Other blood group antigens

Kell (K/k)

Clinically significant (Hemolytic transfusion reactions & WORST cases of HDFN)

IgG

Not affected by enzymes

Reacts with AHG, Warm antibody (agglutination at 37 degrees)

Highly immunogenic (2nd to D antigen)

K- 9% and k- 99.8% high frequency antigen

Sulfhydryl reagents kill kell: ZZAP, DTT, 2-ME, AET

Duffy (Fy a/Fy b)

Clinically significant (Transfusion reactions)

IgG

Destroyed by enzymes

Reacts with AHG, warm antibody

Shows dosage

49% whites (fy a+ b+) and 68% blacks (fy a- b+)

fy a- b- = red cells resistant to malaria (P.knowlesis and P. vivax)

fy a & b required to make fy3

Kidd (Jk a/Jk b)

Clinically significant (Delayed hemolytic transfusion reactions)

IgG

Enhanced by enzymes

Reacts with AHG, warm antibody

Shows doasge

3 phenotypes: jka, jkb, jk3- makes antibodies to jka and jkb

51% blacks (jk a+ b-) 50.3% whites jk a+ b+)

If you have jka or jkb then you have jk3.

If you lack both then you lack jk3 and make abs to all (jka, jkb, jk3)

Lutheran (Lu a/Lu b)

Clinically significant (Lub-mild HDFN)

IgG for Lub; IgM & IgG for Lua

Reacts in AHG, room temperature

Most populations have Lu a- b+ phenotype

Lewis (Le a/Le b)

Body fluid antigen, in secretions, absorbed onto red cell surface

Not clinically significant

IgM

Enhanced by enzymes

Reacts at IS, 37 degrees, & AHG

warm and cold antibody

Lea= Le gene

Leb= Le, H, Se (Le a- b+)

I & i

Not clinically significant

IgM

Enhanced by enzymes

React at IS & room temperature

Cold antibody

Adults have anti-I; newborns have anti-i

Anti-I= Mycoplasma pneumoniae; anti-i= Mono

Pre-warm technique to get rid of antibody

M & N

Not clinically significant , unless reacting at 37 degrees

IgM

Destroyed by enzymes

Reacts at I, 37 degrees, and AHG

Shows dosage

S & s

Clinically significant

IgG

Enzyme variable- (destroys)

Reacts in AHG

Warm antibody

Shows dosage

P blood group

PCH- Paroxysmal Cold Hemoglobinuria (occurs in children following a viral infection)

Called the Donath-Landsteiner Antibody

Biphasic Hemolysis: attaches at cold temperatures and when warmed up, hemolysis occurs

Enzymes that are IgG

K, Fy, Jk, Lub, Lua, S, & s

Blood groups that are IgM

Lua, Le, I, M, & N

Blood groups that show dosage

Fy, Jk, M, N, S, & s

Enhanced by enzymes

Jk, Le, I, P, Rh groups, & ABO

Destroyed by enzymes

M,N, Fya, Fyb, S, & s