Blood Types Explained: ABO, Rh Factor & Transfusion Compatibility

Blood type is defined by antigens on red blood cells (RBCs). Two major systems:

ABO System

  • Type A: A antigens; anti-B antibodies in plasma.
  • Type B: B antigens; anti-A antibodies.
  • Type AB: Both A & B antigens; no anti-A/B (universal plasma donor).
  • Type O: Neither antigen; both anti-A & anti-B (universal RBC donor).

Rh System

  • Rh-positive: D antigen present (85% population).
  • Rh-negative: D antigen absent; can form anti-D if exposed.

Combined Types (8 Common)

A+, A−, B+, B−, AB+, AB−, O+, O−

Transfusion Compatibility

Plasma compatibility is reversed (AB = universal plasma donor).

Clinical Critical Points

  • Type & screen before transfusion.
  • Rh− females of childbearing potential: RhIG (RhoGAM) at 28 wks, delivery, any sensitizing event.
  • Emergency: O− RBCs + AB plasma (universal).

ABO/Rh mismatch → acute hemolytic transfusion reaction (fatal). Precision is non-negotiable.

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RecipientCan Receive RBCs From
O−O− only
O+O−, O+
A−A−, O−
A+A−, A+, O−, O+
B−B−, O−
B+B−, B+, O−, O+
AB−A−, B−, AB−, O−
AB+All types (universal RBC recipient)