Non-ABO&Rh Blood Groups

I and Ii

Carbohydrate

Clinical Significance: Rare

Antibody Class: IgM

Optimal Temp: RT or lower

Rxn Phase” RT

Enzyme: Enhances

DTT: No Change

Dosage: No

Glycotransferases

P1PK

Carbohydrate

Antigens: P1, Pk, and NOR

Phenotypes: P1, P2, P1k, P2k, and null=p

Clinical Significance: Rare

Antibody Class: P1-IgM PK-IgM and IgG

Optimal Temp: P1-cold Pk-cold or warm

Rxn Phase: P1-RT or lower Pk-RT,37C,IAT

Enzyme” Increases

DTT: No change

Dosage: No

Glycotransferases

Globoside

Carbohydrate

Antigens: P, PX2, and ExtB

Clinical Significance: Yes, hemolytic

Antibody Class: IgM and IgG

Optimal Temp: Cold and warm

Rxn Phase: RT,37C, and IAT

Enzyme: Increases

DTT: No change

Dosage: No

MNS

Protein (single pass)

Antigens: M, N, S, s, and U

Clinical significance: MN-No Ss-Yes

Antibody class: MN-IgM Ss-IgG

Optimal Temp: MN-cold Ss-warm

Rxn Phase: MN-RT, rare IAT Ss-IAT

Enzyme: MN-destroyed Ss-variable

DTT: Enhances

Dosage: Yes

Complement Pathway Molecules & Microbial Receptors

Kell

Protein (single pass)

Antigens: K and k, Kpa and Kpb, Jsa and Jsb, and K0 is null

Clinical Significance: Yes

Antibody Class: IgG

Optimal Temp: warm

Rxn Phase: IAT

Enzyme: No change

DTT: Destroyed

Dosage: Occaisonal

Kmod = weak expression of Kell ag

Kx

Protein (multi-pass)

Antigen: Kx

Clinical Significance: Yes

Antibody Class: IgG

Optimal Temp: warm

Rxn Phase: IAT
Enzyme: No change

DTT: Enhanced

Dosage: No

No XK gene = McCleod phenotype

Transport Proteins

Kidd

Protein (multi-pass)

Antigens: Jka, Jkb, Jk3, In(Jk) is inhibitor, and Jk(a-b-)/Jk:-3 is null

Clinical Significance: Yes

Antibody Class: IgG

Optimal Temp: Warm

Rxn Phase: IAT

Enzyme: No change

DTT: No change

Dosage: Yes

Transport Proteins

Duffy

Protein (multi-pass)

Antigens: Fya, Fyb, Fy3, Fy5, and Fy6

Clinical Significance: Yes

Antibody Class: IgG

Optimal Temp: warm

Rxn Phase: IAT
Enzyme: Destroyed

DTT: No change

Dosage: Yes

Fyx phenotype is weakened Fyb, Fy3, and Fy5

Biologic Receptors & Microbial Receptors

Lutheran

Protein (single pass)

Antigens: Lua and Lub, Lu6 and Lu9, Lu8 and Lu14, Aua and Aub

Clinical Significance: Lua-no Lub-yes

Antibody Class: Lua-IgM Lub-IgG

Optimal Temp: Lua-cold/RT Lub-warm

Rxn Phase: Lua-RT Lub-IAT

Enzyme: No change

DTT: Destroyed

Dosage: No

Adhesion Molecules

Diego

Protein (multi-pass)

Antigens: Dia, Dib, Wra, and Wrb

Clinical Significance: Yes Dia, Dib, and Wra

Enzyme: Resistant

DTT: Resistant

Red cell structure and morphology

South East Asian Ovalocytes

Structural Relationship to Red Cell & Transport Proteins

Yt

Protein (GPI-linked)

Antigens: Yta and Ytb

Clinical Significance: No

Antibody Class: IgG

Enzyme: Variable

DTT: Sensitive

On acetylcholinesterase

Xg

Protein (single pass)

Antigens: Xga and CD99

Clinical Significance: No

Antibody Class: Xga-IgG

Rxn Phase: Xga-IAT

Enzyme: Sensitive

DTT: Resistamt

Located on X chr

CD99 elevated in Ewing sarcoma

Adhesion Molecules

Scianna

Protein (single pass)

Antigens: SC:1, SC:2, and SC:3

Clinical Significance: Unknown

Antibody Class: IgG

Rxn Phase: IAT

Enzyme: Resistabt

DTT: Variable

SCnull in Marshall Island and Papa New Guinea

Dombrock

Protein (GPI-linked)

Antigens:Doa, Dob, Gya, Hy, and Joa

Clinical Significance:No HDFN Doa and Dob delayed HTR Hy, Fya, and Joa moderate HTR

Enzyme: Resistant

DTT: Sensitive

Hy- and Jo(a)- in black population

Absent from PNH III RBCs

Colton

Protein (multi-pass)

Antigens: Coa and Cob, Co3, and Co4

Coa requires Co4

Clinical Significance: Yes

Antibody Class: IgG

Rxn Phase: IAT

Enzyme: Resistant

DTT: Resistant

On aquaporins

Transport Proteins

Chido/Rogers

Protein

Antigens: Ch1-Ch6, Rg1, Rg2, WH

Clinical Significance: No

Antibody Class: IgG

Enzyme: Sensitive

DTT: Resistant

Inhibited with pooled plasma

Ag from plasma

HTLA characteristics

Complement Pathway Molecules

Gerbich

Protein (single pass)

Antigens: Ge2, Ge3, Ge4, Wb, Lsa, Ana, and Dha

Clinical Significance: Ge3-mild to moderate HTR and HDFN

Antibody Class: IgG

Rxn Phase: IAT

Enzyme: Ge2 and Ge4-sensitive Ge3-resistant

DTT: Variable

Gerbich null: Leach (Ge:-2-3-4) lacks GPC and GPD producing elliptocytic RBCs

Structural Relationship to Red Cell

Cromer

Protein (GPI-linked)

Antigens: Cra, Tca, Tcb, Tcc, Dra, Esa, ICF, WESa, WESb, and UMC

Clinical Significance: No

Antibody Class: IgG

Rxn Phase: IAT

Enzyme: Resistant

DTT: Variable/slight destruction

Null phenotype = Inab

PNH III Lack cromer antigen

Complement Pathway Molecules & Microbial Receptors

Knops

Protein (single pass)

Antigens: Kna, Knb, McCa, McCb, SI1, SI1, Yka

Clinical Significance: No

Antibody Class: IgG

Rxn Phase: IAT

Enzyme: Resistant

DTT: Variable - weakened or destroyed

Null = Helgeson phenotype

CR1 complement regulatory

Biologic Receptors

Cost

Protein

Blood Group Collection

Antigens: Csa and Csa

Clinical Significance: No

Enzyme: Resistant

DTT: Variable

Vel

Protein

Antigens: Vel

Clinical Significance: Yes

Antibody Class: Mix of IgG and IgM

Enzyme: Resistant/Enhances

DTT: Variable

Small integral protein 1

Can be null

Complement activation causing HTRs

John Milton Hagen

Protein (GPI-linked)

Antigens: JMH

Clinical Significance: No

Antibody Class: IgG

Enzyme: Sensitive

DTT: Sensitive

Elderly may produce anti-JMH

Adhesion Molecules

SID

Carbohydrate

Antigens: Sda

Antibody Class: IgM and IgG

Rxn Phase: IgM-room temperature IgG-IAT

Enzyme: Resistant

DTT: Resistant

901 series

Depends on N-acetylgalactosamine

Shiny mixed filed agglutination

Can be inhibited with Sda(+) urine

Indian

Protein (single pass)

Antigens: Ina and Inb, INFI, INJA, INRA, andINSLA

Clinical Significance: No

Rxn Phase: IAT

Enzyme: Sensitive

DTT: Sensitive

Reduced expresssion on RBC w/In(Lu) phenotype

Adhesion Molecules & Biologic Receptors

Lan

Protein (Multi-pass)

Antigens: Lan

Clinical Significance: Yes

Rxn Phase: IAT

Enzyme: Resistant

DTT: Resistant

ATP binding casette and heme synthesis

Augustine

Protein

Antigens: Ata

Clinical Significance: Yes

Enzyme: Resistant

DTT: Resistant

Equilibrative nucleoside transporter