Is an ABO Incompatibility Reaction?
An ABO incompatibility reaction can occur if you receive the
wrong type of blood during a blood transfusion. It’s a rare but serious and
potentially fatal response by your immune system to incompatible blood.
These reactions are extremely rare because doctors are aware of
the danger of using the wrong blood during a transfusion. There are many
precautions in place to reduce the chances of a mistake. Your doctor and nurse know
what symptoms to look for if a reaction does occur during or after your transfusion.
This allows them to provide you with treatment as quickly as possible.
The four main blood types are A, B, AB, and O. If you’re type A,
your red blood cells have proteins attached to them known as A antigens. Type B
blood cells carry B antigens. Type AB blood has both A and B antigens, and type
O blood has neither A nor B antigens.
Your immune system will produce antibodies against any blood
antigens you don’t have in your own blood. That means people with type A blood create
antibodies against B antigens. A person with type A blood receiving a
transfusion of type B or AB blood would lead to an ABO incompatibility
reaction. In an ABO incompatibility reaction, your immune system attacks the
new blood cells and destroys them.
If you have type AB blood, you have both A and B antigens. This
means you’re a universal recipient and you can receive any type of blood.
However, you can only donate blood to other people who have type AB blood.
If you have type O blood, which has no antigens, you’re a
universal donor. You can give your blood to anyone without triggering their
immune system, but you can only receive type O blood.
Before a blood transfusion, your doctor will test your blood to
determine your blood type. A small sample will be crossmatched with some of
your donated blood. The two samples of blood are then mixed and viewed under a
microscope. This allows your doctor to be certain an incompatibility reaction
won’t take place.
Causes an ABO Incompatibility Reaction?
Human error is the most likely cause of an ABO incompatibility
reaction. If your transfusion uses the wrong blood type, it could be the result
of mislabeled blood, incorrectly completed forms, or a failure to check donated
blood before the transfusion.
Are the Symptoms of an ABO Incompatibility Reaction?
You’ll have symptoms within a few minutes of receiving a
transfusion if you have an ABO incompatibility reaction. These may include:
- a strong feeling that something bad is about to
- fever and chills
- breathing difficulties
- muscle aches
- chest, abdominal, or back pain
- blood in your urine
Is an ABO Incompatibility Reaction Diagnosed?
Medical staff will stop the blood transfusion if they suspect you
might be having an incompatibility reaction. They’ll tell the blood bank about
it because there’s a risk that the wrong blood could also have been given to
Your doctor will test samples of your blood for evidence of
destruction of your red blood cells. They’ll also test your urine to see if it has
hemoglobin, a component released from broken-down blood cells. They’ll
double-check your blood type and carry out the crossmatch procedure again.
While these procedures occur, your doctor or nurse will monitor
your vital signs, including your:
- blood pressure
- heart rate
Are the Treatments for an ABO Incompatibility Reaction?
You may need to enter the intensive care unit. After stopping
your blood transfusion, the medical staff will attach a saline drip to the line
to keep it open.
The goal of treatment is to prevent you from having kidney
failure, extensive blood clotting, and blood pressure that’s abnormally low.
You may receive oxygen and intravenous fluids. You may also receive a drug to
increase your urine output. If you’re at risk of having widespread clotting,
you may receive a transfusion of plasma or platelets.
Can I Prevent an ABO Incompatibility Reaction?
There isn’t much that patients can do to prevent ABO
incompatibility reactions. However, most hospitals and blood banks have systems
in place to reduce the chance that such a reaction will occur. These include:
- checking the identities of donors to ensure that
their details match the information on their blood samples
- correctly labeling stored samples
- double-checking the blood type of both patients
and blood packs before each transfusion
Is the Long-Term Outlook?
During an ABO incompatibility reaction, the red blood cells
inside your circulatory system break down. Blood clotting may occur throughout
your body, shutting off the blood supply to vital organs or causing a stroke.
Too much blood clotting can use up clotting factors and leave you at risk of
Some of the products released from broken-down blood cells can
cause kidney damage and possibly kidney failure. An ABO incompatibility
reaction can be life-threatening unless your doctor successfully treats it right
away. However, if you have a reaction and receive the correct treatment without
delay, you should recover completely.