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Analysis of ABO subgroups which result in ABO discrepancies in Iranian blood donors

  • Seyedeh Farzaneh Jalali
    Affiliations
    Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Hemmat Exp. Way, Next to the Milad Tower, P.O. Box: 14665-1157 Tehran, Islamic Republic of Iran

    Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
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  • Samira Gudarzi
    Affiliations
    Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Hemmat Exp. Way, Next to the Milad Tower, P.O. Box: 14665-1157 Tehran, Islamic Republic of Iran
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  • Naser Amirizadeh
    Affiliations
    Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Hemmat Exp. Way, Next to the Milad Tower, P.O. Box: 14665-1157 Tehran, Islamic Republic of Iran
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  • Fateme Mirzaeeian
    Affiliations
    Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Hemmat Exp. Way, Next to the Milad Tower, P.O. Box: 14665-1157 Tehran, Islamic Republic of Iran
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  • Arezoo Oodi
    Correspondence
    Corresponding author.
    Affiliations
    Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Hemmat Exp. Way, Next to the Milad Tower, P.O. Box: 14665-1157 Tehran, Islamic Republic of Iran
    Search for articles by this author
Published:October 26, 2022DOI:https://doi.org/10.1016/j.transci.2022.103586
      The ABO blood group system plays a vital role in the blood transfusion and transplantation medicine [
      • Hosseini‐Maaf B.
      • Hellberg Å.
      • Chester M.A.
      • Olsson M.L.
      An extensive polymerase chain reaction–allele‐specific polymorphism strategy for clinical ABO blood group genotyping that avoids potential errors caused by null, subgroup, and hybrid alleles.
      ]. It consists of the major A, B, O alleles and many of subtypes with weak expression of A or B antigens on red blood cells. The results of both forward and reverse ABO typing are necessary for ABO blood group typing, as they are both necessary for interpreting the results [
      • Arumugam P.
      • Hamsavardhini S.
      • Ravishankar J.
      • Bharath R.
      Resolving ABO discrepancies by serological workup‐an analysis of few cases.
      ]. ABO discrepancies may be due to technical or human errors, weak subgroups, the transient expression of antigens in some disease like carcinomas and mixed-filled agglutination after massive or chronic transfusion [
      • Kaur G.
      • Kaur P.
      • Basu S.
      • Kaur R.
      Blood group discrepancies at a tertiary care centre–analysis and resolution.
      ,
      • Meny G.
      Recognizing and resolving ABO discrepancies.
      ,
      • Storry J.R.
      • Condon J.
      • Hult A.K.
      • Harrison A.
      • Jørgensen R.
      • Olsson M.L.
      An age‐dependent ABO discrepancy between mother and baby reveals a novel A weak allele.
      ]. The incidence of ABO discrepancies among blood donors was reported from 0.02 % to 0.06 %, Also the ABO subgroups are considered the most common cause of ABO discrepancies [
      • Kaur G.
      • Kaur P.
      • Basu S.
      • Kaur R.
      Blood group discrepancies at a tertiary care centre–analysis and resolution.
      ,
      • Sharma T.
      • Garg N.
      • Singh B.
      ABO blood group discrepancies among blood donors in Regional Blood Transfusion Centre GTB Hospital, Delhi, India.
      ,
      • Makroo R.N.
      • Kakkar B.
      • Agrawal S.
      • Chowdhry M.
      • Prakash B.
      • Karna P.
      Retrospective analysis of forward and reverse ABO typing discrepancies among patients and blood donors in a tertiary care hospital.
      ]. Weak ABO subgroups are categorized as type II (Weak/missing antigen) or type IV (due to presence of Anti–A1) ABO discrepancy [
      • Jain A.
      • Gupta A.
      • Malhotra S.
      • Marwaha N.
      • Sharma R.R.
      An ABO blood grouping discrepancy: Probable B (A) phenotype.
      ]. Mistyped A and B weak blood group as O and B(A) as cisAB and AxB during routine serologic tests can have serious consequences, such as hemolytic adverse transfusion reactions [
      • Jiao L.X.
      • Zhang J.Y.
      • Chen L.
      • Yu X.L.
      • Han Y.
      • Yang F.
      • et al.
      Gene identification of rare B (A) blood group.
      ].
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