Blood typing
Cross matching; Rh typing; ABO blood typing; Blood group; Anemia - immune hemolytic blood type; ABO blood type; A blood type; AB blood type; O blood type
Blood typing is a method to tell what type of blood you have. Blood typing is done so you can safely donate your blood or receive a blood transfusion. It is also done to see if you have a substance called Rh factor on the surface of your red blood cells.
Your blood type is based on whether or not certain proteins are on your red blood cells. These proteins are called antigens. Your blood type (or blood group) depends on what types your parents passed down to you.
Blood is often grouped according to the ABO blood typing system. The 4 major blood types are:
- Type A
- Type B
- Type AB
- Type O
How the Test is Performed
A blood sample is needed. The test to determine your blood group is called ABO typing. Your blood sample is mixed with antibodies against type A and B blood. Then, the sample is checked to see whether or not the blood cells stick together. If blood cells stick together, it means the blood reacted with one of the antibodies.
Blood sample
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
The second step is called back typing. The liquid part of your blood without cells (serum) is mixed with blood that is known to be type A and type B. People with type A blood have anti-B antibodies. People with type B blood have anti-A antibodies. Type O blood contains both types of antibodies.
The 2 steps above can accurately determine your blood type.
Rh typing uses a method similar to ABO typing. When blood typing is done to see if you have Rh factor on the surface of your red blood cells, the results will be one of these:
- Rh+ (positive), if you have this substance
- Rh- (negative), if you do not have this substance
How to Prepare for the Test
No special preparation is necessary for this test.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
Why the Test is Performed
Blood typing is done so you can safely receive a blood transfusion or a transplant. Your blood type must closely match the blood type of the blood you are receiving. If the blood types do not match:
- Your immune system will see the donated red blood cells as foreign.
- Antibodies will develop against the donated red blood cells and attack these blood cells.
The 2 ways that your blood and the donated blood may not match are:
- A mismatch between blood types A, B, AB, and O. This is the most common form of a mismatch. In most cases, the immune response is not very severe.
- Rh factor may not match. The immune response can be much more severe.
Blood typing is very important during pregnancy. Careful testing can prevent a severe anemia in the newborn and jaundice .
Severe anemia in the newborn
Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In some infants, it can be life threatening. Normally, red...
Jaundice
Newborn jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replac...
Normal Results
You will be told which ABO blood type you have. It will be one of these:
- Type A blood
- Type B blood
- Type AB blood
- Type O blood
You will also be told whether you have Rh-positive blood or Rh-negative blood.
Based on your results, your health care providers can determine which type of blood you can safely receive:
- If you have type A blood, you can only receive types A and O blood.
- If you have type B blood, you can only receive types B and O blood.
- If you have type AB blood, you can receive types A, B, AB, and O blood.
- If you have type O blood, you can only receive type O blood.
- If you are Rh+, you can receive Rh+ or Rh- blood.
- If you are Rh-, you can only receive Rh- blood.
Type O blood can be given to anyone with any blood type. That is why people with type O blood are called universal blood donors.
Risks
There is very little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Fainting or feeling lightheaded
- Multiple punctures to locate veins
- Excessive bleeding
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Hematoma
(blood buildup under the skin)
Hematoma
Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...
- Infection (a slight risk any time the skin is broken)
Considerations
There are many antigens besides the major ones (A, B, and Rh). Many minor ones are not routinely detected during blood typing. If they are not detected, you may still have a reaction when receiving certain types of blood, even if the A, B, and Rh antigens are matched.
A process called cross-matching followed by a Coombs test can help detect these minor antigens. It is done before transfusions, except in emergency situations.
Coombs test
The Coombs test looks for antibodies that may stick to your red blood cells and cause red blood cells to die too early.
References
Goodnough LT. Transfusion medicine. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 177.
Howard MR, Hamilton PJ. Blood groups and blood testing. In: Howard MR, Hamilton PJ, eds. Haematology: An Illustrated Colour Text . 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 41.
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Erythroblastosis fetalis, photomicrograph - illustration
Antibodies from an Rh negative mother may enter the blood stream of her unborn Rh positive infant, damaging the red blood cells (RBCs). The infant responds by increasing RBC production and sending out immature RBCs that still have nuclei. This photograph shows normal RBCs, damaged RBCs, and immature RBCs that still contain nuclei.
Erythroblastosis fetalis, photomicrograph
illustration
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Blood types - illustration
The four main blood types: A, B, AB and O.
Blood types
illustration
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Erythroblastosis fetalis, photomicrograph - illustration
Antibodies from an Rh negative mother may enter the blood stream of her unborn Rh positive infant, damaging the red blood cells (RBCs). The infant responds by increasing RBC production and sending out immature RBCs that still have nuclei. This photograph shows normal RBCs, damaged RBCs, and immature RBCs that still contain nuclei.
Erythroblastosis fetalis, photomicrograph
illustration
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Blood types - illustration
The four main blood types: A, B, AB and O.
Blood types
illustration
Review Date: 2/11/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.