Universal blood type and Rh factor. The donor is universal: what blood type is suitable for everyone? Compatible blood transfusion

What blood group suits everyone? It is known that there are 4 of its species, which were isolated by scientists many years ago. Today, doctors know that not every biological material is suitable for transfusion to a patient with a different group. However, there is a universal blood that suits everyone without exception. Such blood is used if there is no suitable one in stock and no one can donate it for the patient.

What types exist and how to define them

Scientists conducted a series of necessary studies, during which they found that there are 4 different groups. After this discovery was made, it was followed by another, which showed the incompatibility of some groups with each other. It turns out that if a person is injected with a biomaterial that is not suitable for him, he will simply die.

According to the ABO system, the following types are distinguished:

0 (I) - first (zero);
A (II) - the second;
In (III) - the third;
AB (IV) - the fourth.

Groups can be determined in the laboratory. This process consists in the presence or absence of aggregation of red blood cells.

Drops of biomaterial are added to special solutions and the agglutination process is evaluated:

If there is no reaction, the first one is released.
If a reaction occurs in solutions with α and α + β, then the second one.
When blood cells stick together in a solution of β and α + β blood, a third is assigned.
The fourth is allocated if the reaction has occurred completely in all special solutions.

Usually this study is carried out immediately after birth, the result fits into the baby's card. As well as the blood type is determined at transfusion stations and in the military registration and enlistment office upon admission to the service. Knowing which group the blood belongs to is important.

Differences between different types of blood

Erythrocytes, which form the basis of blood, have various protein cells. Their set is individual for each living organism. Such cells are antigens and can be combined in different ways.

This determines that not every group is suitable for transfusion in a particular case:

representatives of the second type have antigen A;
the third type is due to the presence of B cells;
the fourth has both A and B molecules.

It should be noted that the first group lacks all antigens. Blood serum is equipped with special antigens that cause agglutination. When non-self proteins enter the body, red cells are immediately activated and begin to block them by gluing.

As a result of such a process, irreparable things can happen, namely:

blockage of blood vessels;
blood clotting;
blocking the supply of oxygen to the cells of the whole organism.

As a result of such processes, the body dies. That is why it is impossible to infuse absolutely any biomaterial to a sick person.

The least fortunate carriers of the 4th group, since such people are in the minority. It's hard for them to find suitable blood, therefore, it is often necessary to use the one that suits all types for a blood transfusion.

Factors affecting transfusion

When transfusing, it is necessary to take into account the blood group of the recipient and donor, as well as their Rh factor.

Even if the type is the same, then different Rh factors are a contraindication to the procedure:

I can only accept the same group.
II can accept both its own and I.
III fits I and III.
IV accepts all other types.

Which group is right for everyone? This plate shows that the universal group is the first. It is it that can be transfused to a carrier of any other blood. However, for those who have the first type, only a person with the same group can act as a donor.

Despite the versatility, before infusing the biomaterial, it is necessary to take into account the Rh factor. In case of incompatibility, a strong release of antibodies can occur, which will lead to blood clotting, which means the death of a living organism.

So, the first group can be transfused to everyone. It is considered the most common, so its stocks are usually in sufficient quantities in medical institutions.

However, it is better to use the appropriate blood type, and it is better to transfuse the universal as a last resort, in order to avoid complications and a long rehabilitation of the patient after the procedure.

Foundations of Universality

For quite a long time, I was considered a universal group, despite the fact that complications did occur during its transfusion. Until now, experts believe that in an emergency, all people can be transfused with I.

This species was singled out as universal due to the fact that:

has no antigens;
does not cause the process of agglutination in solution.

When carrying out the procedure, it must be taken into account that if a person donating blood has an antigen corresponding to the patient's antibodies, immediate reaction, which will cause the process of sticking red blood cells. As a result, blockage of blood vessels will occur with a possible fatal outcome.

However, the first one does not have antigens, so it can be infused into all other groups.

Modern medicine does not welcome the transfusion of the so-called universal group. It has long gone out of practice and is possible only in the most urgent cases.

In medical institutions, blood transfusion is carried out exclusively using the same samples for transfusion. The first is used in special cases and in strictly limited quantities in order to extend the life of the patient to a full-fledged procedure.

The need to know the blood type

If there is no record and knowledge of what type and Rhesus, then you must immediately take an analysis to find out.

This need is due to the following:

definition this indicator difficult in an emergency
an error can lead to irreversible consequences;
to become a donor for a loved one;
for safe conception and carrying a pregnancy.

Although many people know their blood type and Rh, an emergency blood transfusion is performed to determine whether the donor and recipient are compatible.

Universal blood is a concept that is rarely used in medical practice. Only in cases where there is no other way to save a person's life. What type does the first one belong to, however, its transfusion in large quantities can lead to serious complications for human life and health. Be sure to transfuse only the first negative, which does not cause the process of agglutination.

During the planned procedure, materials from the donor and recipient are initially taken and studied in the laboratory for compatibility. If compatibility has been fixed, then blood transfusion is possible.

Blood supplies the body with vital elements - amino acids, carbon, fats, oxygen. There are four blood types, and each of us is the owner of one of them. What vessels interact with each other? Do they have distinctive features? AiF-Krasnoyarsk was looking for answers with the help of an expert - a general practitioner-gastroenterologist Tatyana Mayorova.

What does blood type mean?

“Blood type is a genetic trait of a person,” explains Tatyana Mayorova. - It denotes the content of antigens and antibodies in erythrocytes (these are proteins responsible for the reaction immune system on "foreign" blood). There are four blood types recognized by the international system: O (I), A (II), B (III) and AB (IV). O - means that there are no antigens in the composition of the blood. A - in the composition of the antigen "A", B - antigen "B", and AB - antigens of two types at once. Meanwhile, even people with the same blood type will have different antigens. Some will be more, some less.

Also, the blood differs in the Rh factor. This is a protein that is found on the surface of erythrocytes - red blood cells. According to statistics, 15% of people have no Rh factor. They are called Rh negative. The remaining 85% have it.”

To find out your blood type, it is enough to donate it from a vein or a finger. Results can be seen in just a few minutes.

When is a donor dangerous?

The most popular blood type is the first. It has up to 33% of the inhabitants of the earth, in some areas - half of the population.

“People with the first negative group are considered universal donors,” notes Tatyana Mayorova. “Their blood has no antigens at all. It can be transfused in emergency cases, when there are no analogues, for any person, up to 500 milliliters. I note that transfusion of the wrong blood type can be deadly for a person.

The 2nd blood group does not have such extensive compatibility. Rh-positive donors can donate their blood to patients with the 2nd or 4th positive groups. And they themselves as a recipient can receive blood of the 1st and 2nd groups. In this case, the Rh factor can be any - both positive and negative.

People with the 3rd negative blood type will only fit the identical and the first negative. Those with a third positive were a little more fortunate. They have not two, but four donors. For people with this blood, the third and the first with any Rh factor will do. But others will elicit a rejection reaction.

The rarest

The fourth blood group is the youngest and rarest. There are about 10% of people with this indicator in the world. Since this group appeared relatively recently (about 1 thousand years ago), scientists put forward several versions of its appearance.

The first - the group appeared as a result of mutation of different bloodlines and mixing of races, the second - its appearance is associated with the opposition to viruses that threatened the life of mankind, and the third theory - a new genetic trait appeared due to the evolution of an organism that protected itself from unnatural or "bad" food.

Doctors note the universality of the fourth positive blood type. She matches perfectly with everyone else as a donor. But it can only accept those identical to its Rh factor. The fourth negative group also has full compatibility, but only with negative representatives of antigens.

The experiment of scientists showed that insects mostly circle around people with the first blood group and negative Rh. They also prefer to bite those whose secretions secrete saccharides that make the blood taste sweeter.

In the practice of physicians, there are cases when a patient has severe and profuse blood loss. In this case, there is a need for transfusion (transfusion) from another person. Before the procedure, a lot of tests are carried out for the possibility of combining by group and Rh factor. Transfusion of incompatible blood in complicated cases can be fatal. It is generally accepted that the owners of the first blood group are universal donors. Many modern doctors argue that this compatibility is conditional and there is no suitable blood for everyone.

A blood group is a description of the individual antigenic characteristics of erythrocytes. This classification was first made by an Austrian scientist at the beginning of the 20th century, and at the same time the concept was voiced - incompatibility. Thanks to this discovery, many lives were saved, because the transfusion of inappropriate material leads to disastrous consequences. In practice, 4 blood groups are distinguished:

0 (I) first (null) - it contains no antigens, but contains α and β antibodies. In view of the absence of foreign particles (antigens), this group is applicable for transfusion to all people. A donor with a 0 (I) group is considered to be universal;
A (II) second - it contains antigen A and antibodies to agglutinogen B. This blood can be transfused to patients with a group that does not contain antigen B (I and II);
In (III) the third one has antigen B and antibodies to agglutinogen A. This blood can be used in relation to recipients (recipient) with I and III groups ami, that is, not containing antigen A;
AB (IV) fourth - has antigens A and B, but does not have antibodies. The owners of this group can serve as a donor only for patients with similar blood. Recipients with the fourth blood group are universal, since they do not have antibodies.

If, during transfusion, antigens of incompatible groups enter the body, the process of gluing foreign erythrocytes is activated. As a result, the process of blood circulation is disturbed. Oxygen ceases to flow in the required volume to organs and tissues, and blood coagulation occurs in the future. Such a violation may lead to serious complications up to and including death. In this connection, it is very important to take into account the compatibility of the blood of the donor and the recipient.

Also, when transfusing, the Rh factor, a special protein located on the membrane of red blood cells, should be taken into account. The term is used in relation to the D antigen of the Rh factor. The designation Rh+ is used for Rh positive (D antigen present), Rh- for Rh negative (no D antigen), and is indicated after the blood type designation. The difference between the blood group and the Rh factor is that immunization against Rh is relevant only for transfusion or placental exposure during pregnancy.

Universal donors and recipients

In the case of transfusion of red blood cells (the main component of the transfusion material), people with group 0 and Rh D negative are considered universal donors. Representatives of AB (IV) and positive Rh D are recognized as universal recipients. These statements are true only in terms of the interaction of foreign particles of the recipient A and B for transfusion of red blood cells and reactive sensitivity to foreign cells of Rhesus D. People with the HH system (Bombay phenotype) are an exception, it is permissible for them to receive material for transfusion only from HH donors, since they have antibodies against the H antigen present in red blood cells.

People with A and B antigens or atypical antibodies are excluded from the number of donors. Antibody reactions A and B are not always taken into account. The reason is that a small amount of plasma containing foreign particles is overflowing. For example, when transfusion of 0 and D Rh- blood to a recipient with A and D Rh+, immune reactions between the recipient's B antibodies and red blood cells will not occur.

It is worth noting that a small amount of plasma in the donor material used for transfusion has A antibodies that can react with foreign particles on the red cell membrane, but dangerous reaction will not happen, as the action will be weakened.

Surface antigen erythrocytes, with the exception of A, B and Rh D, are capable of provoking detrimental effects if they begin to interact with the appropriate antibodies to activate a protective reaction. The process of transfusion is hampered by the fact that platelets and leukocytes have independent systems of surface foreign particles and sensitization may occur after transfusion ( hypersensitivity) to foreign cells. Group 0 plasma, with antibodies A and B, can only be used for recipients 0, since the antibodies react aggressively to the antigens of the contacted group. AB plasma transfusion can be performed in patients of any AB0 group.

In conditions modern medicine the recipient is transfused with blood that is strictly compatible with his group and Rh factor. The use of universal is resorted to only in cases where the risk is justified. The cause may be the occurrence of an emergency situation and the danger of death. If there is no blood desired group and Rh factor, then doctors use the universal one.

In medical practice, quite often there are cases when patients lose a large amount of blood. For this reason, they need to transfuse it from another person - a donor. This process is also called transfusion. Before transfusion, a large number of tests are carried out. It is necessary to find the right donor so that their blood is compatible. With complications, violation of this rule often leads to death. At the moment, it is known that a universal donor is a person with the first blood group. But many doctors are of the opinion that this nuance is conditional. And there is no person in this world whose connective tissue of the liquid type is suitable for absolutely everyone.

What is a blood group

The blood group is usually called the totality of the antigenic properties of the erythrocytes present in a person. A similar classification was introduced in the 20th century. At the same time, the concept of incompatibility appeared. Due to this, the number of people who successfully underwent a blood transfusion procedure has increased significantly. In practice, there are four types. Let's briefly consider each of them.

First blood group

Zero or the first blood group has no antigens. It contains alpha and beta antibodies. It does not have foreign elements, so people with (I) are called universal donors. It can be transfused to people with other blood types.

Second blood type

The second group has type A antigen and antibodies to agglutinogen B. It cannot be transfused to all patients. It is allowed to do this only for those patients who do not have antigen B, that is, patients with the first or second group.

Third blood group

The third group has antibodies to agglutinogen A and type B antigen. This blood can be transfused only to the owners of the first and third groups. That is, it is suitable for patients who do not have antigen A.

Fourth blood type

The fourth group has antigens of both types, but does not include antibodies. The owners of this group can only transfer part of their blood to the owners of the same type. It has already been said above that a person with blood group 0 (I) is a universal donor. What about the recipient (the patient who takes it)? Those who have the fourth blood type can take any, that is, they are universal. This is because they do not have antibodies.

Features of transfusion

If antigens of the group that are incompatible get into the human body, then foreign red blood cells will gradually stick together. This will lead to poor circulation. Oxygen in such a situation abruptly ceases to flow to the organs and all tissues. The blood in the body begins to clot. And if you do not start treatment on time, it will lead to quite serious consequences. That is why before committing the procedure, it is necessary to conduct tests for the compatibility of all factors.

In addition to the blood type, the Rh factor must be taken into account before transfusion. What's this? It is a protein found in red blood cells. If a person has a positive indicator, then he has an antigen D in his body. In writing, this is indicated as follows: Rh +. Accordingly, Rh- is used to mark a negative Rh factor. As is already clear, this means the absence of group D antigens in the human body.

The difference between blood type and Rh factor is that the latter only plays a role during transfusion and during pregnancy. Often a mother with the D antigen is not able to bear a child who does not have it, and vice versa.

The concept of universality

During the transfusion of red blood cells, people with blood type one with a negative Rh are called universal donors. Patients with the fourth type and the positive presence of antigen D are universal recipients.

Such statements are only suitable if a person needs to receive an A and B antigen reaction during a blood cell transfusion. Often such patients are sensitive to foreign cells of a positive Rh. If a person has an HH system - the Bombay phenotype, then such a rule does not apply to him. Such people can receive blood from HH donors. This is due to the fact that in erythrocytes they have antibodies specifically against H.

Universal donors cannot be those who have A, B antigens or any other atypical elements. Their reactions tend to be taken into account infrequently. The reason is that during transfusion, a very small amount of plasma is sometimes transported, in which foreign particles are directly located.

Finally

In practice, most often a person is transfused with blood of the same group and the same Rh factor that he has. The universal option is resorted to only when the risk is really justified. Indeed, even in this case, an unforeseen complication may occur, which will entail cardiac arrest. If the necessary blood is not available, and there is no way to wait, then doctors use a universal group.

Blood transfusion is a serious procedure that must be performed according to certain rules. First of all, it's about compatibility. Most often, donation is necessary to help the seriously ill. These can be a variety of blood diseases, complex operations or other complications that require a transfusion.

Donation appeared a long time ago, so at the moment this procedure is not new and is common among all departments in medicine. The very concept of group compatibility appeared more than a hundred years ago. This was explained by the fact that specific proteins were found in the plasma and in the erythrocyte membrane. Thus, three blood groups were identified, which today are called the AB0 system.

Why is there no compatibility?

Quite often, the blood of one group or another is not suitable for the recipient. Unfortunately or fortunately, there is no universal group, so you have to select a donor all the time according to certain criteria. If there is a mismatch, an agglutination reaction may occur, which is characterized by gluing of the donor's erythrocytes and the recipient's plasma.

If you take donor blood of the second group for a recipient with a positive Rh from a donor with a second only with a negative one, then this will be incompatibility, since in this case it is necessary to focus not only on the group itself. It is very dangerous to ignore such information, because after the shock, the recipient may die. Plasma and all its components of each person are individual in terms of the number of antigens, which can also be determined by different systems.

Transfusion rules

In order for the transfusion to be successful, it is necessary to follow some rules of thumb regarding the selection of groups and, accordingly, the donor:

take into account the compatibility of blood groups of the recipient and the donor according to the AB0 system;
determine the positive or negative Rh factor;
conduct a special test for individual compatibility;
conduct a biological test.

Such preliminary checks of the donor and recipient groups must be carried out without fail, as they can provoke shock or even death in the recipient.

How to determine the correct blood type for a transfusion?

To determine this indicator, a special serum is used. If some antibodies are present in the serum that correspond to antigens from red blood cells. In this case, red blood cells form small clusters. Depending on the group, erythrocytes agglutinate with a certain type of serum. For example:

serum test for groups B(III) and AB(IV) contains anti-B antibodies;
serum for groups A(II) and AB(IV) contains anti-A antibodies;
as for groups such as 0(I), they do not agglutinate with any test serum.

"Not" compatibility of groups of mother and child

If a woman with a negative Rh factor is pregnant with a positive one, then incompatibility may occur. In this case, the universal blood type does not help, because the selection of the Rh factor becomes more important. Such contact occurs only at the birth of a child, and during a second pregnancy, a miscarriage or premature birth of a dead baby may occur. If the newborn survives, then he is diagnosed with hemolytic disease.

Fortunately, today there is a special substance that is administered to the mother and, accordingly, blocks the formation of antibodies. Therefore, such a hemolytic disease is already almost on the verge of extinction. In this case, donation may not be needed at all.

Group compatibility test for transfusion

There is a fairly common way to determine a suitable donor. To do this, take up to 5 ml of blood from a vein, place it in a special apparatus with a centrifuge and drip a drop of special serum. After that, a few more drops of the recipient's blood are added there, and the ongoing actions are observed for five minutes. It is also necessary to add one drop of isotonic sodium chloride solution there.

If agglutination has not occurred during the entire reaction time, then compatibility of the selected blood groups is observed. Thus, the donor can donate blood in the right amount. Another known control method for checking the compatibility of the transfusion. To do this, the recipient is injected with a few milliliters of blood for three minutes, if everything goes well and no side effects are observed, then you can add a little more. As a rule, such a procedure is already carried out as a control, when a donor is provided to the recipient as a permanent transfusion or a single one. There is a certain table of such a scheme, according to which they do a control check and only after that do the transfusion.

Registration of blood transfusion

After the transfusion is completed, a record of the identified group, Rh factor and other possible indications is recorded in the recipient and donor card. If the donor has approached, then, with his agreement, they take the data for further transfusion, since the first compatibility has already been successfully identified. In the future, both patients should be monitored periodically, especially if the donor has contracted with this center. This is quite widely practiced today, because it is sometimes very difficult to find a suitable donor with a rare group.

There is nothing dangerous to register in this way for help, because in this way you help the sick and rejuvenate your body a little. It has long been proven that periodic blood donation helps to renew our body, thereby stimulating hematopoietic cells to work actively.

The fact that life is closely connected with blood, that a person dies from great blood loss, was not in doubt in the most ancient times. Even qualities such as courage, strength and endurance were associated with blood, so in ancient times they drank blood to acquire them.

History of blood transfusion [show]

The idea of replacing lost or old "sick" blood with young and healthy blood arose as early as the 14th-15th centuries. Faith in blood transfusion was very great. So, the head of the Catholic Church, Pope Innocent VIII, being decrepit and infirm, decided on a blood transfusion, although this decision was in complete contradiction with the teachings of the church. Innocent VIII's blood transfusion was performed in 1492 from two young men. His result was unsuccessful: the patient died from "senility and weakness", and the young men - from embolism.

If we recall that the anatomical and physiological foundations of blood circulation were described by Harvey only in 1728, it becomes clear that before that, blood transfusion could not practically be carried out.

In 1666, Lower published the results of experiments on transfusion of blood into animals. These results were so convincing that the court physician of Louis XIV Denis and the surgeon Emerez in 1667 repeated Lowerer's experiments on dogs and transfused lamb's blood into a seriously ill patient. Despite the imperfect technique, the patient recovered. Encouraged by this success, Dany and Emerez gave a second transfusion of lamb blood. This time the patient died.

At the trial, the French Academy of Sciences acted as an arbitrator, whose representatives did not consider it possible to accuse Denis and Emerets of using an insufficiently studied method, as this would slow down the development of the problem of blood transfusion. However, the arbitrators did not recognize the actions of Denis and Emerenz as correct and considered it necessary to limit the practical use of blood transfusion, since this would transfer into the hands of various charlatans, of whom there were so many among doctors, an extremely dangerous method. The method was recognized as promising, but in each particular case it required special permission from the Academy. This wise decision did not close the possibility of further experimental study of the method, but put significant obstacles in the way of a practical solution to the problem of blood transfusion.

In 1679, Merklin and in 1682 Ettenmüller reported the results of their observations, according to which, when the blood of two individuals is mixed, agglutination sometimes occurs, which indicates incompatibility of the blood. Despite the lack of knowledge of this phenomenon, in 1820, Blundel (England) successfully performed a blood transfusion from person to person.

In the 19th century about 600 blood transfusions have already been performed, but most of the patients died during the transfusion. Therefore, not without reason, the German surgeon R. Volkmann in 1870 ironically remarked that three rams are needed for blood transfusion - one that gives blood, the second that allows itself to be transfused, and the third that dares to do so. The cause of many deaths was group blood incompatibility.

A big obstacle to blood transfusion was its rapid clotting. Therefore, Bischoff in 1835 proposed the transfusion of defibrinated blood. However, after the transfusion of such blood, many serious complications arose, so the method was not widely used.

In 1880, G. Guyem published works on the study of the causes of death from blood loss. The author introduced the concept of relative and absolute anemia and proved that with absolute anemia, only blood transfusion can save the animal from death. So blood transfusion received a scientific justification.

However, agglutination and blood clotting continued to hamper the use of blood transfusions. These obstacles were removed after the discovery by K. Landsteiner and Ya. Jansky (1901-1907) of blood groups and the proposal of V. A. Yurevich, M. M. Rozengart and Gyusten (1914) to use sodium citrate to prevent blood clotting. In 1921, the classification of blood groups by Ya. Jansky was adopted as an international one.

In Russia, the first works on blood transfusion appeared in 1830 (S.F. Khotovitsky). In 1832, Wolf for the first time successfully transfused the patient's blood. A large number of works on the problem of blood transfusion followed (N. Spassky, X. X. Salomon, I. V. Buyalsky, A. M. Filomafitsky, V. Sutugin, N. Rautenberg, S. P. Kolomnin, etc.). The works of scientists covered the issues of indications, contraindications and blood transfusion techniques; devices for its implementation were proposed, etc.

In 1848, A. M. Filomafitsky first studied the mechanism of action of transfused blood, he also made a special apparatus for blood transfusion. I. M. Sechenov in experiments found that blood transfusion has not only a substitutive, but also a stimulating effect. V. Sutugin already in 1865 published the results of experiments on dogs with transfusion of blood defibrinated and preserved at a temperature of 0 ° C, i.e. for the first time he raised and resolved the question of the possibility of preserving blood.

In erythrocytes, there are also antigens of the Hr-Hr 0, rh′, rh″ system, which cause the formation of specific antibodies, but their antigenic properties are weaker than those of the Rh factor. Most common cause immunization is antigen rh′(c), the least antigenic rh″(e) and Hr 0 (d). All individuals with Rh-negative blood are simultaneously Hr-positive if they have the rh'(c) antigen. The presence of the Hr antigen makes it necessary to warn against transfusions of Rh-negative blood to recipients with Rh-positive blood or without determining the patient's Rh-affiliation at all, since it is possible to cause immunization or a post-transfusion complication for the rh'(c) antigen if the patient turns out to be Hr-negative.

According to modern concepts (Fischer, Race), the Rh system is, in fact, a complex of six antigens of the Rh-Hr systems associated in one pair of chromosomes. A person can have antigens from both systems (Rh and Hr) or only one system (Rh or Hr), but there are no people who do not have one of these two antigenic systems. Currently, 27 combinations of antigen types are known.

Before blood transfusion, it is imperative to establish the Rh affiliation of the donor and recipient and conduct a test for Rh compatibility. When transfusing blood, one should strictly adhere to the principle of using blood of the same name according to the Rh factor.

About 80% of people have I and II blood groups, 15% - III and 5% - IV blood group. Every healthy person can donate their blood for transfusion, i.e., be a donor. Donation benefits not only the sick, for whom a blood transfusion sometimes saves lives, but also the donor himself. Taking a small amount of blood from a person (200-250 ml) enhances the activity of the hematopoietic organs.

Additionally:

Order of the Ministry of Health of the Russian Federation of November 25, 2002 N 363 "On approval of the Instructions for the use of blood components"
Principles of infusion therapy (see Solutions for infusion therapy, solutions for correcting BCC deficiency, Whole blood, Blood plasma)

In some diseases and significant blood loss, it becomes necessary to transfuse the patient with blood from a healthy person. But you can not transfuse blood from any person. If the blood of two people is incompatible, then the red blood cells of the transfused blood stick together in the body of the person to whom it was transfused, which can lead to death. Human erythrocytes contain two substances that have been called glued substances - agglutinogens A and B; there are two agglutinins in plasma a and β. Bonding of erythrocytes (agglutination) occurs only when substances of the same name meet: A with a and B with β. In the blood of each person, there are no combinations that lead to gluing, they occur only when incompatible blood is transfused. According to the presence of certain glued and gluing substances, four blood groups were distinguished in people (Table 25).

As can be seen from Table. 25, adding blood I group to any other is not accompanied by agglutination of erythrocytes, i.e., it is quite possible. The vertical bar in the table shows that the blood I groups can be poured into people with I, II, III and IV blood groups, blood Group III - III and IV groups, and blood group IV - only IV group. The horizontal lines make it possible to determine which blood groups can be transfused to a person with a certain blood type. For example, a person with I blood type can only be transfused I groups, but in the blood IV groups, you can add blood of any group, although in the latter case, available in erythrocytes IV groups of both agglutinogens A and B meet with the same agglutinins a and plasma β I, II and III groups and, it would seem, agglutination should occur.

But the fact is that a small amount of transfused (donor) blood is usually taken, and it, together with its agglutinins, is diluted with the own blood of the person receiving the blood ( recipient), to such an extent that it loses the ability to glue the recipient's erythrocytes. At the same time, the donor's erythrocytes, as whole cells, cannot be diluted during transfusion and stick together in case of incompatibility. Therefore, when transfusing blood, first of all, the agglutinogens of the blood of the donor and the agglutinins of the recipient are taken into account.

About 80% of people have I and II blood types, 15% - III and 5% - IV blood group. Everyone can donate their blood for transfusion, i.e., be a donor healthy man. Donation benefits not only the sick, for whom a blood transfusion sometimes saves lives, but also the donor himself. Taking blood from a person (200-250 ml) enhances the activity of hematopoietic organs.

For thousands of years, people were not aware of the true purpose of blood, but on a subconscious level they understood that the red liquid flowing through the veins is of particular value. It was used in various religious ceremonies, and bloodletting was performed on seriously ill patients. Today, almost everything is known about her. Modern knowledge has given physicians a unique world of erythrocytes, platelets, leukocytes, antigen (Rhesus factor) and other substances that flow in the blood, by which a doctor can determine the state of health. However, why in humanity they are different and the blood of which group can be safely transfused to all people.

She is the source of life. A continuous flow of living energy supplies every cell of the body with all the necessary substances. The flow of the internal environment is a complex mechanism, for the study of which humanity took its entire history. A lot is known about her, but not enough to close forever. In some Asian countries, for example, there is still a tradition where it is imperative to know the blood type of your passion before the wedding.

There is also a legend according to which only one flowed in the veins of the first people - the first group. And only then, with the development of civilization, the rest appeared. There are special diets, food for each blood group, they learn from it the fate, the character of a person. In a word, blood is not only a source of energy for the body, but a broad, multifaceted concept.

Until the second half of the last century, enough was known about it, but the Rh factor was discovered only in 1940, by finding a new antigen in human erythrocytes. Subsequently, it was found that the Rh factor and blood type do not change throughout life. It was also noted that according to the laws of genetics, the properties of blood are inherited. As already noted, people were treated with bloodletting, but not in every case such medical assistance ended in recovery. Many people died, and the cause of death could not be determined until the early 20th century. Later, numerous studies gave a clue, and at the very beginning of the last century, the scientist K. Landsteiner substantiated the concept of groups.

Discovery of global significance

By the method of scientific research, he proved what directions there are. People can have only 3 (subsequently, J. Jansky from the Czech Republic supplemented the table with 4 groups). Blood plasma contains agglutinins (α and β), erythrocytes - (A and B). Of the proteins A and α or B and β, only one of them can be contained. Accordingly, we can designate a scheme where:

α and β - (0);
A and β - (A);
α and B - (B);
A and B - (AB).

The "D" antigen is directly positioned with the concept of the Rh factor. Its presence or absence is directly related to such medical terms as "positive or negative Rh factor." The unique identifiers of human blood are: Rh compatibility and blood group compatibility.

For the discovery, K. Landsteiner received the Nobel Prize and read a report on what concept he had developed. In his opinion, the discovery of new proteins in cells will continue until scientists are convinced that there are no two antigenically similar people on the planet, with the exception of twins. In the fortieth year of the last century, the Rh factor was discovered. It was found in Rhesus macaque erythrocytes. Almost a quarter of the world's population is negative. The rest is positive. It (Rh with any value) does not affect the blood type and the owner, for example, the 4th can live with a positive or negative Rh.

You need to know about blood

However, when, even if it fits the group and all the rules are met, complications were noted in patients. They could have been caused by different reasons, but the main one was the mismatch of the signs of the rezu factor. If a fluid with Rh + was transfused to someone with Rh-, antibodies were formed in the patient's blood against the antigen and, during the secondary procedure of the same blood fluid, they reacted by destroying or "gluing" the erythrocytes of the human donor.

And then they came to the conclusion that not only she can be incompatible. It can only be transfused with Rh+ to Rh+. This condition is obligatory both for the negative Rh factor and plus, for the donor and the patient. Today, a large number of other antigens have been discovered that are embedded in erythrocytes and form more than a dozen antigenic structures.

A transfusion is often the last step to save a person when they need urgent help. To comply with all the rules, a compatibility test was introduced. To minimize the risks in a therapeutic procedure, you can use compatibility tests. The internal environment of another group may turn out to be incompatible, and then a sad outcome is likely.

Before the procedure, a test is prescribed and carried out, where the blood type and Rh factor are documented.

Conducting a mandatory test will determine: to testify the ABO compatibility of the donor and the patient, to confirm the antibodies in the patient's serum, which will be positioned against the antibodies of the human donor's erythrocytes. An identity test with respect to the Rh factor can be carried out: a test with 33 percent polyglucin, a test with ten percent gelatin.

serial data

More often than other methods, a test with polyglucin is used. It is practiced when help is needed with a transfusion. To obtain the result, the reaction is achieved in a centrifuge tube for five minutes without heating. In the second example, when a sample with 10% gelatin is used, the following are combined: a drop of donor erythrocytes, two drops of a 10% gelatin solution heated to liquefaction, two drops of the patient's serum and 8 ml of saline.

After short manipulations, the final result is obtained - whether the donor's blood turned out to be incompatible with the patient's blood. They also practice biological testing. In general, it aims to exclude any force majeure due to the presence a large number secondary group systems. To minimize the risks at the beginning of a blood transfusion, another sample is tested - a biological one.

There are only four main groups. It can be assumed that they are included in the category of compatible and incompatible concepts, that is, one group can suit everyone. Blood can be transfused from one person to another, based on a set of medical rules.

First group. Suitable for everyone. People with the 1st group are considered universal donors.
Second. Compatible with 2nd and 4th.
Third. Suitable for persons from the 3rd and 4th.
Fourth. Can be used for transfusion to people with a similar group. It just suits them.

However, for such recipients, if assistance is required, any blood will do.

An important factor is heredity

Basic rules, and what kind of blood the child will have relative to the group of parents.

Always remain constant: Rh factor, blood type.
Blood type does not depend on gender.
Given the laws of genetics, a blood type can be inherited.

Inheritance, or what kind of blood a baby can have, is indicated by the framework of genetic rules. If the father and mother are carriers of the first group, then the newborn will inherit it. If the second - we can confidently say that the offspring will have the first or second. If the third - the environment of the first or third group will flow in the baby's veins. Mom and dad with AB (IV) will not have a baby with a zero group.

In addition to blood fluid, human tissues also have specificity. From this we can conclude that tissue compatibility and blood transfusion are interrelated. To avoid rejection of tissues or organs during their transplantation, physicians first determine the biological compatibility of the donor and the patient, at the level of tissue compatibility of organs.

As well as in the manipulation of the internal environment, tissue compatibility and blood transfusion play a large role in medicine. However, this value was important in the recent past. Today, universal ones have been developed: artificial leather, bones. They allow you to bypass the problem of tissue rejection during transplantation. Therefore, tissue compatibility and blood transfusion is an issue that is gradually fading into the background in medicine.

Blood transfusion can be compared to an organ transplant, so many compatibility tests are performed before the procedure. Nowadays, blood is used for transfusion strictly suitable for such parameters as group and Rh factor. The use of incompatible blood in large volumes can result in the death of the patient.

It is believed that the first is suitable for everyone. According to modern doctors, this compatibility is very conditional and as such there is no universal blood type.

A bit of history

Attempts at blood transfusion began to be made several centuries ago. In those days, they did not yet know about the possible incompatibility by blood. Therefore, many transfusions ended unsuccessfully, and one could only hope for a lucky break. And only at the beginning of the last century, one of the most important discoveries in hematology was made. In 1900, after numerous studies, an immunologist from Austria, K. Landsteiner, discovered that all people can be divided into three types of blood (A, B, C) and therefore proposed his own transfusion scheme. A little later, a fourth group was described by his student. In 1940, Landsteiner made another discovery - the Rh factor. Thus, it became possible to avoid incompatibility and save many human lives.

However, there are cases when a transfusion is urgently needed, and there is no time and opportunity to look for a suitable donor, for example, this was the case during the war at the front. Therefore, physicians have always been interested in the question of which of the blood groups is universal.

What is versatility based on?

Until the middle of the 20th century, it was assumed that group I was universal. It was considered compatible with any other, so its carrier, on occasion, could be used as a universal donor.

Indeed, cases of its incompatibility with others during transfusion were noted quite rarely. However, for a long time, unsuccessful transfusions were not taken into account.

Compatibility was based on the fact that some combinations form flakes, while others do not. Clotting occurs as a result of red blood cells sticking together, which in medicine is called agglutination. It was because of the adhesion of red cells and the formation of blood clots that the death of patients occurred.

The division of blood into groups is based on the presence or absence of antigens (A and B) and antibodies (α and β) in it.

There are various proteins on the surface of red blood cells, and a set of them is laid down genetically. The molecules by which a group is defined are called antigens. Carriers of the first group do not have this antigen at all. In people from the second, red cells contain antigen A, from the third - B, from the fourth - both A and B. At the same time, there are antibodies in the plasma against foreign antigens. Against antigen A - agglutinin α and against antigen B - agglutinin β. The first group has antibodies of both types (α and β). The second has only β antibodies. In people whose group is the third, agglutinin α is contained in the plasma. People with the fourth antibody in the blood do not have at all.

When transfusing, only single-group blood can be used

If the donor has an antigen that is the same name as the antibodies of the recipient's plasma, then erythrocytes will stick together as a result of the attack of agglutinins on a foreign element. The process of coagulation begins, vascular blockage occurs, the supply of oxygen stops, and death is possible.

Since there are no antigens in the blood of group I, during its transfusion to a person with any other, erythrocytes do not stick together. For this reason, it was believed that it suits everyone.

Finally

Today, the recipient receives blood from a donor strictly with the same group and Rh factor. The use of the so-called universal blood can be justified only in emergency cases and in transfusions in limited quantities, when there is a question of saving a life, and at the moment there is no necessary one in the store.

In addition, medical scientists have found that there are many more varieties of blood. Therefore, the topic of compatibility is much broader and continues to be the subject of study.