Introduction
The red blood cells have proteins called antigens attached to their surface. We have A, B, O, or AB blood types depending on the antigen present. The ABO system is further classified as Rh-positive or Rh-negative depending on the cells' presence or absence of the Rh-D factor. Therefore, people with Rh- blood type are donors to both Rh- and Rh+.
There are different proteins in the Rh system, and RhD is the most significant protein (antigen) checked for blood transfusion. A person in the golden blood group lacks all Rh antigens, whereas a person in the Rh-negative blood group lacks only RhD antigens. If the protein is present, meaning the blood is Rh+, when blood is given to someone Rh-, the recipient's immune system will identify the protein as dangerous and create antibodies against it. Therefore, the Rh protein is an antigen, triggering an immune response.
All these Rh proteins can cause mild to moderate anemia faster than regular destruction of red blood cells, leading to paleness and tiredness. In addition, the red blood cells themselves may be less elastic, and the overall blood volume of the individual may be altered.
What Is Golden Blood?
Its life-saving potential is enormous, yet only a handful of people in the world contain this blood type. Therefore, golden blood is only given to patients in extreme cases because it is almost impossible to replace.
Blood samples donated to blood banks are anonymized. However, scientists often seek to directly track Rh-zero blood donors so that more blood can be donated. In addition, golden blood holds immense scientific value; it could help researchers unravel the physiological significance of the unique and complex Rh system.
Rh-null blood can be transfused to those with a negative Rh blood type. That is why scientists consider it a wealthy possession and often say it is worth its weight in gold. However, blood transfusion is a big problem for a person born with this rare blood type, as they can only receive Rh-null blood. It makes it very critical yet dangerous to survive with this blood type. Suppose Rh-null individuals receive blood from an Rh-positive person or someone carrying the Rh antigens. In that case, their antibodies could react with the incompatible donor blood cells, triggering a potentially lethal immune system response.
What Is the Cause of Golden Blood Type?
The golden blood group occurs due to genetic mutation, most commonly in the RHAG gene, which is responsible for the Rho-associated glycoprotein. This protein directs the Rh antigens towards the RBC membrane.
RHAG mutation is also frequently related to a disease known as hereditary stomatocytosis. Such individuals suffer from prolonged mild hemolytic anemia and increased breakdown of RBCs. The Rh-null phenotype can also be found in some instances of congenital anemias.
The following conditions that increase the chances of having a golden blood group are:
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Consanguineous marriage (marriage between cousins, brother-sister, or anybody who is a near or distant relative).
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Autosomal genes carry hereditary disease traits.
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Changes or complete deletion of specific genes are RHD and RHCE or RHAG.
Can Golden Blood Be a Choice for Donation?
Yes, golden blood can be used for donation. Due to the absence of antigens on RBCs, an Rh null individual is a universal donor, and this blood type can be transfused to anyone, especially those with rare blood types. It can be accepted by anyone who requires a blood transfusion without the risk of having blood transfusion reactions as adverse effects. However, its scarcity makes it difficult to find this kind.
On the other hand, Rh null blood type is troublesome for those with it. If such folks need a blood transfusion, receiving any blood type that carry the Rh antigen inevitably leads to adverse blood transfusion reactions.
What Are the Complications of the Golden Blood Type?
People with Rh null or golden blood type may experience:
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Mild to Moderate Congenital Hemolytic Anemia: This condition leads to rapid destruction of red blood cells (RBCs), causing low hemoglobin levels, paleness, and weariness. This develops due to structural defects in RBCs, such as:
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Mouth-shaped or slit-shaped RBCs.
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Decreased elasticity in red blood cells.
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Abnormal covering of RBCs.
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Increased fragility of RBCs due to absence of Rh antigens.
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Abnormal blood cell volume.
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Blood Transfusion Issues: Individuals with the golden blood variety usually face challenges during or after a blood transfusion. If such a person’s blood gets exposed to Rh antigens from the donor’s blood, they readily react and form corresponding antibodies. So, for such patients, hospitals need to follow a set of particular protocols and be equipped with quick response management.
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Rh Incompatibility in Pregnancy: If the pregnant female carries Rh null blood, her fetus turns out to be Rh-positive. If the mother’s Rh null blood gets sensitized by the baby’s Rh-positive blood, then the mother’s blood produces protective proteins known as antibodies. These antibodies could pose problems in future pregnancies or cause abortion or hemolytic crisis (an infection or sepsis in such individuals may precipitate massive hemolysis, subsequent kidney failure, and other complications).
Can Blood Transfusions Be Done for Golden Blood Type?
Individuals with the golden blood type can only receive transfused blood from people with a similar blood group; otherwise, the Rh antigens present on the donated red blood cells would result in an immune reaction. Finding a donor for such individuals is extremely difficult because few people have golden blood. So, people having the golden blood type are recommended to donate for themselves for their future needs, with the blood being stored.
Golden blood has a high demand also because of its universal compatibility with any rare blood type within the Rh system, meaning it has the immense life-saving capability.
Conclusion
People with Rh-null blood can donate blood to people with any blood group, but due to its rarity, it can be challenging for them to get it. Besides, donating golden blood across borders is not easy. The process is often hampered by bureaucracy. Some countries just do not allow it. However, carrying an Rh-null blood type has no side effects or health complications. However, such individuals can suffer from mild anemia, or else they can spend their lives normally.
Because of the rarity of the blood, the people of this blood group need to be extra cautious. They cannot be reckless with activities that can cause injuries and blood loss. On the other hand, it's also essential for them to be mindful. Rh-null is the result of a genetic mutation, which is hereditary. Therefore, the risk of having golden blood is higher in families with consanguineous marriages.
