Universal dispenser and universal recipient

Universal donor: blood group 0; Universal recipient: blood group AB

In transfusion medicine in the AB0 system, universal donors are people with blood group 0 negative and universal recipients are people with blood group AB positive. In fact, these terms only apply to the donation of red blood cell concentrates, as it is exactly the opposite when donating blood plasma . This distinction is important because a faulty transfusion or whole blood donation can lead to an acute haemolytic transfusion reaction (HTR).

history

The terms universal recipient and universal donor originate from a time (up to the 1990s) when the transfer of whole blood was still common for blood transfusions . Today, on the other hand, the transfer of the individual blood components required ( blood products ) is common, since the missing blood components can then be given in a more targeted and economical manner if necessary. In addition, the separated blood components can be stored for much longer as they have different optimal storage temperatures and shelf lives.

Instead of universal recipients and universal donors, one speaks more concretely today of

Universal receiver for blood plasma ( frozen fresh plasma )

Universal recipient erythrocyte concentrate

Universal donor blood plasma

Universal donor erythrocyte concentrate

Universal donor for whole blood

Universal donor and universal recipient with regard to the major and minor reactions

The historical term universal donor means the universal donor for whole blood . People with blood group 0 are considered to be universal donors (when transfusing whole blood) because they can donate their blood to people of any other blood group if necessary.

With blood group 0, the antigen H (fucose) is found on the surface. Antigen H is a precursor of antigens A and B and therefore does not lead to the formation of antibodies against this antigen H.

In order to avoid the destruction of the recipient erythrocytes (hemolysis) by antibodies against A and B in the donor's serum (minor reaction) (example: donor blood group A, recipient blood group AB), red blood cell concentrates are not administered nowadays, rather than whole blood.

Universal dispenser for erythrocytes

Reactions between plasma and erythrocytes of the different blood groups (agglutination = clumping)

Today we speak of a universal dispenser for erythrocytes ( erythrocyte concentrate ). The universal donor for erythrocytes is blood group 0. This is identical to the universal donor for whole blood .

Universal receiver for erythrocytes

The universal recipient for erythrocytes is blood group AB (see picture - table - fourth column).

Universal donor for blood plasma

Blood group AB is the universal donor for blood plasma , as its plasma contains neither anti-A nor anti-B.

Universal receiver for blood plasma

The universal recipient for blood plasma is blood group 0 (see picture - table - first line). Since they have no blood group characteristics A or B on their erythrocytes, they can be transfused with any blood plasma.

Rh system

In the case of transfusions, in addition to the AB0 system, the Rh factors must also match. However, the first wrong infusion in which a rh-negative recipient receives Rh-positive blood does not yet lead to symptoms, since the recipient only forms antibodies after this first contact. Universal donors with regard to the Rh system are rh-negative donors. Donors with rh-negative blood do not have antibodies against the Rh factor in their blood (more precisely: in their serum).

Rh-positive people also have no “anti-Rh” (antibodies against the Rh factor) in their serum (analogous to the AB0 system). Analogous to the AB0 system, one could expect that rh-negative people have “anti-Rh” in their serum. That's not the case. Antibodies against the Rh factor (ie "anti-Rh") are only formed after the first contact of the rh-negative recipient with Rh-positive donor blood - an allergy ( immune response ) , so to speak, takes place. Only these “allergic” Rh-negative people have “Anti-Rh” in their serum and are therefore no longer considered donors for Rh-positive people.

Conversely, the transfusion of rh-negative blood does not have any negative effects for a Rh-positive recipient. Because the rh-negative donor blood does not provoke any antibody formation in the recipient. In any case, the Rh-positive recipient already has the Rh trait on his erythrocytes and will therefore not form any antibodies against the Rh trait.

Universal recipients of the Rh system are Rh-positive people. Since they already carry the Rh factor on their erythrocytes, it does not matter whether they are transfused with Rh-positive blood or Rh-negative blood.

In rare cases, the rhesus factor occurs only in a weakened form (D ^weak ). For the blood transfusion, such patients take an intermediate position between Rh-positive and Rh-negative. If they are to receive blood, they will be transfused with rh-negative blood. If you donate blood, your blood is considered Rh positive.

In medical parlance, instead of rh-negative or rh-positive, negative or positive is used for a short time. For example: blood group A negative (written: A− or A ^- ); Blood group 0 positive (written 0+ or 0 ⁺ ).

Combination of the AB0 system with the Rh system

**Blood group compatibility**
receiver	Donor
receiver	0−	0+	B−	B +	A−	A +	AB−	AB +
AB +	×	×	×	×	×	×	×	×
AB−	×		×		×		×
A +	×	×			×	×
A−	×				×
B +	×	×	×	×
B−	×		×
0+	×	×
0−	×

(A × in the table means that a transfusion from donor to recipient is possible.)

Since the AB0 system and the Rh system exist side by side in the blood, both must be used together when assessing the universal recipient and universal donor.

Today, only blood from the same group is generally transferred, and blood group 0 rh-negative is considered a universal donor only in emergencies. However, if blood of the same blood group is present, this is preferable in any case.

Summary

Universal donor for whole blood: blood group 0 negative (in emergencies, blood group 0 rh-negative is considered a universal donor, blood from the same group should be transferred)
Universal recipient for whole blood: blood group AB positive (in emergencies, blood group AB rh-positive is considered a universal recipient, blood of the same group should generally be transferred)
Universal donor for red blood cell concentrate: blood group 0 rh-negative (identical to universal donor for whole blood)
Universal receiver for red blood cell concentrate: blood group AB (identical to universal receiver for whole blood)
Universal donor for blood plasma: blood group AB (regardless of whether Rh-positive or rh-negative, as both have no anti-Rh in the plasma)
Universal receiver for blood plasma: blood group 0 (regardless of whether Rh-positive or rh-negative, as neither has anti-Rh in the plasma)