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Thirty-three major blood group systems (including the AB and Rh systems) were recognised by the International Society of Blood Transfusion (ISBT) in October 2012.[1] In addition to the ABO antigens and Rhesus antigens, many other antigens are expressed on the red blood cell surface membrane. For example, an individual can be AB RhD positive, and at the same time M and N positive (MNS system), K positive (Kell system), and Lea or Leb positive (Lewis system). Many of the blood group systems were named after the patients in whom the corresponding antibodies were initially encountered.

The ISBT definition of a blood group system is where one or more antigens are "controlled at a single gene locus or by two or more very closely linked homologous genes with little or no observable recombination between them".[2]

Blood grouping postulates[]

Blood is composed of cells suspended in a liquid like substance. The liquid portion is the plasma. Suspended in the plasma are three types of cells:

The most common type of grouping is the ABO grouping. The varieties of glycoprotein coating on red blood cells divides blood into four groups:

  • A (A oligosaccharide is present)
  • B (B oligosaccharide is present)
  • AB (A and B oligosaccharides are present)
  • O (neither A nor B, only their precursor H oligosaccharide present)

There are subtypes under this grouping (listed as A1, A2, A1B or A2B…) some of which are quite rare. Apart from this there is a protein which plays an important part in the grouping of blood. This is called the Rh factor. If this is present, the particular blood type is called positive. If it is absent, it is called negative. Thus we have the following broad categories:[3]

  • A1 Negative (A1 -ve)
  • A1 Positive (A1 +ve)
  • A1B Negative (A1B -ve)
  • A1B Positive (A1B +ve)
  • A2 Negative (A2 -ve)
  • A2 Positive (A2 +ve)
  • A2B Negative (A2B -ve)
  • A2B Positive (A2B +ve)
  • B Negative (B -ve)
  • B Positive (B +ve)
  • B1 Positive (B1 +ve)
  • O Negative (O -ve)
  • O Positive (O +ve)

Rare blood types[]

In the "ABO" system, all blood belongs to one of four major groups: A+/-, B+/-, AB+/-, or O+/-. But there are more than two hundred minor blood groups that can complicate blood transfusions. These are known as rare blood types. Whereas common blood types are expressed in a letter or two, with maybe a plus or a minus, a smaller number of people express their blood type in an extensive series of letters in addition to their 'AB-' type designation.

Blood group systems[]

ISBT[1] System name System symbol Epitope or carrier, notes Chromosome
001 ABO ABO Carbohydrate (N-Acetylgalactosamine, galactose). A, B and H antigens mainly elicit IgM antibody reactions, although anti-H is very rare, see the Hh antigen system (Bombay phenotype, ISBT #18). 9
002 MNS MNS GPA / GPB (glycophorins A and B). Main antigens M, N, S, s. 4
003 P P1 Glycolipid. Antigen P1. 22
004 Rh (Rhesus) RH Protein. C, c, D, E, e antigens (there is no "d" antigen; lowercase "d" indicates the absence of D). 1
005 Lutheran LU Protein (member of the immunoglobulin superfamily). Set of 21 antigens. 19
006 Kell KEL Glycoprotein. K1 can cause hemolytic disease of the newborn (anti-Kell), which can be severe. 7
007 Lewis LE Carbohydrate (fucose residue). Main antigens Lea and Leb - associated with tissue ABH antigen secretion. 19
008 Duffy FY Protein (chemokine receptor). Main antigens Fya and Fyb. Individuals lacking Duffy antigens altogether are immune to malaria caused by Plasmodium vivax and Plasmodium knowlesi. 1
009 Kidd dbMHC Protein (urea transporter). Main antigens Jka and Jkb. 18
010 Diego DI Glycoprotein (band 3, AE 1, or anion exchange). Positive blood is found only among East Asians and Native Americans. 17
011 Yt or Cartwright YT Protein (AChE, acetylcholinesterase). 7
012 XG XG Glycoprotein. X
013 Scianna SC Glycoprotein. 1
014 Dombrock DO Glycoprotein (fixed to cell membrane by GPI, or glycosyl-phosphatidyl-inositol). 12
015 Colton CO Aquaporin 1. Main antigens Co(a) and Co(b). 7
016 Landsteiner-Wiener LW Protein (member of the immunoglobulin superfamily). 19
017 Chido/Rodgers CH/RG C4A C4B (complement fractions). 6
018 Hh/Bombay H Carbohydrate (fucose residue). 19
019 Kx XK Glycoprotein. X
020 Gerbich GE GPC / GPD (Glycophorins C and D). 2
021 Cromer CROM Glycoprotein (DAF or CD55, regulates complement fractions C3 and C5, attached to the membrane by GPI). 1
022 Knops KN Glycoprotein (CR1 or CD35, immune complex receptor). 1
023 Indian IN Glycoprotein (CD44 adhesion function?). 11
024 Ok OK Glycoprotein (CD147). 19
025 Raph MER2 Transmembrane glycoprotein. 11
026 JMH JMH Protein (fixed to cell membrane by GPI). Also known as Semaphorin 7A or CD108. 6
027 Ii I Branched (I) / unbranched (i) polysaccharide. 6
028 Globoside GLOB Glycolipid. Antigen P. 3
029 GIL GIL Aquaporin 3. 9
030 Rh-associated glycoprotein RHAG Rh-associated glycoprotein. 6
031 Forssman FORS Globoside alpha-1,3-N-acetylgalactosaminyltransferase 1 (GBGT1) 9
033 Langereis[4] LAN ABCB6. Porphyrin transporter 2
032 Junior[4] JR ABCG2. Multi-drug transporter protein 4


  1. 1.0 1.1 Table of blood group systems v3.0. International Society of Blood Transfusion. URL accessed on May 11, 2013.
  2. ISBT Committee on Terminology for Red Cell Surface Antigens. Terminology Home Page. URL accessed on 2009-02-13.
  3. Information Courtesy: Indian Red Cross Society, Tamil Nadu Branch.
  4. 4.0 4.1 Helias V, Saison C, Ballif BA, Peyrard T, Takahashi J, Takahashi H, Tanaka M, Deybach J-C, Puy H, le Gall M, Sureau C, Pham B-N, le Pennec P-Y, Tani Y, Cartron J-P, Arnaud L (2012) ABCB6 is dispensable for erythropoiesis and specifies the new blood group system Langereis. Nature Genetics 44 (2): 170 DOI: 10.1038/ng.1069

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