Korean J Blood Transfus.  2025 Apr;36(1):1-6. 10.17945/kjbt.2025.36.1.1.

ABO/RhD-Mismatch Transfusion

• Kim HJ
• Ko DH

• KMID: 2566832
• DOI: http://doi.org/10.17945/kjbt.2025.36.1.1

Abstract

ABO/RhD-mismatch transfusions are frequently encountered in clinical practice, so a systematic and thorough understanding of these events is necessary. In the case of ABO minor-incompatible transfusions, it is important to consider the possibility of hemolytic transfusion reactions because of the reaction between the ABO antibodies in the blood product and the patient’s red blood cells. For platelet products, the risk is approximately 1 in 9,000. In ABO major-incompatible transfusions, red blood cell products are contraindicated, but plasma or platelet products may be allowed in situations such as blood product shortages. In RhD major-incompatible transfusions, the use of Rh immunoglobulin to prevent alloimmunization may be considered depending on the patient’s clinical status and the availability of blood products. In the case of RhD major-incompatible red blood cell transfusions, however, such prevention is difficult to apply in Korea. ABO/RhD-mismatch transfusion may also affect the long-term outcomes of patients, in addition to immediate hemolytic transfusion reactions. Therefore, decisions must be made based on the patient’s clinical situation considering the benefits and potential risks.

Keyword

ABO; RhD; Mismatch