A patient with O+ blood is waiting for a transfusion. In the blood bank, the following blood groups are available. Which is the most appropriate one for the patient?

Appeared in: AIIMS Delhi NO-2016

Explanation

Individuals with Type O blood have no A or B antigens on their red blood cells, which prevents an immune reaction from the recipient's antibodies.
The plasma of a Type O individual contains both Anti-A and Anti-B antibodies. This means they can only receive blood that lacks both A and B antigens, which is Type O blood.
Giving a Type O patient any blood with A or B antigens (like Type A, B, or AB) would cause the patient's antibodies to attack the transfused cells, leading to a severe hemolytic transfusion reaction.
Since the patient is Rh-positive (O+), they can safely receive either O-positive or O-negative blood. The option 'O' represents the only compatible ABO group among the choices.

Option B: This blood type contains A-antigens. The O+ recipient has Anti-A antibodies in their plasma, which would attack these A-antigens and cause a transfusion reaction.
Option C: This blood type contains both A and B antigens. The O+ recipient has both Anti-A and Anti-B antibodies, which would attack both antigens on the transfused red blood cells.
Option D: This is incorrect and dangerous. Blood groups are not universally interchangeable. Transfusing an incompatible blood type is a medical emergency and can be fatal.

Clinical Relevance

Nursing practice connection: Use the key finding related to Blood transfusion compatibility based on ABO and Rh systems to guide bedside assessment, documentation, and the next nursing action.
Correct blood typing and cross-matching is a critical nursing responsibility to prevent life-threatening transfusion reactions. Always double-check patient and blood product identification before administration.
In an emergency where the patient's blood type is unknown, O-negative blood is used as the universal donor type because it lacks A, B, and Rh antigens, minimizing the risk of a reaction.
Nurses must monitor patients closely during the first 15 minutes of a transfusion, as this is when most severe reactions occur. Symptoms include fever, chills, back pain, and shortness of breath.

How to Approach the Question

First, identify the patient's blood type from the question stem: O+.
Recall the core principle of blood transfusion: the donor's red blood cell antigens must not react with the recipient's plasma antibodies.
Analyze the patient's blood type (O+): No A/B antigens on their RBCs, but they have both Anti-A and Anti-B antibodies in their plasma.
Evaluate each option based on this principle:
Can an 'O' recipient get 'A+' blood? No, the recipient's Anti-A antibodies will attack the A-antigens.
Can an 'O' recipient get 'AB+' blood? No, the recipient's Anti-A and Anti-B antibodies will attack both A and B antigens.

Concept Tested & Keywords

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E6 Physiology Essentials Sembulingam 10e Part 1 pp. 146-148, 147-149

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