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ABO incompatibility is a response of the immune system that happens if two dissimilar and not well-matched blood types are mixed together.

Causes of A, B and O incompatibility

A,B and O are three main blood types. These types are based on the molecules on the exterior of the blood cells.   These molecules function as immune system triggers or antigens in people with different blood types.  Two of these surface molecules are found in every person.  But Blood Type O does not hae any molecule. So the various blood types are

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* Type A (AA or AO molecules)

* Type B (BB or BO molecules)

* Type AB

* Type O

People who have one blood type form antibodies or proteins that may make their immune system react against other blood types. Being exposed to a different type of blood type can result in a reaction known as ABO incompatibility.  This is more evident when a person goes for blood transfusion or there is an organ transplant. The blood types must be matched so that there is no ABO incompatibility reaction.

Which blood type will react with the other?

* A patient with type A blood will react against type B or type AB blood

* A patient with type B blood will react against type A or type AB blood

* A patient with type O blood will react against type A, type B, or type AB blood

Since Blood Type O does not have any surface molecule, there is no immune response by Type O.  This is why people with Blood Type O are called ‘universal donors’. But people who have Type O can only receive type O blood.  Since antibodies are a part of the liquid part of the blood or plasma, one has to make sure that there is no immune reaction, which is ensured by getting the blood and plasma transfusions matched.

ABO Incompatility symptoms or Transfusions Reactions

. The following are the symptoms of ABO incompatibility:

* Back pain

* Fever

* Yellow skin (jaundice)

* Blood in urine

* Feeling of “imminent doom”

Tests and Diagnosis for ABO Incompatibility

.This is done by doing a CBC or complete blood count to  look for damaged red blood cells. Mild  anemia may be seen in patients who have this problem.  Lab testing is done of the donor’s blood and the patient’s blood to find if they are compatible or not  Bilrubin levels are high also in people with ABO incompatibility.

ABO Incompatibility Treatment

The treatment is in the form of

  1. Drugs called antihistamines that can treat allergic reactions
  2. Steroids given to treat allergies and swelling
  3. Flush given intravenously or through the veins
  4. Blood pressure lowering through medicines; if it is on the higher side

ABO incompatibility  complications and risks

There are risks of kidney failure, low blood pressure that needs ICU treatment and even death if ABO incompatibility is not treated.

Prognosis of ABO Incompatibility

If the treatment is done properly, full recovery is possible. But if it is not treated and causes complications, then death can result.

How do I know if I have ABO incompatibility?

After doing a blood transfusion recently, do you feel that you are having some of the symptoms aforementioned? If yes, contact your health-care provide.


Proper testing of donor and patient for the rightful blood types before transfusion can prevent the problem.

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