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Chapter: Biology of Disease: Transfusion and Transplantation

The Discovery of the Blood Group Systems

It has been known since the seventeenth century that the transfusion of blood between individuals could have rapid and fatal consequences.

THE DISCOVERY OF THE BLOOD GROUP SYSTEMS

It has been known since the seventeenth century that the transfusion of blood between individuals could have rapid and fatal consequences. Fortunately, in 1900 Landsteiner (1868–1943) discovered that individuals could be classified into different groups depending on the characteristics of their erythrocytes and the presence of specific antibodies in their plasma to erythrocyte anti-gens. These discoveries laid the foundations for the routine and safe therapeu-tic transfusion of blood. Landsteiner drew blood from a number of individuals and separated the erythrocytes from the plasma. He then mixed together all possible combinations of erythrocytes and plasma from these individuals together and showed that only certain combinations resulted in the clump-ing or agglutination of the erythrocytes (Figure 6.2). These patterns of agglu-tination showed that there were different blood groups, which Landsteiner named A, B and O. In 1902 von Decastelo (1872–1960) and Sturli (1873–1964) discovered a fourth blood group which he called AB. It became clear that fatal blood transfusions resulted from incompatible blood being transfused and


that these procedures were successful when the blood transfused was of an identical blood group. The discovery of the ABO blood group system led to Landsteiner receiving the Nobel Prize for Physiology and Medicine in 1930. Landsteiner later discovered other blood group systems, including the Rh sys-tem. Since then, numerous other systems have been discovered, as shown in Table 6.2. These blood groups systems have been assigned numbers by the  International Society for Blood Transfusion (ISBT) and these, together with  the conventional abbreviations, are shown. There is insufficient space in this chapter to discuss all blood groups and only those of greatest clinical significance will be discussed.




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