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Harrison's Principles of Internal Medicine, 18e
| Part 7. Oncology and Hematology > Section 2. Hematopoietic Disorders > |
Chapter 113. Transfusion Biology and Therapy
Sections: Blood Group Antigens and Antibodies, Pretransfusion Testing, Blood Components, Adverse Reactions to Blood Transfusion, Alternatives to Transfusion, Further Readings.
Topics Discussed: blood transfusion; pharmacotherapy of hematologic disorders.
Excerpt:"The study of red blood cell (RBC) antigens and antibodies forms the foundation of transfusion medicine. Serologic studies initially characterized these antigens, but now the molecular composition and structure of many are known. Antigens, either carbohydrate or protein, are assigned to a blood group system based on the structure and similarity of the determinant epitopes. Other cellular blood elements and plasma proteins are also antigenic and can result in alloimmunization, the production of antibodies directed against the blood group antigens of another individual. These antibodies are called alloantibodies.The first blood group antigen system, recognized in 1900, was ABO, the most important in transfusion medicine. The major blood groups of this system are A, B, AB, and O. O type RBCs lack A or B antigens. These antigens are carbohydrates attached to a precursor backbone, may be found on the cellular membrane either as glycosphingolipids or glycoproteins, and are secreted into plasma and body fluids as glycoproteins. H substance is the immediate precursor on which the A and B antigens are added. This H substance is formed by the addition of fucose to the glycolipid or glycoprotein backbone. The subsequent addition of N-acetylgalactosamine..."
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