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Understanding Lewis and Kell Blood Groups in Blood Banking

Learn about the Lewis and Kell blood group antigens, their clinical significance, and the detection of Kell antibodies. Recognize different Lewis phenotypes and the impact of Kell antibodies on HDFN and transfusion reactions.

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Understanding Lewis and Kell Blood Groups in Blood Banking

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  1. Faculty of Allied Medical Science Blood Banking (MLBB 201)

  2. Lewis and Kell Blood Groups Prof.Dr. Nadia AlySadek Blood Bank Director, MRI

  3. Outcomes • By the end of this lecture, the students will be able to: • Recognize the Lewis and Kell blood group antigens • Know their clinical importance

  4. Lewis antigens are carbohydrate structures carried on glycolipids. They differ from other blood groups in that they are not produced by RBCs , but they become incorporated into the red cell membrane from the plasma.

  5. Types of Lewis antigens There are two main antigens:- 1- Le a 2- Le b There are 4 Lewis phenotypes:- 1- Le (a+b-): only found in ABH non-secretors 2- Le (a-b+): only found in ABH secretors

  6. 3- Le (a+b+) only found in ABH secretors 4- Le (a-b-) RBCs have no Lewis antigens Lewis antibodies are only made by individuals with the Le (a-b-) red cells. They are not clinically significant as they are not active at 37 degrees.

  7. Kell system It includes K (KEL 1) with a frequency of 9% in Northern Europeans and 1.5% in African populations. The k (KEL 2) antigen is of high frequency in all populations. (KEL 3) is found in about 2% of Caucasians but not present in Africans or Japanese.

  8. (KEL 4) is of high frequency in all populations. • (KEL 6) is completely confined to African individuals.

  9. Kell antibodies • These antibodies are clinically significant. They cause severe hemolytic disease of fetus and newborn (HDFN) as well as hemolytic transfusion reactions. • Patients with Kell antibodies should be transfused with antigen-negative blood.

  10. Kell system antibodies are usually IgG and predominantly (IgG1).

  11. Difference between HDFN due to anti-K or anti-D 1. Anti-K HDFN is associated with lower concentrations of amniotic fluid bilirubin concentration than anti-D HDFN. 2. Post- natal hyperbilirubinaemia is not prominent in babies with anti-K.

  12. 3. There is reduced reticulocytosis and normoblast % in the anti-K disease. 4. Kell antigen appears on early erythroid cells much before the Rh antigen. Kell negative girls and women of child-bearing age should receive K- blood transfusion.

  13. Detection of Kell antibodies Anti-K directly agglutinate K+ red cells. -Antiglobulin test is the method of choice for their detection.

  14. Universal Blood group A and B antigens on red cells can be removed, in vitro, by converting them back to the H antigen. This is done by removal of the immunodominant sugar with an appropriate enzyme. They become group O. These enzymes are obtained from bacteria (A-zyme) and green coffee beans (B-zyme).

  15. Study question State true or false:- 1- Lewis antigens are produced by the RBCs 2- Le (a-b+) are only found in ABH secretors 3- Le (a-b-) have antigens on RBCs

  16. Assignments • Plasma Exchange عائشة خضر احمد

  17. Thank You

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