Modern Blood Banking and Transfusion – Test Bank Questions and Answers with Detailed Rationales

,Antigen-Antibody Characteristic Chart*
ANTIGENS
Antigen RBC Antigen Antigen Antigen
Antigen Antigen ISBT Freq. % Expression Distrib. Demonstrates Modification
System Name Name W B at Birth Plasma/RBC Dosage Enzyme/Other
D RH1 85 92 strong RBC only no Enz. ↑


C RH2 70 34 strong RBC only yes Enz. ↑
E RH3 30 21 strong RBC only yes Enz. ↑

c RH4 80 97 strong RBC only yes Enz. ↑
e RH5 98 99 strong RBC only yes Enz. ↑
Rh
ce/f RH6 64 strong RBC only no Enz. ↑
Ce RH7 70 strong RBC only no Enz. ↑
Cw RH8 1 rare strong RBC only yes Enz. ↑

G RH12 86 strong RBC only no Enz. ↑
V RH10 1 30 strong RBC only no Enz. ↑



VS RH20 1 32 strong RBC only no
K KEL1 9 rare strong RBC only occ Enz. → AET+ ↓ ZZAP ↓++


k KEL2 98.8 100 strong RBC only occ Enz. → AET+ ↓ ZZAP ↓++
Kpa KEL3 2 rare strong RBC only occ Enz. → AET+ ↓ ZZAP ↓++

Kell Kpb KEL4 99.9 100 strong RBC only occ Enz. → AET+ ↓ ZZAP ↓++
Jsa KEL6 .01 20 strong RBC only occ Enz. → AET+ ↓ ZZAP ↓++

Jsb KEL7 99.9 99 strong RBC only occ Enz. → AET+ ↓ ZZAP ↓++
†Kx — 99.9 99.9 weak RBC low occ Enz. → AET+ ↓ ZZAP ↓++



FYa FY1 65 10 strong RBC only yes Enz. ↓ AET ↓ ZZAP ↓



FYb FY2 80 23 strong RBC only yes Enz. ↓ AET ↓ ZZAP ↓
FY3 100 strong RBC only no Enz. → AET → ZZAP →
Duffy
FY5 100 ? ? no Enz. → AET → ZZAP →

•FY6 100 ? ? RBC only ? Enz. ↓ AET → ZZAP ↓




*This chart is to be used for general information only. Please refer to the appropriate chapter for more detailed information.
AET = 2-aminoethylisthiouronium bromide; ↑ = enhanced reactivity; → = no effect; ↓ = depressed reactivity; occ = occasionally; CGD = chronic granulomatious disease;
HDN = hemolytic disease of the newborn; HTR = hemolytic transfusion reaction; NRBC = non-red blood cell; RBC = red blood cell; WBC = white blood cell; ZZAP = dithiothreitol
plus papain.
• No human antibody to FY6 has been reported.
† It has been found that Kx is inherited independently of the Kell system; consequently it is no longer referred to as K15.

,ANTIBODIES
Immunoglobin Clinical
Serology Comp. Class Optimum Significance
Stimulation Saline AHG Binding IgM IgG Temperature HTR HDN Comments
RBC occ yes no occ yes warm yes yes Very rarely IgA anti-D may be
produced; however, this is
invariably with IgG.
RBC occ yes no occ yes warm yes yes
RBC/NRBC occ yes no occ yes warm yes yes Anti-E may often occur without
obvious immune stimulation.
RBC occ yes no occ yes warm yes yes
RBC occ yes no occ yes warm yes yes Warm autoantibodies often appear
to have anti-e-like specificity.
RBC occ yes no occ yes warm yes yes
RBC occ yes no occ yes warm yes yes
RBC/NRBC occ yes no occ yes warm yes yes Anti-Cw may often occur without
obvious immune stimulation.
RBC occ yes no occ yes warm yes yes
RBC occ yes no occ yes warm yes yes Antibodies to V and VS present
problems only in the black population,
where the antigen frequencies are in
the order of 30 to 32.
RBC occ yes no occ yes warm yes yes
RBC occ yes some occ yes warm yes yes Some antibodies to Kell system have
been reported to react poorly in
low ionic media.
RBC no yes no rarely yes warm yes yes
RBC no yes no no yes warm yes yes Kell system antigens are destroyed
by AET and by ZZAP.
RBC rarely yes no rarely yes warm yes yes
RBC rarely yes no rarely yes warm yes yes Anti-K1 has been reported to occur
following bacterial infection.
RBC no yes no no yes warm yes yes
RBC no yes no occ yes warm yes yes The lack of Kx expression on RBCs
and WBCs has been associated with
the McLeod phenotype and CGD.
RBC rare yes some rare yes warm yes yes Fya and Fyb antigens are destroyed by
enzymes. Fy (a–b–) cells are resistant
to invasion by P. vivax merozoites, a
malaria-causing parasite.
RBC rare yes some rare yes warm yes yes
RBC no yes rarely no yes warm yes yes FY3 and 5 are not destroyed by
enzymes.
RBC no yes ? no yes warm FY5 may be formed by interaction of
Rh and Duffy gene products.
FY6 is a monoclonal antibody which
reacts with most human red cells
except Fy(a–b–) and is responsible
for susceptibility of cells to penetration
by P. vivax.
(Continued on inside back cover)

, Modern Blood Banking
& Transfusion Practices
SIXTH EDITION