der antifermentativen, lytischen und agglutinierenden Wirkungen des Blutserums und der Lymphe.'' Zentralblatt Bakteriologie 1900;27:357-62.</ref> and in co-operation with [[Alexander S. Wiener]] the [[Rhesus blood group system|Rhesus group]] in 1937.<ref>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.</ref> Development of the [[Coombs test]] in 1945,<ref>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.</ref> the advent of [[transfusion medicine]], and the understanding of [[hemolytic disease of the newborn]] led to discovery of more blood groups, and now 30 [[human blood group systems]] are recognized by the [[International Society of Blood Transfusion]] (ISBT),<ref name=iccbba/> and across the 30 blood groups, over 600 different blood group antigens have been found,<ref name="newenglandblood1"/> many of these are very rare or are mainly found in certain ethnic groups. Blood types have been used in [[forensic science]] and were formerly used to demonstrate impossibility of [[parental testing|paternity]] (e.g., a type AB father cannot be the father of a type O infant), but both of these uses are being replaced by [[genetic fingerprinting]], which provides greater certainty.<ref>{{cite journal |author=Johnson P, Williams R, Martin P |title=Genetics and Forensics: Making the National DNA Database |journal=Science Studies |volume=16 |issue=2 |pages=22–37 |year=2003 |pmid=16467921 |pmc=1351151}}</ref> ==Cultural beliefs and other claims== A [[Blood types in Japanese culture|popular belief in Japan]] is that a person's ABO blood type is predictive of their [[Personality psychology|personality]], [[moral character|character]], and [[Interpersonal compatibility|compatibility with others]]. This belief is also widespread elsewhere in [[Asia]], notably [[Taiwan]].<ref name=AP>{{cite news | url = http://aol.mediresource.com/channel_health_news_details.asp?news_id=6661&news_channel_id=11&channel_id=11 | title = Myth about Japan blood types under attack | agency = Associated Press | publisher = AOL Health | accessdate = 2007-12-29 | date = 2005-05-06}}</ref> Deriving from ideas of historical [[scientific racism]], the theory reached Japan in a 1927 psychologist's report, and the militarist government of the time commissioned a study aimed at breeding better soldiers.<ref name="AP"/> The fad faded in the 1930s due to its unscientific basis. The theory has long since been rejected by scientists, but it was revived in the 1970s by [[Masahiko Nomi]], a broadcaster who had no medical background.<ref name="AP"/> == References == {{Reflist|2}} == Further reading == *{{cite web | url = http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen | title = Blood Groups and Red Cell Antigens, a guide to the differences in our blood types that complicate blood transfusions and pregnancy. | accessdate = September 15, 2006 | last = Dean | first = Laura | format = HTML, also PDF, Flash and PRC versions | publisher = [[National Center for Biotechnology Information]]}} *Mollison PL, Engelfriet CP and Contreras M. ''Blood Transfusion in Clinical Medicine''. 1997. 10th edition. Blackwell Science, Oxford, UK. ISBN 0-86542-881-6. == External links == *[http://www.ncbi.nlm.nih.gov/gv/mhc/xslcgi.cgi?cmd=bgmut/home BGMUT] Blood Group Antigen Gene Mutation Database at [[National Center for Biotechnology Information|NCBI]], [[NIH]] has details of genes and proteins, and variations thereof, that are responsible for blood types * {{OMIM|110300}} (ABO) * {{OMIM|111680}} (Rhesus D) * {{cite journal |author=Farr AD |title=Blood group serology--the first four decades (1900--1939) |journal=Medical History |volume=23 |issue=2 |pages=215–26 |year=1979 |month=April |pmid=381816 |pmc=1082436}} * {{cite web | url = http://www.gentest.ch/index.php?content=bloodtype&langchange=en | title = Blood group test, Gentest.ch | accessdate = 2006 | format = HTML, JavaScript | publisher = Gentest.ch GmbH}} * {{cite web | url = http://www.bloodbook.com/type-sys.html | title = Blood typing systems other than ABO | accessdate = 2008-07-15| date = 2005-09-10 | publisher = BloodBook.com }} * {{cite web | url = http://www.lifeshare.org/facts/raretraits.htm | title = Blood Facts - Rare Traits | accessdate = September 15, 2006 | publisher = LifeShare Blood Centers}} * {{cite web | url = http://anthro.palomar.edu/vary/vary_3.htm | title = Modern Human Variation: Distribution of Blood Types | accessdate = November 23, 2006 | date = 2001-06-06| publisher = Dr. Dennis O'Neil, Behavioral Sciences Department, Palomar College, San Marcos, California | archiveurl = http://web.archive.org/web/*/http://anthro.palomar.edu/vary/vary_3.htmhttp://web.archive.org/web/*/http://anthro.palomar.edu/vary/vary_3.htm| archivedate = 2006-02-21}} * {{cite web | url = http://www.bloodbook.com/world-abo.html | title = Racial and Ethnic Distribution of ABO Blood Types - BloodBook.com, Blood Information for Life | accessdate = September 15, 2006 | authorlink = | publisher = bloodbook.com}} * {{cite web | url = http://abobloodgroup.googlepages.com/home | title = Molecular Genetic Basis of ABO | accessdate = July 31, 2008 | authorlink = | publisher =}} * [http://www.etoolsage.com/Calculator/Blood_Type_Calculator.asp Blood Type Calculator] -The calculator is used to determine the blood type of child when the blood type of parents are known. {{Human group differences}} {{HDN}} {{transfusion medicine}} {{DEFAULTSORT:Blood Type}} [[Category:Blood]] [[Category:Genetics]] [[Category:Hematology]] [[Category:Transfusion medicine]] [[af:Bloedgroep]] [[ar:فئات الدم]] [[bn:রক্তগ্রুপ]] [[bs:Krvne grupe]] [[bg:Кръвна група]] [[ca:Grup sanguini]] [[cv:Юн ушкăнĕ]] [[cs:Krevní skupina]] [[da:Blodtype]] [[de:Blutgruppe]] [[es:Grupo sanguíneo]] [[eo:Sangogrupo]] [[eu:Odol talde]] [[fa:گروه خونی]] [[fr:Groupe sanguin]] [[gl:Grupo sanguíneo]] [[gu:રક્તના પ્રકાર]] [[ko:혈액형]] [[hi:रक्त समूह]] [[id:Golongan darah]] [[it:Gruppo sanguigno]] [[he:סוג דם]] [[lv:Asins grupas]] [[lt:Kraujo grupė]] [[hu:Vércsoport]] [[mk:Крвна група]] [[ml:രക്തഗ്രൂപ്പുകൾ]] [[ms:Jenis darah]] [[mn:Цусны бүлэг]] [[my:သွေးအုပ်စု]] [[nl:Bloedgroep]] [[ja:血液型]] [[nn:Blodtype]] [[uz:Qon guruhlari]] [[nds:Bloodgrupp]] [[pl:Grupy krwi]] [[pt:Grupo sanguíneo]] [[ro:Grupă sanguină]] [[ru:Группа крови]] [[sq:Grupet e gjakut]] [[simple:Blood type]] [[sk:Krvná skupina]] [[sl:Krvna skupina]] [[sr:Крвне групе]] [[sh:Krvna grupa]] [[su:Golongan getih]] [[fi:Veriryhmä]] [[sv:Blodgrupp]] [[ta:இரத்த வகை]] [[te:రక్త వర్గం]] [[th:หมู่โลหิต]] [[tr:Kan grubu]] [[uk:Група крові]] [[ur:بلڈ گروپ]] [[vi:Nhóm máu]] [[zh:血型]]'