All 8 blood types

❑ Blood type A Rh-

Antigens (on the surface of the red blood cells):
A indicates there are A antigens. (Rh- indicates there are no Rh antigens)

Antibodies (in the blood plasma):

B antibodies
Rh antibodies.
(If there are A antigens but no B nor Rh antigens, the antibodies in the blood plasma are B and Rh
antibodies.)

The blood type notation A Rh- indicates which antigens and

antibodies are present in the blood.

❑ Blood type A Rh+

Antigens (on the surface of the red blood cells):
A indicates there are A antigens.
Rh+ indicates there are Rh antigens.

Antibodies (in the blood plasma):

B antibodies.
If there are A and Rh antigens but no B antigens, the antibodies in the blood plasma are B antibodies.

❑ Blood type B Rh-

Antigens (on the surface of the red blood cells):
B indicates there are B antigens.
(Rh- indicates there are no Rh antigens.)
Antibodies (in the blood plasma):
A antibodies.
Rh antibodies.
(If there are B antigens but no A nor Rh antigens, the antibodies in the blood plasma are A and Rh
antibodies.)

❑ Blood type B Rh+

Antigens (on the surface of the red blood cells):
B indicates there are B antigens.
Rh+ indicates there are Rh antigens.

Antibodies (in the blood plasma):

A antibodies.
If there are B and Rh antigens but no A antigens, the antibodies in the blood plasma are A antibodies.

❑ Blood type AB Rh-

Antigens (on the surface of the red blood cells):
AB indicates there are both A and B antigens.
(Rh- indicates there are no Rh antigens.)

Antibodies (in the blood plasma):

Rh antibodies.
(If there are A and B antigens but no Rh antigens, the antibodies in the blood plasma are Rh antibodies.)
 ❑ Blood type AB Rh+
Antigens (on the surface of the red blood cells):
AB indicates there are both A and B antigens.
Rh+ indicates there are Rh antigens.

Antibodies (in the blood plasma):

No antibodies!
(If all possible antigens are present, A, B and Rh antigens, there are no antibodies in the blood plasma.)

❑ Blood type O Rh-

Type O blood gets its name because it has neither A nor B antigens! In other languages O is often
pronounced as "null".

Antigens (on the surface of the red blood cells):

No antigens!
(O indicates there are neither A nor B antigens.)
(Rh- indicates there are no Rh antigens.)

Antibodies (in the blood plasma):

A antibodies.
B antibodies.
Rh antibodies.
(If there are no antigens at all on the surface of the red blood cells, all three possible antibodies are present in
the blood plasma: A, B and Rh antibodies.)
 ❑ Blood type O Rh+
Type O blood gets its name because it has neither A nor B antigens! In other languages O is often
pronounced as "null".

Antigens (on the surface of the red blood cells):

(0 indicates there are neither A nor B antigens.)
Rh+ indicates there are Rh antigens.

Antibodies (in the blood plasma):

A antibodies.
B antibodies
(If there are Rh antigens but no A nor B antigens, the antibodies present in the blood plasma are A and B
antibodies.)

Disclaimer:
The fact that people with Rh- blood do not naturally have Rh antibodies in the blood plasma (as one can
have A or B antibodies, for instance) is not taken into consideration in this game. In reality a person with
Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+
blood. The received blood cells with Rh antigens can trigger the production of Rh antibodies in an individual
with Rh- blood. In the game one has to pretend that all patients with Rh- blood type has received Rh+ blood
in previous blood transfusions.

Also, the antibodies are here referred to as A antibodies, B antibodies and Rh antibodies. These are also
commonly referred to as anti A antibodies, anti B antibodies, and anti Rh antibodies.
How do you determine a patient's blood type?
You need to know the patient’s blood type in order to make safe blood transfusions. Primarily you try to
give the same blood type in a blood transfusion as the patient has got.

From Tutorial 1 you know that the blood type notation indicates what antigens there are on the surface of
the red blood cells. So, to determine blood type, you need to find out which antigens are present. You can
work that out by mixing the patient’s blood with three different reagents containing either of the three
antibodies: A, B or Rh.

Test tubes containing three different reagents with either A, B or Rh antibodies. The antibodies attach to
antigens on the patient's red blood cells if they match.

Blood typing procedure:

1. Mix!
First mix the patient's blood with three different reagents including either of the three different antibodies, A,
B or Rh antibodies!

2. Look for agglutination!

Then you take a look at what has happened. In which mixtures has clumping, or agglutination, occurred?
The agglutination indicates that the blood has reacted with a certain antibody and is therefore not compatible
with blood containing that kind of antibody. If the blood does not agglutinate, it indicates that the blood does
not have the antigens binding the special antibody in the reagent.
3. Figure out the ABO blood group!
Start by taking a look at the test tubes containing A and B antibodies. Has the blood agglutinated in either of
these two tubes?

No agglutination in test tube A, indicates that the patient's red blood cells do not have A antigens.
Agglutination in the tube containing B antibodies indicates that the patients' red blood cells have got B
antigens, thus belongs to blood group B.

4. Figure out the Rh blood group!

Now have a look at the test tube containing Rh antibodies! Has the blood agglutinated or not?

No agglutination indicates that the patient's red blood cells don't have Rh antigens, thus the blood is Rh-.

5. Figure out the blood type!

Now that you know which antigens are in the patient's blood, you can figure out the blood type!
Since agglutination only occurred in the test tube containing B antibodies, the blood got B antigens but no A
or Rh antigens. Thus, the blood type is B Rh- .
Test yourself!
Can you determine the blood type?

Agglutination in all three test tubes indicates that all three antigens are present in the blood: A, B and Rh.
Accordingly, the blood type is AB Rh+.

Can you determine the blood type?

Agglutination in the test tubes contaning A antibodies and B antibodies. Accordingly, the blood type is AB
Rh-.
Can you determine the blood type?

Agglutination in the test tube with Rh antibodies indicates that the blood has got Rh antigens but no A nor B
antigens.
The blood type is O Rh+.

What has happened when the blood agglutinates?

The blood will agglutinate if the antigens in the patient's blood match the antibodies in the test tube.
Antibodies attach to A antigens - they match like a lock and key - and thus form a clump of red blood cells.
In the same way B antibodies attach to B antigens and Rh antibodies to Rh antigens. In the test tubes where
agglutination has occurred, the patient's red blood cells have been linked together, like bunches of grapes,
instead of floating around one by one.

Disclaimer:
The fact that people with Rh- blood do not naturally have Rh antibodies in the blood plasma (as one can
have A or B antibodies, for instance) is not taken into consideration in this game. In reality a person with
Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+
blood. The received blood cells with Rh antigens can trigger the production of Rh antibodies in an individual
with Rh- blood. In the game one has to pretend that all patients with Rh- blood type has received Rh+ blood
in previous blood transfusions.

Also, the antibodies are here referred to as A antibodies, B antibodies and Rh antibodies. These are also
commonly referred to as anti A antibodies, anti B antibodies, and anti Rh antibodies.

How do you perform safe blood transfusions?

A blood transfusion involves taking blood from one person (a donor) and giving it to another to replace
blood lost in major accidents, or during life-saving operations, for instance. In order to make safe blood
transfusions it is important to know to what blood type the patient belong to. Mixing incompatible blood
types could be dangerous and lethal. Early blood transfusions consisted of whole blood, but modern medical
practice commonly uses only components of the blood, such as red blood cells or plasma. If you have lost
blood due to an injury or surgery red blood cells are the most commonly transfused part of the blood. Red
blood cells are also used for transfusion if you have anemia (uh-NEE-me-uh).

Blood transfusion is the process of receiving blood products into one's circulation. Transfusions are usually given through a tiny tube that is inserted into a vein
with a small needle.

What happens if you get the wrong blood in a transfusion?

Immunological reactions occur when the receiver of a blood transfusion has antibodies that work against the
donor blood cells. Then the red blood cells from the donated blood will clump, or agglutinate. The
agglutinated red cells can clog blood vessels and stop the circulation of the blood to various parts of the
body. The agglutinated red blood cells can also crack open, leaking toxic contents out in the body, which
can have fatal consequences for the patient.
Compatible blood
For a blood transfusion to be successful, AB0 and Rh blood groups must be compatible between the donor
blood and the patient blood. You primarily try to give the same blood type as the patient herself/himself has
got. However, some blood types could be rare in different parts of the world or hospitals might be out of
stock with a particular blood type. Therefore, you need to know which blood types are “compatible”, that is
which other blood types fit a patient with a certain blood type.

For example, a person with blood type B Rh- has got A and Rh antibodies and cannot receive a blood
transfusion with red blood cells which have A and Rh antigens like A Rh+ or AB Rh+.

What happens when blood clumps or agglutinates?

If the blood is not compatible in a blood transfusion,then the red blood cells from the donated blood will
clump or agglutinate. The agglutinated red cells can clog blood vessels and stop the circulation of the blood
to various parts of the body. The agglutinated red blood cells may also crack and their contents leak out in
the body. The red blood cells contain hemoglobin which becomes toxic when outside the cell. This can have
fatal consequences for the patient.

The antibodies' task is to act against foreign substances in the body. To a person with B blood the A antigens
is considered foreign. The A antigen and the A antibodies can bind to each other in the same way that the B
antigens can bind to the B antibodies. This is what would happen if, for instance, a B blood person receives
blood from an A blood person. The red blood cells will be linked together, like bunches of grapes, by the
antibodies. As mentioned earlier, this clumping could lead to death.

Who can receive blood from whom?

People can happily receive blood from the same blood type as their own, but they have antibodies against
any antigens not found on their own red blood cells. Look at the "Compatible blood chart" below!
ABO blood system
O can only receive blood from: O
A can receive blood from: A and O
B can receive blood from: B and O
AB can receive blood from: AB, A, B and O

Rh blood system
Rh+ can receive blood from: Rh+ and Rh-
Rh- can receive blood from: Rh-

This "Compatible blood chart" refers to blood transfusions with red blood cells.

People with O Rh- blood can only receive O Rh- blood.

People with O Rh+ can receive both O Rh+ and O Rh- blood.
People with blood type AB Rh+ can recieve blood from all blood types and therefore are called Universal
receivers.

What if there is no time for blood typing?

In emergencies, there are exceptions to the rule that the donor's blood type must match the recipient's
exactly. Blood type O Rh- is the only type of blood that people of all other blood types can receive, so it is
used in situations when patients need a transfusion but their blood type is unknown. People with blood type
O Rh- are called Universal donors.

Can donate red blood cells Can receive red blood cells
Blood Type Antigens Antibodies
to in a transfusion from
AB Rh+ A, B and Rh None AB Rh+ AB Rh+
AB Rh -
A Rh+
A Rh -
B Rh+
B Rh -
O Rh+
O Rh -
AB Rh - A and B None AB Rh - AB Rh -
AB Rh+ A Rh -
B Rh -
O Rh -
 A Rh+ A and Rh B A Rh+ A Rh+
AB Rh+ A Rh -
O Rh+
O Rh -
A Rh - A B A Rh - A Rh -
A Rh+ O Rh -
AB Rh -
AB Rh+
B Rh+ B and Rh A B Rh+ B Rh+
AB Rh+ B Rh -
O Rh+
O Rh-
B Rh - B A B Rh- B Rh -
B Rh+ O Rh -
AB Rh-
AB Rh+
O Rh+ Rh A and B O Rh+ O Rh+
A Rh+ O Rh -
B Rh+
AB Rh+

O Rh - None A and B AB Rh+ O Rh -

AB Rh -
A Rh+
A Rh -
B Rh+
B Rh -
0 Rh+
0 Rh -

Be a blood donor!
Blood donors must be at least 17-18 years old in most countries.

Disclaimer:
The fact that people with Rh- blood do not naturally have Rh antibodies in their blood plasma (as one can
have A or B antibodies, for instance) is not taken into consideration in this game. In reality a person with
Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+
blood. The received blood cells with Rh antigens can trigger the production of Rh antibodies in an individual
with Rh- blood. In the game one has to pretend that all patients with Rh- blood type has received Rh+ blood
in previous blood transfusions.

Also, the antibodies are here referred to as A antibodies, B antibodies and Rh antibodies. These are also
commonly referred to as anti A antibodies, anti B antibodies, and anti Rh antibodies.

NOTE: A person with blood type O Rh- blood is considered to be a "universal donor", which means that any person, regardless what blood type you belong to,
could receive O Rh- blood in a transfusion, for instance in an emergency situation when there is no time for blood typing. Recent research indicates that this may
no longer be totally accurate, because of a better understanding of the complex issues of immune reactions related to incompatible donor blood cells.