Golden Blood, or Rh-null blood is an extremely rare blood type that has only been identified in 43 people around the world in the last 50 years. It is sought after both for scientific research and blood transfusions, but also incredibly dangerous to live with for the people who have it, because of its scarcity.

To understand golden blood it’s important to understand how blood types work. Human blood may look the same in everyone, but it’s actually very different. On the surface of every one of our red blood cells we have up to 342 antigens – the molecules that trigger the production of certain specialized proteins called antibodies – and it’s the absence of certain antigens that determines a person’s blood type. Around 160 of these antigens are considered common, meaning they are found on the red blood cells of most humans on the planet. If someone lacks an antigen that is found in 99 percent of all humans then their blood is considered rare, and if they lack an antigen found in 99.99 percent of humans, their blood is considered very rare.

The 342 known antigens belong to 35 blood group systems, of which the Rh, or ‘Rhesus’, system is the largest, with 61 antigens. It’s not uncommon for humans to be missing one of these antigens. For example, around 15 percent of Caucasians miss the D antigen, the most significant Rh antigen, making them RhD negative. In contrast, Rh negative blood types are much less common in Asian populations (0.3 percent). But what if a human is missing all of the 61 Rh antigens?

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Until half a century ago, doctors believed that such an embryo couldn’t even survive in the uterus, let alone develop into a normal, healthy adult. But in 1961, an Aboriginal Australian woman was identified as having Rh-null blood, meaning she lacked all the antigens in the Rh blood system, which made no sense at the time. Since then, only 43 people with Rh-null blood have been identified.

Rh-null blood is called “golden blood” for two reasons. The most important one is that its complete lack of Rh antigens means that it can be accepted by anyone with a rare blood type within the Rh blood system. Its life-saving potential is so enormous that even though blood samples donated at blood banks are anonymized, scientists often try to track the donors of Rh-null blood to directly ask them to donate more. However, because of its scarcity, golden blood is only given to patience in the most extreme cases, because it is almost impossible to replace.

But golden blood also holds immense scientific value as it could help researchers unravel the mysteries of the physiological role of the intriguingly complex Rh system.

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Rh-null blood can be given to anyone with a negative Rh blood type, which is why scientists often say that it’s worth its weight in gold, but what if a person born with this unusual blood type ever needs a blood transfusion. That would be a big problem, as they could only receive Rh-null blood. This makes it very dangerous to live with. If they receive blood from someone who is ‘positive’ for one of the 61 Rh antigens they lack, their own antibodies could react with the incompatible donor blood cells, triggering a potentially lethal immune system response.

In 2014, The Atlantic wrote about Thomas, one of the only 43 people known to have Rh-null blood, and the precautions he had taken throughout his life to avoid finding himself in situations where he would require blood transfusions. As a child, his parents didn’t allow him to go to summer camp for fear that he might have an accident, and as an adult, he always drove very cautiously and never travelled to countries that lacked modern hospitals. He also carried with him a special card that confirmed his ultra-rare blood type, in case he was ever hospitalized.

I guess you could look at having golden blood as both a blessing and a curse. On one hand, you have the power to save countless lives through a simple blood donation, but you also live with the terrifying thought of ever needing a blood transfusion yourself.

via Mosaic Science