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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">ABO incompatibility</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>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.</p><p>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.</p><p>Due to modern testing techniques, this problem is very rare.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The different blood types are:</p><ul><li>Type A</li><li>Type B</li><li>Type AB</li><li>Type O </li></ul><p>People who have one blood type may form proteins (<a test="test" href="./002223.htm">antibodies</a>) that cause their immune system to react against one or more of the other blood types. </p><p>Being exposed to another type of blood can cause a reaction. This is important when someone needs to receive a blood transfusion or have an organ transplant. The blood types must be compatible to avoid an ABO incompatibility reaction.</p><p>For example:</p><ul><li>People with type A blood will react against type B or type AB blood.</li><li>People with type B blood will react against type A or type AB blood.</li><li>People with type O blood will react against type A, type B, or type AB blood.</li><li>People with type AB blood will not react against type A, type B, type AB, or type O blood. </li></ul><p>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.</p><p>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.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>The following are symptoms of ABO incompatible <a test="test" href="./001303.htm">transfusion reactions</a>:</p><ul><li>Low back pain</li><li>Blood in urine</li><li>Chills</li><li>Feeling of impending doom</li><li>Fever</li><li>Nausea and vomiting</li><li>Shortness of breath</li><li>Increased heart rate</li><li>Pain at infusion site</li><li>Chest pain</li><li><a test="test" href="./003093.htm">Dizziness</a></li><li>Bronchospasm (spasm of the muscles lining the lung; causes cough)</li><li>Yellow skin and whites of the eyes (<a test="test" href="./000210.htm">jaundice</a>)</li><li><a test="test" href="./000501.htm">Acute kidney failure</a></li><li>Low blood pressure</li><li><a test="test" href="./000573.htm">Disseminated intravascular coagulation (DIC)</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical exam. Blood tests will usually show:</p><ul><li>The <a test="test" href="./003479.htm">bilirubin level</a> is high</li><li>The <a test="test" href="./003642.htm">complete blood count</a> (CBC) shows damage to red blood cells or <a test="test" href="./000560.htm">anemia</a></li><li>The recipient's and donor's blood are not compatible</li><li>Elevated <a test="test" href="./003471.htm">lactate dehydrogenase</a> (LDH)</li><li>Elevated <a test="test" href="./003474.htm">blood urea nitrogen (BUN)</a> and <a test="test" href="./003475.htm">blood creatinine</a>; in case of renal injury</li><li>Prolonged <a test="test" href="./003652.htm">prothrombin time</a> or <a test="test" href="./003653.htm">partial thromboplastin time</a> (findings of DIC)</li><li>Positive <a test="test" href="./003344.htm">direct antiglobulin test</a> (DAT)</li></ul><p>Urine tests show the presence of hemoglobin due to breakdown of red blood cells.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>In case of any reaction, the transfusion should be stopped immediately. Treatment may also include:</p><ul><li>
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Medicines used to treat allergic reactions (antihistamines)
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</li><li>
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Medicines used to treat swelling and allergies (steroids)
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</li><li>Fluids given through a vein (<a test="test" href="./002383.htm">intravenously</a>)</li><li>
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Medicines to raise blood pressure if it drops too low
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</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>ABO incompatibility can be a very serious problem that can result in death. With the right and timely treatment, a full recovery is expected.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications that may result include:</p><ul><li>Kidney failure</li><li>Low blood pressure needing intensive care</li><li>Death</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if you have recently had a blood transfusion or transplant and you have symptoms of ABO incompatibility.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Careful testing of donor and recipient blood types before transfusion or transplant can prevent this problem.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Transfusion reaction - hemolytic; Acute hemolytic transfusion reaction; AHTR; Blood incompatibility - ABO</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Manis JP. Blood components, product modifications, and blood donor screening. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. <em>Tietz Textbook of Laboratory Medicine</em>. 7th ed. St Louis, MO: Elsevier; 2023:chap 91.</p><p>San Miguel CE, Kaide CG. Blood and blood components. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 108.</p><p>Schipperus MR, Wiersum-Osselton JC. Transfusion reactions to blood and hematopoietic stem cell therapy products. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. <em>Hematology: Basic Principles and Practice</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 117.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 6/17/2024</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
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