We all know we should donate blood, but probably don't as much as we should. Every year almost 5 million Americans need blood transfusions and would likely die without them. Approximately 32,000 bottles of blood are used each day in the United States for people who loose blood during operations or from traumatic injuries. Other people needs blood transfusions because of suffering illness like sickle-cell, anemia where they all need transfusions throughout their lives to live.
The network of blood donation and transfusion in any country is a hugely vital part of keeping injured people alive and well. Don't, you think this would be so easy if we all have same blood type but we don't. And some of us have such rare blood types that any injury, any procedure, or any accident can be life-threatening. Imagine your blood type is so rare and so unique that if you get hurt, almost no one else in the worlds donated blood would be able to save you. So, rare that scientists would do almost anything to get their hands on a point of it to study.
For the people who have the rarest blood type in the world 'Rh-Null', it's the world's most dangerous blood type to have because only 43 people in the world are discovered to have it. Meaning if you get hurt, basically no one else's blood would be compatible with yours. Most of us have probably heard of the usual blood type system, or even know our own blood type. O+, AB-,A+, O-. This classification determines who we can donate blood, or receive it from any other. There are a total of 33 different classification systems recognized but most people only need to worry about the two most common ones, the ABO and Rh systems. The ABO system classifies blood type on the presence of antigens present in blood that are, antigen A and antigen B. "Antigens are glycoprotein markers embedded in the cell membrane and help your immune system to distinguish between your body's own cells and foreign cells like viruses or bacteria."
In an A blood type the A antigen is found on the blood cell itself and an A or anti-B antibody is found in the blood serum. In a B blood type a B antigen is found on the blood cell and a B or anti-A antibody is found in the serum. Blood type AB has both A and B antigens on the blood cells and neither of the corresponding antibodies against them in the serum. And blood type O has neither antigen on the cells but has antibodies A and B in the serum. When blood is donated, the red blood cells are separated from the plasma where the antibodies are located through a process called blood fractionation. This ensures that only the red blood cells get donated and not their corresponding antibodies since that would cause an adverse reaction in the recipient. Your immune system will produce antibodies against any blood antigens you don't have in your own blood. A person with type A blood that receives B blood would have an ABO incompatibility reaction. The anti-B antibodies present in the patient's blood would agglutinate with the B antigens on the donated red blood cells making the blood cells clump together and block small blood vessels. The immune system would then attack the new blood cells and destroy them because it is unaware type of blood. It's rare for this to happen but if it does it is serious and potentially fatal. Transfusion is considered safe as long as the serum of the recipient does not contain antibodies for the blood cell antigens of the donor. So this is why if you have type AB blood you're a universal recipient - you don't have either of the antibodies that would attack A or B donor blood. However this also means you can only donate blood to other people who have A B blood. You can donate your blood universally if you have BLOOD TYPE O. You can give your blood to a A B or O without triggering their immune system. However there are other antigens that need to be accounted for beyond the ones and the ABO system before donating or receiving blood safely. This is where the rhesus system comes in. The rhesus, or Rh system, is the second most significant blood group system.
These are the most important antigens with the most significant one being the D antigen. Depending on whether the RH-D antigen is present, each blood type is assigned a positive or negative symbol. People with Rh-D negative can only receive blood from Rh-D negative blood person. But people who are Rh D+ can receive either Rh D positive or Rh D negative blood. The negative blood types, A negative, B negative, AB negative, and O negative are more rare than their positive counterparts. And while the D antigen is the most important one in the Rh system there are a total of 60 other Rh antigens making it the largest of any of the blood classifications. These eight blood types are the most common way of describing our blood types.
There are millions of varieties, each classified according to the exact antigens that coat the surface of our red blood cells. To know your exact blood type you'd have to write it out antigen by antigen. Luckily for most of us many of the antigens we have don't affect our ability to receive or donate blood because many of us or even everyone has them. For example more than 99.9% of people carry the antigen called Vel. So for most of us donating blood to one another we wouldn't need to worry about this antigen as it wouldn't trigger an immune response. But for every 5,000 people there's one person who does lack the Vel antigen who shouldn't receive blood from the other 4,999. Their immune system recognizes the Vel antigen as foreign and if given Vel positive blood they could have kidney failure and possibly die. But doctors do screen for as many of these variants as possible to make sure to find the best match for a blood transfusion. But sometimes this best match isn't really possible and this is why the rarer your blood the harder things get.
The world's rarest blood type, Rh-null is called Rh-null because it has none of the 61 antigens present in the Rh blood system we previously discussed. It is rare enough to have a few of the antigens in the Rh system missing from your blood but the chances of missing them all are astronomically small. Doctors call it the golden blood because for anyone who has any type of rare Rh blood type, missing a few antigens here or there, the Rh-null blood can be accepted where other more typical blood types could not be. You can't receive blood from anyone else except the 42 other people that exist who have been found to have the same blood type. And of the people known to have it only a handful of them are active donors and they're spread across the world. And the logistics of shipping blood around the world are stupidly complicated. Bureaucracy and paperwork can hold things up at the borders, which can create a myriad of issues. Fresh blood has a shelf life of four weeks and it has to be stored at 4 degrees Celsius, which is challenging during transportation, especially to remote areas. This means that any holdup at customs can render the blood unusable. The UAE for example won't accept any blood into the country that isn't from the Gulf states. These types of logistics and bureaucracy make it very hard for someone with rare blood to get a transfusion, especially in a sudden emergency when they need the blood fast.
For a Swiss man with Rh-null blood, this meant as a child, he couldn't go to summer camp or do outdoor sports because his parents feared he could get an injury with no ability to get a blood transfusion. As an adult he can't travel to countries without modern hospitals. The only realistic way he can navigate this danger is to continuously donate blood to himself, meaning twice a year he donates blood to keep on reserve in case he ever needs it. And he can't really donate much more than that because Rh-null blood also comes with some adverse effects. The Rh antigens that most of us have are thought to play a role in maintaining the integrity of the red blood cell membrane. This means that red blood cells break down quicker than they should result in a hemolytic anemia. This can lead to fatigue, shortness of breath, and jaundice and can makes frequent blood donation not possible. And because only a handful of people with this rare blood ever donate it, this places a large burden on those who do when someone else needs this type of blood.
The Swiss man I mentioned before once had a call that a newborn baby was in dire need of his type of blood. To save the baby's life, he would need to run to the blood donation center. This meant taking a taxi to Geneva and taking time-off of work, none of which is allowed to be reimbursed due to the blood donation laws in some parts of Europe. He was able to help in this instance, but quickly realized that the cost and burden of donating his valuable blood would ultimately fall on him. Anyone with this rare type of blood can help anyone at the time of need or emergency, an ability to help where no one else can. It probably feels pretty amazing to know you've played a part in saving someone's life. But this also comes with the unfortunate burden of being, in a sense, on call for your entire life, should the need for your blood arise. This poses an interesting ethical question. It's up to you to donate blood at a moment's notice, whether you're in a client meeting, at your own wedding, or on vacation. At what point does your moral obligation to help someone else in need begin and end? But for every person who was otherwise doomed without this donated blood, the importance of it obviously can't be overstated. And this serves as a reminder that hospitals around the world rely on the good deed of blood donation to save lives, whether your blood is rare or not.
Since the very first blood transfusions in the 1800s they have saved millions of lives and played a vital role in shaping our modern world. In times of peace they've saved citizens from unfortunate accidents and in times of war have saved the lives of countless wounded soldiers. During World War II, the American Red Cross flew almost two hundred thousand bottles of whole blood from the US to the Allied forces in Europe. More than fifty thousand pints of blood were needed for the soldiers fighting during the D-day invasion of Normandy alone. The level of coordination needed for the collection and transport of this much blood is astounding.
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