Fredrick Chalinga: The Science Behind Blood Group Immunogenicity
Fredrick Chalinga, Medical Technologist at Aga Khan University Hospital, shared a post on LinkedIn:
“O-negative is the universal donor.
Yes…but not always.
And surprisingly, Blood Group A is often considered less immunogenic than Blood Group B.
Why? Let’s break it down.
Why is Blood Group A less immunogenic?
The A antigen is structurally closer to naturally occurring substances found in the human body and some bacteria.
Because of this, the immune system tends to react less aggressively against it compared to the B antigen.
This is one reason why:
- Anti-B antibodies are often stronger than Anti-A
- Group B incompatibility reactions can be more severe in some cases
- Blood Group A is generally considered less immunogenic
Why O-negative is NOT always a universal donor?
We usually say O-negative blood is ‘universal’ because it lacks A, B, and Rh(D) antigens.
But red cells carry many other clinically significant antigens besides ABO and Rh.
Examples include:
- Kell
- Duffy
- Kidd
- MNS and others
A patient previously exposed through transfusion or pregnancy may develop antibodies against these antigens.
In such cases, even O-negative blood can trigger a hemolytic transfusion reaction.
This is why:
- Antibody screening matters
- Crossmatching is essential
- ‘Universal donor’ has limitations in real clinical practice
Transfusion medicine is far more complex than just ABO and Rh typing- and that’s what makes Immunohematology fascinating.”
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