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Maxime Dely: When ABO Compatibility Isn’t Enough for Safe Transfusion
Sep 20, 2026, 05:17

Maxime Dely: When ABO Compatibility Isn’t Enough for Safe Transfusion

Maxime Dely, Therapeutic Solutions Sales Consultant at Terumo Blood and Cell Technologies, shared a post on LinkedIn:

Why can some patients become incompatible with certain blood types?

We often think that blood transfusion compatibility relies mainly on the ABO and Rh systems.

Yet, red blood cell membranes carry hundreds of antigens belonging to numerous blood group systems: Rh, Kell, Duffy, Kidd, MNS…

When a patient receives multiple transfusions, their immune system may encounter antigens that are absent from their own red blood cells.

They can then produce alloantibodies — a process known as alloimmunization.

During a subsequent transfusion, these antibodies may recognize transfused red blood cells as foreign and trigger their destruction, leading to hemolysis and, in some cases, a delayed hemolytic transfusion reaction.

Therefore, two units can be ABO-compatible while still being immunohematologically incompatible.

This is why antibody screening, red cell phenotyping, and sometimes molecular genotyping are essential for selecting appropriately matched red blood cell units in certain patients.

Transfusion medicine is becoming increasingly personalized.

How far could genetics take us in improving transfusion compatibility?”

Maxime Dely: When ABO Compatibility Isn’t Enough for Safe Transfusion

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