GOLONGAN DARAH Semester I 2016
History Karl Landsteiner
(1900)
Sistem golongan darah Paling penting: - ABO - Rhesus
Golongan Darah
History of Blood Groups and Blood Transfusions
•Experiments with blood transfusions have been carried out for hundreds of years. Many patients have died and it was not until 1901, when the Austrian Karl Landsteiner discovered human blood groups, that blood transfusions became safer. He found that mixing blood from two individuals can lead to blood clumping. The clumped RBCs can crack and cause toxic reactions. This can be fatal. •
http://nobelprize.org/medicine/educational/landsteiner/readmore.html
History of Blood Groups and Blood Transfusions (Cont.)
• Karl Landsteiner discovered that blood clumping was an immunological reaction which occurs when the receiver of a blood transfusion has antibodies against the donor blood cells. •Karl Landsteiner's work made it possible to determine blood types and thus paved the way for blood transfusions to be carried out safely. For this discovery he was awarded the Nobel Prize in Physiology or Medicine in 1930.
What is blood made up of? An adult human has about 4–6 liters of blood circulating in the body. Blood consists of several types of cells floating around in a fluid called plasma. The red blood cells (RBCs) contain haemoglobin, a protein that binds oxygen. RBCs transport oxygen to, and remove carbon dioxide from the tissues. The white blood cells fight infection. The platelets help the blood to clot, if you get a wound for example. The plasma contains salts and various kinds of proteins.
Erythrocytes ■ Structure – Biconcave, anucleate ■ Components – Hemoglobin – Lipids, ATP, carbonic anhydrase ■ Function – Transport oxygen from lungs to tissues and carbon dioxide from tissues to lungs
19-6
GOLONGAN DARAH SISTEM ABO ANTIGEN (Aglutinogen) :
Merupakan glikoprotein yang terdapat pada permukaan sel darah merah Perbedaan golongan darah karena perbedaan jenis antigen Macam antigen: Antigen A dan Antigen B ANTIBODI (Aglutinin):
Molekul protein yang yang dihasilkan oleh sel-B (limfosit B) untuk merespon adanya antigen. Terdapat pada serum atau cairan darah. Macam antibodi. Anti-A dan Anti-B
AB0 blood grouping system Blood group A If you belong to the blood group A, you have A antigens on the surface of your RBCs and B antibodies in your blood plasma.
Blood group B If you belong to the blood group B, you have B antigens on the surface of your RBCs and A antibodies in your blood plasma.
Blood group AB If you belong to the blood group AB, you have both A and B antigens on the surface of your RBCs and no A or B antibodies at all in your blood plasma.
Blood group O If you belong to the blood group O (null), you have neither A or B antigens on the surface of your RBCs but you have both A and B antibodies in your blood plasma.
Pengecekan Golongan Darah
Reaksi Transfusi/Penggumpalan Darah
Menurut Mandel pembentukan antigen diawasi oleh gen maka segala sifatnya akan diwariskan. Gen A, B, O merupakan pasangan kromosom yang dapat mewariskan kepada keturunannya.
Misalnya ; Ayah gol. darah A , genotifnya AO dan Ibu gol. darah B, genotifnya BO Kemungkinan anaknya: Ayah
A
O
B
AB
BO
O
AO
OO
Ibu
Ayah gol. darah AB , genotifnya AB dan Ibu gol. darah O, genotifnya OO Kemungkinan anaknya; Ayah
A
B
O
AO
BO
O
AO
BO
Ibu
Ayah gol. darah A , genotifnya, AO dan Ibu gol. darah AB, genotifnya OO Kemungkinan anaknya ;
AYAH A
O
iBU A
AA
AO
B
AB
BO
SISTEM RHESUS ■ RHESUS : +
■ RHESUS : ■ REAKSI ERITROBLASTOSIS FETALIS – IBU : Rh – – BAYI : Rh +
Distribution of Rh(D) Types Population
Rh(D) pos
Rh(D) neg
Caucasian
86%
14%
AfricanAmerican
95%
5%
Oriental
>99%
<1%
ABO & Rh(D)
18
Penggumpalan Rh Dalam keadaan normal , serum atau plasma orang tidak mengandung anti Rh akan tetapi orang dapat distimuler (dipacu) untuk membentuk antibodi rhesus , yaitu dgn jalan : 1. Transfusi misal ; jika seorang perempuan Rh neg karena sesuatu hal harus ditolong dengan tranfusi dan kebetulan darah yg diterimanya berasal dari donor Rh pos sehingga perempuan tersebut distimuler untuk membentuk anti Rh. Akibatnya serum darah perempuan yg semula bersih dari anti Rh, sekarang mengandung anti Rh. Lebih-lebih jika transfusi dilakukan lebih dari sekali, maka banyak anti Rh akan bertambah.
2. Perkawinan Eritroblastosis Fetalis
Ibu Rhesus (-)
Ayah Rhesus (+)
Bayi Pertama Rhesus (+)
plasenta
Bayi ke dua dst Rhesus (+)
Ikterus / Eritroblastosis fetalis / HDN Kematian Janin dalam kandungan
Eritrosit bayi masuk kedalam Sirkulasi darah ibu terbentuk Zat anti rhesus
