The red cells of an individual contain antigens on cell surfaces that correspond to their blood group. Antibodies in the serum that identify such antigen locate on the surfaces of red cells of another blood group. At present, 35 blood group systems representing over 300 antigens are listed by the International Society of Blood Transfusion (ISBT).
The ABO system is the most important blood-group system in human-blood transfusion, since any person above the age of 6 months possess clinically significant anti-A and/or anti-B antibodies in their serum. Blood group A contains antibody against blood group B in serum and vice-versa, while blood group O contains no A/B antigen but both their antibodies in serum.
The Rh system (Rh meaning Rhesus) is the second most significant blood-group system in human-blood transfusion, and the most significant Rh antigen is the D antigen. The presence or absence of the Rh(D) antigen is signified by the + or ? sign, so that for example the A? group is ABO type A and does not have the Rh (D) antigen.
In addition to the ABO antigens and Rh antigens, many other antigens are expressed on the red blood cell surface membrane. For example, an individual can be AB, D positive, and at the same time M and N positive (MNS system), K positive (Kell system), Lea or Leb negative (Lewis system), and so on, being positive or negative for each blood group system antigen.
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