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ABO incompatibility
Transfusion reaction - hemolytic; Acute hemolytic transfusion reaction; AHTR; Blood incompatibility - ABO
A, B, AB, and O are the 4 major blood types. The types are based on small substances (molecules) on the surface of the blood cells.
When people who have one blood type receive blood from someone with a different blood type, it may cause their immune system to react. This is called ABO incompatibility.
Due to modern testing techniques, this problem is very rare.
Causes
The different blood types are:
- Type A
- Type B
- Type AB
- Type O
People who have one blood type may form proteins ( antibodies ) that cause their immune system to react against one or more of the other blood types.
Antibodies
An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...
Being exposed to another type of blood can cause a reaction. This is important when someone needs to receive blood (transfusion) or have an organ transplant. The blood types must be compatible to avoid an ABO incompatibility reaction.
For example:
- People with type A blood will react against type B or type AB blood.
- People with type B blood will react against type A or type AB blood.
- People with type O blood will react against type A, type B, or type AB blood.
- People with type AB blood will not react against type A, type B, type AB, or type O blood.
Type O blood does not cause an immune response when it is given to people with type A, type B, or type AB blood. This is why type O blood cells can be given to people of any blood type. People with type O blood are called universal donors. But people with type O can only receive type O blood.
Both blood and plasma transfusions must be matched to avoid an immune reaction. Before anyone receives blood, both the blood and the person receiving it are tested carefully to avoid a reaction. Usually, a reaction occurs because of a clerical error causing someone to receive incompatible blood.
Symptoms
The following are symptoms of ABO incompatible transfusion reactions:
- Back pain
- Blood in urine
- Chills
- Feeling of "impending doom"
- Fever
-
Yellow skin and whites of the eyes (
jaundice
)
Jaundice
Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jau...
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Exams and Tests
The health care provider will perform a physical exam. Blood tests will usually show:
-
The
bilirubin level
is high
Bilirubin level
The bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. Bi...
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The
complete blood count
(CBC) shows damage to red blood cells or
anemia
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
ImageRead Article Now Book Mark ArticleAnemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
ImageRead Article Now Book Mark Article - The recipient's and donor's blood are not compatible
Urine tests show the presence of hemoglobin due to breakdown of red blood cells.
Treatment
Treatment may include:
- Drugs used to treat allergic reactions (antihistamines)
- Drugs used to treat swelling and allergies (steroids)
- Fluids given through a vein (intravenously)
- Medicines to raise blood pressure if it drops too low
Outlook (Prognosis)
ABO incompatibility can be a very serious problem that can result in death. With the right treatment, a full recovery is expected.
Possible Complications
Complications that may result include:
- Kidney failure
- Low blood pressure needing intensive care
- Death
When to Contact a Medical Professional
Call your provider if you have recently had a blood transfusion or transplant and you have symptoms of ABO incompatibility.
Prevention
Careful testing of donor and recipient blood types before transfusion or transplant can prevent this problem.
References
Bellone M, Hillyer CD. Acute hemolytic transfusion reactions. In: Shaz BH, Hillyer CD, Roshal M, Abrams CS, eds. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects . 2nd ed. Philadelphia, PA: Elsevier; 2013:chap 61.
Miller RD. Patient blood management. In: Miller RD, ed. Miller's Anesthesia . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 61.
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Jaundiced infant - illustration
Newborn jaundice (producing yellow skin) can have many causes, but the majority of these infants have a condition called physiological jaundice, a natural occurrence in the newborn due to the immature liver. This type of jaundice is short term, generally lasting only a few days. Jaundice should be evaluated by a physician until decreasing or normal levels of bilirubin are measured in the blood.
Jaundiced infant
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
-
Jaundiced infant - illustration
Newborn jaundice (producing yellow skin) can have many causes, but the majority of these infants have a condition called physiological jaundice, a natural occurrence in the newborn due to the immature liver. This type of jaundice is short term, generally lasting only a few days. Jaundice should be evaluated by a physician until decreasing or normal levels of bilirubin are measured in the blood.
Jaundiced infant
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 5/20/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
