Malcolm Needs

I wonder if there is something wrong here Cliff. I am convinced that I hit the button for the correct answer - and I see that nobody else has got it right yet either?

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YES!

In the UK a unit of blood would NEVER be sent out to a hospital without a full (and matching) ABO type - both forward and reverse. We would also do everything possible to ensure that, if the forward and reverse ABO types of any patient do not match, we find out why before transfusion. An ABO mismatch is probably the most common cause of fatal haemolytic transfusion reactions (although, thank goodness, they are NOT common), and this is why we will always go "the extra mile" to try to prevent any such situation.

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Sorry Neil, but I have to point out that this is not completely accurate. Any red cell antigens that are adsorbed onto the red cell surface, rather than being an integral part of the red cell membrane remain the type of the patient, rather than the donor. This is true of the Lewis phenotype (for instance, if the recipient was Le[a+b-], and the donor was Le[a-b+], after the transplant, the red cells will group as Le[a+b-], and not as Le[a-b+]}. This is also true of antigens within the Chido/Rodgers Blood Group System, and certain others. If the recipient is a Secretor, they will continue to secrete ABO substance of the original ABO type, which, of course, will also be adsorbed onto the red cell surface (as well as being in the plasma, leading to the phenomenon of "accommodation", and this is why most recipients stay with a reverse group of "AB" after an ABO mis-matched stem cell/bone marrow transplant. SORRY TO BE A PEDANT, PARTICULARLY AS I AGREE WITH EVERYTHING ELSE YOU HAVE WRITTEN!

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In the UK, the Guidelines would (quite correctly in my own opinion) NOT allow us to perform electronic issue on any sample, whatever the pathology, on a patient where the forward ABO type does not match the reverse ABO type (apart from Newborn babies).

Off the top of my head, as it were, the nearest source I can site is Hult AK, Dykes JH, Storry JR, Olsson ML. A and B antigen levels acquired by group O donor-derived erythrocytes following ABO-non-identical transfusion or minor ABO-incompatible haematopoietic stem cell transplantation. Transfusion Medicine 2017; 27: 181-191. DOI: 10.1111/tme.12411.

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Thank you very much Neil.

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Neil Blumberg, I'll leave this one to you!

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The +s stands for strongly expressed. The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface). "I apologize for this dumb question." BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER. If you don't know the answer, the dumb thing is to not ask the question in the first place. NEVER be afraid to ask a question on here,

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